Taiwan on guard after first human avian flu H6N1 infection

[Gert van der Hoek]

(H6N1 watch) Bird flu virus may become dangerous

(11-14 10:39)

Researchers in Taiwan called on health agencies to raise their guard after a flu virus that commonly circulates among chickens was found for the first time in a human being.

The strain found in a 20-year-old patient from central Taiwan was of relatively low virulence, but the risk is that it could mix with other viruses to become more dangerous, they said.

“Our report highlights the continuous need for preparedness for a pandemic of unpredictable and complex avian influenza,'' they warned, AFP reports.

Writing in The Lancet, a team led by Wu Ho-sheng from Taiwan's Centers for Disease Control reported on the case of a woman who was in hospital in May with a fever, cough and breathing difficulties.

The CDC announced the incident in June. Publication in the peer-reviewed journal provides fuller details of the agency's response and a wider assessment of the risk.

Gene sequencing of a throat swab sample showed that the cause was a local strain of H6N1 influenza virus, the team reported.
H6N1 is a subtype of flu found among wild birds and domestic poultry on many continents.

In Taiwan, though, a unique genetic lineage of H6N1 has evolved over more than 40 years, previous research has found.

The local strain has shown the potential to cross-infect lab mammals, but this was the first time it had been linked to infection in a human.

The sample taken from the woman notably had a so-called G228S mutation in a surface protein called haemagglutinin, helping the virus to latch onto cells in the human upper respiratory tract.

The unnamed woman recovered after being treated with the anti-viral drug Tamiflu, said the study.

More: The Standard

See also:

Origin and molecular characterization of the human-infecting H6N1 influenza virus in Taiwan

Protein Cell. Origin and molecular characterization of the human-infecting H6N1 influenza virus in Taiwan.

First Case of New Bird Flu Identified in Human Patient

First Case of Human Infection with Avian Influenza virus A(H6N1) in Taiwan (HK CHP, June 21 2013)

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[Gert van der Hoek]

Re: Taiwan on guard after first human avian flu H6N1 infection

Bird Flu Strain Infects Human for 1st Time

LONDON November 14, 2013 (AP)

By MARIA CHENG AP Medical Writer

A strain of bird flu that scientists thought could not infect people has shown up in a Taiwanese woman, a nasty surprise that shows scientists must do more to spot worrisome flu strains before they ignite a global outbreak, doctors say.

On a more hopeful front, a company on Wednesday reported encouraging results from its first human tests of a possible vaccine against a different type of bird flu that has been spreading through Asia since first appearing in China last spring that is feared to have pandemic potential.

The woman, 20, was hospitalized in May with a lung infection. After being treated with Tamiflu and antibiotics, she was released. One of her throat swabs was sent to the Taiwan Centres for Disease Control. Experts there identified it as the H6N1 bird flu, widely circulating in chickens on the island.

The patient, who was not identified, worked in a deli and had no known connection to live birds. Investigators couldn't figure out how she was infected. But they noted several of her close family and friends also developed flu-like symptoms after spending time with her, though none tested positive for H6N1. The research was published online Thursday in the journal Lancet Respiratory Medicine.

More ABC-News

 

[Giuseppe]

Re: Taiwan on guard after first human avian flu H6N1 infection

The case IS NOT A NEW ONE, it has been reported in late May 2013. See the full story: http://www.flutrackers.com/forum/showthread.php?t=207803

 

[Biological]

Re: Taiwan on guard after first human avian flu H6N1 infection

Spot on! If anything it is the "1st documented" Human H6N1 case! 4-6 months on!

 

[Biological]

Re: Taiwan on guard after first human avian flu H6N1 infection

See (if not already seen)
BMC Proceedings | Full text | Different immune responses to three different vaccines following H6N1 low pathogenic avian influenza virus challenge in Taiwanese local chicken breeds
http://www.biomedcentral.com/1753-6561/5/S4/S33/

http://www.biomedcentral.com/content/pdf/1753-6561-5-S4-S33.pdf

 

[Gert van der Hoek]

Re: Taiwan on guard after first human avian flu H6N1 infection

See also:

Origin and molecular characterization of the human-infecting H6N1 influenza virus in Taiwan

Protein Cell. Origin and molecular characterization of the human-infecting H6N1 influenza virus in Taiwan.

