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Another H5N1 Confirmed Child in Qena Egypt
Recombinomics Commentary
June 23, 2007

An Egyptian four-year old child has contracted bird flu. Dina Ali, from Deshna town in the Upper Egyptian governorate of Qena, was admitted to Qena Fever Hospital on Sunday, said Health Ministry spokesman Abdel-Rahman Shahin.

The child was suffering from high temperature and respiratory problems after being in direct contact with infected birds, he noted. The spokesman said the child was given the Tamiflu and was now in a stable condition.

The above translation describes another confirmed H5N1 under 10-year old case in Qena.  The last three confirmed cases in Egypt have been in Qena and increases the number of confirmed children in upper Egypt.

Most of the earlier cases have been mild, although the 10F case was fatal.  The H5N1 from recent cases map to the same branch on a phylogenetic tree.  At the Options VI influenza conference in Toronto, new nomenclature was described for H5N1 clades and sub-clades.  The Qinghai strain is Clade 2.2 and all H5N1 west of China has been sub-clade 2.2.  New branches in 2.2 have not been defined, but the isolates in early 2006 from Egypt, Djibouti, Israel, and Gaza would form a distinct branch, which would be clade 2.2.1 (assigning the “1” to this region).  This season, the 2.2.1 clade split into several additional branches.  If numbers were assigned chronologically, the Gharbiya cluster would be  The sequences with the 3 BP deletion would be  Sequences with the Mongolian cleavage site would be including the three isolates from Aswan (10F, 2M, 3F), as well as the 5M and 2F from Menia, and the fatal (10F) case from Qena.

All clade isolates have been from children in upper Egypt.  Most have been mild, raising concerns that the number of H5N1 infections is markedly higher than the confirmed cases.

Sequence information on the recent Qena cases, as well as poultry isolates from upper Egypt would be useful.

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