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H5N1 Bird Flu Familial Cluster in Azerbaijan Grows
March 30, 2006
Five young people, three of them from the Askerov family, have died from bird flu in Azerbaijan. But the girl, who is now in hospital, is the first new case of suspected infection since the first week of this month.
Velibeyov said the girl had probably caught the virus via the same route as her other family members, who are thought to have been infected while plucking feathers from dead swans.
The above comments on another H5N1 bird flu case in the Askerov family raise additional concerns about WHO assurances and analysis. In addition to three family members who have died, a close friend was also fatality infected with H5N1. Comments on the origin of the infections fail to account for infections over an extended time frame.
The index case in the cluster died on Feb 23. Her cousins and friend died between March 3 and March 10. Now a fifth person has been hospitalized and is still alive on March 30. The extended time frame of this cluster is more consistent with human-to-human transmission than a common source that produces disease over such a long time frame.
Human-to-human transmission of H5N1 among family members is quite common and is linked to the majority of reported cases. The size of these clusters increased dramatically in Turkey. S227N was isolated from the index case in that cluster, raising the possibility of genetic changes that increase the efficiency of human-to-human transmission.
That cluster was geographically close to the current cluster in Azerbaijan and raises the possibility that this change or a similar change has increased the efficiency of H5N1 to humans. The transmission of H5N1 to a human cluster over an extended time frame is cause for concern.