Wednesday, September 08, 2021

Hong Kong Monitoring Another Human H5N6 Case On The Mainland

 

#16,171

The summer surge in human H5N6 infections in Mainland China continues, with another case with an onset in August, this time in Guangxi Province. This is the 18th case reported by China since last December, and represents a sudden, and marked, increase in case reports.

Last week, in CCDC Weekly: Outbreak Report - Five Independent Cases of Human Infection With HPAI H5N6 — Sichuan Province, we looked at China's equivalent of the CDC's MMWR report on a series of 5 of these cases going back to May. 

While we've not seen any obvious clustering of cases (other than a husband & wife in Hunan province who likely shared an exposure), the recent spate of H5N6 cases - particularly in late summer - is concerning, as this is normally the slowest time of the year for avian flu transmission. 

First today's Hong Kong report, then I'll return with a brief postscript. 


CHP closely monitors human case of avian influenza A(H5N6) in Mainland
 
The Centre for Health Protection (CHP) of the Department of Health is today (September 8) closely monitoring a human case 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 case involves a 48-year-old woman living in Liuzhou, Guangxi, who had contact with live domestic poultry before the onset of symptoms. She developed symptoms on August 25 and was admitted for treatment on August 29. The patient is in serious condition.

From 2014 to date, 42 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 or 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/Wednesday, September 8, 2021
Issued at HKT 18:10

Avian H5N6, which had been well controlled in China between since the summer of 2017 due to their highly successful nationwide H5+H7 poultry vaccination program (see OFID: Avian H5, H7 & H9 Contamination Before & After China's Massive Poultry Vaccination Campaign), suddenly begun spreading again since late last year. 

Most of those who have been infected had recent, close contact with poultry, yet we've not been hearing of any poultry outbreaks of HPAI H5N6 from China's MOA

This raises questions over the effectiveness of the H5 component of their vaccine after 3 years, and suggests that the vaccine may be masking the normally obvious symptoms of HPAI infection in poultry, but not preventing its spread.