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Qinghai H5N1 in Kuwait
Recombinomics Commentary
February 26, 2007

Kuwait has confirmed 20 cases of the deadly avian flu in birds including falcons, chickens and turkeys, a spokesman for the Health Ministry said Sunday.

He the cases were found at the Kuwait Zoo, farms and a clinic for falcons. The zoo and bird markets would be closed temporarily, and exports and imports of birds would be halted, he said.

This small oil-rich state last confirmed case of the deadly H5N1 strain of the virus was in 2005 when officials discovered the disease in a flamingo.

The above comments describe the detection of H5N1 in Kuwait.  Although media reports indicated H5 was in a flamingo in Kuwait in the fall of 2005, Kuwait has never filed an OIE report on H5N1.  Reporting of H5 in poultry on farms is mandatory, so a report should be filed on the chickens and turkeys described above.  The filing would be the 47th country reporting the Qinghai strain of H5N1 since its discovery at Qinghai Lake in May, 2005.  Other than China, South Korea, and Japan, the reports of Qinghai H5N1 represented the first H5N1 by that country.

The expanded geographical reach of Qinghai H5N1 began in the summer of 2005, with reports of H5N1 in Russia, Kazakhstan, and Mongolia.  In the fall of 2005, Qinghai H5N1 spread into Europe, the Middle East, and Africa.  However, the reports of the spread were limited.  Romania and western Turkey reported H5N1 in the fall.  Media reports indicated H5 was in a flamingo in Kuwait, and sequences released in the fall of 2006 indicated H5N1 was in a teal in Egypt in December 2005.  Similarly, in 2006 Turkey indicated that H5N1 had also been detected in eastern Turkey in 2005.

However, the vast majority of the H5N1 cases in 2006 were reported in February and March.  Many were linked to non-migratory mute swans that had died after a harsh winter, which may have contributed to increased levels of H5N1 that could then be detected by various surveillance programs with poor sensitivity for Qinghai H5N1.

This season, report failures are also suspected.  Although the winter has been milder this season, the location and timing of H5N1 reports this season strongly suggests that H5N1 is widespread in Europe, the Middle East, and Africa.  In late 2006 Ukraine, Egypt, Sudan, Nigeria, and Ivory Coast reported H5N1.  In early 2006 H5N1 was reported in Hungary and Krasnodar.  This month H5N1 was reported at additional locations in Krasnodar, Moscow, England, Turkey, Pakistan, and Afghanistan.

The report of H5N1 at several locations in several species strongly suggests H5N1 is widespread in the Middle East, since countries to the north, east, and southwest have all reported H5N1 recently.  Kuwait neighbors of Iraq, Iran, and Saudi Arabia are highly suspect due ti proximity to the outbreak described above.

H5N1 reporting failures in Europe, the Middle East, and Africa remain a cause for concern.

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