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H5N1 Re-emerges in Nigeria
Recombinomics Commentary
December 20, 2006

Veterinary Association spokesman Bala Mohammed says more states have reported new cases of the disease, in the last few weeks.
"What we considered a resurgence is becoming alarming. From an initial three, then 10 states, almost all the states have been having a recurrence,"

Experts on bird flu are increasingly worried that Nigeria risks becoming a permanent host to the virus.

The above comments describe the re-emergence of H5N1 in Nigeria and raise additional concerns on H5N1 surveillance.  Data from last season indicates H5N1 should once again be re-emerging in Europe, the Middle East, and Africa.  However, only a handful of countries in the region (Ukraine, Egypt, Sudan, and now Nigeria) have reported the re-emergence of H5N1.

Last season H5N1 was reported in Turkey and Romania in October, 2005.  Although neighboring countries denied H5N1 infections until early 2006, subsequent data indicate infections began in the fall and were widespread by December of 2005.  The failure to report outbreaks in these countries again this season is cause for concern.  Thus far only one sequence from Egypt has been made public this season.  Although the isolate had many regional markers, it had a number of new polymorphisms indicating new H5N1 was migrating into the area. The increasing number of reports in Africa raises questions about reporting in the Middle East and Europe.

H5N1 has been recently confirmed in South Korea and Vietnam, signaling additional migration in those areas.

The rapid spread in Nigeria, couple with H5N1 in South Korea signal a new season with increased infections, yet the same countries that failed to report H5N1 in the fall of 2005 are also failing to report H5N1 from the same time period this season.

Failure to report and address the infections will lead to additional spread.  H5N1 surveillance remains scandalously poor, even though H5N1 has been aggressively spreading since 2003.
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