H5N6 is one of the new generation of HPAI H5 viruses that began to make itself known in China in 2013 and 2014. A reassortment of the venerable H5N1 virus, which had been the major HPAI player in the world for a decade, H5N6 appeared nearly simultaneously in China and Laos in the spring of 2014 (see H5N6: The Other HPAI H5 Threat).
Unlike it's H5N8 cousin (and its reassortants), H5N6 has caused a handful of human infections in China, and among known cases has a very high fatality rate.
Surveillance, testing, and reporting being what it is (or isn't) in China, we don't really know the true burden of human illness from this emerging virus, although infection is considered rare.
In 2014 H5N6 was also reported in Vietnam, and continues to erupt there, and has turned up this year in dead or dying birds in Hong Kong (see Hong Kong Robin Positive For H5N6).
While not yet as well travelled as HPAI H5N8, which turned up in Europe and North America late last year, this virus (along with H7N9) is also viewed as having the potential to expand its geographic range.
In a departure from the practices of many other Chinese Provinces, Guangdong has been pretty good about quickly reporting human infections with novel flu viruses, likely due to their close proximity and relationship with Hong Kong.
Two reports: First from the Emergency Management Office of Guangdong Province, and the second from Hong Kong's CHP.
2015-12-29 17:21:00 Ben
December 29, 2015, the Shenzhen Municipal report one case of H5N6 cases. Wu patient (female, 26 years old), living in Bao'an District, Shenzhen, Shenzhen designated hospital now hospitalized in critical condition.
Experts assess that: The case appeared sporadic cases, lower the risk of spreading the virus at this stage.
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Notification of confirmed human case of avian influenza A(H5N6) in Guangdong
The Centre for Health Protection (CHP) of the Department of Health (DH) has been notified of a confirmed human case of avian influenza A(H5N6) by the Health and Family Planning Commission of Guangdong Province today (December 29) affecting a 26-year-old woman in Shenzhen.
The patient lives in Bao'an, Shenzhen. She is currently hospitalised for treatment and in a critical condition.
A spokesman for the DH said, "All novel influenza A infections (including H5N6) are notifiable diseases in Hong Kong.
"Locally, we will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments."
"In view of cases confirmed on the Mainland, members of the public should maintain good personal, food and environmental hygiene at all times during travel," the spokesman urged.
"All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.
Regarding health education for travellers, the display of posters and broadcast of health messages in departure and arrival halls, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are proceeding.
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As we wait and watch for the return of H5N8/H5N2 in North America, or the resumption of Egypt’s H5N1 epidemic, it is worth noting that we've seen a unusually high number of new HPAI H5 viruses cropping up around the world over the past year (see You Say You Want An Evolution?).
While it is impossible to predict what any of these individual HPAI subtypes do - or where they will eventually spread – the rapidly increasing diversity and spread of these viruses raises the stakes not only for the poultry industry, but potentially for public health as well.
And given its limited ability to infect humans, HPAI H5N6 is one of those viruses we tend to watch most closely.