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H5N1 Fatality in Gharbiya in Nile Delta
Recombinomics Commentary
December 24, 2006

When officials realised the woman was part of the same family, they tested her for bird flu and confirmed that she was infected with H5N1, and she was moved to a Cairo hospital, but died shortly thereafter.

The two siblings are in hospital in Cairo and have been treated. The rest of the family is under close medical surveillance, Bushra said.

The above comments confirm the second fatality this season in the Gharbiya province in the Nile Delta.  The first case died October 30 and lived about 15 miles north of the current cluster of three confirmed cases.  Two of the four confirmed cases this season have been fatal, and the geographical and familial clustering are cause for concern.

Moreover, the failure to test the hospitalized patients because of a lack of a bird link is an additional cause for concern.  The four confirmed cases, as well as additional suspect cases, are in the Nile Delta under the flight path of migratory birds birds infected with the H5N1 Qinghai strain.  These birds excrete feces with H5N1, so direct contact with birds should not be a testing requirement.

The disease onset dates of the siblings of the index case also suggest human-to-human transmission may have also become more efficient.  The H5N1 from the earlier case had M230I, which is found in the efficiently transmitted human H1N1, H3N2, and influenza B strains.

The clustered fatal infections in the migratory path across the Nile Delta remain causes for concern.

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