#17,214
Avian H5N6 - which was first reported in China in the spring of 2014 - initially averaged only 3 or 4 human infections a year until late 2020, when its number began to climb significantly. A record 35 cases were reported in 2021, and for 2022 (including today's case) China has announced an additional 18 cases.
As has been mentioned ad nauseum in this blog (see last March's HK CHP Reports 2 (Fatal) Cases of H5N6 on the Mainland (from 2021), China hasn't always been quick to report human cases of HPAI H5N6 (and other disease outbreaks).
We often only get reports belatedly, and usually with few details. Outcomes are rarely reported, and we've no idea how complete the reporting is. China tends to treat `bad news' as a national security issue, and has a habit of releasing information `strategically', particularly during politically `sensitive times'.
HPAI H5N6 is a particular concern because it has a high fatality rate in humans, and continues to evolve and adapt to mammalian hosts (see Study: Pathogenicity and Transmissibility of Clade 2.3.4.4h H5N6 Avian Influenza Viruses in Mammals).
Today's case report is typically sparse, and all we know is summed up in 2 sentences from an announcement by Hong Kong's CHP:
The case involves a 54-year-old man living in Changsha, Hunan, who developed symptoms on November 2, 2022. He was admitted for treatment on November 5, 2022, and was in critical condition.
More than 2 months after-the-fact, however, and yet we get no details on potential exposures, or even if the patient survived. Most (but not all) H5N6 cases have been linked to poultry exposure, while at the same time, China has not reported a concurrent jump in H5N6 outbreaks in poultry.
In 2022 China also reported sporadic infections with novel H3N8 (see here and here), H9N2 (see here), and H10N3 (see here), and less than two weeks ago we learned that a Fatal H5N1 Infection In Guangxi Province last September was due to the clade 2.3.4.4b virus currently spreading across Europe and the Americas.
Numerous studies suggest that reported novel flu cases likely represent only a small fraction of actual cases (e.g. Lancet: Clinical Severity Of Human H7N9 Infection), and given the current chaos in China surrounding COVID, the numbers officially reported are almost certainly significant under counts.
The full statement from Hong Kong's CHP follows:
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 (January 6) 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 54-year-old man living in Changsha, Hunan, who developed symptoms on November 2, 2022. He was admitted for treatment on November 5, 2022, and was in critical condition.
From 2014 to date, 82 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/Friday, January 6, 2023
Issued at HKT 17:08
The good news is that none of these novel avian flu viruses appear to have acquired the ability to spread efficiently between humans, which severely limits their ability to impact public health.
The bad news is, nature isn't going to stop trying to create a better flu virus.
Which is why we desperately need better surveillance and reporting - not just in China - but around the world.
