A Fatal Familial Cluster of H5N1 Bird Flu in Azerbaijan Is Likely
Recombinomics Commentary March 4, 2006

A top official in Azerbaijan said on Saturday a family of six people could have contracted bird flu, although it was too early to be sure.

"The preliminary diagnosis is severe pneumonia but this is a suspicious case," said Abbas Velibeyev, deputy health minister, on ATV television.

When asked if the family, which keeps chickens and has seen two children die in the last month [...]

The description above appears to be another familial H5N1 infection with human-to-human transmission. Two children have already died and four other family members are hospitalized. The location of this outbreak relative to large clusters in Turkey and Iraq suggests the clusters are linked to S227N.

S227N was noted in the index case of the Turkey outbreak. Although it was said to be missing from the isolate from the sister of the index case, it is unclear if the isolate was from mammalian cells or chicken eggs. Chicken eggs are known to select against polymorphisms which increase the affinity for human receptors, which ahs been shown for S227N.

This cluster in Azerbaijan suggests S227N is spreading in the area. Although it has been over two months since the outbreak in Turkey was reported. WHO and consultants are hoarding the sequences from this outbreak.