#16,275
China's summer of H5N6 continues, with another belated report from the mainland of a 66 y.o. male patient from Yongzhou in Hunan Province - admitted to the hospital a month ago with H5N6 infection - who remains in critical condition. While the frequency of reported cases has slowed during the month of October, the delayed reporting of cases from China may be skewing the picture.Since if first emerged in 2014, we've seen an average of 4 to 5 cases reported a year out of China. At least, until December of last year. Over the past 10 months we've seen 25 cases officially reported, double the total from the previous 6 years.
First today's report from Hong Kong's CHP, then I'll return with a 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 (October 27) 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 66-year-old man living in Yongzhou in Hunan Province. He is a farmer and had contact with live domestic poultry. He developed symptoms on September 25, and was admitted for treatment on September 27. The patient is in critical condition.
From 2014 to date, 49 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: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.
- 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.
Ends/Wednesday, October 27, 2021
Issued at HKT 17:00
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. Given the ability of HPAI H5 viruses to hitch a ride on (relatively) immune migratory birds, how long H5N6 stays put is unknown.
In 2019, in EID Journal: Genetic Characterization of Avian Influenza A(H5N6) Virus Clade 2.3.4.4, Russia, 2018, we looked at the detection of the virus some 5000 km north and west of Sichuan China, where it first emerged in 2014.
Over the past two months 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.
China CCDC Weekly: Genetic Characterization of Two Human A (H5N6) Viruses — Guangxi , China, 2021
CCDC Weekly: Outbreak Report - Five Independent Cases of Human Infection With HPAI H5N6 — Sichuan Province
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 in 2017. Much of it has occurred over the summer months - typically the slowest time of the year for HPAI H5 transmission - which means we'll be watching China closely in the months ahead.
