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Bird Flu Pandemic Potential in North Korea is Significant

Recombinomics Commentary
March 27, 2005

>> North Korea's state media have recently stressed campaigns against the outbreak of bird flu and set up quarantines at airports, sea ports and border areas, while categorically assuring that the country is completely free from the epidemic.

The announcement by North Korea of a bird flu outbreak is cause for concern.  The situation is both politically and genetically unstable, creating a significant pandemic potential. There have been rumors of an outbreak for several weeks, and quarantines at airports may indicate the outbreak has been going on for a longer time period.  Even now the announcement does not include the subtype, although the culling of hundreds of thousands of birds would indicate it is HPAI (Highly pathogenic Avian Influenza).  Food shortages may also cause problems limiting the monitoring or consumption of dead or dying birds.

On the genetic side, North Korea is literally surrounded by potential problems with the H5 subtype.  Most recently there was an H5N2 outbreak in South Korea at the beginning of this year.  Last season there was an H5N1 outbreak in South Korea.  A closely related H5N1 caused considerable problems in Japan to the east of Korea.  To the west is China where there were also several H5N1 outbreaks last season.  Earlier H5N1 was detected in duck meat being shipped from Shanghai to South Korea.  To the north is Russia, where H5 has been isolated in migrating birds in Primorie, just northeast of North Korea.

However, there are additional genetic instability issues in South Korea.  H3N2, H6N1, and H9N2 were found in live markets in 2003.  Some of these isolates had genes that had reassorted and recombined with genes found in Hong Kong.  There was also recombination between H9N2 isolates found primarily in South Korea. 

In addition, H9N2 and H1N1 swine isolates were also reassortants and recombinants.  The genes involved were from Korean avian H9N2 and human WSN/33 H1N1.  These isolates have evidence of extreme genetic instability.  Although the WHO has questioned the authenticity of these sequences at GenBank, after investigating for 5 months they have yet to present any evidence indicating the sequences deposited at GenBank on Oct 2004 are not authentic.  The inability of the WHO to resolve this issue in a timely manner raises serious questions about their ability to accurately assess the bird flu situation in North Korea.

Thus, the political and genetic instabilities are causes for concerns that significantly increase the pandemic potential of the bird flu outbreak in North Korea.
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