WHO confirms 7 human bird flu cases in Azerbaijan

Mar 21, 2006 (CIDRAP News) – The World Health Organization (WHO) today confirmed seven human cases of H5N1 avian influenza in Azerbaijan, making it the eighth country with officially recognized human illnesses.

A WHO reference laboratory in Britain confirmed the infection in samples from 7 of 11 patients tested, ranging in age from 10 to 21 years, the WHO said. Five of those patients, ranging from 16 to 21 years old, died of the illness.

The cases push the WHO's count of fatal cases over 100 for the first time. The agency now lists 184 confirmed cases with 103 deaths. Two cases reported in Egypt in the past few days have not yet been confirmed by a WHO reference lab.

The WHO said six of the cases occurred in the small settlement of Daikyand in the Salyan rayon in southeastern Azerbaijan, a former Soviet state on the west side of the Caspian Sea.

A 17-year-old girl was the first to succumb to the disease, on Feb 23, the WHO reported. Her death was followed by that of her 20-year-old female cousin on Mar 3 and the cousin's 16-year-old brother on Mar 10. A 17-year-old girl who was a close friend of the family died Mar 8. All four young people lived together or near each other, the WHO said.

"The additional two cases in Salyan involved a 10-year-old boy, who has recovered, and a 15-year-old girl, who is hospitalized in critical condition," the WHO said. The seventh case was in a 21-year-old woman from the western rayon of Tarter, who died Mar 9.

Two more patients, from Salyan and the adjacent area of Neftchela, have been hospitalized with pneumonia symptoms and are being tested, the agency said.

WHO and Azeri investigators have not yet determined how the patients were exposed to the virus. Interviews with family members have not revealed any history of direct exposure to dead or diseased poultry in several of the cases, the agency said.

However, there is some evidence that local residents might have collected carcasses of numerous swans, dead for some weeks, as a source of feathers, the WHO reported. Adolescent girls and young women usually have the job of defeathering birds, and a WHO team is investigating whether this could have been the source of infection in Daikyand, where most of the patients were girls between the ages of 15 and 20.

Azerbaijan is the third country outside East Asia, after Turkey and Iraq, with confirmed human cases of H5N1. The other countries with recognized cases are Cambodia, China, Indonesia, Vietnam, and Thailand. Vietnam has had the most cases by far—93, with 42 deaths—but has reported none in recent months.

The H5N1 virus first turned up in Azerbaijan in wild birds in February, with confirmation on Feb 10. The WHO reported Mar 10 that authorities were looking into a possible human cluster of 10 cases. On Mar 14, the agency said three patients who died had tested positive for an H5 virus and that confirmation of H5N1 was highly likely.

Also today, Egyptian authorities reported two more human H5N1 cases, in addition to the two reported in the past few days, according to an Agence France-Presse (AFP) report.

A 17-year-old boy named Mohammed Mahmud Abdul Ghani Ghabash, from Gharibiyah province north of Cairo, was hospitalized Mar 19, according to Health Minister Haten al-Ghabali, the story said. He worked on his father's poultry farm, where 3,000 birds died of flu over the weekend, AFP reported.

In addition, a 30-year-old woman named Fatima Mohammed Yussef, from Qaliubiya, north of Cairo, has been hospitalized with avian flu symptoms, the story said. It said she had continued working with her chickens despite a ban on the activity after the H5N1 virus struck Egypt in mid-February.

The story gave no information about testing of the two patients.

Two other Egyptians recently tested positive for the virus in a US Navy laboratory in Cairo, according to previous reports. A 30-year-old woman died of the illness Mar 17, and a 28-year-old man was hospitalized but improving as of yesterday.

See also:

Mar 21 WHO statement on Azeri cases
http://www.who.int/csr/don/2006_03_21a/en/index.html

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