Avian Flu,H5N1 Diary

Friday, March 13, 2015

China Reports 2nd H5N1 Case of 2015

# 9819

Despite being the probable birthplace of H5N1, and having both the world’s largest population and the greatest number of poultry – for reasons that are less than clear – China remains only 5th on the list of countries with the most reported human H5N1 cases, trailing well behind Egypt, Indonesia, Vietnam and Cambodia.

This disparity is even greater when you factor in the differences in population, making the incidence of H5N1 in Egypt more than 90 times higher (per capita) than reported in China. [?]

Why this should be so isn’t clear [?], although some of the theories offered include:

• Differences in H5N1 clades in circulation (China is predominantly 2.3.2 & 2.3.4 while Egypt is 2.2.1)
• Differences in how poultry are kept and raised between the two countries
• Suspected weaknesses, secretiveness or deficits in surveillance and reporting from within China more likely

Whatever the reason, over the past 5 years China has only reported an average of 2 human H5N1 cases a year.
  
Credit WHO – March 3rd Table


All of which makes the following notification of China’s second H5N1 case of the year to Hong Kong’s CHP the more newsworthy.

13 March 2015
CHP notified by NHFPC of one human case of avian influenza A(H5N1) in Sichuan 
The Centre for Health Protection (CHP) of the Department of Health (DH) today (March 13) received notification from the National Health and Family Planning Commission (NHFPC) of a human case of avian influenza A(H5N1) affecting  a man  aged 46 in Sichuan.
According to the information provided by NHFPC, the patient is a poultry worker who lived in Suining. He developed a cough and chest discomfort on February 18. He attended a local hospital on February 21 and passed away on February 27. His specimen, which was tested by the relevant authority, was positive for avian influenza A(H5N1).
"Locally, we will remain vigilant and work closely with the UN's/World Health Organization and relevant health authorities to monitor the latest developments," a spokesman for the DH said.
Health surveillance measures have been implemented at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers and the DH also conducts temperature checks by handheld devices. Suspected cases will be immediately referred to public hospitals for follow-up. 
Regarding health education for travellers, the display of posters and broadcasting of health messages in departure and arrival halls, environmental health inspection and provision of regular updates to the travel industry and other stakeholders are ongoing. 
Travellers, especially those returning from avian influenza-affected areas with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas. 
The public should remain vigilant and take heed of the advice against avian influenza below:
(Continue . . .)

China’s first H5N1 case of 2015 was reported in the latest WHO Influenza at the human-animal interface summary dated March 3rd.

China reported a human infection with an avian influenza A(H5N1) virus in a 37-year-old woman from Jiangsu province. She developed symptoms on 14 January 2015, was admitted to hospital on 20 January. The patient had a history of exposure to poultry. No further cases among contacts were reported.

Although it has been nearly 2 months since China filed an H5N1 OIEupdate (see Follow-up report No. 2), the last report showed 18 poultry and/or wild bird outbreaks recorded in December and early January (see OIE map below).