#17,511
Following unprecedented spread of HPAI H5 in birds worldwide, and a growing number of reported spillovers into mammalian species (see UK HAIRS Risk Assessment), we've seen increased focus placed on identifying and reporting potential zoonotic flu infections in humans.
Last month the UK announced the detection of two asymptomatic poultry workers whose nasal and throat swabs have tested positive for H5N1, and we've seen a handful of other H5 infections around the globe in recent months (see reports from Chile and Ecuador).
Three months ago, in UK Novel Flu Surveillance: Quantifying TTD, we saw estimates it could take between 3 and 10 weeks and anywhere between a few dozen to a few thousand infections before community spread would become apparent.
In hopes of improving the speed of detection, last week the CDC held a webinar for clinicians on recognizing, treating, and reporting zoonotic (avian & swine) influenza cases in the community (see COCA Call : What Providers Need to Know about Zoonotic Influenza), and today the ECDC has released similarly themed guidance for hospitals.
Enhanced surveillance of severe avian influenza virus infections in hospital settings in the EU/EEA
Guidance
26 Jun 2023
Cite:
This document describes how to strengthen surveillance in hospital settings for the identification of severely affected patients infected with avian influenza virus in the EU/EEA.
Executive summary
Avian influenza virus outbreaks are continuing during the summer months, causing mass mortality in sea-breeding bird colonies, including gulls. A larger exposure of human population to sick or dead birds and mammals is expected to occur.
Transmission to humans cannot be excluded when avian influenza is circulating in wild birds and mammals and people are directly exposed without wearing protective equipment. During the summer months, infections with seasonal influenza viruses are considered to be very limited, and only a few patients with severe disease caused by the seasonal influenza virus are expected to be admitted to hospitals.
To identify sporadic severe human infections with avian influenza virus in hospital settings, the following approach is proposed:
- People admitted to hospitals with respiratory symptoms should be asked about exposure to birds (wild birds or poultry) or other wild animals (dead or alive) in the two weeks before admission.
- Consider testing for influenza virus hospitalised patients with unexplained viral encephalitis/ meningoencephalitis lacking the aetiological agent diagnosis.
- All influenza A-positive samples from hospitalised patients should be subtyped for seasonal influenza viruses A(H1)pdm09 and A(H3).
- Samples positive for influenza type A virus but negative for A(H1)pdm09 or A(H3) should be immediately sent to national influenza reference laboratories for further analysis and H5 testing.
Enhanced surveillance of severe avian influenza virus infections in hospital settings in the EU/EEA - EN - [PDF-337.09 KB]
Next fall and winter - when seasonal influenza is expected to return - it will be much harder to separate seasonal flu cases from zoonotic flu infections, which makes the next few months an opportune time to ramp up surveillance.
Hopefully, there are no cases out there to find. But we'll never know unless we look.
