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H5N1 Positive Ex-Asia Patient in French Island of Reunion
October 26, 2005
Tests on a man hospitalised on the French island of Reunion in the Indian Ocean indicated he may have contracted bird flu, the authorities said Wednesday.
Preliminary tests indicated the presence of the disease, the government administrator's office on the island said, adding that the man had recently returned from a trip to Asia from where bird flu has been spreading.
The above description suggest that H5N1 is now being exported out of Asia. This is not a surprise. H5N1 is spreading human-to-human in Indonesia and Thailand, and the reported outbreaks are probably just the tip of the iceberg.
H5N1 is endemic to southeast Asia and migrating birds bring in new sequences that can recombine with the endogenous H5N1. All 16 isolates from Qinghai Lake had the PB2 polymorphism E627K, which had never been previously found in H5N1 in birds. However, the polymorphisms had bee found in some human H5N1 cases in Vietnam and Thailand, and most or all patients died.
The migration of E627K into southeast Asia provides a mechanism for changing a mild H5N1 infection into a virulent infection.
More detail on the country of origin and sequence data for 2005 from countries in southeast Asia, especially Indonesia, Vietnam, and Thailand, would be useful.