WHO | Influenza at the Human-Animal Interface, monthly risk assessment summary (20 January 2016)

Clippings:

Since the last WHO Influenza update on 14 December 2015, two new laboratory-confirmed human cases of avian influenza A(H5N1) virus infection were reported to WHO.
A 60-year-old male from Mymensing District in Bangladesh was hospitalized on 12 October 2015 with severe acute respiratory infection (SARI). Nasopharyngeal and throat swabs were collected upon hospital admission as part of SARI surveillance, and tested positive for A(H5N1) virus. The patient fully recovered. Prior to illness onset, the patient was exposed to live backyard poultry.
The second case was in a 42-year-old male from Sichuan Province in China who had an onset of illness on 27 December 2015. He was hospitalized on 31 December 2015 and remains in a critical condition. This case had history of exposure to poultry.
From 2003 through 20 January 2016, 846 laboratory-confirmed human cases of avian influenza A(H5N1) virus infection have been officially reported to WHO from 16 countries (Figure 1). Of these cases, 449 have died.

In this reporting period, five laboratory-confirmed human cases of avian influenza A(H5N6) virus infection were reported to WHO from China (Table 1). All were sporadic cases and with no further transmission among contacts.
Country Province Age Sex Date of Onset Clinical outcome or current status Exposure to
China Guangdong 26 F 24 Dec 2015 Died Handled duck meat
China Guangdong 40 F 22 Dec 2015 Hospitalized Live poultry
China Guangdong 42 M 12 Dec 2015 Died Live poultry market
China Guangdong 25 M 1 Jan 2016 Died Live poultry market
China Guangdong 31 F 8 Jan 2016 Hospitalized Unknown
Since 2013 through to 20 January 2016, ten cases of avian influenza A(H5N6) have been detected of which nine were notified to WHO and one was reported in the scientific literature.1 All nine cases notified to WHO had clinically severe disease. The case reported in the literature, a five-year-old female, was a mild case detected through routine surveillance activities.
Various influenza A(H5) subtypes, such as influenza A(H5N1), A(H5N2), A(H5N3), A(H5N6), A(H5N8) and A(H5N9), continue to be detected in birds in West Africa, Europe and Asia, according to recent reports received by OIE. Since last month?s report on detections of avian influenza A(H5) viruses in birds in France, no human infections have been identified. Although the influenza A(H5) viruses might have the potential to cause disease in humans, so far no human cases of infection have been reported, with exception of the human infections with influenza A(H5N1) and A(H5N6) viruses in China.

Human infections with avian influenza A(H7N9) viruses in China
Since the last WHO Influenza update on 18 December 2015, ten new laboratory-confirmed human cases of avian influenza A(H7N9) virus infection were reported to WHO (Table 2). Cases were reported from Guangdong, Jiangsu, Jiangxi and Zhejiang provinces of China with onsets between 24 November 2015 and 24 December 2015. All cases were exposed to live or slaughtered poultry.
Country Province Age Sex Date of onset Clinical outcome or current status Exposure to
China Zhejiang 65 M 24 Nov 2015 Critical Live poultry
China Zhejiang 51 F 1 Dec 2015 Died Live poultry market
China Jiangsu 41 F 1 Dec 2015 Severe Live poultry
China Zhejiang 77 M 7 Dec 2015 Died Live poultry
China Jiangsu 52 F 11 Dec 2015 Critical Live poultry
China Zhejiang 53 M 12 Dec 2015 Critical Live poultry
China Guangdong 60 M 19 Dec 2015 Died Live poultry
China Jiangxi 46 M 21 Dec 2015 Severe Live poultry
China Zhejiang 58 F 22 Dec 2015 Critical Poultry
China Zhejiang 29 F 24 Dec 2015 Critical Live poultry
A total of 693 laboratory-confirmed cases of human infection with avian influenza A(H7N9) viruses, including at least 277 deaths2, have been reported to WHO (Figure 2). Surveillance for avian influenza A(H7N9) viruses in poultry and live bird markets continued in China, where both seropositive and virus-positive samples continue to be detected

Human infections with avian influenza A(H9N2) virus in Bangladesh
One human infection with avian influenza A(H9N2) virus was reported from Bangladesh. The case was a 46-year-old male poultry worker in a market in Dhaka City. He had onset of illness on 27 October 2015 presenting with fever, runny nose, headache and myalgia. Throat and nasal swabs were collected as part of the market avian influenza surveillance system and tested positive for A(H9N2) virus. The patient recovered. One day prior to illness onset, the case reported handling sick poultry.
Overall public health risk assessment for avian influenza A(H9N2) viruses: This is the third human infection of avian influenza A(H9N2) virus reported from Bangladesh. Further human cases and small clusters could occur as this virus is circulating in poultry populations across Asia and the Middle East. Human cases have also previously been reported from China and Egypt. This virus does not
seem to transmit easily between humans and tends to result in mild clinical disease, therefore the
current likelihood of community-level spread and public health impact of this virus is considered low.


http://www.who.int/entity/influenza/..._2016.pdf?ua=1