18 January 2006

Avian influenza update - human cases in China, Indonesia and Turkey

China

On 10 January 2006, the Ministry of Health in China confirmed an additional case of human infection with avian influenza H5N1 [1].

This most recent case occurred in a six year old boy from the southern Chinese province of Hunan. He developed symptoms of fever and pneumonia on 24 December and is presently hospitalised.

Chinese authorities stated that two previously reported cases have died. These deaths were in a ten year old girl from the Guangxi region, reported on 7 December [2], and a 35 year old man from Jiangxi province, reported on 16 December [3].

The total number of human cases of avian influenza H5N1 in China is now eight, of which five have died.

Indonesia

On 14 January 2006, the Ministry of Health in Indonesia confirmed an additional case of human infection with avian influenza H5N1 [4].

The case was a 29 year old woman who worked as a midwife in a Jakarta hospital. She developed symptoms on 31 December, was hospitalised on 2 January and died on 11 January.

Investigations have discovered evidence of poultry deaths in the woman’s neighbourhood during the two weeks prior to the onset of her illness. It is also thought that the woman visited a live bird market and bought freshly slaughtered chicken in the days immediately prior to her illness. It is highly unlikely that she acquired her infection from an occupational exposure.

Contact tracing has been extensive and there is no evidence to suggest that she transmitted the infection to any patients or colleagues at the hospital.

The total number of human cases in Indonesia is now 17, of which 12 have died.

Turkey

Laboratory tests conducted at Turkey’s national influenza centre in Ankara have confirmed two additional cases of human infection with avian influenza H5N1 [5].

The first newly confirmed case is a five year old boy from Dogubeyazit district in Agri province. He remains hospitalised. The second case is the boy’s 14 year old sister who died on 15 January from a respiratory disease.

As with all human cases reported from Turkey to date, both children developed illness following direct exposure to diseased poultry. No other family members have developed signs of illness.

These newly reported cases bring the total in Turkey to 20, of which four have died. It is likely that other cases will be reported as information and samples are analysed from persons who have been hospitalised with respiratory symptoms.

The global total of World Health Organization-confirmed cases is in the table and can be found on their website [6].  WHO will adjust the number of cases and deaths in Turkey when these cases are confirmed by the WHO-collaborating laboratory in Mill Hill, London.

 

COUNTRY	Cases as of 14 January 2006					DEATHS
	2003	2004	2005	2006	TOTAL
Cambodia	0	0	4	0	4	4
China	0	0	8	0	8	5
Indonesia	0	0	16	1	17	12
Thailand	0	17	5	0	22	14
Viet Nam	3	29	61	0	93	42
Turkey	0	0	0	4	4	2
TOTALS	3	46	94	5	148	79

 

Advice for travellers

There remain no restrictions for travel to countries that have been infected with avian influenza. Nevertheless, travellers should exercise precautions that have been previously posted [7]. Travellers who return ill with a respiratory illness should inform their physicians of their travel history. This includes travellers who return from all areas of Turkey and who have had close contact with poultry or wild birds.  Physicians should evaluate them according to the protocol established by the Health Protection Agency (HPA) [8].

References

1. World Health Organization. Avian influenza - situation in China. 10 January 2006. [cited 18 January 2006] Available at: http://www.who.int/csr/don/2006_01_10/en/index.html

2. World Health Organization. Avian influenza - situation in China - update 46. 7 December 2005. [cited 18 January 2006] Available at: http://www.who.int/csr/don/2005_12_07a/en/index.html

3. World Health Organization. Avian influenza - situation in China - update 49. 16 December 2006. [cited 18 January 2006] Available at: http://www.who.int/csr/don/2005_12_16/en/index.html

4. World Health Organization. Avian influenza - situation in Indonesia. 14 January 2006. [cited 18 January 2006] Available at: http://www.who.int/csr/don/2006_01_14/en/index.html

5. World Health Organization. Avian influenza - situation in Turkey - update 5. 16 January 2006. [cited 18 January 2006] Available at: http://www.who.int/csr/don/2006_01_16/en/index.html

6. World Health Organization. Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO. 14 January 2006. [cited 18 January 2006] Available at: http://www.who.int/csr/disease/avian_influenza/country/

cases_table_2006_01_14/en/index.html

7. NaTHNaC. Avian influenza - advice for travellers to affected areas. 4 November 2005. [cited 18 January 2006] Available at: http://www.NaTHNaC.org/pro/clinical_updates/

avianinfluenza_advice_041105.htm

8. Health Protection Agency. Algorithm for the management of returning travellers from countries affected by avian influenza presenting with a febrile illness: recognition, investigation and initial management. 12 January 2006. [cited 18 January 2006] Available at http://www.hpa.org.uk/web/HPAweb&HPA

webStandard/HPAweb_C/1195733851442