Flu Virus binding to Receptor Cells – Credit CDC
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Complicating Hong Hong's surveillance for additional novel coronavirus cases is their flu season, which has been elevated for more than a month, a growing cluster of Legionnaires' disease, and now a report today of an imported case of H9 avian influenza.
One of the `side benefits' of increased surveillance looking for one pathogen is that others are often detected along the way. The increased surveillance in Mainland China has also turned up an increased number of H9N2 cases.Although H9N2 is considered a lower-threat avian flu virus, it nonetheless has some pandemic potential (see CDC IRAT SCORE). A reminder that nothing happens in a vacuum, and while the novel coronavirus rightfully has most of our attention right now, it's a big world, with a lot of concurrent threats.
CHP investigating a case of influenza A (H9) infection
The Centre for Health Protection (CHP) of the Department of Health (DH) is today (February 7) investigating an imported case of influenza A (H9) infection affecting a boy aged 7.
The patient has underlying illnesses, who has developed cough and runny nose since February 4 and fever on the next day. On February 5, he was brought to Wang Tau Hom Jockey Club General Out-patient Clinic (GOPC) for medical advice, and was transferred to Kwong Wah Hospital (KWH) where he was admitted to the isolation ward for further management. He was transferred to general ward of KWH yesterday (February 6) and was transferred to isolation ward of Princess Margaret Hospital for treatment today. He has been in stable condition.
His nasopharyngeal swab tested positive for the influenza A (H9) virus upon testing. Subtyping result is pending. His clinical diagnosis was avian influenza.
Preliminary investigation of the CHP revealed that the patient visited his maternal grandparents' home in Shenzhen during the incubation period, where backyard poultry was kept. However, the patient had no direct poultry contact recently, nor consumption of undercooked poultry, or contact with patients. His home contacts have remained asymptomatic so far.
"Investigations are ongoing. Healthcare workers of Wang Tau Hom Jockey Club GOPC, KWH and the ambulance service, as well as related patients in KWH, have been put under medical surveillance," a spokesman for the DH said.
"There are various types of influenza viruses. Apart from those which can circulate among humans and cause seasonal influenza, many other influenza A viruses are found in birds and other animal species. Some of these animal viruses may occasionally infect humans, avian influenza viruses are one example. Avian influenza is caused by those influenza viruses that mainly affect birds and poultry, such as chickens or ducks. Human cases infected with avian influenza A viruses have been identified in recent years," the spokesman explained.
Novel influenza A infection, including influenza A(H9), is a notifiable infectious disease in Hong Kong. Eight cases of influenza A (H9N2) had been reported in the past, including two local cases in 1999, one local case each in 2003 and 2007, an imported case in 2008, an imported case and one with the source of infection unclassified in 2009, and one imported case in 2013. No deaths have been recorded so far. Influenza A (H9N2) infection is a mild form of avian influenza.
The CHP will inform the health authority of Guangdong of the case.
"The CHP's surveillance with public and private hospitals, with practising doctors and at boundary control points is firmly in place. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.
"Travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Healthcare professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.
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