Health Professionals

Clinical Updates

15 February 2012

Avian influenza A (H5N1) human cases in Cambodia, China, Egypt, Indonesia and Viet Nam

Avian influenza A (H5N1) virus is endemic in many parts of Asia, and has occurred in parts of Europe and Africa [1-2].

Between 4 November 2011 and 15 February 2012, human cases were reported from Cambodia, China, Egypt, Indonesia and Viet Nam. 

The World Health Organization Western Pacific Regional Office has outlined a strategic approach to control regional outbreaks of avian influenza A (H5N1) and reduce the risk of an influenza pandemic. The main elements of this strategy are:

  • a timely response to human influenza A (H5N1) outbreaks
  • reduce the risk of animal-to-human transmission
  • prepare for rapid intervention at the start of a pandemic
  • pandemic preparedness planning

A  map of the geographical distribution of avian influenza A (H5N1) cases (2003 - 2010) is available from the World Health Organization.

 

Cambodia

Between 4 November 2011 and 15 February 2012, one fatal case was reported in a two-year-old male from Banteay Meanchey province [3].

China

Between 4 November 2011 and 15 February 2012, two cases were reported from the provinces of Guizhou and Guangdong [4-5].

Egypt

Between November 2011 and January 2012, seven cases, including three deaths, were reported [6]. These cases were reported in Menofia and Cairo Governorates during January and in Dakahlia Governorate in November and December 2011 [6].

Indonesia

Between 4 November and 15 February 2012, three fatal cases were reported. The two most recent cases were reported from Bali and DKI Jakarta provinces [7-9].

Viet Nam

In January 2012, Viet Nam confirmed the first case of avian influenza in nearly two years. The case, from Kien Giang Province, died [10].

All the human cases reported in Cambodia, China, Egypt, Indonesia and Viet Nam are known to have had contact with sick or dead poultry before the onset of symptoms [3-10]. 

Global case totals

The global total of confirmed human cases of avian influenza A/(H5N1) reported by the World Health Organization (WHO) as of 8 February 2012 can be found at:

http://www.who.int/influenza/human_animal_interface/EN_GIP

_20120208CumulativeNumberH5N1cases.pdf

Advice for travellers

The greatest risk for transmission of avian influenza from birds to humans occurs with 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 poultry meat or eggs.

There are no restrictions for travel to countries reporting avian influenza. Nevertheless, travellers should exercise precautions.

The Health Protection Agency (HPA), has published algorithms for the management of travellers or visitors arriving from countries (or areas within countries) affected by avian influenza. These 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. They can be found on the HPA website at: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPA

web_C/1195733851442

References

1. World Health Organization. Influenza at the Human-Animal Interface (HAI)

H5N1 avian influenza: timeline of major events. [Accessed 13 February 2012]. Available at:

http://www.who.int/influenza/human_animal_interface/H5N1

_avian_influenza_update.pdf

2. World Health Organization. The Western Pacific Region. Avian Influenza. 3 February 2012. [Accessed 15 February 2012]. Available at:  http://www.wpro.who.int/health_topics/avian_influenza/

3. World Health Organization. Avian influenza – situation in Cambodia. 16 January 2012. [Accessed 15 February 2012]. Available at:  http://www.who.int/csr/don/2012_01_16/en/

4. World Health Organization. Avian influenza – situation in China - update. 24 January 2012. [Accessed 15 February 2012]. Available at: http://www.who.int/csr/don/2012_01_24/en/

5. World Health Organization. Avian influenza – situation in China.  5 January 2012. [Accessed 15 February 2012]. Available at: http://www.who.int/csr/don/2012_01_05b/en/

10. World Health Organization. Avian influenza – situation in Viet Nam. 20 January 2012.

6. World Health Organization. Avian influenza – situation in Egypt – update . 19 January 2012. [Accessed 15 February 2012]. Available at: http://www.who.int/csr/don/2012_01_19b/en/index.html

7. World Health Organization. Avian influenza – situation in Indonesia – update . 19 January 2012. [Accessed 15 February 2012]. Available at: http://www.who.int/csr/don/2012_01_19/en/index.html

8. World Health Organization. Avian influenza – situation in Indonesia. 11 January 2012. [Accessed 15 February 2012]. Available at: http://www.who.int/csr/don/2012_01_11/en/index.html

9. World Health Organization. Avian influenza – situation in Indonesia – update 8. 15 November 2011. [Accessed 15 February 2012]. Available at: http://www.who.int/csr/don/2011_11_15/en/index.html

 [Accessed 15 February 2012]. Available at http://www.who.int/csr/don/2012_01_20/en/index.html

 

Links

Health Protection Agency. Avian influenza

World Health Organization. Avian Influenza

World Health Organization. Situation Updates - Avian Influenza