April 06 Health Alerts

China: avian influenza situation - WHO update 11

27 Apr 2006

The Ministry of Health in China has reported the country's 18th case of human infection with the H5N1 avian influenza virus.
The patient is an 8 year old girl from the south western province of Sichuan. She developed symptoms of fever and pneumonia on 16 Apr 2006. She remains in hospital.

According to the Ministry of Health, an initial investigation determined that poultry deaths recently occurred near the child's home.

Of the 18 laboratory-confirmed cases in China, 12 have been fatal.

Avian flu detected in Bali

26 April

Hundreds of ducks have been culled on Indonesia's Bali island, after samples tested positive for the H5N1 bird flu virus. The birds were culled in Gianyar regency on the popular tourist island and came from a farm and its surrounding areas.
In Indonesia, the H5N1 virus has been reported in birds in most of the country's 33 provinces but there have been previous cullings in Bali. No human cases have been reported on the island. The World Health Organization has confirmed 24 human deaths in Indonesia from the virus from a total 32 confirmed cases, the majority in and around the capital Jakarta.

Avian influenza - situation in Egypt - update 5

21 April 2006

The Ministry of Health in Egypt has informed WHO of the country's fourth death from H5N1 avian influenza. The death occurred in a previously announced patient, an 18-year-old girl from the northern governorate of Minufiyah. She developed symptoms on 5 April and died on 14 April. The Ministry of Health regards cases as confirmed when positive results are obtained in two laboratories: the country's national public health laboratory and the Cairo-based US Naval Medical Research Unit 3 (NAMRU-3). Test results on the country's initial cases have been fully validated by a WHO collaborating laboratory in the United Kingdom. All cases confirmed by the Ministry of Health are now listed in the WHO cumulative table of laboratory-confirmed cases. Of the 12 cases in Egypt, four patients have died and one remains hospitalized in stable condition. Seven patients have fully recovered and been discharged from hospital.

Avian influenza - situation in China - update 10

21 April 2006

The Ministry of Health in China has informed WHO of the country's 12th death from H5N1 avian influenza. The death occurred in a previously reported case, a 21-year-old man from Hubei Province. He died of severe respiratory disease on 19 April. Of the 17 laboratory-confirmed cases in China, 12 have been fatal

Avian influenza - situation in CHINA - update 9

19 April 2006

The Ministry of Health in China has confirmed the country's 17th case of human infection with the H5N1 avian influenza virus. The case occurred in a 21-year-old male migrant worker employed in Wuhan City, Hubei Province. He developed symptoms on 1 April. He is presently hospitalized in critical condition.
The man's source of exposure is under investigation. No poultry outbreaks have been reported in Hubei Province since November 2005. His close contacts have been placed under medical observation.
To date, China has reported 17 cases of H5N1 infection. Of these, 11 have been fatal.

World Health Organization Avian influenza - situation in;INDONESIA - update 10

19 April 2006

The Ministry of Health in Indonesia has confirmed the country's 32nd case of human infection with the H5N1 avian influenza virus. The case occurred in a 24-year-old man from Tangerang, near Greater Jakarta. He developed symptoms on 29 March, was hospitalized on 5 April, and died on 8 April. His source of exposure is presently under investigation. Of the 32 laboratory-confirmed cases in Indonesia, 24 have been fatal.

Avian influenza – situation in Egypt - update 4

13 April 2006

The Ministry of Health in Egypt has informed WHO of the country’s 12th case of human infection with the H5N1 avian influenza virus. The patient is an 18-year-old girl from the northern governorate of Minufiyah. She developed symptoms on 5 April and was hospitalized on 11 April. She remains hospitalized in stable condition. As with all other cases in Egypt, her infection has been linked to direct contact with diseased birds.

Samples from the patient tested positive for H5N1 infection in the country's Central Public Health Laboratory and the Cairo-based US Naval Medical Research Unit 3 (NAMRU-3).

Of the 12 cases in Egypt, three have died and four remain hospitalized. Five patients have fully recovered and been discharged from hospital.

Avian influenza – situation in Indonesia - update 9

12 April 2006

The Ministry of Health in Indonesia has confirmed the country’s 31st case of human infection with the H5N1 avian influenza virus. The case occurred in a 23-year-old man employed as a poultry worker in West Java.

He developed symptoms on 20 March and has since fully recovered. Poultry deaths occurred in the two weeks preceding his visit to a farm.

Of the 31 laboratory-confirmed cases in Indonesia, 23 have been fatal

Avian influenza - situation in Azerbaijan - update 3

11 April 2006

Tests conducted at a WHO collaborating laboratory in the United Kingdom have retrospectively identified an additional human case of H5N1 infection. The case is a 17-year-old girl who developed symptoms on 11 March. She was seriously ill with bilateral pneumonia but has since fully recovered and been discharged from hospital. Early in her course of illness, a diagnosis of H5N1 infection was presumed based on her clinical symptoms and preliminary laboratory results, and she was treated accordingly.
Her 15-year-old cousin, previously confirmed by WHO, developed symptoms on the same day and was hospitalized in critical condition. She has also fully recovered and been discharged from hospital. Both girls, who are neighbours, reside in the small Daikyand settlement in Salyan rayon, where 7 of the 8 cases in Azerbaijan occurred. Active house-to-house surveillance in the settlement has failed to detect any further cases. Retrospective confirmation of this case brings the total in Azerbaijan to 8. Five of these cases were fatal.

