First Human Case of H5N1 (Hong Kong 1997)

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Nine years ago this month the first human case of H5N1 was announced.


Discovery of the first case of influenza A virus (H5N1) in man in HK

August 20, 1997​

<DIR>A strain of influenza A virus (H5N1) has been isolated in man in Hong Kong recently, the Department of Health announced today (Wednesday).
This virus, known to infect birds primarily, was for the first time ever detected in man.
The case involved a three-year-old boy who died in Queen Elizabeth Hospital in May 1997 due to multiple medical complications.
Tracheal aspirate of the boy, sent to the government Virus Unit for testing, grew atypical influenza A virus.
Isolates were then sent to World Health Organisation Collaborating Influenza Laboratories in the United States of America and the United Kingdom as well as a research laboratory in the Netherlands for further identification.
Results from USA and Netherlands showed that the virus was influenza A of H5N1 strain. This is the first time in history this virus was isolated in human being.
The World Health Organisation was informed of the recent discovery.
Speaking at a press briefing today, the Director of Health, Dr Margaret Chan advised members of the public not to panic as there was as yet no conclusive evidence indicating the virus posed any significant threat to man. Investigations indicated that this was the only case found so far.
"In view of the importance of this discovery, a special team has been set up to work closely with local experts, international experts and health agencies to assess the global health impact of this strain of influenza virus in man, and, where applicable, to expedite the development of a new vaccine," Dr Chan said.
"Meanwhile, the Department of Health is actively conducting field investigations and laboratory tests with other organisations to trace the source of infection.
"On the other hand, a medical team was sent to the deceased's home to collect blood specimen from his family members. Blood tests results showed that his family members had not been infected with the virus and the case is considered to be an isolated incident.
"We have also stepped up our influenza surveillance activities and shall continue to monitor the situation closely with international experts/centres," she said.
Dr Chan supplemented that the best way to combat influenza infection is to build up body resistance by having a proper diet with adequate exercise and rest.
Good ventilation should be maintained to avoid the spread of respiratory tract infection, she added.

Source: http://www.info.gov.hk/dh/new/bulletin/20-8-97.htm



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Re: H5N1 Follow up (Hong Kong December 7, 1997)

Re: H5N1 Follow up (Hong Kong December 7, 1997)

<TABLE cellSpacing=0 cellPadding=0 width=450 border=0><TBODY><TR><TD vAlign=top align=left>Updates on H5N1 influenza A situation

December 7, 1997​

<DD>The preliminary investigations showed that at this stage, human-to-human transmission of the H5N1 influenza A virus has not been proven and further investigations will be made to study this possibility, the Special Working Group on H5N1 announced today (Sunday).

<DD>The initial findings also showed that the four H5 cases did not share a common source, nor was the virus transmitted from one case to the others.

<DD>Speaking at a press conference convened after an urgent meeting earlier this afternoon, the Deputy Director of Health, Dr Paul Saw, who is the Chairman of the working group, said: "The first case was confirmed in August. Since then, we have stepped up surveillance and as a result, we have been able to detect the latest three cases.

<DD>"This latest development has caused concern both in the local and the international communities. However, there is no cause for panic as available evidence does not suggest that the disease is widespread."

<DD>Dr Saw said since the detection of the first case in August, Hong Kong had been working closely with the World Health Organisation and the Centres for Disease Control and Prevention and other national authorities in surveillance, case detection and investigation of this new strain of influenza A virus.

<DD>"The WHO has been asked to alert vaccine production centres in the world in the case investigation to follow developments here with a view to preparing the necessary vaccines," he said.

<DD>"Arising from these suspected cases, the Department of Health has stepped up the influenza surveillance activities in Hong Kong and the WHO fully supports the measures being taken."

<DD>To further enhance surveillance in Hong Kong, Dr Saw said, the Department of Health would extend surveillance coverage to all General Out-patient Clinics. The Hospital Authority would also set up surveillance in public hospitals.

<DD>In the meantime, Dr Saw said, the Agriculture and Fisheries Department had also increased surveillance in poultry in collaboration with The University of Hong Kong.

<DD>He said the Department would disseminate to doctors, medical professionals, colleges and health care workers available information about the H5 virus through letters and the Department of Health's homepage on the internet (http:/www.info.gov.hk/dh/).

<DD>The special working group also released the details of the two suspected case discovered yesterday.

<DD>The 54-year-old man involved was admitted to the Queen Elizabeth Hospital on November 29 and died on December 5 of complications arising from pneumonia.

<DD>The 13-year-old girl was admitted on November 26 and is now under treatment in Prince of Wales Hospital.

<DD>Investigations into the two suspected cases are still continuing.

<DD>Dr Saw advised members of the public that the best way to combat influenza infection was to build up body resistance by having a proper diet with adequate exercise and rest.

