8 April 2005: Avian influenza update

Five cases of human avian influenza H5 subtype have been recently reported from Viet Nam.[1] All five cases are in a family from the northern Vietnamese city of Haiphong, and include the father, mother and three daughters. The family members were admitted to hospital on 22 March and remain under medical care.

The number of cases in Viet Nam since mid December is 33, of these 15 have been fatal. As of 4 April 2005, the total number of cases of human avian influenza reported from Cambodia (2), Viet Nam (60), and Thailand (17) since January 2004, is 79 with 49 deaths.[2]

The CDC have recently updated their precautions for travellers and expatriates in countries affected by avian influenza outbreaks. The guidelines can be found on the CDC avian influenza website.

Additional developments include the unofficial reporting of outbreaks of avian influenza in the Democratic People's Republic of Korea.[3] This is the first report of avian influenza in the DPR Korea; no human cases have been reported.

Also, the Health Protection Agency and the UK Departments of Health have published pandemic flu preparedness plans,[4, 5] and the WHO has published a monograph assessing the public health threat of avian influenza.[6] These make valuable contributions to understanding the potential threat of avian influenza to global health and responses of UK health bodies to this threat.

There are no travel restrictions to countries in south east Asia. Travellers are reminded of the following precautions in areas affected by avian influenza:

• Avoid contact with live poultry and wild birds
• Avoid visiting live animal markets and poultry farms
• Avoid contact with surfaces contaminated with animal faeces
• Do not eat or handle undercooked or raw poultry, egg or duck dishes
• Exercise good personal hygiene with frequent hand washing
• Do not attempt to bring any live poultry products back to the UK

It is not recommended that travellers to south east Asia take with them the neuraminidase inhibitor, Oseltamivir (Tamiflu®).

Travellers who return from affected areas who experience fever or respiratory symptoms within 10 days to 2 weeks of return should contact their physician. Physicians should access the HPA algorithm for evaluating potentially infected travellers.

References

1. World Health Organization. Avian influenza - situation in Viet Nam - update 14. 4 April 2005. http:www.who.int/csr/don/2005_04_04/en/
2. World Health Organization. Cumulative Number of Confirmed Human Cases of Avian Influenza A (H5N1) since 28 January 2004
3. World Health Organization. Avian influenza - outbreak in poultry in the Democratic People's Republic of Korea - update 13.
4. Health Protection Agency. Influenza pandemic contingency plan. Version 7.0 February 2005.
5. UK Health Departments. Pandemic Flu. UK influenza pandemic contingency plan. March 2005.
6. World Health Organization. Avian influenza: assessing the pandemic threat. WHO/CDS/2005.29. January 2005.

Links

HPA avian influenza site and management of suspected cases

WHO avian influenza site

CDC avian influenza site