#17,629
In a blog last week I mentioned that China's National Influenza Center's weekly report #32 contained a cryptic, single-line note on page 10 which reads `第 32 周，重庆市报告 1 例人感染 H5N6 禽流感病例，四川省报告 1 例人感染 H9 亚型禽流感病例', which translates to:In the 32nd week, Chongqing City reported a case of human infection with H5N6 avian influenza, and Sichuan Province reported a case of human infection with H9 subtype avian influenza.
I found confirmation of that translation on the F.I.C. (Flu In China) website, which described the case as:
So far, so good. But today Hong Kong's CHP is reporting a different story . . . or perhaps, a different case. Instead of a male in Chongqing with H5N6, they are reporting a female with H5N6 in Sichuan (where an H9 case was reported last week).Week 32 of 2023, China reported a human case of avian influenza A(H5N6) in Chongqing Municipality.
The male patient was in critical condition, had contact history of 2 dead chickens prior to the onset of the disaese, mNGS reported avian influenza(H5N6) and Aspergillus flavus in BLAF.
It is possible the details of last week's H5N6 & H9N2 cases were inadvertently switched (either then, or now). Unfortunately, China continues to hold outbreak information (on HPAI, COVID, and anything else) very close to the vest, and we may have to wait for the next WHO update to sort this out.
In the meantime, we have the following update from Hong Kong's CHP on what is officially, China's 86th human case of H5N6 infection. I'll have a bit more after the break.
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 (August 23) 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 27-year-old female living in Dazhou, Sichuan. She developed symptoms on July 20 and was admitted for treatment on July 22.
From 2014 to date, 86 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, August 23, 2023
Issued at HKT 17:15
During the first six years following H5N6's emergence (in 2014), China reported only 25 human cases. But over the past three years, more than 60 new cases have been announced. While the outcomes of these infections have not always been divulged, about half appear to have been fatal.
Reporting from China is sporadic at best, so we've no idea of how many cases might go undetected or unreported.
Recent studies (see Study: Influenza A (H6N6) Viruses Isolated from Chickens Replicate in Mice and Human lungs Without Prior Adaptation) suggest the H5N6 virus continues to adapt to mammalian hosts. Last summer, the Lancet published Resurgence of H5N6 Avian Influenza Virus in 2021 Poses New Threat to Public Health.
Our great good luck with HPAI H5N6 (so far), is that - unlike H5N8 in 2016, and H5N1 in 2021 - it has not adapted well enough to migratory birds to begin a world tour. All human cases (except 1 in Laos), have been reported by China, and the virus has not expanded beyond Southeast Asia.
But past performance is no guarantee of future results. And so we watch H5N6's journey with more than just academic interest.
