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Common Source for Confirmed H5N1 Bird Flu Cluster in Bandung

Recombinomics Commentary

May 30, 2006

Two additional cases occurred in a 10-year-old girl and her 18-year-old brother from Bandung, West Java. Both children developed symptoms on 16 May, were hospitalized on 22 May, and died on 23 May. Both children had a history of close contact with sick and dying chickens at their home in the week before symptom onset. The identical onset dates strongly suggest that they acquired their infection following a shared exposure to poultry, and not from each other. Follow-up of contacts has not identified further cases of influenza-like illness.

The above description from the WHO update accurately indicates that the same disease onset date strongly suggests a common source for the infection of the siblings.  However, most of the human cases in West Java have a novel HA cleavage site, RESRRKKR, yet that cleavage site has not been described in birds from West Java (see map).  Therefore, sequence analysis of H5N1 from the siblings, as well as poultry in the area would be useful.

Recent local reports describe another suspect familial cluster in an adjacent village in Bandung and three earlier clusters in the area have been described.  Each cluster had at least one member H5N1 confirmed by Hong Kong.  There is also a geographical cluster in Bekasi, also in West Java.

The sequences from these earlier clusters shopuld be released immediately.

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