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Three Fatal H5N1 Bird Flu Cases in Azerbaijan Confirmed
March 13, 2006
Tests have confirmed that three people recently died from bird flu, a top Azerbaijani health official said today.
Deputy Health Minister Abbas Velibeyov told the Associated Press that tests conducted by the World Health Organisation had confirmed the diagnosis of avian influenza in the deaths of a 16-year-old boy on March 10 and a 17-year-old girl on March 8, both of whom were from the same district on the ex-Soviet nation's Caspian Sea coast.
The above comments confirm a new familial cluster of H5N1 bird flu in Azerbaijan. Based on media reports and the initial WHO update, the confirmed cases would be a 20F who died on March 3 in addition to the two cases described above. The 20F (Nabat Askerova) appears to be the sister of the 16M (Shahriyar Asgarov). Once again the WHO update failed to five the disease onset date for the index case and failed to note the relationship between the index case and the 16M, who was in critical condition when WHO issued the Azerbaijan report.
The withholding of this information in Azerbaijan parallels the withholding of similar data in the cases in Turkey. At least three families of cousins had confirmed H5N1 members. Of the seven that were confirmed, four died, but the relationship between the cousins was withheld in the WHO updates.
The location of the cluster in Azerbaijan suggests these cases may also be linked to HA S227N changes in the H5N1 that was detected in the index case in Turkey.
Details on the relationship between the fatal cases and earlier cases were have subsequently been released would be useful as would relationships with newly admitted patients in Azerbaijan.
The sequences of the H5N1 isolated in Turkey have also not been released. These sequences have been sequestered in a private WHO database. The sequences from human cases in Turkey, Iraq, and Azerbaijan should be released when deposited at the private sequence collection.