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Turkish Siblings Test Negative For Influenza

Recombinomics Commentary

January 3, 2006

"The tests on samples from the dead child and four other people suspected (of having bird flu) came back negative," the agency quoted the ministry's basic health services general manager Turan Buzgan as saying.

"The sickness is not a result of bird flu or any influenza virus," he said.

It was not clear what caused the death of 14-year-old Mehmet Ali Kocyigit. He was one of four children from the same family who fell ill.

Although the initial tests on the samples from the four siblings were negative for influenza, samples collect approximately 1 week after symptoms frequently give false negative results.  The samples in Turkey were tested for H5N1 antibody via ELISA testing of serum, and they were tested for the genetic material (RNA) of H5N1 via PCR testing of nasal and/or throat swabs.

However, antibody levels rise through the 3rd or 4th week post symptoms, so samples collected after one weak frequently have antibodies below the detection level.

Similarly, at one week the H5N1 may have been cleared from the nose and throat.  In the cases of the four siblings, their viral pneumonia symptoms would indicate the H5N1 was already in their lungs.  Since no etiological agent has been identified, H5N1 is still at the top of the list of likely suspects.

It remains at the top because of the circumstantial evidence including clinical presentation and linkage to sick and dying poultry.  H5 has already been detected in eastern Turkey and more tests are being run on dead birds from four adjacent provinces in eastern and central turkey.  H5N1 was also been recently confirmed in the Volga Delta, Crimea Peninsula, and Danube Peninsula, all of which can be sources for H5N1 infections in eastern Turkey via migratory birds that can infect local poultry.

Autopsy testing as well as later serum collection from the surviving siblings should provide more samples for a more accurate determination of the etiological agent responsible for the viral pneumonia diagnosis.


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