- The governor of Maysan province told
Reuters the suspected bird flu victim was a 24-year-old pigeon seller from
Amara who died on Sunday. WHO said earlier that Iraqi officials had identified
the victim as a 13-year-old boy.
- "He was suffering from constant
flu. In hospital he turned worse and began bleeding from both his mouth
and nose, and then he died," said Jabbar Zahuri, 38, the dead man's
- The pigeon seller, whom officials identified
as Muhaned Radhi, lived in a house with five brothers and eight sisters.
Health officials have taken samples from them to test for the virus.
- The brother and the sister of a stockbreeder
of pigeons of Amara, in the south of Iraq, deceased Sunday after having
expressed symptoms of the aviary influenza, were hospitalized Friday, according
to the local authorities. "Ali Radi, 10 years, Douaa Radi, 7 years,
were allowed today at the hospital because they presented the symptoms
of the aviary influenza", affirmed the governor of the province of
Missane, Mr. Adel Mohajar Al-Maliki, in a déclarationà the
- The above media comments describe a growing
familial cluster in Amara that has a bimodal disease onset date distribution
and represents more efficient human to human transmission of H5N1.
- The symptoms of the index case match
those of fatal cases in Turkey and northern Iraq. In addition, his pigeons
were H5N1 positive. The above indicate three cousins were hospitalized
on Wednesday and two siblings were hospitalized on Friday. 11 other siblings
are being monitored.
- These data indicate H5N1 is efficiently
transmitting among family members. The circumstances surrounding the infections
of the relatives are not give, but a cluster of six is cause for concern,
as is the large number of siblings under observation.
- Comments by WHO concerning the inability
to find the S227N polymorphisms in any of the Turkey isolates other than
the index case are a cause for concern. Although the Qinghai strain of
H5N1 has been killing wild and domestic birds since May, there were no
confirmed H5N1 human cases associated with this strain until the outbreaks
in Turkey. These outbreaks included extremely large familial clusters and
signaled a more efficient transmission of H5N1 to humans.
- The linkage of S227N, to increased affinity
of H5N1 for human receptors is quite clear, and the loss of this linkage
as indicated in comments by WHO is cause for concern. The selection away
from mammalian receptor bind domain determinants via selection chicken
eggs is well known. More details on the "loss of S227N, as indicated
by WHO comments would be useful.
- The large size of clusters in Turkey
and northern and southern Iraq suggests that the S227N in H5N1 is being
transported by wild birds and is functioning efficiently.
- © 2006 Recombinomics. All rights