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Will H5N6 Cause the Next Pandemic?

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  • Will H5N6 Cause the Next Pandemic?

    Influenza A(H5N6) is an emerging novel avian influenza that apparently derived from a reassortment of A(H5N1) with A(H6N6). H5N6 was first reported in domestic poultry in early 2014 from Laos, Vietnam, and China. Since then it has continued to be widely reported from domestic flocks in these countries (primarily China).

    In April 2014, the first case of a human infected with the H5N6 influenza virus was reported from Sichuan Province in China. Since then, seven additional human cases have been reported, all from China. The most recent case was reported from Jieyang, Guangdong Province a few days ago. Of these eight cases, six have been reported by the World Health Organization (see links below).

    Based on onset dates two of these cases occurred in 2014, four in 2015. Onset dates for the two most recent cases have not yet been reported. Among these cases are five males and three females. One of the females was pregnant. Her child was delivered by caesarian section and the woman is apparently still under treatment. Media reports indicate that the child was not infected. Ages range from 25 to 50 years old. Five the eight have died according to media reports.

    Discussion

    To date, there is no evidence of human-to-human transmission among these eight cases of H5N6. The fatality rate is high, but there are too few cases to project a fatality rate for a larger population of infected individuals. It is not known if subclinical cases of H5N6 are occurring. No asymptomatic cases have been reported and there are no reports of seroprevelance studies of H5N6 among humans.

    As shown in the map below, these eight cases from the past two years are widely scattered over China. The map also depicts the location of reported H5N6 outbreaks in poultry flocks in southern China and northern Laos. Like the distribution of human cases, domestic flocks infected with H5N6 are widely scattered across a large area. The wide-spread geographic distribution of infected poultry along with the dispersed nature of human infections in this area suggests that more human cases are likely to be reported in the future. With such a large animal reservoir this influenza virus could reassort and become more easily transmitted to humans. Were H5N6 to pick up the ability to transit easily among humans, H5N6 could become a deadly pandemic virus.

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    Citations for Human Cases of H5N6


    H5N6 influenza virus infection, the newest influenza (case 1)

    Human infection with a novel, highly pathogenic avian influenza A (H5N6) virus: Virological and clinical findings (case 2 and 3)

    Human Infection with a Novel Avian Influenza A(H5N6) Virus (case 4)

    WHO Links

    http://www.who.int/influenza/human_a..._October14.pdf (case 1)

    http://www.who.int/csr/don/28-decemb...-influenza/en/ (case 2)

    http://www.who.int/csr/don/12-februa...-influenza/en/ (cases 3 and 4)

    http://www.who.int/csr/don/14-july-2...-influenza/en/ (case 5)

    http://www.who.int/csr/don/4-january...enza-china/en/ (case 6)

    Other Selected H5N6 Citations

    Reassortant Highly Pathogenic Influenza A(H5N6) Virus in Laos (May 2015)

    Two novel reassortants of avian influenza A (H5N6) virus in China (May 2015)

    Human H5N6 Influenza Virus Infection: New Disease Outbreak (August 2015)

    http://novel-infectious-diseases.blogspot.com/

  • #2
    Link for case 7:
    China - CHP reports 1 additional human case of H5N6 bird flu Guangdong Province - January 7, 2016 link

    Link for case 8:
    China - Jiangxi reports 1 human Fatal case of H5N6 bird flu from Dec 2015 ex Guangdong Province - January 9, 2016 link

    Comment


    • #3
      Translation Google

      H5N6 bird flu virus come from?

      Dr. Cai Haodong from media 2016-01-11 19:49:38 influenza virus reading ( 788 ) Comments ( 0)

      Disclaimer: This article is from the public platform Sohu settled authors write, except Sohu official account, the views of the authors and do not represent the position of Sohu. Report

      Previous H5N1 and H7N9 bird flu virus has been known. Nearly two weeks, H5N6 bird flu virus once again violating human. Guangdong consecutive four cases of human infection cases, 2 deaths, including one case after the onset of Jiangxi died in hospital after being discovered. Caused widespread concern in society H5H6 bird flu virus is coming from?

      H5N6 low pathogenic avian influenza virus highly pathogenic aptitude transition

      H5N6 subtype avian influenza virus was first isolated in 1975 from the United States out of mallards in vivo [1]. In the past, H5N6 subtype avian influenza virus have been issued at low pathogenic state in the United States, Germany, Sweden, avian species (mainly in ducks) popular, and sometimes can be detected in environmental samples from poultry animal activity [2]. However, few have a significant impact on the poultry animals.

      December 2013, China's Jiangsu Province, a live bird markets in bird flu virus was first discovered in routine surveillance of avian influenza virus H5N6 subtype [3]. When our scientists analyzed the gene of the virus found that the H5N6 subtype of avian influenza virus turned out to be H5N1 and H6N6 avian influenza virus genes from two subtypes reassortment, in which at least six or seven genes from H5N1 highly pathogenic avian influenza virus, and make it past the low pathogenic H5N6 avian influenza virus, "ancestor" very different, with a high pathogenic properties [2, 3].

      This highly pathogenic H5N6 bird flu virus was discovered shortly after it began in the country and Southeast Asia widespread [2]. Laos, Vietnam and China's poultry of highly pathogenic H5N6 subtype have both been bird flu outbreaks. September 2014 of a H5N6 subtype of avian flu on a farm in Heilongjiang Province lead to more than 20,000 geese infected nearly 10,008 thousand geese death [2].

      H5N6 avian influenza virus from birds to mammals animal

      2014, in Heilongjiang Province, outbreaks of highly pathogenic H5N6 avian bird flu during a domestic cat died. Researchers only isolated from lung tissue of domestic cats and birds to the popular animal in highly similar to H5N6 avian influenza virus [4].

