25 October 2005

 

Avian influenza (H5N1): Human cases in Thailand and Indonesia

 

Thailand

The Ministry of Public Health in Thailand has confirmed two cases of human infection with H5N1 avian influenza. These are the first cases in Thailand since 8 October 2004 [1,2].

The first patient is a 48 year old man from Kanchanaburi province. He became unwell on 13 October 2005, and died in hospital on 19 October.  The infection has been linked to close contact with diseased poultry; several outbreaks amongst poultry in the area were reported earlier this month.

The second patient is the man’s seven year old son who assisted his father with defeathering of diseased birds and was hospitalised with respiratory symptoms on 19 October. He is currently recovering in hospital.

Indonesia

The Ministry of Health in Indonesia has confirmed two cases of human infection with H5N1 avian influenza [2].

The first case is a four year old boy from Lampung Province on Sumatra who developed symptoms on 4 October. He was hospitalised, and has made a full recovery.

The second case is a 23 year old man from Bogor, West Java. He was hospitalised on 28 September, and died on 30 September.

Epidemiological investigations of these two cases have concluded that exposure to infected poultry was the likely source of infection.

These reports bring to 121 the number of cases of human infection with influenza A/H5N1 since December of 2003 [3]. Sixty-two of these patients have died for a case fatality rate of 51%.

Recommendations for travellers

There are currently no travel restrictions to countries reporting avian influenza H5N1 cases, as the risk to UK travellers is believed to be very low.  Sustained human to human transmission has not been reported. However, travellers to affected areas are advised to take the following precautions.

• 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 take with them the neuraminidase inhibitor, Oseltamivir (Tamiflu®).

Comprehensive advice on avian influenza can be found on the World Health Organization website at http://www.who.int/csr/disease/avian_influenza/en/

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/avianinfluenza/

guidelines.htm

Up to date information on incidence of avian influenza in birds is available from the World Organization for Animal Health at http://www.oie.int/eng/en_index.htm and from the Animal Welfare page of the Department for Environment, Food and Rural Affairs at http://www.defra.gov.uk/animalh/diseases/notifiable/disease/ai/

index.htm

References

1. World Health Organization. Avian influenza - situation in Thailand - update 35. Available at: http://www.who.int/csr/don/2005_10_20a/en/index.html

2. World Health Organization. Avian influenza - situation in Thailand, Indonesia - update 36. Available at: http://www.who.int/csr/don/2005_10_24/en/index.html

3. World Health Organization. Cumulative number of confirmed human case with avian influenza A/(H5N1) reported top WHO. 24 October 2005. Available at: http://www.who.int/csr/disease/avian_influenza/country/cases_

table_2005_10_24/en/index.html