Clinical Updates
17 March 2006
Avian influenza - Cameroon, Myanmar, Poland, Sweden, Switzerland
It is the policy of NaTHNaC to post reports of H5N1 avian influenza outbreaks once they have been officially reported to the Organisation for Animal Health (OIE). At present there are unconfirmed outbreaks of H5N1 avian influenza in several countries and reports on these outbreaks will be listed on the NaTHNaC Website as and when they are confirmed by the OIE.
Cameroon
On 12 March 2006 the OIE received notification of the first cases of H5N1 avian influenza in Cameroon. The outbreak is thought to have started on 21 February 2006 and has been confirmed at three domestic duck farms in the Doualaré area of Maroua in the Diamaré division of the Extreme North province. A ban on live bird markets and on the movement of poultry and poultry products is now in effect in the city of Maroua and surveillance and epidemiological investigation is under way [1].
Myanmar
The Central Veterinary Diagnostic Laboratory in Mandalay reported Myanmar’s first cases of H5N1 avian influenza on 12 March 2006. The outbreak, involving poultry in the township of Aung Myae Thar Zan in the Mandalay division, was reported to the OIE on 13 March 2006. Movement controls and protective zones are now in place [2].
Poland
Following the report to the OIE of the first cases of H5N1 in Poland on 8 March 2006 [3], two more cases have been confirmed. On 13 March 2006 the OIE reported H5N1 infection in a wild swan found in Kostrzyn, Lubusz Voivodship and a Mergus duck found in Swinoujscie [4].
Sweden
As of 16 March 2006, outbreaks of H5N1 avian influenza have been reported in six counties in Sweden. Ducks found dead between 24 February and 15 March 2006 in Kalmar, Sodermanland, Blekinge, Gotland and Oskarshmn have tested positive for H5N1. Cases have also been reported in an eagle owl and common buzzard in the county of Oxelosund [5].
Switzerland
On 1 March 2006 the OIE reported H5N1 infection in a duck in Geneva [6]. Since then, two more cases have been reported, one in a duck in the village of Steckborn, Thurgau and one in a coot in Feuerthalen, Zurich [7].
Advice for Travellers
Avian influenza in birds continues its international spread. Since February 2006, single cases or outbreaks of avian influenza have been newly detected in the following countries; the first date of OIE confirmation is in parentheses:
Africa: Cameroon (12/3), Egypt (18/2), Niger (28/2), Nigeria (8/2)
Europe and Eurasia: Albania (7/3), Austria (20/2), Azerbaijan (15/2), Bosnia and Herzegovina (20/2), Bulgaria (12/2), France (20/2), Georgia (9/3), Germany (16/2), Greece (13/2), Hungary (1/3), Italy (14/2), Poland (8/3), Serbia and Montenegro (2/3), Slovakia (24/2), Slovenia (12/2), Sweden (16/3), Switzerland (27/2),
Middle East: Iran (15/2), Iraq (2/2 [H5])
East Asia: Myanmar (13/3)
South Asia: India (18/2), Pakistan (3/3 [H5])
Countries affected by avian influenza prior to 2006 and that have reported additional outbreaks in 2006 are (the date of the most recent OIE confirmation is in parentheses): China (7/2), Croatia (24/2), Hong Kong (20/1), Indonesia (6/1), Malaysia (3/3), Romania (6/3), Russia (11/2), Turkey (7/3), and Ukraine (10/3).
There remain no restrictions for travel to countries that have been infected with avian influenza. Nevertheless, travellers should exercise precautions that have been posted [8].
Returned travellers with suspected avian influenza should be evaluated as per the Health Protection Agency algorithm [9].
References
1. Organisation for Animal Health. Immediate notification of H5N1 - Cameroon, 12 March 2006 [cited 15 March 2006] Available at: http://www.oie.int/Messages/060313CMR.htm
2. Organisation for Animal Health. Immediate notification of H5N1 - Myanmar, 13 March 2006 [cited 15 March 2006] Available at: http://www.oie.int/Messages/060313MMR.htm
3. Organisation for Animal Health. Immediate notification of H5N1 -Poland, 8 March 2006 [cited 15 March 2006] Available at: http://www.oie.int/eng/info/hebdo/AIS_28.HTM#Sec19
4. Organisation for Animal Health. Follow-up report (2) - Poland, 13 March 2006 [cited 15 March 2006] Available at: http://www.oie.int/downld/AVIAN%20INFLUENZA/Poland_AI_13_
5. Organisation for Animal Health. Immediate notification of H5N1 -Sweden, 16 March 2006 [cited 17 March 2006] Available at: http://www.oie.int/downld/AVIAN%20INFLUENZA/Sweden_AI_16
6. Organisation for Animal Health Immediate notification of H5N1 -Switzerland, 27 February 2006 [cited 15 March 2006] Available at: http://www.oie.int/eng/info/hebdo/AIS_29.HTM#Sec19
7. Organisation for Animal Health. Follow-up report (2) - Switzerland, 14 March 2006 [cited 15 March 2006] Available at: http://www.oie.int/downld/AVIAN%20INFLUENZA/Switzerland_AI_
8. NaTHNaC. Avian influenza - advice for travellers to affected areas. 4 November 2005. [cited 17 March 2006] Available at: http://www.NaTHNaC.org/pro/clinical_updates/avianinfluenza_advi
9. 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. 14 March 2006. [cited 17 March 2006] Available at: http://www.hpa.org.uk/web/HPAweb&HPA
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Links:
World Organisation for Animal Health (OIE). Update on avian influenza in animals. Available at: http://www.oie.int/downld/AVIAN%20INFLUENZA/A_AI-Asia.htm
Health Protection Agency. Avian Influenza. Available at: http://www.hpa.org.uk/infections/topics_az/influenza/avian/default
World Health Organization. Avian Influenza. Available at: http://www.who.int/csr/disease/avian_influenza/en/
NaTHNaC. Avian influenza - advice for travellers to affected areas. 4 November 2006. Available at: http://www.NaTHNaC.org/pro/clinical_updates/avianinfluenza_advi
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