Travellers

News

18 July 2006

 

Avian influenza - human cases in Indonesia

The Ministry of Health in Indonesia has confirmed two cases of human avian influenza [1,2].

The first newly reported case occurred in a five year old boy from East Java province who became unwell on 14 June 2006 and died two days later.

The second case was in a three year old girl from Jakarta who became unwell on 23 June 2006 and died in hospital on 6 July.

An investigation found cases of chicken deaths in the neighbourhoods of both children; samples from the chickens have tested positive for H5N1.

Global Cases Totals

The global total of laboratory cases reported by WHO as of 14 July 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_07_14/en/index.html

 

COUNTRY

HUMAN CASES as of 20 June 2006

DEATHS

2003

2004

2005

2006

TOTAL

Azerbaijan

0

0

0

8

8

5

Cambodia

0

0

4

2

6

6

China

0

0

8

11

19

12

Djibouti

0

0

0

1

1

0

Egypt

0

0

0

14

14

6

Indonesia

0

0

17

36

53

41

Iraq

0

0

0

2

2

2

Thailand

0

17

5

0

22

14

Turkey

0

0

0

12

12

4

Viet Nam

3

29

61

0

93

42

TOTALS

3

46

95

86

230

132

Advice for travellers

Examination of previous 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 [3].

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 [4]. 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 [5].

References

1. World Health Organization. Avian influenza - situation in Indonesia - update 21. 4 July 2006. [cited 18 July 2006] Available online at http://www.who.int/csr/don/2006_07_04/en/index.html

2. World Health Organization. Avian influenza - situation in Indonesia - update 22. 14 July 2006. [cited 18 July 2006] Available online at http://www.who.int/csr/don/2006_07_14/en/index.html

3. NaTHNaC. Avian influenza - advice for travellers to affected areas. 4 July 2006. [cited 18 July 2006] Available online at http://www.NaTHNaC.org/travel/news/avianinfluenza_

traveladvice.htm

4. 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. 14 July 2006 [cited 18 July 2006] Available online at: http://www.hpa.org.uk/web/HPAweb&HPAweb

Standard/HPAweb_C/1195733851442

5. 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. 19 June 2006 [cited 18 July 2006]. Available online at: http://www.hpa.org.uk/web/HPAweb&HPAweb

Standard/HPAweb_C/1195733851442