WHO risk assessment (monthly)

[gsgs]

## WHO ignores the risk from lab-escapes or human(e.g. "terrorist") deliberately
## created and released viruses
## so presumably they consider that risk smaller than the ones that they mention


http://www.who.int/influenza/human_animal_interface/avian_influenza/archive/en/
http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/index.html

WHO May.10.2013 on H7N9 : The risk has not changed since Apr.13
WHO,Apr.26.2013 on H5N1 : Therefore, the public health risk remains unchanged.
WHO,Apr.13.2013,H7N9
What is the risk of the occurrence of further cases in the affected areas of China and other areas?
The epidemiology of this virus among animals, including the main reservoirs of infection among
animals and the extent of geographic spread, is not yet established. However, it is likely that most
human H7N9 infections so far are associated with infection among as-of-yet undetermined animals
and that further human cases of infection should be expected.
What is the risk of human-to-human transmission?
There is no evidence of sustained human-to-human transmission. However the two possible family
clusters suggest that limited human-to-human transmission may occur where there is close contact
between cases and other individuals, as occurs in families and, potentially, healthcare settings.
Moreover, the genetic changes seen among these viruses suggesting adaptation to mammals is of
concern, and further adaptation may occur.
What is the risk of international spread?
At this time, there is no information to indicate international spread of this virus. However, it is
possible that an infected person, who may or may not have symptoms, could travel to another
country. However, if the virus cannot sustain human-to-human transmission, as appears to be the
current situation, then extensive community spread is unlikely
WHO,Mar.12.2013,H5N1,unchanged
WHO,Feb.15,2013,H5N1,unchanged
WHO,Jan.16.2013,H5N1,unchanged
WHO,Dec.17.2012,H5N1,unchanged
WHO,05.Nov.2012,H5N1,unchanged
WHO,01.Oct.2012 ,H5N1, unchanged.
10 September 2012
Public health risk assessment for avian influenza A(H5N1) viruses: The public health risk for the virus
remain unchanged.
10 August 2012
Overall public health risk assessment for avian influenza A(H5N1) viruses: Two sporadic human cases
reported this month in a country with known endemic influenza A(H5N1) virus circulation in poultry is
within the expected range. From the data available, there is no evidence of onward sustained human
to human transmission at this time hence the public health risk for the virus remains unchanged.
25 June 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.
04 June 2012
Overall public health risk assessment: A decrease in reported events in poultry is expected for this
time of year. Two sporadic cases reported this month in countries with known influenza A(H5N1)
circulation in poultry are within the expected range. These sporadic cases do not appear to have
features that would raise concern regarding onward sustained human to human transmission.
07 May 2012
Overall public health risk assessment: Poultry outbreaks and sporadic human cases and small clusters
would be expected at this time of year. These sporadic cases do not appear to have features that
would raise concern regarding onward sustained human to human transmission.
02 April 2012
Overall public health risk assessment: Poultry outbreaks and sporadic human cases and small clusters
would be expected at this time of year. These sporadic cases do not appear to have features that
would raise concern regarding onward sustained human to human transmission.
05 March 2012
Overall public health risk assessment: an increase in poultry outbreaks and sporadic human cases and
small clusters would be expected at this time of year. Further investigations around the mild cases
detected in Bangladesh are awaited to define public health risk
06 February 2012
Overall public health risk assessment: an increase in poultry outbreaks and sporadic human cases and
small clusters would be expected at this time of year. No further spread has apparently occurred;
therefore the risk to public health has not changed from what would be expected this time of year.
09 January 2012
Epidemiologic investigations have identified only limited human‐to‐human transmission of this virus since its
emergence in 2003, and no community‐level transmission has been noted. Therefore, the sporadic cases and
small clusters being reported are not considered unusual and are not thought to indicate any increase in
public health risk. As well, recent reported evolution of the H5N1 virus is not thought to indicate any increase
in public health risk3.
05 December 2011
Therefore, the sporadic cases
and small clusters being reported are not considered unusual and are not thought to indicate any
increase in public health risk. As well, recent reported evolution of the H5N1 virus is not thought to
indicate any increase in public health risk3.
07 November 2011
03 October 2011
05 September 2011
30 August 2011
Evolution of H5N1 avian influenza virus does not increase risk to public health
WHO closely monitors the evolution of influenza viruses and is aware of recent reports of an H5N1 virus
(described as H5N1 clade 2.3.2.1) circulating in poultry in parts of Asia. Based on available information,
# this evolution of the H5N1 virus poses no increased risk to public health. It is not considered unusual
because influenza viruses are constantly evolving, especially in areas where they circulate regularly in
poultry. The WHO Global Influenza Surveillance and Response System, the group of experts that studies
animal and human influenza viruses that may impact human health, recognized this new clade in February
2011.WHO also routinely assesses the public health risk from all animal influenza viruses. Based on available
information, the identification of this newly-reported H5N1 virus clade does not change the current public
health implications of the H5N1 avian influenza viruses for humans. Human cases of H5N1 infection remain
rare and sporadic events, occurring mostly in areas where H5N1 viruses circulate regularly in poultry.
Human cases could occur wherever the viruses are present in poultry and when humans might be exposed
to infected birds or contaminated environments.
03 August 2011
04 July 2011
17 June 2011 Low pathogenicity H7 viruses are also currently circulating in poultry in
Europe and China. These viruses likely do not pose a significant risk to public health
currently, but warrant consistent monitoring and control in animal populations.

