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After a slowdown in reporting during the month of November, Hong Kong's CHP reports the second H5N6 infection this week from the Mainland, this time involving a 68-year-old man living in Huizhou, Guangdong Province. He reportedly kept poultry at home, fell ill on December 3rd, and is now hospitalized in critical condition.
This is the 53rd case reported by China since the virus emerged in 2014, and the 28th in the past 12 months.
With well over half of all known human infections occurring over the past year, we've seen a recent flurry of risk analyses released by various agencies on this avian virus, including:
CDC Adds A New H5N6 Avian Flu Virus To IRAT List
Since H5N6 has yet to acquire the ability to transmit efficiently from human-to-human, the risks of seeing large, sustained outbreaks is currently low. But, as we saw in PLoS Path: H9N2 Virus-derived M1 Protein Promotes H5N6 Virus Release in Mammalian Cells these HPAI H5 viruses continue to evolve, making them a genuine concern.
China's year-long surge in H5N6 infections comes after a 3-year lull in cases following the introduction of a new H5+H7 poultry vaccine by China, which - along with recent surveillance reports (see here & here) - suggests that some H5N6 viruses may have evolved away from the vaccine's protection and are now spreading stealthily in poultry.
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 (December 11) 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 68-year-old man living in Huizhou in Guangdong Province, who kept poultry at home. He developed symptoms on December 3 and was admitted for treatment on December 7. The patient is in critical condition.
From 2014 to date, 53 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/Saturday, December 11, 2021Issued at HKT 15:57
Hence HK's warnings not to visit live bird markets, and to avoid contact with live poultry.
Given the limits of surveillance and reporting, is likely that there are more H5N6 infections than we are aware of. Some may be mild, or simply misdiagnosed, or may not be reported up the chain of command by local officials.
A 2013 study (see Lancet: Clinical Severity Of Human H7N9 Infection) estimated the number of H7N9 cases during the spring of that year was likely between 12 and 200-times greater than had been reported by China.
Since winter is generally more conducive to the transmission of avian flu viruses, and H5N6 appears well entrenched in Chinese poultry, we can expect to hear of more cases in the months ahead.
