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Human Bird Flu Deaths in Qinghai China?

Recombinomics Commentary
May 25, 2005

>> The affected localities reveal that, as of early April 2005, there have been several deaths of migratory birds. Because of lack of reporting, the news has not traveled widely. Toward the end of April 2005, cases of human infection started to emerge. After 1 May 2005, some tourists who visited the areas were severely affected, and 6 of them died.

Because of this, Mrs. Yi Wu (Chinese Minister of Health) has cut short her visit to Japan and returned home. According to the local news in the affected locality, the number of human casualties is higher than 6.

The deceased persons are all foreign tourists (i.e. not local residents): 2 (a man and a woman) from Chengdu, and one man from Chongqing, Sichuang province. It is unknown from where the remaining casualties come. <<

The above, unconfirmed report has been posted at a Chinese language site as well as ProMed.  Although not confirmed, the report contains details, as well as the names of at least two of the reported dead.  The initial report from China to the OIE detailed the deaths of 519 birds representing five species at the beginning of  May.  The death of five species of migratory birds over such a short time span is unusual.

Qinghai Lake Nature Reserve is within the intersection of the East Asia and Central - South Flyways, which would allow for significant recombination in H5N1 infected birds.  The bar-headed geese migrate from India, where there has been a prolonged outbreak of meningitis in New Delhi, and surrounding municipalities in northern India.  There have been no reported results on H5N1 testing, although there was a recent report of H5N1 positive sera collected in 2002 from poultry workers.

All recent reported H5N1 human fatalities have been in Vietnam and Cambodia this year, with additional deaths last year in Thailand and Vietnam.  Although China has not reported H5N1 infections since 2004, there have been reports of dying geese in Fujan Province, which have been replaced with geese from adjacent Jiangsu and Jiangxi provinces.  Moreover, the HA cleavage site in the 2005 isolates from northern Vietnam matches 2004 isolates from Guangzhou and Yunnan, suggesting recent unreported H5N1 infections.

More information on the human cases in Qinghai would be useful.

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