Co-circulation of two sublineages of HPAI H5N1 virus in the Kingdom of Saudi Arabia with unique molecular signatures suggesting separate introductions into the commercial poultry and falconry sectors

Since early 2007, the Kingdom of Saudi Arabia (KSA) has experienced several highly pathogenic avian influenza (HPAI) H5N1 outbreaks in the falconry and poultry sectors. The public health threat associated with peculiar husbandry systems, requiring close contact between humans and birds of prey, highlights the need of an improved understanding of the epidemiology and of the viral characteristics of H5N1 viruses circulating in the region. Here we report molecular and phylogenetic analyses of H5N1 viruses isolated in the KSA in 2007 in distinct compartments of avian husbandry. From the results of our investigation it appears that two separate introductions into the different sectors occurred. The identification of specific amino acid mutations, which are described as genetic signatures of human influenza A viruses or known to confer resistance to antiviral drugs, raises concerns for the possible human health implications of the KSA H5N1 viruses.