Clinical Updates
29 June 2007
Avian influenza (H5N1) – human cases in Egypt, Indonesia and Viet Nam
Egypt
The Egyptian Ministry of Health and Population has confirmed three human cases of H5N1 avian influenza [1-3].
All three cases are from Qena Governorate and include:
- A 10 year old girl who developed symptoms on 1 June 2007 and died in hospital on 9 June.
- A four year old girl who developed symptoms on 7 June 2007 and is currently in a stable condition in hospital.
- A four year old boy who developed symptoms on 20 June 2007 and is currently in a stable condition in hospital.
Initial investigations indicate that all three children had exposure to sick or dead poultry shortly before the onset of symptoms.
Indonesia
The Ministry of Health of Indonesia has reported three human cases of H5N1 avian influenza [4-6].
- A 16 year old girl from Central Java province who developed symptoms on 25 May 2007 and died in hospital on 29 May.
- A 26 year old woman from Riau province who developed symptoms on 3 June 2007 and died in hospital on 12 June.
- A three year old girl from Riau province who developed symptoms on 18 June 2007 and has since recovered.
Investigations indicate that the source of infection for all three cases was exposure to sick or dead poultry.
Viet Nam
The Ministry of Health has reported two human cases of H5N1 avian influenza; the first to be reported in Viet Nam since November 2005 [7].
- A 29 year old man from Vinh Phuc province who developed symptoms on 10 May 2007 and has made a full recovery.
- A 19 year old man from Thai Nguyen province who developed symptoms on 20 May 2007 and remains in hospital in a stable condition.
Both cases had exposure to poultry shortly before the onset of symptoms.
Global Case Totals
The global total of laboratory cases reported by the WHO as of 29 June 2007 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_2007_06_29/en/index.html
COUNTRY |
HUMAN CASES as of 29 June 2007 |
DEATHS |
|||||
2003 |
2004 |
2005 |
2006 |
2007 |
TOTAL |
||
Azerbaijan |
0 |
0 |
0 |
8 |
0 |
8 |
5 |
Cambodia |
0 |
0 |
4 |
2 |
1 |
7 |
7 |
China |
1 |
0 |
8 |
13 |
3 |
25 |
16 |
Djibouti |
0 |
0 |
0 |
1 |
0 |
1 |
0 |
Egypt |
0 |
0 |
0 |
18 |
19 |
37 |
15 |
Indonesia |
0 |
0 |
20 |
55 |
26 |
101 |
80 |
Iraq |
0 |
0 |
0 |
3 |
0 |
3 |
2 |
Lao PDR |
0 |
0 |
0 |
0 |
2 |
2 |
2 |
Nigeria |
0 |
0 |
0 |
0 |
1 |
1 |
1 |
Thailand |
0 |
17 |
5 |
3 |
0 |
25 |
17 |
Turkey |
0 |
0 |
0 |
12 |
0 |
12 |
4 |
Viet Nam |
3 |
29 |
61 |
0 |
2 |
95 |
42 |
TOTALS |
4 |
46 |
98 |
115 |
54 |
317 |
191 (60%) |
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
An H5N1 avian influenza timeline of major events is also available on the WHO website at: http://www.who.int/csr/disease/avian_influenza/ai_timeline/en/
Advice for travellers
Examination of human cases of avian influenza indicates 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 are no restrictions for travel to countries with avian influenza. Nevertheless, travellers should exercise precautions [8].
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 [9]. 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 H5N1 avian influenza [10].
References
1. World Health Organization. Avian influenza – situation in Egypt – update 16. 11 June 2007 [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2007_06_11/en/index.html
2. World Health Organization. Avian influenza – situation in Egypt – update 17. 12 June 2007 [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2007_06_12/en/index.html
3. World Health Organization. Avian influenza – situation in Egypt – update 18. 25 June 2007 [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2007_06_25/en/index.html
4. World Health Organization. Avian influenza – situation in Indonesia – update 9. 6 June 2007 [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2007_06_06/en/index.html
5. World Health Organization. Avian influenza – situation in Indonesia – update 10. 15 June 2007 [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2007_06_15/en/index.html
6. World Health Organization. Avian influenza – situation in Indonesia – update 11. 25 June 2007 [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2007_06_25a/en/index.html
7. World Health Organization. Avian influenza – situation in Viet Nam. 29 June 2007. [accessed 29 June 2007] Available online at http://www.who.int/csr/don/2005_06_29/en/index.html
8. NaTHNaC Health Information Sheets. Avian influenza – advice for travellers. 4 July 2006. [accessed 29 June 2007]. Available at http://www.nathnac.org/pro/factsheets/
avianinfluenza_advice_040707.htm
9. 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. 28 June 2007 [accessed 29 June 2007] Available at http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPA
10. Health Protection Agency. Algorithm for the management of persons resident in the UK or arriving from areas not known to have avian influenza H5N1 presenting with a febrile respiratory illness after close contact with sick, dying or dead birds: recognition, investigation and initial management. 6 February 2006 [accessed 29 June 2007] Available at http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPA
Disclaimer | Copyright | Privacy | Sitemap | Accessibility