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Volume 12, Number 1—January 2006
THEME ISSUE
Influenza

Overview

H5N1 Outbreaks and Enzootic Influenza

Robert G. Webster*†Comments to Author , Malik Peiris†‡, Honglin Chen†‡, and Yi Guan†‡
Author affiliations: *St. Jude Children's Research Hospital, Memphis, Tennessee, USA; †University of Hong Kong, Hong Kong, SAR, China; ‡Shantou University Medical College, Shantou, Guangdong, China

Main Article

Figure 2

igration routes of Asian birds. A) Distribution and migration routes of bar-headed geese (courtesy of P. Leader). B) The Asia-Pacific region contains >240 species of migratory birds. The 3 flyways run primarily in a north-south direction, overlapping and extending from Australia/New Zealand to India, Central Asia, and Siberia. The outbreak of highly pathogenic (HP) H5N1 in migratory waterfowl at Qinghai Lake, China, affected primarily bar-headed geese (Anser indicus); however, other species,

Figure 2. igration routes of Asian birds. A) Distribution and migration routes of bar-headed geese (courtesy of P. Leader). B) The Asia-Pacific region contains >240 species of migratory birds. The 3 flyways run primarily in a north-south direction, overlapping and extending from Australia/New Zealand to India, Central Asia, and Siberia. The outbreak of highly pathogenic (HP) H5N1 in migratory waterfowl at Qinghai Lake, China, affected primarily bar-headed geese (Anser indicus); however, other species, including gulls and ducks, were affected (16,17). The outbreak started in early May 2005, and by June >5,000 birds had died. The birds exhibited neurologic signs, inability to stand, diarrhea, and death. Systemic infection was detected in all organs tested. C) Bar-headed goose infected with HP H5N1 influenza virus. D) Immunostain of goose pancreas, using H5 monoclonal antibodies (magnification ×400). (C and D, courtesy of H. Chen). Countries shown in red have had outbreaks of HP H5N1 since 2004. The geographic range of H5N1 may be extended by bar-headed geese or by ducks that are less susceptible to lethal infection.

Main Article

1Since this article was written, the H5N1 influenza virus has continued to spread in migratory birds to Turkey, Croatia, and Romania. The global spread of this H5N1 in migratory birds and domestic poultry is inevitable. The question is, "When will it acquire sustained human-to-human transmission?"

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