First Case of New Bird Flu Identified in Human Patient

First Case of Human Infection with Avian Influenza virus A(H6N1) in Taiwan (HK CHP, June 21 2013)

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[Amish Country]

Re: Taiwan on guard after first human avian flu H6N1 infection

New Bird Flu Surfaces in Taiwanese Woman


Published: Nov 13, 2013 | Updated: Nov 18, 2013
By Michael Smith, North American Correspondent, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

A novel variant of avian influenza A infected a 20-year-old woman in Taiwan, investigators there are reporting.

It is the first reported case of an H6N1 avian virus infecting and causing disease in a human, although very similar viruses are endemic in chickens in the island nation, according to Ming-Tsan Liu, PhD, of the Taiwan Centres for Disease Control in Taipei, and colleagues.

The woman was treated in May and made a complete recovery, with no indication that she passed the novel virus to anyone else, the researchers reported in The Lancet Respiratory Medicine.

Enhanced influenza surveillance since then has not turned up any other cases, the researchers reported.

But the situation is reminiscent of the outbreak of H7N9 avian influenza in neighboring China last year, which was also found widely in domestic poultry.

According to the World Health Organization, the H7N9 flu has caused 139 cases of human infection and 45 deaths so far, although more are possible as this year's flu season advances.

The two viruses are similar epidemiologically, according to Richard Webby, PhD, of St. Jude Children's Research Hospital in Memphis and also director of the WHO collaborating center for influenza in the U.S.

But, he told MedPage Today, "the H7N9 does seem to be a more infectious virus and certainly concerns me more than the H6."

The case began May 5, when the woman developed fever and non-productive cough. She was eventually admitted to hospital May 8 with a diagnosis of lower respiratory tract infection.

Throat swabs indicated an un-subtyped influenza A and the samples were sent to the Taiwan Centres for Disease Control, where the genetics of the virus were analyzed.

On the basis of the genetic sequences of the hemagglutinin and neuraminidase genes, the virus was typed as H6N1, and was identical in 96% of its nucleotides to similar viruses that have been found in chickens in Taiwan since 1997, the researchers reported.

Aside from the virus itself, the patient also had antibodies to the viral hemagglutinin protein, additional evidence that she had been infected, the investigators reported.

The patient had no history of recent travel and denied any contact with poultry. Among her close contacts, few had influenza-like illness and none had evidence of the H6N1 virus.

Enhanced surveillance from June 10 to Aug. 13 found 125 cases of influenza-like illness or pneumonia, including 11 with the pandemic H1N1 strain and 23 with H3N2.

But all were negative for H6N1, Liu and colleagues found.

The report raises a familiar question, commented Marion Koopmans, DVM, PhD, of the Erasmus Medical Center in Rotterdam, the Netherlands.

"What would it take for these viruses to evolve into a pandemic strain?" she asked in an accompanying editorial.

The virus might already have taken one essential step -- Liu and colleagues reported that it appears to have an affinity for human lung tissue.

Avian influenza viruses preferentially bind to alpha2-3 sialic acid receptors, they noted, while human-adapted viruses prefer the alpha2-6 sialic acid receptors.

Genetic analysis suggested that the novel virus also prefers the alpha2-6 sialic acid receptors.

"For these avian flu viruses to adapt to humans, they really do have to change the sialic acid, the receptor of the human host cell that the viruses bind to," Webby said.

The novel virus has a "signature molecular change that we do associate with at least going down that pathway," he added.

What other changes might make the virus into more of a threat than it now seems to be remain unclear, Webby said.

But comparing the new virus with others -- such as H7N9 -- might help improve scientists' ability to forecast which avian pathogens are likely to affect humans, he added.

In a sense, that is the "overriding question," Koopmans argued. Is it time, she asked, to review how we watch for influenza at the human-animal interface?

"We surely can do better than to have human beings as sentinels," she concluded.


The study was supported by the Taiwan Centres for Disease Control. The authors declared they had no conflicts.

Koopmans declared she had no conflicts.
http://www.medpagetoday.com/InfectiousDisease/URItheFlu/42896