The Ministry of Agriculture announced here Saturday that the reported death of migratory birds in West China´s Qinghai Province was caused by bird flu.

    The ministry said the national bird flu reference laboratory confirmed that the latest death of migratory birds in Gangcha City of Qinghai Province reported on May 4 was caused by the deadly H5N1 virus.

    The disease did not spread to human kind and fowl, the ministrysaid.

    It said Qinghai had taken emergency measures by closing off the spots to prevent people and fowl from contacting wild birds. Quarantine measures have also been adopted.

---

2005 H5N1 Sequences At GenBank

2005 H5N1 Sequences At GenBank
http://www.recombinomics.com/News/05200502/H5N1_Genbank_Sequences.html
Recombinomics Commentary
May 20, 2005
  
>>  CDC has only one isolate and sequence for H5N1 from North Vietnam cases reported in 2005," said Ruben O碊onis, US Centers of Disease Control and Prevention´s Chief of the Molecular Genetics Section, Influenza Branch <<

The lack of sequences from 2005 isolates is cause for concern.  There are no publicly available 2005 H5N1 sequences at GenBank at this time, although some of the restricted sequences may be publicly available shortly,  The CDC has data from only one case in northern Vietnam, but the number of infected birds is high and more isolates should be forthcoming.  Use of appropriate primers can also generate PCR sequence data from the many samples collected.  The Institute for Hygiene and Epidemiology in Hanoi has collected 1000 serum samples, which were analyzed by the CDC prior to the urgent meeting in Manila.

The analysis of these sequences will demonstrate additional recombination between earlier isolates to generate new 2005 sequences.  The 2005 sequences can be used to predict the sequences of the H5N1 bird flu that will emerge in southeast Asia in the fall.

It is likely that the new isolates will have evolved away from the 2004 isolates being used for a pandemic vaccine, so preparing for 2005 isolates now, rather waiting for them to emerge in the fall would be useful.

---

H5N1 in Qinghai China Imported from India?

>> The birds were found dead on May 4 in Qinghai province´s Gangcha city, the official Xinhua News Agency reported, citing the ministry.

The ministry found the birds died of the deadly H5N1 flu strain, but "the disease did not spread to human kind or fowl,创 Xinhua said. It did not say how many birds had died, or where they came from.  <<

The acknowledgement that the wild bird die-off in early May was linked to H5N1 is somewhat refreshing, but not reassuring.  Initial reports indicated H5N1 had been ruled out, so it is unclear if these earlier statement represented a lack of transparency, or more use of mismatched primers to generate false negatives.  The comments could have also indicated the clinical presentation of the wild ducks were unusual.

The details remain somewhat sketchy.  The recent report describes fatal H5N1 infections in Gangcha city on May 4 and the earlier report describe bar head geese the began dying May 6 on Bird Island in nearby Qinghai Lake.  There were 178 fatalities on the western side of the lake. 

Since the dead geese were initially said to be negative for bird flu, it is unclear if other wild birds were tested.  The geese however arrive at the Qinghai Lake Nature Reserve in May and June after spending the winter on the plains of India.

India has recently acknowledged H5N1 antibodies in sera from 3 poultry workers collected in 2002.  Currently there are fatal infections in India, which have been diagnosed as miningococcemia and meningitis, which are secondary infections of influenza.

Although WHO had announced in Febraury that unexplained deaths would be tested for H5N1, there is little evidence that the mysterious meningococcal-like deaths in the Philippines, or the recent or earlier deaths in India were tested for H5N1.

Thus, while WHO has called two urgent meetings to focus of the human-to-human spread of H5N1 in northern Vietnam, a plan to correct the scandalously poor surveillance remains unclear, even though WHO has acknowledged that the 2005 pandemic may have begun. 

There have been no public announcement of results of H5N1 testing of dead patients in the Philippines or India, although WHO has made announcements that the human-to-human transmission in northern Vietnam is of a milder disease and is probable.