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Influenza Deaths in Nepal Raise Concerns

Recombinomics Commentary

September 14, 2005

Assistance Minister for MoHP Nikshya Shumsher Rana said that ministry attention was drawn to the published news, and cross checks found that 60 percent of the deaths were due to other reasons, like viral influenza and other diseases.

According to the Epidemiology and Disease Control Unit (EDCU), only 204 deaths out of the 1249 reported by the 2nd week of September 2005 were due to JE.

The above comments on influenza deaths are cause for concern.  After the H5N1 wild bird flu outbreak at Qinghai Lake was reported, third party reports indicated that there were significant numbers of human cases in China in Tibet and adjacent regions like Nepal.  India has reported a Japanese Encephalitis (JE) outbreak and media reports have indicated a high percentage of those cases were laboratory confirmed with IGM antibodies in serum or cerebral spinal fluid.

The above report from Nepal indicates that the majority of deaths there were not due to JE and that many were due to viral influenza.

Nepal was the origin of the dangerous California strain that swept across the world last season and is the H3N2 vaccine target for the upcoming season.  The H3N2 virus is also evolving via recombination and acquisition a avian sequences, so an outbreak of fatal flu in the region is cause for concern, which is significantly increased by over 1000 deaths that include influenza

Sero-type data on the fatal flu cases is urgently needed.  Prior studies indicated that containment of efficiently transmitted pandemic influenza had a small window of opportunity. Nepal is somewhat isolated, and that may extend the window for intervention, so sero-type data should have a very high priority.

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