Travellers

News

20 April 2006

 

Avian influenza - human cases in Azerbaijan, Indonesia, Egypt and China

Azerbaijan

A 17 year old girl was confirmed to have avian influenza on testing by a WHO collaborating laboratory [1]. The girl developed symptoms on 11 March and was hospitalised with pneumonia. She has made a full recovery.

The girl’s 15 year old cousin, previously reported [2], developed symptoms on the same day and has also made a full recovery. Both girls resided in Daikyand settlement in the Salyan district where seven of Azerbaijan’s eight cases of human infection with avian influenza have occurred.

Indonesia

The Ministry of Health in Indonesia has confirmed two cases of human avian influenza since 12 April 2006 [3,4].

The first case was in a 23 year old man employed as a poultry worker in West Java. He developed symptoms on 20 March and has fully recovered.

The second case was in a 24 year old man from Tangerang, near Greater Jakarta. He developed symptoms on 29 March and died in hospital on 8 April.

Egypt

The Ministry of Health in Egypt has confirmed avian influenza in an 18 year old girl from Minufiyah governorate [5]. She developed symptoms on 5 April and was hospitalised on 11 April where she remains in a stable condition. Her infection has been linked to direct contact with diseased birds. Samples from the patient were positive in Egypt’s Central Public Health Laboratory and the US Naval Medical Research Unit 3 (NAMRU-3). Verification by a WHO collaborating laboratory is pending.

China

 

The Ministry of Health in China has confirmed avian influenza in a 21 year old man from Wuhan City in Hubei province [6]. He developed symptoms on 1 April and is presently hospitalised in a critical condition. The source of the man’s infection is under investigation. No poultry outbreaks have been reported in Hubei province since November 2005. Close contacts of the man have been placed under medical observation.

Global Case Totals

The global total of laboratory-confirmed cases reported by the WHO as of 19 April 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_04_19/en/index.htm

 

COUNTRY

HUMAN CASES as of 19 April 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

9

17

11

Egypt

0

0

0

4

4

2

Indonesia

0

0

17

15

32

24

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

52

196

110

WHO will adjust the figures in its cumulative number of cases in Egypt following results of external verification.

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 [7].

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 [8]. 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 Azerbaijan - update 3. 11 April 2006. [cited 19 April 2006]. Available online at http://www.who.int/csr/don/2006_04_11/en/index.html

2. World Health Organization. Avian influenza - situation in Azerbaijan - update 2. 21 March 2006 [cited 19 April 2006]. Available online at http://www.who.int/csr/don/2006_03_21a/en/index.html

3. World Health Organization. Avian influenza - situation in Indonesia - update 9. 12 April 2006. [cited 19 April 2006] Available online at http://www.who.int/csr/don/2006_04_12/en/index.html

4. World Health Organization. Avian influenza - situation in Indonesia - update 10. 19 April 2006 [cited 19 April 2006] Available online at http://www.who.int/csr/don/2006_04_19a/en/index.html

5. World Health Organization. Avian influenza - situation in Egypt - update 4. 13 April 2006. [cited 19 April 2006] Available online at http://www.who.int/csr/don/2006_04_13/en/index.html

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

7. NaTHNaC. Avian influenza - advice for travellers to affected areas. 7 April 2006. [cited 19 April 2006] Available at http://www.NaTHNaC.org/travel/news/avianinfluenza_traveladvice_ 070406.htm

8. 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. 18 April 2006 [cited 19 April 2006] Available online at http://www.hpa.org.uk/web/HPAweb&HPA
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