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H5N1 Confirmed in Brother in Hunan China
November 15, 2005
A senior Chinese official says H5N1 antibodies have been detected in a nine-year-old boy in Hunan province, the first admission of a human bird flu infection in China, the South China Morning Post reported on Wednesday.
The above comments signal a major change in reported H5N1 cases in China. Although H5N1 infections in poultry and swine have been reported previously, there have been no reported human cases. Moreover, this case was linked in infections linked to migratory birds and the confirmed cases was the brother of a fatal case, who had the same exposure and similar symptoms. The sero-conversion would also be sufficient to make the above case an official WHO case if confirmed by an international lab, which seems certain.
The positive result increase the likelihood that the other Hunan patient a well as the Liaoning case will also sero-convert, increasing the number of reported cases in China as well as the number of cases linked to H5N1 wild bird flu.
The number of wild bird flu cases in China is increasing rapidly. The Hunan cases were the third outbreak reported to OIE by China in the past month. It was followed by four Liaoning outbreaks as well as a second Anhui outbreak and an outbreak in Hubei. Recently, media reports also described two more outbreaks in Xinjiang Province, increasing concerns of additional human cases linked to the wild bird linked outbreaks.
Although the above case is the first linked to wild birds, similar cases were described in Kazakhstan ad Novosibirsk. These human cases also involved pneumonia in patients linked to infected birds and like the case above, initially tested negative for H5N1. However, it is unclear if these patients were subsequently tested for sero-conversion, which may not be detected until a month after exposure.
The above case also increases the genetic diversity of H5N1 tied to human infections. As this diversity grows, the number of suspect human cases also increases. The above case, like those in other countries, tested positive after several negative tests were run. It is likely that more aggressive testing would generate more positive human cases.
Indeed, third party boxun reports indicate that the number of fatal H5N1 cases in China linked to the current series of H5N1 outbreaks is markedly higher than the one case represented by the sister of the above case.