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Military Withdrawal from H5N1 Culling in South Korea

Recombinomics Commentary 15:08
April 22, 2008

The military decided to cut the number of troops deployed to help slaughter avian-influenza infected poultry after news broke that a soldier may have contracted the disease.

``We believe the corporal is unlikely to have contracted avian influenza, but we are taking every precaution with other troops,'' a military official told Yonhap.

The above comments describe the withdrawal of the military from culling operations in South Korea.  The withdrawal follows the news on the hospitalized soldier who appears to have initially tested positive for H5N1.  Media reports described additional hospitalized patients, but their link to culling operations or the military is unclear.

The poultry outbreak in South Korea is at record levels, and the military was deployed for the first time.  There are almost 50 suspect or confirmed locations, and recently plans were announced to increase testing on duck farms.  Although there have been reports of H5N1 in dead waterfowl, H5N1 can also cause asymptomatic infections in waterfowl, even though the same virus is lethal in chickens and humans.

However, there have been prior reports of mild H5N1 in Egypt and the H5N1 status of symptomatic patients in India and Bangladesh remains unclear, because most are not tested.  The outbreak in South Korea is unusual because the temperature in Korea is milder, but the H5N1 is spreading at record levels and rates in South Korea, raising concerns of genetic change and altered transmissibility.

Milder human cases raise concerns about human to human transmission, because infected hosts are more mobile, leading to more contacts and opportunities for transmission.

Sequence data from the earlier poultry outbreaks would be useful.  Last season the H5N1 in South Korea was the Uvs Lake strain, but since that outbreak there has been human to human transmission in Pakistan as well as record levels of H5N1 in India and Bangladesh.

The possibility of mild H5N1 in South Korea raises pandemic concerns and may be linked to the recent decision in Japan to implement a pre-pandemic vaccine program targeting first responders and up to 10-20 million citizens in Japan.

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