<DD>"Good ventilation should be maintained to avoid the spread of respiratory tract infection.

<DD>"As for the young, the elderly and those with chronic diseases, they should seek medical consultations promptly if they develop influenza-like illness," Dr Saw added. <DD>

</DD></TD></TR></TBODY></TABLE>Source:http://www.info.gov.hk/dh/new/bulletin/07-12-97.htm

 

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Re: H5N1 Additional Cases (Hong Kong December 16 1997)

Re: H5N1 Additional Cases (Hong Kong December 16 1997)

<DIR><DIR>Initial assessment of Influenza A H5N1 cases</DIR><DIR></DIR><DIR></DIR><DIR></DIR><DIR></DIR><DIR></DIR><DIR>December 16, 1997</DIR><DIR></DIR><DIR></DIR><DIR></DIR><DIR>Initial assessment made by the Special Working Group on Influenza A H5N1 noted an association with poultry in some of the cases under investigation, Director of Health, Dr Margaret Chan said at a press conference today (Tuesday).
She noted that genetic analysis of the H5N1 virus in the first four cases so far had shown avian gene sequences while laboratory results of the other cases were pending.
Information collected during the investigation of the first seven cases - six confirmed and one suspected - indicated that some patients had contacts with poultry before the onset of the disease while others had not.
"This points to the fact that the transmission of the virus both from bird-to-human and human-to-human are possible," Dr Chan said.
"However, the efficiency of transmission from human-to-human should not be high or there should be hundreds and thousands of such cases in the territory by now, according to past experience with other types of influenza. Thus, the present cluster of cases detected in Hong Kong had not reached epidemic proportions."
"While the mode of transmission requires further study, the Hong Kong Government is proactive and considers it necessary to introduce a number of preventive measures to protect public health.
"The Inter-departmental Co-ordinating Committee on H5N1 convened this morning came up with a plan of action including tightened control on import of chicken, enhanced surveillance in both man and poultry, as well as improvements in environmental hygiene in markets."
She said that the Hong Kong Health Authority had been working very closely with the World Health Organisation (WHO) and the Centres for Disease Control (CDC) in USA in dealing with the investigation and study of this new strain of Influenza A H5N1 strain in man.
As one of the 110 surveillance centres for the monitoring of influenza, Hong Kong had played a vital part in detecting this new strain of flu in human.
The Department of Health was currently conducting four epidemiological studies to ascertain the mode of transmission.
CDC was conducting further tests on genetic sequencing of the virus and also working at full speed on the development of a test for blood samples taken.
WHO would distribute H5N1 virus testing kits to all of its Collaborating Centres around the world shortly for surveillance purpose.
However, time and more cases were required to provide scientific evidence that could be used for drawing up conclusive findings.
In the meantime, a lot of work had been done by the Department of Health and experts in this field to provide data for scientific analysis.
Of the seven cases being analysed so far, all were tested positive by the Hong Kong Government Virus Unit. Six had been confirmed by the CDC while the remaining one was classified as "suspected" pending CDC's independent confirmation.
Two of these cases indicated exposure to poultry within the incubation period, but the histories of the remaining five cases were less clear.
"Over 550 interviews were conducted and 2 550 laboratory specimens were taken during the course of investigations."
Follow-up on patient contacts showed all those with flu like illness had recovered. Results of throat swabs taken from contacts in the first few cases were all negative while results for the last three cases were pending.
Test results on the more than two thousand blood samples which could shed more light on the form of transmission could not be confirmed pending development and refinement of test by CDC.
So far, two patients had fully recovered, one under treatment in satisfactory condition, two under treatment in critical condition and two died.
In the meantime, two more cases were classified as "suspected" by the Department of Health, making the total number of Influenza A H5N1 cases in human nine.
The two latest cases involved a two year old boy and a three year old girl who were cousins of a confirmed case (5 year-old girl).
They had mild symptoms only and were now receiving treatment in hospital. Their conditions were satisfactory.
Follow-up investigation of the two cases had already started. The public would be kept informed of the latest development.
On treatment for this new strain of flu, Dr Chan said amantadine was found to be an effective agent if used during the early stage. Such information had been made available to government doctors and private practitioners.
For the public, Dr Chan advised that the best way to combat influenza infection was to build up body resistance by having a proper diet with adequate exercise and rest.
"Good ventilation should also be maintained."
To prevent this avian flu, the public are advised to maintain good personal hygiene. They should wash their hands thoroughly after handling live poultry. They should also avoid coming into contact with of sick or diseased poultry.
But Dr Chan also pointed out that chicken cooked thoroughly were safe for eating.
Note to Editors:
A table distributed at the press conference showing the update of the seven cases will be sent through the GIS fax machine.

Source: http://www.info.gov.hk/dh/new/bulletin/16-12-97a.htm
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Note: This is the first discussion of possible H2H transmission and the first reporting of a familial cluster.







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