#17,830It has been nearly 3 months since the last reported human H5N6 infection came out of China (see Hong Kong CHP Monitoring Fatal H5N6 Infection On Mainland (Chongqing)), which described a fatal case (68,M) who fell ill in the first week of August, and died on August 20th.
Belated reporting of cases has become the norm out of China, with delays of more than 2 months not uncommon. Today, Hong Kong's CHP has announced another fatal case (33, F) - this time with an onset on October 20th, and who died on November 15th.
Beyond her age, location (Bazhong City in Sichuan Province), and the fact that she had had visited a live poultry market prior to the onset of symptoms (timeframe not provided), no other details are offered.
First the announcement from HK's CHP, after which I'll have a bit more.
CHP closely monitors human case of avian influenza A(H5N6) on Mainland
The Centre for Health Protection (CHP) of the Department of Health is today (December 22) closely monitoring a human case of avian influenza A(H5N6) on the Mainland, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.
The case involves a 33-year-old female living in Bazhong City in Sichuan Province, who had visited a live poultry market before the onset of symptoms. She developed symptoms on October 20 and was admitted for treatment on October 22. She passed away on November 14.
From 2014 to date, 88 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:
While H5N1 clade 2.3.4.4b gets the bulk of our attention, H5N6 continues to demonstrate its ability to spillover into humans, often producing severe or fatal illness. While China has now reported 88 infections, the true number is likely higher, as many cases likely go unrecognised.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, December 22, 2023
Issued at HKT 17:00
Unlike its H5N1 cousin, H5N6 hasn't adapted well enough to migratory birds to embark on a world tour. All but one of the 89 known human cases have come from China (1 from Laos), although the virus has been found in migratory birds and/or poultry in Vietnam, Laos, and Cambodia.
Recent studies (see mSphere: An HPAI H5N6 Virus With Remarkable Tropism for Extra-respiratory Organs in the Ferret Model) suggest the H5N6 virus continues to adapt to mammalian hosts, while 18 months ago the Lancet published Resurgence of H5N6 Avian Influenza Virus in 2021 Poses New Threat to Public Health.
H5N6 - along with Cambodia's clade 2.3.2.1c H5N1 virus - remind us that HPAI H5 continues to explore multiple evolutionary paths, and that others may very well emerge over time.
While most will never rise to the level of a major public health threat, it only takes one to plunge us back into a global crisis. And with our current level of surveillance and reporting, we may never see it coming.
