Thursday, September 30, 2021

HK CHP: Two More Cases Of H5N6 On The Chinese Mainland


Mainland China's summer of H5N6 avian flu continues today with yet another announcement of (2) human infections with this often deadly virus.  The first case (M,55) - as was yesterday's  fatal case - was infected in Guilin, Guangxi province in August, but remains in serious condition.  

The second case is from Chongqing Municipality (M,77), was hospitalized on September 19th, and has since died.   Both cases reportedly had contact with poultry prior to infection. 

Together these represent the 22nd and 23rd H5N6 cases reported by China since last December, which is very nearly 50% of all the cases reported by China since the virus first emerged in 2014.  This uptick in cases comes after a nearly 3-year lull in both H5 and H7 virus cases in China. 

HP closely monitors two human cases of avian influenza A(H5N6) in Mainland

The Centre for Health Protection (CHP) of the Department of Health is today (September 30) closely monitoring two human cases of avian influenza A(H5N6) in the Mainland, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

The first case involves a 55-year-old man living in Guilin in Guangxi, who had prior exposure to a live poultry market before the onset of symptoms. He developed symptoms on August 23, and was admitted for treatment on August 30. The patient is in serious condition.

The second case involves a 72-year-old man living in Chongqing Municipality, who had contact with sick poultry before onset. He developed symptoms on September 16, and was admitted for treatment on September 19. The patient has passed away.

From 2014 to date, 47 human cases of avian influenza A(H5N6) have been reported by Mainland health authorities.

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

The public should maintain strict personal, hand, food and environmental hygiene and take heed of the advice below when handling poultry:
  • Avoid touching poultry, birds, animals or their droppings;
  • When buying live chickens, do not touch them and their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume the eggs immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs;
  • Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done;
  • Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to the toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and
  • Wear a mask if fever or respiratory symptoms develop, when going to a hospital or clinic, or while taking care of patients with fever or respiratory symptoms.
​The public may visit the CHP's pages for more information: the avian influenza page, the weekly Avian Influenza Report, global statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.

Ends/Thursday, September 30, 2021
Issued at HKT 19:51

So far, human infection with H5N6 has been primarily reported in China (and 1 from Laos), although the virus has been found in migratory birds in Vietnam, Laos, and Cambodia. As we discussed yesterday, in Taiwan & South Korea Both Warn On Fall Arrival Of Migratory Birds, how long H5N6 remains primarily a Chinese problem is unknown.

Over the past month China's CDC has published two detailed outbreak reports (see below) in their CCDC Weekly. Both of which warn that HPAI H5N6 continues to mutate and reassort, and that its threat to public health is increasing.


While we haven't seen any obvious signs of human-to-human transmission of H5N6, this recent surge in human infections is the largest we've seen since the spring wave of H7N9.  And given the recent, belated announcements by the Chinese government, this outbreak could be bigger than the current numbers suggest. 

Since summer is traditionally the least active time of the year for avian flu transmission,  we'll be watching the developments in China - and its neighbors - carefully over the fall and winter months.