5 January 2006

Possible Human Cases of Avian Influenza in Turkey

It is increasingly likely that two deaths have occurred in eastern Turkey associated with human infection with avian influenza A (H5N1).  Media reports indicate that a 14 year old boy from the village of Van, eastern Anatolia, died on 1 January 2006 following pneumonia-like symptoms [1]. His sister is reported to have died today, 5 January 2006.  The siblings lived and worked on a poultry farm.  The two deaths are part of a cluster of people with respiratory illness including other members of the family and some outside the family.

Testing for influenza viruses has been performed by Turkish laboratories with preliminary results indicating an influenza A H5 subtype.   Testing to confirm if this is the avian influenza H5N1 is being arranged at WHO laboratories.  The Turkish authorities, with the support of the WHO, are investigating this cluster of cases.

If confirmed, these are the first cases of human avian influenza in Europe.  As areas with birds infected with the virus expand, it can be expected that cases will rarely occur in humans. It should be stressed, however, that avian influenza remains largely a disease of poultry and that human cases confirmed to date have had close contact with infected poultry.

Advice for Travellers

There are no travel restrictions to areas infected with avian influenza.  Travellers should exercise precautions that have been previously posted [2]. Travellers who return ill with a respiratory illness should inform their physicians of their travel history.  Physicians should evaluate them according to the protocol established by the Health Protection Agency (HPA) [3].

Further information will be posted as it becomes available.

References

1. Avian influenza, human - Turkey (03): diagnosis reversed. Archive no 20060104.0027. In Promed Mail [online]. Boston US: International Society for Infectious Diseases, 4 January 2006 [cited 5 January 2006]. Available at http://www.Promedmail.org.

2. NaTHNaC. Avian influenza - Advice for travellers to affected areas. 4 November 2005. Online resource [cited 5 January 2006]. Available at: http://www.NaTHNaC.org/pro/clinical_updates/

avianinfluenza_advice_041105.htm

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

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