Human H5N1 cases in Azerbaijan called likely

Mar 14, 2006 (CIDRAP News) – Authorities in Azerbaijan have reported that three people who died of suspected avian influenza were infected with an H5 virus, and further tests very likely will confirm it to be H5N1, the World Health Organization (WHO) said today.

"H5N1 is the only strain within the H5 subtype known to cause human infections," the WHO said. "It is highly likely that the H5N1 strain will be detected in further tests." Those tests will be conducted at a WHO reference laboratory in Britain.

If confirmed as H5N1, the three cases will be the first ones in Azerbaijan, a former Soviet republic in the Caucasus region on the west side of the Caspian Sea. The country would be the eighth nation to face human cases of H5N1, following Vietnam, Thailand, Cambodia, Indonesia, China, Turkey, and Iraq.

Yesterday the WHO recognized the avian flu in a 12-year-old Indonesian girl who died Mar 1, apparently the same girl whose case was announced by Indonesian authorities Mar 10. Her case increased the WHO's reckoning of the global toll to 177 cases with 98 deaths. Confirmation of the Azerbaijani cases would boost the death toll to 101.

The WHO announced Mar 10 that Azerbaijani authorities were investigating 10 suspected human cases of H5N1.

The victims who tested positive for an H5 virus included a 17-year-old girl from Sarvan settlement who died Feb 23 and a 20-year-old woman from Daikyand settlement who died Mar 3, the agency said. Both villages are in the southeastern area of Salyan.

The other patient was a 21-year-old woman from the central-western province of Tarter, who died Mar 9, the WHO said.

In its Mar 10 statement, the WHO mentioned a 17-year-old girl who died Feb 23 but said she was thought to have died of a respiratory illness that had afflicted her for more than a year. That report also had said all 10 patients were from the same town (Daikyand).

A portable field laboratory provided by US Naval Medical Research Unit 3, based in Cairo, Egypt, tested samples from the three patients, the WHO said. The lab, which arrived in the country yesterday, provides reliable results, the agency said.

A Reuters report today said the three patients became ill after contact with sick birds and were not thought to have infected one another. "I do not believe the virus passed from human to human," said Shyakar Babayeva, head nurse at the institute in Baku, the capital, where the patients were treated.

WHO spokesman Dick Thompson said test results were still pending on two other Azerbaijanis who died of suspected avian flu, according to a Canadian Press report published today.

Thompson also said several other possible cases are being investigated, including some clustered in families, according to the report.

In confirming the case in the Indonesian girl, the WHO said she lived in Boyolali in central Java. She fell ill Feb 19, was hospitalized Feb 23, and died Mar 1. Chickens in her household had died in the days just before she got sick, the agency said.

The girl had a 10-year-old brother who became ill on Feb 19 and died Feb 28, the WHO said. But because his symptoms looked like dengue hemorrhagic fever, he was not tested for avian flu. "It will therefore never be known whether he may have died following co-infection with dengue and H5N1 avian influenza," the WHO said.

In other developments:

  • A Hungarian H5N1 vaccine for humans has been approved by Hungary's pharmaceutical authorities, according to an Agence France-Presse (AFP) report today. Announcing the approval, Prime Minister Ferenc Gyurcsany said the vaccine is intended for people working with diseased birds.
  • India reported new outbreaks of H5N1 in poultry in Maharashtra state, about 85 miles from India's first outbreak, discovered last month, according to AFP. An agriculture ministry official said four samples from four different villages in the Jalgaon district tested positive. Officials said 75,000 birds in the area would be killed to contain the outbreak.
  • Several seagulls from southern Croatia tested positive for the virus, according to another AFP report. The seagulls came from the town of Pantana, near Split on the southern coast, officials said. About 1,200 birds from the area have been tested since two swans there were found infected with the virus in mid-February, AFP reported.

See also:

Mar 14 WHO statement on situation in Azerbaijan
http://www.who.int/csr/don/2006_03_14/en/index.html

Mar 13 WHO statement on case in Indonesia
http://www.who.int/csr/don/2006_03_13/en/index.html

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