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Influenza A(H5N1) - Multistate (world) - Monitoring human cases (ECDC/CDTR, January 17 2014)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 3, 12-18 January 2014
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Influenza A(H5N1) - Multistate (world) - Monitoring human cases
Opening date: 15 June 2005 Latest update: 16 January 2014
Epidemiological summary
A fatal case of A(H5N1) was reported on 8 January 2014 in Canada.
The case had onset of symptoms on 27 December 2013 during a return flight from Beijing to Edmonton via Vancouver. The patient developed symptoms while flying that worsened during travel. The patient was admitted to hospital on arrival in Edmonton and passed away on 3 January 2014. Tests at a reference laboratory confirmed influenza A(H5N1) infection on 7 January. The case had not been outside of Beijing during the trip to China and had not visited live bird markets or farms.
Thirty-nine human cases with influenza A(H5N1) virus infection have been laboratory-confirmed worldwide since the beginning of 2013 and as of 16 January 2014. The countries affected during this period are Cambodia (26), Egypt (4), Indonesia (3), China (2), Vietnam (2), Bangladesh (1) Canada ex China (1). Among these cases, 25 were fatal, most of them in Cambodia (14). The last case of A(H5N1) in China was reported in February 2013.
From 2003 through to 16 January 2014, 649 laboratory-confirmed human cases with avian influenza A(H5N1) virus infection have been officially reported from 16 countries. Of these cases, 385 have died.
In Cambodia, the reported incidence of human cases has increased in 2013 compared to previous years (26 cases in 2013 compared with 21 cases from 2005 through to December 2012). However, the case-fatality ratio among reported cases has decreased (54% in 2013 compared with 90% over all previous years).
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ECDC assessment
The risk of secondary cases and co-primary cases among the close contacts of the Canadian case is considered to be very low since more than 20 days have passed since the onset of disease, transmission of A(H5N1) on board aircrafts has never been documented, and there is no evidence of sustained human-to-human transmission of A(H5N1) ever occurring.
The risk of healthcare-associated transmission in Canada is considered to be very low.
The evidence points to an isolated case who was infected following exposure in China, although the source and mode of transmission has not yet been established. A(H5N1) is a strain of avian influenza that occasionally crosses the species barrier and infects humans.
Sporadic cases originating in areas where A(H5N1) transmission has been documented in the recent past are therefore not unexpected.
Although the case reported from Canada had an atypical clinical presentation and exposure to potentially infected birds has not been established, these circumstances do not change the ECDC recommendations that: Europeans travelling to China and South-East Asia should avoid live poultry markets and any contact with chickens, ducks, wild birds, and their droppings. This reduces the risk of exposure not only to A(H5N1) but also to A(H7N9). Poultry meat and eggs should be well cooked.
Hong Kong reported the world's first outbreak of bird flu among humans in 1997, when six people died. Most human infections are the result of direct contact with infected birds, and countries with large poultry populations in close contact with humans are considered to be most at risk of bird flu outbreaks.
There are currently no indications of a significant change in the epidemiology associated with any clade or strain of the A(H5N1) virus from a human health perspective. This assessment is based on the absence of sustained human-to-human transmission, and on the observation that there is no apparent change in the size of clusters or reports of chains of infection. However, vigilance for avian influenza in domestic poultry and wild birds in Europe remains important.
Actions
ECDC follows the worldwide A(H5N1) situation through epidemic intelligence activities in order to identify significant changes in the epidemiology of the virus. ECDC re-assesses the potential of a changing risk for A(H5N1) to humans on a regular basis. WHO is now reporting H5N1 cases on a monthly basis. ECDC will continue monthly reporting in the CDTR to coincide with WHO reporting.
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COMMUNICABLE DISEASE THREATS REPORT
Week 3, 12-18 January 2014
(...)
Influenza A(H5N1) - Multistate (world) - Monitoring human cases
Opening date: 15 June 2005 Latest update: 16 January 2014
Epidemiological summary
A fatal case of A(H5N1) was reported on 8 January 2014 in Canada.
The case had onset of symptoms on 27 December 2013 during a return flight from Beijing to Edmonton via Vancouver. The patient developed symptoms while flying that worsened during travel. The patient was admitted to hospital on arrival in Edmonton and passed away on 3 January 2014. Tests at a reference laboratory confirmed influenza A(H5N1) infection on 7 January. The case had not been outside of Beijing during the trip to China and had not visited live bird markets or farms.
Thirty-nine human cases with influenza A(H5N1) virus infection have been laboratory-confirmed worldwide since the beginning of 2013 and as of 16 January 2014. The countries affected during this period are Cambodia (26), Egypt (4), Indonesia (3), China (2), Vietnam (2), Bangladesh (1) Canada ex China (1). Among these cases, 25 were fatal, most of them in Cambodia (14). The last case of A(H5N1) in China was reported in February 2013.
From 2003 through to 16 January 2014, 649 laboratory-confirmed human cases with avian influenza A(H5N1) virus infection have been officially reported from 16 countries. Of these cases, 385 have died.
In Cambodia, the reported incidence of human cases has increased in 2013 compared to previous years (26 cases in 2013 compared with 21 cases from 2005 through to December 2012). However, the case-fatality ratio among reported cases has decreased (54% in 2013 compared with 90% over all previous years).
(?)
ECDC assessment
The risk of secondary cases and co-primary cases among the close contacts of the Canadian case is considered to be very low since more than 20 days have passed since the onset of disease, transmission of A(H5N1) on board aircrafts has never been documented, and there is no evidence of sustained human-to-human transmission of A(H5N1) ever occurring.
The risk of healthcare-associated transmission in Canada is considered to be very low.
The evidence points to an isolated case who was infected following exposure in China, although the source and mode of transmission has not yet been established. A(H5N1) is a strain of avian influenza that occasionally crosses the species barrier and infects humans.
Sporadic cases originating in areas where A(H5N1) transmission has been documented in the recent past are therefore not unexpected.
Although the case reported from Canada had an atypical clinical presentation and exposure to potentially infected birds has not been established, these circumstances do not change the ECDC recommendations that: Europeans travelling to China and South-East Asia should avoid live poultry markets and any contact with chickens, ducks, wild birds, and their droppings. This reduces the risk of exposure not only to A(H5N1) but also to A(H7N9). Poultry meat and eggs should be well cooked.
Hong Kong reported the world's first outbreak of bird flu among humans in 1997, when six people died. Most human infections are the result of direct contact with infected birds, and countries with large poultry populations in close contact with humans are considered to be most at risk of bird flu outbreaks.
There are currently no indications of a significant change in the epidemiology associated with any clade or strain of the A(H5N1) virus from a human health perspective. This assessment is based on the absence of sustained human-to-human transmission, and on the observation that there is no apparent change in the size of clusters or reports of chains of infection. However, vigilance for avian influenza in domestic poultry and wild birds in Europe remains important.
Actions
ECDC follows the worldwide A(H5N1) situation through epidemic intelligence activities in order to identify significant changes in the epidemiology of the virus. ECDC re-assesses the potential of a changing risk for A(H5N1) to humans on a regular basis. WHO is now reporting H5N1 cases on a monthly basis. ECDC will continue monthly reporting in the CDTR to coincide with WHO reporting.
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