News
30 May 2008
Avian influenza (H5N1) – human cases in Bangladesh, Indonesia, and Egypt
Bangladesh
The Ministry of Health has confirmed the first reported case of human infection with avian influenza (H5N1) in Bangladesh [1]. The case, identified during retrospective surveillance, was a 16-month-old male from Komalapur, Dhaka, who developed symptoms on 27 January 2008 and has subsequently recovered. The child was exposed to live and slaughtered chickens at his home. Other members of his family have remained well. Influenza A (H5N1) was laboratory confirmed by the World Health Organization (WHO) Reference Laboratory and US Centers for Disease Control and Prevention.
Indonesia
The Ministry of Health has confirmed a new human case of avian influenza (H5N1) in a 13-year-old male from Wonogiri District, Central Java Province [2]. The case developed symptoms on 14 April 2008, was hospitalised on 21 April, and died on 23 April. Investigations indicate that the child was exposed to sick and dead poultry.
Egypt
The Ministry of Health and Population has confirmed a human case of avian influenza (H5N1) in a 2-year-old male from Al-Honsanya, Shargiyah Governorate [3]. The case developed symptoms on 13 April 2008, was hospitalised on 14 April, and currently remains in hospital. Investigations indicate that the child had contact with sick and dead poultry.
Global case totals
The global total of confirmed human cases of avian influenza (H5N1) reported by WHO as of 28 May 2008 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
COUNTRY |
HUMAN CASES as of 28 May 2008 |
DEATHS |
||||||
|---|---|---|---|---|---|---|---|---|
2003 |
2004 |
2005 |
2006 |
2007 |
2008 |
TOTAL |
||
Azerbaijan |
0 |
0 |
0 |
8 |
0 |
0 |
8 |
5 |
Bangladesh |
0 |
0 |
0 |
0 |
0 |
1 |
1 |
0 |
Cambodia |
0 |
0 |
4 |
2 |
1 |
0 |
7 |
7 |
China |
1 |
0 |
8 |
13 |
5 |
3 |
30 |
20 |
Djibouti |
0 |
0 |
0 |
1 |
0 |
0 |
1 |
0 |
Egypt |
0 |
0 |
0 |
18 |
25 |
7 |
50 |
22 |
Indonesia |
0 |
0 |
20 |
55 |
42 |
16 |
133 |
108 |
Iraq |
0 |
0 |
0 |
3 |
0 |
0 |
3 |
2 |
Lao PDR |
0 |
0 |
0 |
0 |
2 |
0 |
2 |
2 |
Myanmar |
0 |
0 |
0 |
0 |
1 |
0 |
1 |
0 |
Nigeria |
0 |
0 |
0 |
0 |
1 |
0 |
1 |
1 |
Pakistan |
0 |
0 |
0 |
0 |
3 |
0 |
3 |
1 |
Thailand |
0 |
17 |
5 |
3 |
0 |
0 |
25 |
17 |
Turkey |
0 |
0 |
0 |
12 |
0 |
0 |
12 |
4 |
Viet Nam |
3 |
29 |
61 |
0 |
8 |
5 |
106 |
52 |
TOTALS |
4 |
46 |
98 |
115 |
88 |
32 |
383 |
241(63%) |
WHO case definitions for human infections with influenza A (H5N1) virus are available on the WHO website at: http://www.who.int/csr/disease/avian_influenza/guidelines/case_
An avian influenza (H5N1) timeline of major events is also available at: http://www.who.int/csr/disease/avian_influenza/ai_timeline/en/in
Advice for travellers
Examination of human cases of avian influenza indicates 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 are no restrictions for travel to countries with avian influenza. Nevertheless, travellers should exercise precautions [4].
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. 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 has also published a second algorithm for the management of persons resident in the UK or arriving from areas not known to have avian influenza (H5N1).
Both algorithms provide guidance for physicians on the recognition, investigation and initial management of persons with a history of fever and respiratory symptoms, after close contact with sick, dying or dead birds within seven days of presentation. The algorithms can be found on the HPA avian influenza guidelines webpage at: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb
References
1. World Health Organization. Avian influenza – situation in Bangladesh - update. 28 May 2008. [Accessed 28 May 2008]. Available at: http://www.who.int/csr/don/2008_05_28/en/index.html
2. World Health Organization. Avian influenza – situation in Indonesia – update 42. 30 April 2008. [Accessed 28 May 2008]. Available at: http://www.who.int/csr/don/2008_04_30/en/index.html
3. World Health Organization. Avian Influenza – situation in Egypt- update 10. 17 April 2008. [Accessed 28 May 2008] Available at http://www.who.int/csr/don/2008_04_17/en/index.html
4. NaTHNaC. Avian influenza – advice for travellers. 4 July 2006. [Accessed 28 May 2008]. Available at: http://www.nathnac.org/travel/news/avianinfluenza_traveladvice.h
Links
Health Protection Agency. Avian influenza. [accessed 28 May 2008] Available at: http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListN
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