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Paradigm Shift Intervention Monitoring
H5N1 Guangdong China Case
He came to Hong Kong last Saturday and sought medical attention from a private clinic in Mong Kok.
He subsequently developed a fever and convulsions and was taken to the Accident and Emergency Department of Caritas Medical Centre on Monday, where he was admitted with suspected encephalitis.
Tests later showed he has H5 Influenza A.
The above comments describe an H5N1 case (2M) from Guangdong Province who was diagnosed in Hong Kong. The diagnosis was delayed because of the unusual presentation. Subsequent sequence analysis indicated the case was clade 18.104.22.168, which is frequently identified in wild birds in southern China, as well as the most recent prior H5N1 case from Shenzhen.
Sequences from that fatal case were promptly released by the WHO regional center in Beijing. There were multiple receptor binding domain changes associated with H5N1 spread in humans.
Prompt release of the H5N1 sequences from this case would be useful.