Avian influenza - situation in Egypt - update 3

6 April 2006

The Ministry of Health in Egypt has announced the country's 11th case of human infection with the H5N1 avian virus and its third death. The case occurred in an 18-year-old girl from the Minufiyah governorate, north of Cairo. She developed symptoms on 29 March, was hospitalized on 5 April, and died today. Tests conducted by the country's Central Public Health Laboratory were positive for H5N1 infection. To date, Egyptian health authorities have confirmed 11 human cases of H5N1 infection. Three of these cases were fatal. In a pattern similar to that seen elsewhere, all case have occurred in children and young adults, and all have a history of close contact with dead or diseased poultry. The country's first seven cases and two fatalities have been described in previous WHO updates. The eighth case is a 31-year-old Egyptian national who works in Jordan. The man recently visited his hometown in Fayoum governorate, south of Cairo, where poultry outbreaks were officially confirmed during the last week of February. While there, he participated in the slaughter of poultry. He returned to Jordan on 29 March, following two days of travel by ferry boat. He was hospitalized with symptoms of respiratory disease on 30 March. He remains hospitalized in Jordan in stable condition. Given his exposure history and what is known about the incubation period of this disease, health authorities in both Egypt and Jordan have concluded that the man almost certainly acquired his infection while in Egypt. The ninth case, announced by the government on 5 April, is a 16-month-old girl from the southern governorate of Sohaj. The child's infection was detected on 4 April. She is presently hospitalized in stable condition. The tenth case, announced today, is an 8-year-old boy from the Qaliubiya governorate near Cairo. He is presently hospitalized in stable condition.

Avian influenza - situation in Cambodia - update

6 April 2006

The Ministry of Health in Cambodia has confirmed the country's sixth case of human infection with the H5N1 avian influenza virus. The case occurred in a 12-year-old boy from the south-eastern province of Prey Veng, which borders Viet Nam. The boy developed symptoms of fever and headache on 29 March. He was initially treated at a private clinic, then hospitalized in Phnom Penh on 4 April. He died on 5 April. Samples from the boy tested positive for H5N1 infection at the Pasteur Institute in Cambodia. A team from the Ministry of Health, WHO, and the Pasteur Institute investigated the situation in the child's village yesterday. Numerous chicken deaths and some duck deaths were noted to have occurred in the neighbourhood in recent weeks. The child reportedly gathered dead chickens for distribution to village families for consumption. The investigative team identified 25 close contacts of the child. None of these people show signs of illness at present. House-to-house surveillance for signs of influenza-like illness is continuing. This case is the sixth in Cambodia and the second this year. All six cases were fatal.

Avian influenza and food safety: statement by Dr LEE Jong-Wook, WHO Director-General

Since the beginning of February 2006, the highly pathogenic H5N1 avian influenza virus has spread to affect wild or domestic birds in 17 new countries in Africa, Asia, Europe, and the Middle East.
The World Health Organization reconfirms that, when poultry products are safely handled and properly cooked, humans are not at risk of acquiring H5N1 infection through food.
Although the H5N1 virus is highly infectious among poultry, it is not easily transmissible to humans. Since December 2003, this virus is known to have infected 173 people, of whom 93 have died. Not one of these cases has been linked to the consumption of properly cooked poultry or poultry products.

Avian influenza – situation in Indonesia - update 8

4 April 2006

The Ministry of Health in Indonesia has confirmed an additional case of human infection with the H5N1 avian influenza virus. The case, which was fatal, occurred in a 20-month-old girl who resided in Kapuk, West Jakarta. She developed symptoms of fever and cough on 17 March, was hospitalized on 22 March, and died on 23 March.

Field investigation found a history of deaths in a chicken flock near her home about one week prior to symptom onset. Chicken deaths in the neighbourhood have continued, but the cause has not yet been identified. Family members and neighbours have been placed under observation and samples from these people have been taken for testing. Preliminary results are negative, but follow-up investigation is continuing.

The newly confirmed case brings the total in Indonesia to 30. Of these cases, 23 were fatal.

Avian influenza situation in Egypt WHO update 2

3 April 2006

Samples from four patients, previously announced by the Egyptian Ministry of Health as infected with the H5N1 avian influenza virus, have now been tested in a WHO collaborating laboratory in the United Kingdom. Positive H5N1 results were obtained for all four patients. WHO has updated its cumulative number of cases accordingly.

The four cases were described in WHO updates issued on 20 March and 29 March. Two of the patients died. Two patients fully recovered and have now been discharged from hospital. A fifth patient, previously announced by the Ministry of Health, remains hospitalized. External diagnostic confirmation of this patient, an 18-year-old girl from the Kafr El-Sheikh governorate, is pending. On 2 April, Egyptian authorities announced that an additional two residents of Kafr El-Sheikh, a 6-year-old girl and her 18-month-old sister, were shown to have H5N1 infections in local laboratory tests.

Further diagnostic confirmation is pending. Both girls remain hospitalized in stable condition. Egypt is the ninth country to report laboratory-confirmed human cases in the current outbreak, which began in Viet Nam in December 2003. Four of these countries reported their first human cases this year: Turkey, Iraq, Azerbaijan, and Egypt.