      After the occurrence of human infection with the H5N6 Guangdong bird flu, swine flu virus scientists conducted a routine monitoring. It detects the two strains of H5N6 swine flu virus in 160 pig samples. Researchers in these two strains of influenza virus gene analysis, they are from the avian influenza virus [5].

      Although the H5N6 influenza virus to mammals related research is still small, but two studies have been sufficient to prove, H5N6 bird flu virus is likely to acquire the ability to infect mammals section, and may cause harm to human health.

      H5N6 avian influenza virus from birds to humans animals

      May 2014, Nanchong one case 49 year old man suffering from severe pneumonia resulting in death. Doctors isolated from the patient's throat swab specimens to highly pathogenic avian influenza virus subtype H5N6. Doctors found that this patient is a poultry market salesman, before his illness, his family sold the poultry geese have 1, 2 and 5 chickens sick ducks died. Doctors detected from one of the three to the same poultry in bird flu virus [6]. It seems certain that this patient's infection-related contact with sick birds. This is China's first reported human H5N6 avian influenza virus infection. Subsequently, in December 2014, February 2015 and July 2015 and in our country, Guangdong and Yunnan reported three cases of human infection with the highly pathogenic H5N6 bird flu, coupled with recent consecutive four cases in Guangdong and Jiangxi Province human infection with H5N6 avian influenza virus, a total of eight cases, five deaths, one case cured, two cases still in hospital, critically ill virus. These cases illustrate the severity of H5N6 subtype avian influenza virus has been able to break into the world of animals from birds to human health hazards.

      Cases of human infection with the H5N6 avian influenza virus is not only only eight cases

      It has been thought to occur in May 2014 of Nanchong avian influenza virus subtype H5N6 human infections is the world's first example. But in fact, there is one case of H5N6 avian influenza virus infection in children with mild cases did not attract attention. February 16, 2014, a 5-year-old girl because of fever, sore throat to Changsha an influenza surveillance sentinel hospital. Doctors at the same time for her treatment of her throat swabs were collected to Changsha City Center for Disease Control and Prevention. After two days of girls fever, symptoms gradually improved. However, the results of throat swab specimens discovered girls, H5 subtype of influenza A virus-positive, H1 subtype of influenza virus negative. Girls throat swab specimen was sent to the Hunan Provincial Disease Prevention and Control Center and the China Disease Prevention and Control Center for further testing. About one year later, this strain of the virus was confirmed to be H5N6 avian influenza virus [7]. Therefore, the current laboratory-confirmed cases of human infection with the H5N6 avian influenza virus, a total of nine cases, all occurred in the country, children with mild cases this is the first example of a truly global avian influenza virus subtype H5N6 human cases.

      This case described in Example 5-year-old girls avian influenza virus subtype H5N6 human cases are not only severe cases, it may be some mild infections have not been found, it is worth our attention.

      Nearly 100 years, the highly pathogenic H5N6 avian influenza virus in poultry animal epidemic rampant. In 2014, the World Organisation for Animal Health (OIE) received including China, the Laos, Vietnam three countries 12 report from the H5N6 bird flu. 2015 The H5N6 bird flu outbreaks have been reported since increased to 47, almost four times in 2014 [8]. Poultry animal epidemic-prone, and will definitely increase the risk of human infection. Although the H5N6 subtype of avian influenza virus so far only occasionally infect humans, there is no evidence of the occurrence of inter-human transmission, but it also requires us to maintain a high degree of vigilance, avoid contact with poultry animals, prevent H5N6 subtype avian influenza virus against humanity.


      References
      [1] Garcia M, Suarez DL, Crawford JM, et al Evolution of H5 subtype avian influenza A viruses in North America Virus Res 1997. 51 (2):... 115-24.
      [2] FAO Avian influenza A (H5N6):. The latest addition to emerging zoonotic avian influenza threats in East and Southeast Asia 2014-11-30 http://www.fao.org/ag/againfo/programmes/en.. /empres/home.asp.
      [3] Qi X, Cui L, Yu H, Ge Y, Tang F. Whole-Genome Sequence of a Reassortant H5N6 Avian Influenza Virus Isolated from a Live Poultry Market in China, 2013.LID - 10.1128 / genomeA.00706-14 [ doi] LID - e00706-14 [pii] Genome Announc 2014. 2 (5)...
      . [4] Yu Z, Gao X, Wang T, et al Fatal H5N6 Avian Influenza Virus Infection in a Domestic Cat and Wild Birds in China Sci Rep 2015. 5:.. 10704.
      .. [5] Li X, Fu Y, Yang J, et al Genetic and biological characterization of two novel reassortant H5N6 swine influenza viruses in mice and chickens Infect Genet Evol 2015. 36:. 462-6.
      [6] Pan M, Gao R, Lv Q, et al Human infection with a novel, highly pathogenic avian influenza A (H5N6) virus:. Virological and clinical findings J Infect 2016. 72 (1):.. 52-9.
      [7] Chen T, Zhang R. Symptoms seem to be mild in children infected with avian influenza A (H5N6) and other subtypes J Infect 2015. 71 (6):.. 702-3.
      [8] Update on highly pathogenic avian influenza in animals (type H5 and H7). Http://www.oie.int/.


      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • #4
        Thanks for posting this, Pathfinder. It does provide additional background details.

        The young girl reported from Changsha, Hunan Province, may be the first known human case of H5N6, only identified retrospectively. This would be the ninth reported case to date. It will be interesting to see if the World Health Organization reports this case.
        http://novel-infectious-diseases.blogspot.com/

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