Clinical Updates
5 January 2006
Avian influenza (H5N1) human cases in Indonesia and China
Indonesia
On 23 December 2005, the Ministry of Health in Indonesia confirmed two additional cases of human infection with avian influenza H5N1 [1].
The first case is an eight year old boy from Central Jakarta. He developed symptoms on 8 December, was hospitalised on 13 December, and died on 15 December.
The second case occurred in a 39 year old man from East Jakarta. He developed symptoms on 9 December, was hospitalised on 11 December, and died on 12 December.
Family members and close contacts of both cases were observed and tested for possible infection. Investigations are underway to determine the source of the infection and samples from birds in both neighbourhoods have been taken and are undergoing tests.
These additional cases bring the total number in Indonesia to 16, of which 11 have died.
China
On 30 December 2005, the Ministry of Health of China confirmed an additional case of human infection with avian influenza H5N1 [2].
The case occurred in a 41 year old woman from the south-eastern province of Fujian. She developed symptoms on 9 December, and died in hospital on 21 December. Although initial tests for H5N1 were negative, further tests on 23 December including polymerase chain reaction (PCR) tests were positive for H5N1 virus.
Close contacts and family members have been placed under observation, but remain well. The presence of H5 virus has not been confirmed in poultry in the vicinity of either the patient’s residence or place of work. Investigators have also not been able to confirm any direct contact between the patient and poultry prior to the onset of symptoms. Investigations are therefore ongoing to determine the source of infection.
This is China’s seventh laboratory-confirmed case of human infection with H5N1. Of these cases, 3 have died.
The cumulative number of confirmed human cases of avian influenza A/H5N1 infection reported to World Health Organization (WHO) is tabulated below, and can be found on the WHO website at: www.who.int/csr/disease/avian_influenza/country/
cases_table_2005_12_30/en/index.html
COUNTRY |
CASES as of 30 December 2005 |
DEATHS |
|||
2003 |
2004 |
2005 |
TOTAL |
||
Cambodia |
0 |
0 |
4 |
4 |
4 |
China |
0 |
0 |
7 |
7 |
3 |
Indonesia |
0 |
0 |
16 |
16 |
11 |
Thailand |
0 |
17 |
5 |
22 |
14 |
Viet Nam |
3 |
29 |
61 |
93 |
42 |
TOTALS |
3 |
46 |
93 |
142 |
74 |
Recommendations for travellers
Current recommendations for travellers have been recently posted by NaTHNaC: Avian influenza - Advice for travellers to affected areas. During the upcoming Lunar New Year, it is particularly important that visitors to Asia practice preventive measures as there will be increased preparation and consumption of poultry for the holiday [3].
References
1. World Health Organization. Avian influenza - situation in Indonesia - update 50. 23 December 2005. [cited 4 January 2006] Available at http://www.who.int/csr/don/2005_12_23/en/
2. World Health Organization. Avian influenza - situation in China - update 51. 30 December 2005. [cited 4 January 2006] Available at http://www.who.int/csr/don/2005_12_30/en/
3. Centers for Disease Control and Prevention. Notice about avian influenza A (H5N1) in Asia during travel during the Lunar New Year. 29 December 2005. [cited 4 January 2006]. Available at: http://www.cdc.gov/travel/other/
avian_flu_lunar_newyear_2006.htm
Links
Guidelines on the management of travellers returning from avian influenza-infected regions with a febrile illness are available from the Health Protection Agency at: http://www.hpa.org.uk/infections/topics_az/
Up-to-date information on incidence of avian influenza in birds is available from the World Organisation for Animal Health at http://www.oie.int/eng/en_index.htm
A summary statement from NaTHNaC on cases of avian influenza in poultry and wildfowl can be found at: http://www.NaTHNaC.org/pro/clinical_updates/
avianinfluenza_cases_291205.htm
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