8 August = 2005

8=20 August 2005

H5N1 Flu=20 Virus Confirmed in Russia; Is Mongolia Next?

Russia=20 has now officially confirmed to the OIE that the poultry outbreaks in = the=20 Novosibirsk region (Oblast) of Siberia that began in July 18-July 22 was due to the = avian=20 influenza H5N1. In = addition,=20 Mongolia has reported deaths of waterfowl due to an avian influenza A = virus with=20 definitive identification of whether the virus is H5N1 or not expected = by August=20 12.

Initial=20 reports of the outbreak in Russia suggested the virus might be H5N2 = rather than=20 H5N1. The August 5^th report on the OIE website, however, has = proved=20 that the virus is H5N1 based on tests performed in at least four (4)=20 laboratories (www.oie.int/eng/= info/hebdo/a_current.htm=20 . The tests included ELISA for antigen and antibody, PCR for the = M-protein gene=20 and a hemagglutinin test.

At=20 least 13 villages in Novosibirsk were found to have evidence of H5N1 = infection,=20 either by virus isolation or antibody to H5N1. Infected species included = ducks,=20 chicken, turkeys and geese. The disease in these species was attributed = to=20 contact with wild waterfowl at water reservoirs, in particular lakes = frequented=20 by both wild waterfowl and domestic birds. Of note, there was no = evidence of=20 H5N1 infeciton oin any of 14 commercial poultry farms=20 tested.

Meanwhile,=20 on August 8^th the OIE published an =93Alert Message=94 from = the Ministry=20 of Food and Agriculture in Ulaanbaator (www.oie.int/messages/0= 50808MNG.htm) Mongolia that 80 dead birds, = including=20 wild ducks, geese, and swan (migratory birds) had died on Erhel lake in = Huvsugel=20 province. The cause was = an=20 avianinfluenza virus, but the precise type is pending further testing = and is=20 expected this Friday, 12 August 2005.

Sequencing=20 of the H5N1 virus in Russia and of the avian influenza in Mongolia will = help to=20 determine the origin and degree of relatedness to the H5N1 avian = influenza virus=20 reported in June from two locations from two locations in western China = and to=20 the H5 virus found in = Kazakhstan.=20 If the same virus is found in all these locations then it is likely that = wild=20 migratory birds are transporting the infection across thousands of=20 kilometers.

New=20 infections should then be anticipated in south Asia, Europe, and the = Americas as=20 these birds continue in their long-established and well-mapped migratory = routes. Infection of = poultry, pigs,=20 and humans should also be anticipated along these international = migratory bird=20 flypaths.

Daniel=20 R. Lucey, MD, MPH

Adjunct=20 Professor of Microbiology and Immunology

Georgetown=20 University School of Medicine

Director,=20 Centre for Biologic Counterterrorism and Emerging = Diseases

Department=20 of Emergency Medicine

Washington=20 Hospital Center

Washington,=20 DC

e-mail:Daniel.R.Lucey@Medstar.net

Beijing,=20 China = 8 Aug=20 2005