Tuesday, March 08, 2022

HK CHP Reports 2 (Fatal) Cases of H5N6 on the Mainland (from 2021)

 

#16,619

China continues to belatedly report human cases of HPAI H5N6, adding two more cases from November of 2021 from Guangxi Province. This makes 35 cases in 2021 that we know of, and brings China's reported total to 73 cases since the virus emerged in 2014.

China often reports cases weeks, sometimes even months, after the fact. `Bad news' is often released `strategically'. So far, China has announced 9 cases in 2022 (all from January), but it is anyone's guess how many more may be in the queue.

Today's announced cases involve a 12-year-old girl and a 79-year-old man living in Liuzhou in Guangxi, who had visited a live poultry market before onset. It isn't stated that they are from the same household, but their onset dates (17th & 18th of Nov.), location, and history suggest it. 

First today's announcement from the CHP, then I'll have more.

CHP 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 (March 8) 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 12-year-old female living in Liuzhou in Guangxi, who had visited a live poultry market before onset. She developed symptoms on November 17 last year and was admitted for treatment on November 20. She passed away on December 4.

The second case involves a 79-year-old man living in Liuzhou in Guangxi, who had visited a live poultry market before onset. He developed symptoms on November 18 last year and was admitted for treatment on November 22. He passed away on December 3.

From 2014 to date, 73 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/Tuesday, March 8, 2022
Issued at HKT 18:40

Although human H5N6 infections remain sporadic, and most likely are the result of direct contact with infected poultry, there are some cases with no known poultry contact.

This opens the possibility of occasional human-to-human transmission, although that appears to be rare. 

H5N6 causes severe illness in the majority of known cases and has a high (40%-50%) case fatality rate. It continues to evolve (and reassort) in poultry and wild birds, particularly in China, and over the past few months has sparked renewed interest by health agencies around the world.

CDC Adds A New H5N6 Avian Flu Virus To IRAT List

WHO: Assessment of Risk Associated with Influenza A(H5N6) Virus

UK HSA Risk Assessment On HPAI H5N6
 
For now, H5N6 is primarily a concern to those who have close contact with live poultry in China.  We continue to watch its progress closely, however, looking for any signs of enhanced transmissibility. 

Although not in the same league as H5N6, Hong Kong's CHP also announced another human H9N2 case on the Mainland in their Weekly Avian Influenza report.  Not surprisingly, this report is also from November of 2021


H9N2 cases are generally mild or moderate, and only rarely result in death.  Most reported cases are in children - and while fewer than 100 cases have been reported to date - human infection in places like China, Pakistan, and Southeast Asia are problem more common than we know. 

This follows last week's release (see HK CHP Reports 6 More Human H9N2 Cases On the Mainland (3 - 2021, 3 - 2022), where we looked at the history, and (limited) pandemic potential, of H9N2 in considerable depth.