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Turkey Sequences Like Ukraine and Qinghai Lake H5N1
January 8, 2006
virus that recently caused a deadly outbreak in eastern Turkey was slightly different from a genetic point of view from the one detected among birds in the northwest three months ago
It is more like the one found in central China and Ukraine
The above comments indicate the H5N1 in Turkey has changed and is more like H5N1 from Qinghai Lake and the Ukraine. Although the Qinghai Lake strain was never officially linked to human cases, third party reports indicated a significant number of humans were infected and died. Similarly, the strain in the Ukraine as characterized as “unique” and “dangerous to humans”. Isolates from the Ukraine had two HA clevage sites, GERRRKKR and RERRRKKR. These differences may have evolved H5N1 closer to more efficient human transmission, and additional small changes in Turkey increased the efficiency further.
H5N1 has been evolving via recombination and acquisition of mammalian polymorphism. These additional small changes appear to have increased the efficiency for infecting humans. Since this new version of H5N1 is being transported and transmitted by migratory birds, there are simultaneous outbreaks in poultry and people all across Turkey. These isolates almost certainly have PB2 E627K, which would enhance the ability of the H5N1 to replicate at cooler temperatures, which could accelerate spread in the winter months during flu season.
The H5N1 in wild birds in Turkey will transmit this version of H5N1 to countries to the south. Turkey has conceded that H5N1 has been detected but unreported since early December. Unfortunately, the lack of reporting of H5N1 appears to be widespread, since H5N1 has been in Turkey since October. There is little reason to suspect that the H5N1 resident in Turkey since October has been confined to Turkey since October.
Reporting of H5N1 in Europe, the Middle East, and Africa remains scandalously poor and hampers potential intervention or control efforts.