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Unstable Bird Flu Genes Dictate WHO Visits to China and India
June 10, 2005
>> "All of this shows the virus remains unstable, unpredictable and very versatile," Omi told a news conference."It may have new and unpleasant surprises in store for all of us." ……….
Omi said the virus appeared to be moving in different ways in different places, apparently becoming more transmissable but less fatal in Vietnam while becoming more pathogenic in China.
"It is very difficult to predict what will happen under these circumstances, but the best thing I can say is to keep our vigilance high," he said………….
Sharing information, making virus samples available to WHO laboratories and improving animal husbandry practices were all key to preventing a pandemic, Omi said.
But the disease usually appears in rural areas where surveillance is harder and involves both health and agriculture sectors, making a coordinated response a challenge. <<
The above WHO comments highlight the need to gather additional data. H5N1 evolves via recombination within hosts that are infected with two viruses. As the number of hosts infected with H5N1 increase, the number of possible new recombinants also increase. New emerging strains can be predicted based on the current gene pool, but the holes in the database are substantial. WHO and FAO should be encouraging affected countries to get more serious about collecting and sharing data.
The two most glaring examples are China and India. China has almost certainly generated sequence data for the Qinghai Lake isolates. This data should be publicly available via deposits at GenBank. Currently there are no 2005 H5N1 sequences. China, Vietnam, Thailand, and Indonesia certainly have sequences data, even if only from birds. The 2004 H5N1 bird sequences are virtually identical to the human sequences, so bird sequences will be quite useful.
The initial reports from Qinghai Lake described bar headed geese as the only bird flu victims. Although the number of species expanded, the bar headed geese are key. They winter in northern India and can fly 1000 miles in 24 hours (the distance from northern India to Qinghai Lake). There are almost certainly H5N1 sequences in India. Although India has claimed to lack facilities to isolate and sequence H5N1 they can simply pack up bird dropping and ship them off if they can't come up with the appropriate resources.
Similarly the meningitis cases in northern India as well as the dying crows in western India should be tested for H5N1. WHO has previously indicated they will test unexplained deaths fro H5N1. So for there is little evidence that Meningitis / meningococcal deaths in the Philippines and India have been tested for H5N1.
Like China's blanket denials of human H5N1 cases, WHO blanket calls for vigilance are inadequate. Media reports quote Chinese official as saying WHO is welcome to visit all areas of China. Similarly, India has not told WHO or FAO to stay out.
It is time for WHO to get off the phone and get on the ground in China and India to get real data on increasingly ominous developments.