25 October 2006

 

Avian influenza - human cases in Indonesia

The Ministry of Health In Indonesia has confirmed an additional three cases of human avian influenza [1]:

A 67 year old woman from West Java province who developed symptoms on 3 October and died in hospital on 15 October. Chickens in the woman’s household and neighbourhood are reported to have died shortly before the onset of her symptoms

An 11 year old boy from Jakarta province who developed symptoms on 2 October and died in hospital on 14 October. The boy is known to have had contact with dead chickens before the onset of his symptoms.

A 27 year old woman from Central Java province who developed symptoms on 8 October and died in hospital on 13 October. The source of the woman’s infection is currently under investigation.

Global Case Totals

The global total of laboratory cases reported by the World Health Organization (WHO) as of 16 October 2006 is in the table below and can be found on the WHO website at:

http://www.who.int/csr/disease/avian_influenza/country/

cases_table_2006_10_16/en/index.html

COUNTRY	HUMAN CASES as of 16 October 2006					DEATHS
	2003	2004	2005	2006	TOTAL
Azerbaijan	0	0	0	8	8	5
Cambodia	0	0	4	2	6	6
China	1	0	8	12	21	14
Djibouti	0	0	0	1	1	0
Egypt	0	0	0	15	15	6
Indonesia	0	0	19	53	72	55
Iraq	0	0	0	3	3	2
Thailand	0	17	5	3	25	17
Turkey	0	0	0	12	12	4
Viet Nam	3	29	61	0	93	42
TOTALS	4	46	97	109	256	151

A map illustrating the location of human cases of avian influenza that have occurred in 2006 can be found at: http://gamapserver.who.int/mapLibrary/Files/Maps/

Global_H5N1Human_since2006_FIMS_20061016.png 

WHO case definitions for human infections with influenza A (H5N1) virus are available on the WHO website at http://www.who.int/csr/disease/avian_influenza/guidelines/

case_definition2006_08_29/en/index.html

Advice for travellers

Examination of human cases of avian influenza has indicated that the greatest risk for transmission from birds to humans comes when there is close human contact with domestic poultry. This is particularly so in settings of diseased household flocks and when there has been slaughtering, de-feathering, and preparation of poultry for consumption. No cases have been linked to consumption of properly cooked meat or eggs.

There remain no restrictions for travel to countries with avian influenza. Nevertheless, travellers should exercise precautions [2].

The Health Protection Agency (HPA), Centre for Infections has published an algorithm for the management of travellers or visitors arriving from countries (or areas within countries) affected by avian influenza [3]. These regions are revised as new information is provided from the WHO and the World Organisation for Animal Health (OIE) on detection of avian influenza. Countries may be removed from the list if they have been declared free of avian influenza.

The HPA algorithm provides guidance on the recognition, investigation and management of persons with fever or history of fever and respiratory symptoms, and who have had an exposure to persons or birds with suspected avian influenza (H5N1) within seven days of the development of their symptoms. Physicians who see persons whom they suspect may have avian influenza should evaluate them according to this algorithm. The HPA has published a second algorithm to reflect the situation of a traveller from an area (including within the UK) where there is no known avian influenza [4].

References

1. World Health Organization. Avian influenza - situation in Indonesia - update 36. 16 October 2006. [cited 25 October 2006] Available at http://www.who.int/csr/don/2006_10_16/en/index.html

2. NaTHNaC. Avian influenza - advice for travellers to affected areas. 4 July 2006. [cited 25 October 2006] Available at http://www.NaTHNaC.org/pro/clinical_updates/

avianinfluenza_advice.htm

3. Health Protection Agency. Algorithm for the management of returning travellers and visitors from countries affected by avian influenza (H5N1) presenting with a febrile respiratory illness: recognition, investigation and initial management. 13 October 2006 [cited 25 October 2006] Available at http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPA

web_C/1195733851442

4. Health Protection Agency. Algorithm for the management of persons resident in the UK arriving from areas not known to have avian influenza H5N1 presenting with febrile respiratory illness after close contact with sick, dying or dead birds: recognition, investigation and initial management. 6 September 2006 [cited 25 October 2006]. Available online at: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPA

web_C/1195733851442