Wednesday, December 15, 2021

Hong Kong CHP Monitoring 4 More H5N6 Human Infections On the Mainland


#16,416

Hong Kong's CHP has announced they are monitoring 4 more H5N6 cases on the Mainland, at least 3 of which occurred during a month-long lull in reporting during November. As we discussed three weeks ago, when the WHO issued their Assessment of Risk Associated with Influenza A(H5N6), China often belatedly reports on cases. 

`Bad news' - particularly about infectious disease outbreaks - is often treated as a national security matter in China, so a lack of reports isn't necessarily indicative of a lack of reportable events.

Given the record number of H5N6 cases over the summer, it made little sense that they should stop abruptly in early November when the weather was growing cooler and more conducive for avian flu transmission. 

We've now seen 6 cases announced in the past week, 5 of which occurred in November. 

Beyond China's `strategic' releasing of information, it is also likely that many cases go undetected in China, since surveillance and reporting - particularly in more rural regions - is less than robust. 

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.

Today's report from Hong Kong brings the total number of H5N6 human infections reported by China since 2104 to 57, with 31 of those occurring in the past 12 months. Human province, it seems, has become a bit of a hotspot, taking the case count lead (n=13) from Guangdong province with today's report. 

CHP closely monitors four human cases of avian influenza A(H5N6) in Mainland 

The Centre for Health Protection (CHP) of the Department of Health is today (December 15) closely monitoring four 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.

Details of the cases are listed in the table below:

 

From 2014 to date, 57 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/Wednesday, December 15, 2021
Issued at HKT 17:22

With well over half  of all known human H5N6 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. 

Which is why we watch events in China intently, looking for any signs this virus has acquired new abilities to transmit among humans.