Giuseppe
Emeritus
[Source: World Health Organization, full PDF document: (LINK). Edited.]
Influenza at the human-animal interface - Summary and assessment as of 25 June 2012
Human infections with avian influenza A(H5N1) virus and associated animal health events
From 2003 through 25 June 2012, 606 laboratory-confirmed human cases with avian influenza A(H5N1) virus infection have been officially reported to WHO from 15 countries, of which 357 died. Since January 2012, 28 human cases of influenza A(H5N1) virus infection have been reported to WHO.
Since the last update 1 new human case was reported from Egypt. No further cases linked to the confirmed case were reported. The case had exposure to backyard poultry. (see table 1)
Table 1: laboratory-confirmed human cases with avian influenza A(H5N1) virus infection reported between 4 and 25 June 2012
[Country ? Province ? Age
? Sex - Date of onset - Date of Hospitalisation ? Oseltamivir treatment Start date - Date of discharge - Exposure to]
In 2012, Egypt reported smaller number of cases with the virus infection (10 cases) for the first 6 months of the year comparing to the previous years (30 cases in 2009, 19 cases in 2010, 31 cases in 2011). The median age of reported cases has shifted upwards. Children under the age of 10 y old were overrepresented during 2009 relative to older age groups, this has decreased during recent years. It is not clear if this is due to differences in exposure, susceptibility for infection, health seeking behaviour or testing practices. Children under the age of 10 y old seem to have a better survival rate than older age groups as was noted previously(1). (see table 2)
Table 2: laboratory ?confirmed human cases of avian influenza A(H5N1) virus infection in Egypt 2009-2012
[Year of onset ? 2009 ? 2010 ? 2011 ? 2012]
(...)
Overall public health risk assessment:
Based on previous years observations, a decrease in reported events in poultry is expected for this time of year. One sporadic case reported this month in the country with known influenza A(H5N1) virus circulation in poultry is within the expected range. From the data available there is no risk of onward sustained human to human transmission.
All human infections with non-human influenza viruses as such are reportable to WHO under IHR (2005).
More information on influenza at the human-animal interface is available from WHO (http://www.who.int/influenza/human_animal_interface/en/ ); additional information on influenza in animals is available from OIE (www.oie.int/animal-health-in-the-world/web-portal-onavian-influenza/ ), FAO (www.fao.org/avianflu/en/index.html ), and OFFLU (http://www.offlu.net/index.html ).
Relevant Links:
WHO Table: Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO: http://www.who.int/influenza/human_animal_interface/EN_GIP_LatestCumulativeNumberH5N1cases.pdf
WHO Table: H5N1 avian influenza: timeline of major events http://www.who.int/influenza/human_animal_interface/avian_influenza/H5N1_avian_influenza_update.pdf
WHO Archive: Avian Influenza situation updates: http://www.who.int/influenza/human_animal_interface/avian_influenza/archive/en/index.html
World Organisation of Animal Health (OIE) webpage: Web portal on Avian Influenza: www.oie.int/animal-health-in-the-world/web-portal-on-avian-influenza/
Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza: www.fao.org/avianflu/en/index.html
Updated unified nomenclature system for the highly pathogenic H5N1 avian influenza viruses http://www.who.int/influenza/gisrs_laboratory/h5n1_nomenclature/en/index.html
(1) http://www.who.int/wer/2012/wer8713/en/index.html
(2) Approaches to Controlling, Preventing and Eliminating H5N1 Highly Pathogenic Avian Influenza in Endemic Countries. Rome, United Nations Food and Agriculture Organization, 2011
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Influenza at the human-animal interface - Summary and assessment as of 25 June 2012
Human infections with avian influenza A(H5N1) virus and associated animal health events
From 2003 through 25 June 2012, 606 laboratory-confirmed human cases with avian influenza A(H5N1) virus infection have been officially reported to WHO from 15 countries, of which 357 died. Since January 2012, 28 human cases of influenza A(H5N1) virus infection have been reported to WHO.
Since the last update 1 new human case was reported from Egypt. No further cases linked to the confirmed case were reported. The case had exposure to backyard poultry. (see table 1)
Table 1: laboratory-confirmed human cases with avian influenza A(H5N1) virus infection reported between 4 and 25 June 2012
[Country ? Province ? Age
? Sex - Date of onset - Date of Hospitalisation ? Oseltamivir treatment Start date - Date of discharge - Exposure to]- Egypt - Kfr Elsheikh governorate ? 4 ? F - 25/04/2012 - 26/04/2012 - 26/04/2012 - 7/05/2012 - Backyard poultry]
In 2012, Egypt reported smaller number of cases with the virus infection (10 cases) for the first 6 months of the year comparing to the previous years (30 cases in 2009, 19 cases in 2010, 31 cases in 2011). The median age of reported cases has shifted upwards. Children under the age of 10 y old were overrepresented during 2009 relative to older age groups, this has decreased during recent years. It is not clear if this is due to differences in exposure, susceptibility for infection, health seeking behaviour or testing practices. Children under the age of 10 y old seem to have a better survival rate than older age groups as was noted previously(1). (see table 2)
Table 2: laboratory ?confirmed human cases of avian influenza A(H5N1) virus infection in Egypt 2009-2012
[Year of onset ? 2009 ? 2010 ? 2011 ? 2012]
- Median age ? 3y ? 27y ? 21y - 31.5y
- Number of cases ? 39 ? 29 ? 39 - 10*
- Proportion of <10 y old - 80% - 20% - 36% - 30%
- CFR overall - 10% - 45% - 38% - 50%
- CFR in cases <10 y old - 6% - 16% ? 0 ? 0
- * first 6 months of the year
(...)
Overall public health risk assessment:
Based on previous years observations, a decrease in reported events in poultry is expected for this time of year. One sporadic case reported this month in the country with known influenza A(H5N1) virus circulation in poultry is within the expected range. From the data available there is no risk of onward sustained human to human transmission.
All human infections with non-human influenza viruses as such are reportable to WHO under IHR (2005).
More information on influenza at the human-animal interface is available from WHO (http://www.who.int/influenza/human_animal_interface/en/ ); additional information on influenza in animals is available from OIE (www.oie.int/animal-health-in-the-world/web-portal-onavian-influenza/ ), FAO (www.fao.org/avianflu/en/index.html ), and OFFLU (http://www.offlu.net/index.html ).
Relevant Links:
WHO Table: Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO: http://www.who.int/influenza/human_animal_interface/EN_GIP_LatestCumulativeNumberH5N1cases.pdf
WHO Table: H5N1 avian influenza: timeline of major events http://www.who.int/influenza/human_animal_interface/avian_influenza/H5N1_avian_influenza_update.pdf
WHO Archive: Avian Influenza situation updates: http://www.who.int/influenza/human_animal_interface/avian_influenza/archive/en/index.html
World Organisation of Animal Health (OIE) webpage: Web portal on Avian Influenza: www.oie.int/animal-health-in-the-world/web-portal-on-avian-influenza/
Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza: www.fao.org/avianflu/en/index.html
Updated unified nomenclature system for the highly pathogenic H5N1 avian influenza viruses http://www.who.int/influenza/gisrs_laboratory/h5n1_nomenclature/en/index.html
(1) http://www.who.int/wer/2012/wer8713/en/index.html
(2) Approaches to Controlling, Preventing and Eliminating H5N1 Highly Pathogenic Avian Influenza in Endemic Countries. Rome, United Nations Food and Agriculture Organization, 2011
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