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Paradigm Shift Intervention Monitoring
Hokkaido University released the
H5N1 sequence from a duck in Fukushima, A/duck/Fukushima/2/2011,
which was collected in January, 2011. Like the sequence from the
whooper swan in Hokkaido, A/whooper
swan/Hokkaido/4/2011, it had S227R
(in addition to V223I and M230I).
A third sequence from Tochigi, A/peregrine
falcon/Tochigi/15/2011, had the earlier changes (V223I and M230I),
but did not have S227R.
The duck sequence was closely related to the whooper swan protein sequence (the duck also had E362D), raising concerns that the receptor binding domain changes (V223I, S227R, M230I) are widespread in H5N1 clade 2.3.2 in northern Japan, including the region most affected by the earthquake and tsunami.
The three receptor binding domain changes raise concerns that this emerging sub-clade could infect humans. These concerns were increased by the recent reports of two confirmed H5N1 cases in the Kamalapur area of Dhaka, Bangladesh.
Prior H5N1 cases in birds and a child in Bangladesh were associated with clade 2.2. However, clade 2.3.2 has been circulating in wild birds in Japan, Russia, and Mongolia since 2009, and there are concerns that this sub-clade will spread to areas to the southwest, including Bangladesh and India.
Sequence data on the two confirmed cases in Bangladesh would be useful.