Avian Influenza A Virus (H5N1) Outbreaks, Kuwait, 2007

Ahmad Al-Azemi; Justin Bahl; Sameer Al-Zenki; Yousif Al-Shayji; Sami Al-Amad; Honglin Chen; Yi Guan; J.S. Malik Peiris; Gavin J.D. Smith


Emerging Infectious Diseases. 2008;14(6):958 

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The results of this study confirm that clade 2.2 HPAI (H5N1) viruses were responsible for the poultry outbreaks recorded in Kuwait in early 2007. Notably, the viruses from Kuwait are most closely related to other 2007 subtype H5N1 isolates from Germany and Russia, but not to other 2007 isolates from Egypt, England, Ghana, and Hungary for which data are available (Figure 2). Furthermore, none of the current isolates from Europe or the Middle East has a close phylogenetic relationship with clade 2.2 isolates from China in 2005, although data on recent subtype H5N1 isolates from northern China are lacking.[5,12] These relationships, along with reemergence of genetically similar viruses in widely distant geographic locations such as Germany, Krasnodar, and Kuwait (Figure 1, panel B), indicate that clade 2.2 influenza (H5N1) viruses may have become endemic in wild birds in central or eastern Asia (including Siberian Russia), from where they have been repeatedly introduced to Europe and the Middle East. Although it remains unclear in which hosts these viruses are maintained, the geographic distribution of closely related viruses suggests that migratory bird species are likely acting as vectors. Also, continued endemicity of clade 2.2 viruses in parts of Eurasia may result in the diversification of the virus in different geographic areas, as has been seen for subtype H5N1 lineages in eastern and Southeast Asia.[11] Therefore, systematic surveillance in poultry and wild bird populations will be an important tool for tracking the evolution of clade 2.2 influenza (H5N1) viruses in this region.


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