- The Health Ministry announced Thursday that contrary
to an earlier announcement it is possible that an Israeli man hospitalized
Saturday at Rebecca Sieff Hospital in Safed may have contracted a virulent
strain of the bird flu virus. The man's blood will be further tested both
in Israel and England, the ministry said.
- On Tuesday the Health Ministry reported that it was examining
suspicions that a 57-year-old Galilee resident, hospitalized since the
weekend, had contracted bird flu. The man was employed at the Lake Hula
nature reserve and his job was to feed the birds there. A test on saliva
taken from his pharynx showed that he did not carry the virus, but on Thursday
it was revealed that his blood tests raised suspicions that he had the
disease, and had probably contracted a virulent strain of the virus.
- The above comments suggest that the 57 year old patient
has contracted H5N1. A positive H5 antibody at this early date is an indication
of significant antibody. If the titer increases four fold, the data will
represent confirmation of H5, which would be the first confirmed H5N1 human
case outside of Asia.
- Although Israel has not reported H5N1 in birds, H5N1
has been reported in OIE reports from Turkey, Romania, and Croatia. Although
there have been many reports of dying birds in the Middle east, media reports
indicate only Kuwait has confirmed H5N1 in a wild bird (see map).
- H5N1 is expected in Israel. H5N1 in wild birds was widely
detected in Siberia over the summer. The positive birds were in migratory
flight paths that go from Siberia to the Caspian and Black seas in the
fall and then to Africa for the winter. During the migration from Europe
to Africa, 500 million wild birds fly over Israel and adjacent countries.
- H5N1 infections in Isael are of particular concern because
H9N2 isolates in Israel contain donor sequences to create S227N in HA.
This polymorphism increases HA affinity for human receptors, which would
be associated with more efficient transmission to humans. Moreover, all
H5N1 wild bird sequences of PB2 contain E627K, which has been associated
with increased virulence in mammals as well as the ability to grow the
34 C. The ability of H5N1 to grow at the lower temperature would also
increase the efficiency of transmission to the upper respiratory tract.
- Thus, it would be useful to test contacts of the patient
to identify additional positives and isolate the H5N1 for sequencing.
Detection of HA S227N would represent a serious increase in the efficiency
of H5N1 to infect humans.
- Information on Henry L. Niman:
- Recombinomics, Inc. Founder and President, Henry L Niman
earned a PhD at the University of Southern California in 1978. His dissertation
focused on feline retroviral expression in tumors in domestic cats.