Avian Flu Diary: HK CHP Notified Of Fatal H5N6 Case In Guangxi Province

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Although H7N9 activity in China has slowed markedly since the introduction of a new H5+H7 poultry vaccine last summer, over the past three months we've seen an uptick in HPAI H5N6 activity - in poultry and in humans.

Last August China reported their 2nd human infection of 2018 (see Guangxi Province Report Their 3rd Human H5N6 Infection)
That was followed in late September by their 3rd (see HK CHP Notified Of Human H5N6 Case In Gaungdong Province).
On September 29th the MOA Announced An HPAI H5N6 Outbreak In Guizhou Province Poultry, followed on October 9th by an H5N6 Outbreak In Hunan Province Poultry.
Just last week we saw : China MOA: H5N6 Outbreak In Hubei Province Poultry

Today Hong Kong's CHP has been notified of China's 4th H5N6 infection of 2018, and the third since September. The 44 y.o. male patient - now deceased - denied having any contact with live poultry.

CHP notified of human case of avian influenza A(H5N6) in Guangxi

The Centre for Health Protection (CHP) of the Department of Health (DH) today (October 31) received notification of an additional human case of avian influenza A(H5N6) in Guangxi from the National Health Commission, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

The case involved a 44-year-old man from Hechi in Guangxi. He developed symptoms on October 18, was hospitalised on October 21 and died on October 27. The patient denied that he had contact with live poultry before the onset of symptoms.

From 2014 to date, 22 human cases of avian influenza A(H5N6) have been reported by the Mainland health authorities.

"All novel influenza A infections, including H5N6, are notifiable infectious diseases in Hong Kong," the spokesman said.

Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchasing live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.

Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment of potential diseases. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.

While local surveillance, prevention and control measures are in place, the CHP will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments.

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This Asian HPAI H5N6 virus should not be confused with the milder European origin HPAI H5N6 virus reassortment that turned up in South Korea, Japan, and Northern Europe last winter.

The name is the same, but their lineage and threat to human health are quite different.

Asian HPAI H5N6 - while only identified in 22 patients so far - has proven to be fatal in more than half those cases. So far - unlike it's HPAI H5N8 and HPAI H5N1 cousins - it has yet to spread beyond Asia.

For more on the history of this lesser known virus, you may wish to revisit: