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Fatality in Northern Vietnam Linked to H5N1 Wild Bird Flu?

Recombinomics Commentary

September 2, 2005
A 58-year-old man from Hanoi was admitted to a hospital in the capital on August 24 and died the same day, said a doctor who identified herself only as Lien.

Pham Ngoc Dinh, deputy director of the National Institute for Hygiene and Epidemiology, said the man tested positive for the H5 component of the bird flu virus, but the N1 element has not been determined. More tests are being conducted.

The man from Soc Son District ate duck a week before dying. It was purchased from a market, and no other family members became ill after eating the poultry, said Nguyen Van Loan, director of the district Preventive Medicine Centre.

The above description of the death of a patient in northern Vietnam is cause for concern.  This year most of the H5N1 in the north have survived.  The deaths have been concentrated in the south, where virtually all confirmed cases have died.

The distinction between the north and south may become blurred as H5N1 flies into the region from bird nature reserves such as Qinghai Lake.  These birds can bring in new sequences and recombine with indigenous H5N1.  Thus far, the H5N1 in Vietnam, Thailand, Cambodia, Laos, and Malaysia has been distinct from H5N1 elsewhere.  There were some changes, primarily in northern Vietnam due to recombination with H5N1 most commonly found in Guangdong province and South Korea / Japan.

However, this season the H5N1 wild bird flu has unique sequences, including the PB2 polymorphisms E627K, which is associated with virulence in mammals.

Thus, the new sequences and new challenges may be unusually severe this season.

The sequence of  H5N1 from this new case may be particularly revealing.


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