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Vaccine Resistant H5N1 Cases in Egypt Raise Concerns
Recombinomics Commentary 13:26
March 5, 2009

Mr. Yusuf Mohamed Said Abdel Azim of the second village management Yousef province of Fayoum, Friend, developed symptoms on Wednesday and entered the hospital Saturday

Abdullah Nagy Amran, comes from the northern Egyptian governorate of Alexandria, some 220 km northwest of Cairo, the state MENA news agency quoted the spokesman Abdel Rahman Shahine as saying.
The boy showed symptoms after contacting with dead birds on Wednesday, and he is in a stable condition

The above comments describe the two most recent H5N1 confirmed cases in Egypt.  Although widely separated in space (see updated map), the two cases are close in time and were likely infected by the vaccine resistant strain of H5N1.

This strain emerged just over a year ago and quickly became dominated in poultry, including vaccinated flocks.  The last human case reported last season was infected with the resistant strain and almost all poultry isolates from the late spring and summer were the vaccine resistant strain.

Although NAMRU-3 has not released any poultry or human sequences this season, two of the human isolates were included in a WHO HA phylogenetic tree of vaccine candidates indicate the human isolates had evolved away from last seasons sequences, but were still derived from the vaccine resistant strain.

These data indicate the H5N1 has defeated the extensive vaccine program in Egypt and now was dominant in the poultry and human population.  The two cases above were confirmed within two days of each other and media reports suggest there is a familial cluster in Cairo.

This spike in human cases that are likely infected with vaccine resistant H5N1 is cause for concern.

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