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Bird Flu Mutation in Egypt Has Not Increased Transmissibility Between Humans

Despite two cases of genetic mutation in bird flu in Egypt that moderately reduced the effectiveness of oseltamivir, the most strongly recommended drug, the United Nations health agency is not changing its recommendation because the level of resistance is not yet well established and the virus has not become more easily transmissible between humans.

"At this time there is no indication that oseltamivir resistance is widespread in Egypt or elsewhere," the UN World Health Organization (WHO) said in its latest <"http://www.who.int/csr/don/2007_01_18/en/index.html">update, noting that this mutation in the H5N1 virus had previously been identified in Viet Nam in a single case in 2005 and current laboratory testing suggested reduced susceptibility was moderate.

"Moreover, these mutations are not associated with any known change in the transmissibility of the virus between humans. Based on these considerations, the public health implications at this time are limited. Finally, these findings do not indicate a need for a change in phase level. The WHO pandemic preparedness level remains at three."

Ever since the first human case of H5N1, linked to widespread poultry outbreaks in Viet Nam and Thailand, was reported in January 2004, UN health officials have warned that the virus could evolve into a human pandemic if it mutates into a form which could transmit easily between people.

The so-called Spanish flu pandemic of 1918-1920 is estimated to have killed from 20 million to 40 million people worldwide. Overall, there have been 267 reported human H5N1 cases, 161 of them fatal. More than 200 million birds have died worldwide from either the virus or preventive culling.

In the two new Egyptian cases, a 16-year-old girl and her 26 year-old uncle died. Both patients had been on treatment with oseltamivir for two days before the clinical samples that yielded the viruses were taken.

In this and all other H5N1 investigations, there is close coordination between WHO and the Egyptian Ministry of Health and Population, the agency said. The Egyptian authorities, WHO and its collaborating centres will continue to share with the public all relevant information from the on-going investigations and analyses as soon as it becomes available, it added.

Source: United Nations