 

[gsgs]

Ecdc:

Ecdc:

http://ecdc.europa.eu/en/publicatio...9)-China-rapid-risk-assessment-8-may-2013.pdf

more than 3000 contacts of the cases were traced, which did not lead to the detection of
additional laboratory-confirmed cases
In China, many samples from birds were tested but less than 1% were positive
National authorities should make preparations for the occurrence of confirmed
cases in the EU/EEA Member States;
(as of 6 May
2013) and focuses on developments after the publication of ECDC?s Rapid Risk
Assessment of 3 April 2013 [1], updated 12 April 2013 [2].
Close to 3000 contacts have been followed-up and only four are reported to have
developed symptoms,
As of April 26, national and provincial avian influenza
reference laboratories in China have collected 390 628 samples for virus testing from 13 014 surveillance sites
around the country, including 2 587 live-poultry markets, 337 poultry slaughterhouses, 8 808 poultry farms, 341
wild birds habitats, 277 pig slaughterhouses, 31 pig farms, and 633 other sampling spots. It is reported that
218 897 samples were tested, including 150 837 serology samples and 68 060 pathology samples. Of the 68 060
samples, only 46 tested positive for the virus, resulting in a positive rate of 0.07% [22].

Of those animals tested positive, almost all (44) were from 14 live-poultry markets

The risk of the disease spreading to Europe via humans in the near future is considered low

It is also likely that ? as in the Jiangsu-to-Taiwan case ? there
will eventually be laboratory-confirmed cases in the EU

There is insufficient evidence to quantify the risk of A(H7N9) developing into a virus that transmits from human to
human. Close monitoring of the outbreak epidemiology, clinical features and the viruses? genetic variation over
time will be critical for assessing this risk; instruments like the Influenza Risk Assessment tool can be used for this
task [61, 62]. However, that risk is certainly not zero.

The risk of the A(H7N9) virus arriving in Europe with migratory birds cannot be quantified at this time

The
hypothesis that poultry in the affected area have been infected by wild birds has not been confirmed

 

[gsgs]

Re: WHO risk assessment (monthly)

WHO,2014/01/24, http://www.who.int/influenza/human_...enza_Summary_IRA_HA_interface_24January14.pdf
H5N1:the risk of community-level spread of this virus remains low
H7N9:no identifyable risk statement
H9N2: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.

ECDC,2014/01/27: http://www.ecdc.europa.eu/en/public...ina-rapid-risk-assessment-27-January-2014.pdf

my snippets from it:
Further information about influenza A(H7N9) detections in China can be
found at the Global Animal Disease Information System EMPRES-i [30].
30. Food and Agriculture Organization of the United Nations (EGADIS). Low pathogenic avian influenza –
H7N9 12/01/2014 – China 2014. Available from: http://empres-i.fao.org/eipws3g/#h=0.
intravenous pathogenicity index
Currently, the most likely scenario in China, and therefore worldwide, is that this event remains
a localised, widespread zoonotic outbreak in which the virus is transmitted sporadically to humans
in close contact with the animal reservoir. However, with the regular influenza season now ongoing
in southern China and elsewhere in the northern hemisphere there is a potential risk for co-infections
and the development of new reassortants with the possibility of increased capacity to transmit among
human populations.
Chinese New Year, which falls on 31 January this year, will dramatically increase the potential
for human exposure to both A(H7N9) and seasonal influenza viruses, increasing the risk of
reassortment in humans
Considering the spread of influenza A(H5N1) over national and geographic borders in and outside Asia,
it is nothing short of surprising that neighbouring Asian countries have not reported more cases of
influenza A(H7N9). It is possible that additional countries will be affected in the coming months.
The current influenza A(H7N9) viruses are considered to have pandemic potential [63].
63. Nicoll A, Danielsson N. A novel reassortant avian influenza A(H7N9) virus in China – what are
the implications for Europe. Euro Surveill. 2013;18(15).
the risk of the disease spreading to Europe via humans in the near future is still considered low.
To date, there is no epidemiological evidence that avian influenza can be transmitted to humans
through the consumption of cooked food, notably poultry meat and eggs.
There is insufficient evidence to quantify the risk of influenza A(H7N9) developing into a virus that
transmits from human to human, thereby increasing the risk of an influenza pandemic.
Close monitoring of the outbreak epidemiology, clinical features and the genetic characteristics
of the virus will be critical for assessing this risk; instruments like the Influenza Risk Assessment
Tool (IRAT) can play a role [64,65].
The risk of increased transmission of H7N9 viruses between humans is not negligible
The risk of influenza A(H7N9) virus being transported to Europe in viraemic poultry through
legal trade is negligible
The risk of the avian influenza A(H7N9) viruses arriving in Europe with migratory birds cannot
be quantified. ECDC and the European Food Safety Authority (EFSA) have performed multiple
independent risk assessments in the past regarding avian influenza that also cover pathways
for avian influenza A(H7N9) [64,70,71]. The hypothesis that poultry in the affected area has
been infected by wild birds has not been confirmed but neither can it be excluded.
Surveillance in wild birds for this novel virus has not been initiated in the EU/EEA.