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Paradigm Shift Intervention Monitoring
received on 16/03/2011 from Dr Toshiro Kawashima, CVO, Animal Health
Division, Ministry of Agriculture, Forestry and Fisheries, Tokyo , Japan
Report type Follow-up report No. 8
Start date 15/12/2010
Date of first confirmation of the event 19/12/2010
Report date 16/03/2011
Date submitted to OIE 16/03/2011
Reason for notification Reoccurrence of a listed disease
Date of previous occurrence 01/04/2009
Manifestation of disease Clinical disease
Causal agent Highly pathogenic avian influenza virus
Nature of diagnosis Clinical, Laboratory (basic), Laboratory (advanced), Necropsy
This event pertains to the whole country
Related reports Immediate notification (20/12/2010)
Follow-up report No. 1 (22/12/2010)
Follow-up report No. 2 (19/01/2011)
Follow-up report No. 3 (23/01/2011)
Follow-up report No. 4 (04/02/2011)
Follow-up report No. 5 (14/02/2011)
Follow-up report No. 6 (24/02/2011)
Follow-up report No. 7 (03/03/2011)
Follow-up report No. 8 (16/03/2011)
The above comments summarize OIE reports on confirmed H5N1 in wild birds identified throughout Japan, including northern Japan. Sequences from three isolates from these outbreaks have been made public at Genbank. Two of the three (in Hokkaido and Fukushima) have S227R. All three sequences are the Fujian strain (clade 2.3.2) which have been circulating in wild birds for several years, including the large outbreaks in Japan, South Korea, and Russia in the spring of 2008. The clade 2.3.2 sequences have two additional receptor binding domain changes (V223I and M230I), which were present in the clade 2.2 sequences from the Gharbiya cluster in Egypt in late 2006. The Gharbiya cluster is the largest H5N1 cluster in Egypt reported to date. All three patients died and the RBD changes raised concerns of increase transmission in human.
The recent acquisition of S227R increased concerns because of the known changes in receptor binding specificity due to S227N, which was predicted and confirmed in 2 of the 4 sequences from Turkey in 2006. The recent reports of two confirmed cases in Kamalpur, a Bangladesh slum have increased concerns that clade 2.3.2 has migrated to Bangladesh and is involved in the two recent cases (as well as symptomatic contacts).
The worsening situation at the Daiichi nuclear power facility in Fukushima, Japan increases concerns that the H5N1 circulating in wild birds and poultry in the region will be impacted by the release of ionizing radiation. This radiation can lead to rapid evolution of clade 2.3.2 H5N1, which may lead to selection of changes that increase transmission in humans in the region. These changes could quickly spread through displaced persons living in crowded conditions that are far from ideal.
Close monitoring of these persons as well as H5N1 sequences from wild birds and poultry, a timely release of such sequences would be useful.