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Absence of Poultry In Fatal H5N1 Case In Guizhou China
Recombinomics Commentary 14:00
January 22, 2012

The Centre for Health Protection (CHP) of the Department of Health received notification from the Ministry of Health (MoH) today (January 22) concerning a confirmed human case of influenza A (H5N1) in Guizhou.

A CHP spokesman said the patient was a 39-year-old man living in Guizhou. He developed symptoms on January 6 and was admitted to a hospital on the same day. He is now in critical condition. The man did not report obvious exposure history to poultry before the onset of symptoms.

The above comments from the Hong Kong CHP are remarkably similar to the recent fatal H5N1 in Shenzhen, China, and the absence of poultry contact again suggest this is another clade case due to wild birds.  The sequences from that case were promptly released by the WHO regional center in Beijing, and rapid release of sequences from this case would be useful.

The earlier case had a number of receptor binding domain changes, including V223I and M230I which were in the Gharbia cluster in Egypt and these changes have become fixed in clade  In addition the earlier case had S227R as well as Q196K and an acquisition of a basic amino acid in the HA cleavage site, signaling recombination.  The above changes raise concerns that this sub-clade is close to achieving a combination of changes associated with aerosol transmission.

Censored papers at Nature and Science describe a small number of changes that produce aerosol transmission in ferrets.  Only five changes in two gene segments were required, which are likely to involve E627K in PB2, as well as four receptor binding domain changes. 

Four of the five changes have been reported in prior publications, although the precise combination have been withheld based on an ill advised recommendation by a National Science Advisory Board for Biosecurity (NSABB) in the US composed of members who have a profound lack of understanding of influenza evolution and the current distribution of receptor binding domain changes currently in circulation. 

This lack of understanding of influenza evolution by the NSABB is compounded by a failure of the editorial boards of Nature and Science to exercise sound judgment in the advancement of science. 

This combination of serious lapses in intellectual thought has created a significant hazard to the world’s health.

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