Travellers

News

11 May 2006

 

Avian influenza - human cases in Egypt, China and Indonesia

 

Egypt

The Ministry of Health in Egypt has reported that an 18 year old girl from Minufiyah governorate, previously confirmed as having avian influenza [1], has died [2]. She developed symptoms on 5 April and died on 14 April.

The Ministry of Health has also confirmed avian influenza in a 27 year old woman from Cairo [3]. She was hospitalised on 1 May 2006 with bilateral pneumonia and died on 4 May [4]. Her infection has been linked to exposure to diseased poultry in a household in Minufiyah governorate.

All cases of human avian influenza confirmed by the Ministry of Health are now listed in the World Health Organization (WHO) cumulative table of laboratory-confirmed cases.

China

The Ministry of Health in China has confirmed avian influenza in an eight year old girl from the south-western province of Sichuan [5]. She developed symptoms of fever and pneumonia on 16 April and remains hospitalised. Initial investigations determined that poultry deaths had recently occurred near the child’s home.

The Chinese Ministry of Health has also reported that a 21 year old man from Hubei province, previously confirmed as having avian influenza [6], died of severe respiratory disease on 19 April [7].

Indonesia

The Ministry of Health in Indonesia has confirmed avian influenza in a 30 year old man from Greater Jakarta [8]. He developed symptoms on 17 April and died in hospital on 26 April. The man lived in close proximity to poultry, although investigations to determine the cause of his infection are continuing.

Global Case Totals

The global total of laboratory-confirmed cases reported by the WHO as of 8 May 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_ta ble_2006_05_08/en/index.html

 

COUNTRY

HUMAN CASES as of 8 May 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

10

18

12

Egypt

0

0

0

13

13

5

Indonesia

0

0

17

16

33

25

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

63

207

115

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, defeathering, 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 [9].

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 [10]. 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.

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 within seven days of their arrival in the UK. Physicians who see persons whom they suspect may have avian influenza, should evaluate them according to this algorithm.

References

1. World Health Organization. Avian influenza - situation in Egypt - update 4. 13 April 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_04_13/en/index.html

2. World Health Organization. Avian influenza - situation in Egypt - update 5. 21 April 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_04_21a/en/index.html

3. World Health Organization. Avian influenza - situation in Egypt - update 6. 4 May 2006. [cited 9 May 2006] available online at http://www.who.int/csr/don/2006_05_04/en/index.html

4. World Health Organization. Avian influenza - situation in Egypt - update 7. 5 May 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_05_05/en/index.html

5. World Health Organization. Avian influenza - situation in China - update 11. 27 April 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_04_27/en/index.html

6. World Health Organization. Avian influenza - situation in China - update 9. 19 April 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_04_19/en/index.html

7. World Health Organization. Avian influenza - situation in China - update 10. 21 April 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_04_21/en/index.html

8. World Health Organization. Avian influenza - situation in Indonesia - update 11. 8 May 2006. [cited 9 May 2006] Available online at http://www.who.int/csr/don/2006_05_08/en/index.html

9. NaTHNaC. Avian influenza - advice for travellers to affected areas. 7 April 2006. [cited 9 May 2006] Available online at http://www.NaTHNaC.org/travel/news/avianinfluenza_trav

eladvice_070406.htm

10. 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. 4 May 2006 [cited 9 May 2006] Available online at http://www.hpa.org.uk/web/HPAweb&HPA

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