Although the number of new human H5N6 infections being reported by China have fallen the past few months, since late 2020 we've seen a huge resurgence of human infections on the Mainland. This virus is particularly concerning due to its high fatality rate (40%-50%) in humans.
Undoubtedly an undercount, between 2014 and 2020 China reported only 3 to 4 cases a year, but that number has soared by well over 50 cases since December 2020.
Reports, when we get them, tend to contain few details, and are often delayed by weeks or even months. Today's case involves a child who fell ill 7 weeks ago, and who has been hospitalized for well over a month.
Curiously, despite linking most human H5N6 infections to contact with infected poultry, China has not reported a concurrent jump in H5N6 outbreaks in poultry. Admittedly, getting timely reports from China on disease outbreaks - in humans, wild birds, or poultry - has always been difficult.
In China, `Bad news' is often treated as a national security threat or a politically sensitive issue, and is often parceled out strategically by official government sources and/or state controlled media.
This morning Hong Kong's CHP has released the following report on what is purported to be the 81st human H5N6 infection in China since 2014. I'll have a brief postscript after the break.
The Centre for Health Protection (CHP) of the Department of Health is today (October 21) 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 3-year-old boy living in Nanning, Guangxi. He developed symptoms on September 1 and was admitted for treatment on September 11. He is in serious condition.From 2014 to date, 81 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/Friday, October 21, 2022
Issued at HKT 17:45
Over the past few months we've also seen reports of infection with novel H3N8 (see here and here), H9N2 (see here), and H10N3 (see here) come out of China. We've previously seen studies suggesting that reported novel flu cases likely represent only a small fraction of actual cases (e.g. Lancet: Clinical Severity Of Human H7N9 Infection).
The good news is that none of these novel viruses appears to have acquired the ability to spread efficiently between humans, which severely limits their ability to impact public health.
The bad news is, nature will continue to refine and hone these viruses, increasing the chances that one of them will eventually acquire the skills required to spark a pandemic.
When that may happen, and with what virus, is unknown. But we'd better be prepared for it when it come.
