11 January 2006

 

Avian influenza in Turkey - update

The World Health Organization (WHO) with the Turkish Ministry of Health has now confirmed a total of 15 cases of human avian influenza in Turkey [1]. Four of the cases had been reported previously [2], 5 cases on 8 January 2006 and 5 cases on 9 January 2006 [3].

The most recent case reported on 10 January, is a 37 year old woman from the central Turkish province of Sivas [1]. Although no poultry outbreaks have been officially reported in this province, it is located near areas with confirmed outbreaks in birds, and she had a history of exposure to diseased chickens.

The ten other cases reported on 8 and 9 January are [3]:

• three cases from Anakara Province; two brothers aged five and 2, and a man, aged 65 years. They are hospitalised in Anakara.
• two cases from Agri Province, Dogubeyazit district; a nine year old girl and her three year old brother.
• five cases from Kastamonu, Corum and Samsun provinces bordering the Black Sea area in northern Turkey, and from Van province.

Laboratory testing for avian influenza performed in Turkey indicates that these cases have been caused by the H5N1 influenza A subtype. WHO considers the quality of Turkey’s National Influenza Centre in Ankara to be high.

To date, two of the reported cases have been fatal. An additional fatality is presumed to have been caused by avian influenza, but has not been confirmed.

Initial investigations have found no evidence to suggest that the transmissibility of the virus has increased or that it is being transmitted from person-to-person. Almost all the persons under investigation have a documented link to dead or diseased poultry.

The Turkish government have launched an intense public awareness campaign. It is hoped that better public understanding of the disease and risk behaviour will help to reduce the risk of additional human cases.

Advice for Travellers

While there are no travel restrictions to Turkey or to other countries that have been infected with avian influenza, travellers should exercise precautions that have been posted [4]. Travellers who return ill with a respiratory illness should inform their physicians of their travel history. This includes travellers who return from all areas of Turkey and who have had close contact with poultry or wild birds.  Physicians should evaluate them according to the protocol established by the Health Protection Agency (HPA) [5].

References

1. World Health Organization. Avian influenza - situation in Turkey - update 3. 10 January 2006. [cited 11 January 2006] Available at: http://www.who.int/csr/don/2006_01_10a/en/index.html

2. World Health Organization. Avian influenza - situation in Turkey. 7 January 2006. [cited 11 January 2006] Available at http://www.who.int/csr/don/2006_01_07/en/index.html

3. World Health Organization. Avian influenza - situation in Turkey - 9 January 2006. [cited 11 January 2006] Available at: http://www.who.int/csr/don/2006_01_09/en/index.html

4. NaTHNaC. Avian influenza - Advice for travellers to affected areas. 4 November 2005. [cited 11 January 2006] Available at http://www.NaTHNaC.org/pro/clinical_updates/

avianinfluenza_advice_041105.htm

5. Health Protection Agency. Algorithm for the management of returning travellers from countries affected by avian influenza presenting with a febrile illness: recognition, investigation and initial management. 5 January 2006. [cited 11 January 2006] Available at http://www.hpa.org.uk/web/HPAweb&HPA

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