11 November 2011

Avian influenza A/(H5N1) human cases in Egypt, Indonesia, Cambodia and Bangladesh

Since 2003, 63 countries/territories have experienced outbreaks of avian influenza A (H5N1). The infection continues to be a global threat for poultry and humans [1].

The period between 4 April and 4 November 2011 has shown an increase in the numbers of outbreaks reported from Asia and Egypt. There were no reports of newly affected countries during this period. The pattern of human illness and deaths related to avian influenza has not changed [2].

Egypt

Since the beginning of 2011, 33 human cases of avian influenza have been reported including 19 new cases between 4 April and 4 November 2011 [3-9]. Twelve of the 33 cases were fatal [3-9].

Indonesia

Ten human cases of avian influenza have been reported during 2011 including five new cases between 4 April and 4 November. Eight of the ten cases were fatal. The most recent cases have been reported from Bali and DKI Jakarta provinces [10-13].

Cambodia

Eight human cases of avian influenza have been reported during 2011, including five new cases between 4 April and 4 November 2011. Most of the recent cases have been reported in Banteay Meanchey, Kampong Cham and Prey Veng provinces. All cases of H5N1 infections reported in humans in 2011 have been fatal [14-18].

Bangladesh

As of 11 April 2011, two human cases of avian influenza have been reported. Both cases occurred in March 2011 in Dhaka.

All the human cases reported in Egypt, Indonesia, Cambodia and Bangladesh are known to have had contact with sick or dead poultry before the onset of symptoms [19-20]. 

Global case totals

The global total of confirmed human cases of avian influenza A/(H5N1) reported by the World Health Organization (WHO) as of 3 November 2011 is in the table below and can be found at:

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

_20111102CumulativeNumberH5N1casesN.pdf

* China (Includes cases reported in Hong Kong SAR)

**CFR: case fatality ratio

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. The Food and Agriculture Organization of the United Nations. Media Centre. Increased preparedness and surveillance urged against variant strain. 29 August 2011. [Accessed 10 November 2011]. Available at:

http://www.fao.org/news/story/en/item/87196/icode/

2. The European Centre of Disease Prevention and Control (ECDC). Rapid Risk Assessment. Potential resurgence of highly pathogenic H5N1 avian influenza. September 2011. [Accessed 10 November 2011]. Available at:

http://ecdc.europa.eu/en/publications/publications/1109_ter_

risk_assessment_h5n1_bird_flu_resurgence.pdf

3. World Health Organization. Avian influenza – situation in Egypt – update 56. 2 November 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_11_02/en/index.html

4. World Health Organization. Avian influenza – situation in Egypt – update 55. 9 August 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_08_09/en/index.html

5. World Health Organization. Avian influenza – situation in Egypt – update 54. 22 June 2011. [Accessed 11 November 2011]. Available at:

http://www.who.int/csr/don/2011_06_22/en/index.html

6. World Health Organization. Avian influenza – situation in Egypt – update 53. 16 June 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_06_16/en/index.html

7. World Health Organization. Avian influenza – situation in Egypt – update 52. 1 June 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_06_01/en/index.html

8. World Health Organization. Avian influenza – situation in Egypt – update 51. 21 April 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_04_21d/en/index.html

9. World Health Organization. Avian influenza – situation in Egypt – update 50. 11 April 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_04_11/en/index.html

10. World Health Organization. Avian influenza – situation in Indonesia – update 7. 26 October 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_10_26/en/index.html

11. World Health Organization. Avian influenza – situation in Indonesia – update 6. 10 October 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_10_10/en/index.html

12. World Health Organization. Avian influenza – situation in Indonesia – update 5. 3 June 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_06_03/en/index.html

13. World Health Organization. Avian influenza – situation in Indonesia – update 4. 13 May 2011. [Accessed 11 November 2011]. Available at:

http://www.who.int/csr/don/2011_05_13/en/index.html

14. World Health Organization. Avian influenza – situation in Cambodia – update 6. 19 August 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_08_19/en/index.html

15. World Health Organization. Avian influenza – situation in Cambodia – update 5.   2 August 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_08_02/en/index.html

16. World Health Organization. Avian influenza – situation in Cambodia – update 4.  10 June 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_06_10/en/index.html

17. World Health Organization. Avian influenza – situation in Cambodia – update 3.  21 April 2011. [Accessed 11 November 2011]. Available at:

http://www.who.int/csr/don/2011_04_21c/en/index.html

18. World Health Organization. Avian influenza – situation in Cambodia – update 2.  11 April 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_04_11b/en/index.html

19. World Health Organization. Avian influenza – situation in Bangladesh – update. 11 April 2011. [Accessed 11 November 2011]. Available at: http://www.who.int/csr/don/2011_04_11a/en/index.html

20. The Government of the People's Republic of Bangladesh. The Institute of Epidemiology Disease Control and Research (IEDCR). 2nd human case of influenza H5N1 in 2011. 15 March 2011. [Accessed 11 November 2011]. Available at:http://www.iedcr.org/images/Healthmessages/2nd%20

Human%20case%20of%20H5N1.pdf

Links

Health Protection Agency. Avian influenza

World Health Organization. Avian Influenza