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H5 Confirmed in Cyprus
January 26, 2006
"The H5 virus has been confirmed" in tests conducted in the Turkish Republic of Northern Cyprus (TRNC), the breakaway statelet recognised only by Turkey, prime minister Ferdi Sabit Soyer told reporters late Wednesday.
Samples taken from a chicken and a turkey in a village near Famagusta on the eastern coast of the island have been sent to Turkey and Britain to determine whether it was the deadly H5N1 strain, he added
The confirmation of H5 in Cyprus strongly suggests that the poultry deaths were from H5N1. H5N1 infections in Turkey have been widespread in species that could transmit H5N1 to Cyprus as well as all countries bordering Turkey.
Turkey first reported H5N1 in October, 2005 in western Turkey. Although poultry deaths were also reported in eastern Turkey at the time, H5N1 was not confirmed. However, recent OIE filings indicate H5N1 was detected in eastern Turkey in November and additional outbreaks have been reported for December and January. These data indicate H5N1 has been throughout Turkey since October and migrating birds passing through Turkey over the past several months would have dispersed H5N1 throughout the Middle East and Africa.
However, no country in the Middle East or Africa has filed an OIE report on H5N1. Alternative explanations for wild bird and poultry die offs in the region lack credibility. Credibility of these reports has been further damaged by reports of widespread culling in neighboring countries, couple with visits by representatives of WHO, the EU, and the United States. There is little doubt of H5N1 infections in these areas, but these infections are being monitored via clinical presentation, rather than confirmatory lab results, or the confirmatory lab results are not being reported.
The same approach appears to be applied to human cases. Although suspect cases in Turkey are still being admitted, these cases are being treated as H5N1 positive cases (isolation and Tamiflu), but they are not being reported as H5N1 confirmed cases. The failure to confirmed extends to family members of confirmed cases. The number of confirmed cases remains at 21, even though the number of poultry cases under investigation has exploded, increasing the exposure of humans to H5N1. However, most of these cases have been mild and three of the four fatalities limit to the first 4 cases, although the 4th case has yet to be confirmed. All four fatal cases initially tested negative, further demonstrating the unreliability of the laboratory testing.
These false negatives have generated positive media reports on the status of H5N1 in humans in Turkey. The newly admitted patients have been largely ignored and the focus has been on the recovery of the 21 confirmed cases. These reports have created a false sense of security and have given license to neighboring countries to also deny human cases, even when such cases are fatal.
The failure to confirm H5N1 in poultry and patients remains cause for concern.