FEB 06 Health Alerts

China: avian influenza WHO update

27 February 2006

The Ministry of Health in China has reported 2 additional laboratory confirmed cases of human infection with the H5N1 avian influenza virus. Both patients are in critical condition.The 1st patient is a 9 year old girl from the eastern province of Zhejiang. Symptom onset followed a visit to relatives in the adjacent province of Anhui. No animal outbreaks have been reported in Zhejiang Province since 2004. The 2nd patient is a 26 year old female farmer from Anhui Province. She developed symptoms following contact with diseased poultry. H5N1 virus has been isolated from samples of dead poultry in the neighbourhood. China has reported 14 laboratory confirmed cases. Of these, 8 have been fatal.

Indonesia avian influenza situation WHO update

27 February 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 27 year old woman from West Java Province. Investigations carried out by local authorities found reports of chicken deaths in the woman's neighborhood 4 days prior to her onset of symptoms. The newly confirmed case brings the total in Indonesia to 27. Of these, 20 were fatal.

Avian influenza - situation in Nigeria

Abridged WHO report
22 February 2006

The outbreak of H5N1 avian influenza in poultry, confirmed at a commercial farm in Kaduna State on 8 February, has now spread to commercial farms in several other contiguous states. No human cases have been detected to date.
To date, four patients with respiratory symptoms and a history of exposure to diseased poultry have been investigated for possible infection. This number includes a woman who died of an acute respiratory illness on 16 February. The three remaining patients are all in good condition.
The initial outbreak in Kaduna state is now known to have begun on 10 January, raising the possibility that earlier human exposures and cases may have occurred in that area and elsewhere. At hospitals in Kaduna, Kano, and Katsina near affected farms, staff from the WHO-led teams have now examined hundreds of patient records, searching for possible cases that may have occurred earlier. No such cases have been identified to date.

The scale of the outbreak in birds is not yet fully understood.

Avian influenza – situation in India

Abridged WHO report
21 February 2006

On 18 February, agricultural authorities in India confirmed the country’s first outbreak of highly pathogenic H5N1 avian influenza in poultry. The disease was detected at several commercial farms in the Navapur sub-district in the western state of Maharashtra. The outbreak is now thought to have begun on 27 January. Agricultural authorities have reported that some backyard farms are also affected.Mass culling of bird at affected farms continued today.
The government has equipped a Navapur hospital for the management, in isolation, of possible human cases. WHO was informed today that 12 patients with fever and respiratory illness in Navapur sub-district have been hospitalized for observation as a precautionary measure. An additional 3 patients have been hospitalized, also for observation, in the Vaira sub-district of the adjacent Gujarat state.

Avian influenza situation in Indonesia

© World Health Organization 2006. All rights reserved
20 February 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 23-year-old man from East Jakarta who was employed as an egg seller at a wet market. None of the contacts traced showed influenza-like illness.
The newly confirmed case brings the total in Indonesia to 26. Of these, 19 were fatal.

Avian influenza – situation in Iraq - Update 3

© World Health Organization 2006. All rights reserved
17 February 2006
The Ministry of Health in Iraq has confirmed the country’s second case of human infection with the H5N1 avian influenza virus. The case, which was fatal, occurred in a 39-year-old man from the northern province of Sulaimaniyah. He developed symptoms on 18 January and died on 27 January. He was the uncle of the country’s initial case, a 15-year-old girl who died 17 January, and provided care for her during her illness. He also had a documented history of exposure to infected domestic birds. Samples from an initial 15 patients under investigation for possible infection were tested today at a US Naval Medical Research Unit located in Cairo, Egypt. Apart from the 39-year-old fatal case, all test results were negative.

WHO Situation in China

© World Health Organization 2006. All rights reserved
13 February 2006
The Ministry of Health in China has reported the country’s 12th laboratory confirmed case of human infection with the H5N1 avian influenza virus.
The case occurred in a 20-year-old female farmer from the south-central province of Hunan. She developed symptoms on 27 January and was subsequently hospitalized with severe pneumonia. Symptom onset followed the culling of poultry raised by her household. She died on 4 February.
To date, China has reported 12 laboratory-confirmed cases. Of these, eight have been fatal.

WHO Situation In Indonesia

13 February 2006
The Ministry of Health in Indonesia has confirmed an additional two cases of human infection with the H5N1 avian influenza virus. Both cases were fatal.
The first case occurred in a 22-year-old woman who developed symptoms on 25 January and died on 10 February. Her neighbours kept chickens. Samples from these chickens and from pet birds in a market near the woman’s home are being tested by Indonesia’s animal health authorities.
The second case occurred in a 27-year-old woman who developed symptoms on 31 January and died on 10 February. Deaths of chickens in her neighbourhood were reported four days prior to symptom onset.
The two women resided in different sub-districts of West Java Province.

The newly confirmed cases bring the total in Indonesia to 25. Of these, 18 were fatal.

Avian influenza situation in China update

9 February 2006
The Ministry of Health in China has reported the country’s eleventh laboratory confirmed case of human infection with the H5N1 avian influenza virus. The case is a 26-year-old female farmer from the south-eastern province of Fujian. She developed symptoms on 10 January and was subsequently hospitalized with pneumonia. She remains under treatment in stable condition. Like many of the other cases in China, this one occurred in an area where no recent poultry outbreaks have been officially reported.
Of China’s eleven laboratory confirmed cases, seven have been fatal. The cases have occurred in seven provinces and regions: Anhui, Fujian, Guangxi, Jiangxi, Hunan, Liaoning, and Sichuan.
Since May 2005, agricultural authorities have reported 32 poultry outbreaks across the country, the majority of which were reported in October and November 2005. Three poultry outbreaks have been reported so far this year: one in Sichuan Province on 3 January, one in Guizhou Province on 10 January, and one in Shanxi Province on 8 February.

Bird flu confirmed in Nigeria

9 February 2006

The World health Organisation has published confirmation of the detection of H5N1 influenza in domestic birds in northern Nigeria. At present, the outbreak is thought to be confined to a large commercial farm, located in Kaduna State in the northern part of the country, where thousands of chickens were kept in battery cages.
Investigations are urgently needed to determine whether the outbreak, which began almost a month ago, has spread from the farm to affect
household flocks. Poultry deaths in the adjacent province of Kano have been reported, but the cause has not yet been determined. In Nigeria, as in other parts of Africa, most village households maintain free-ranging flocks of poultry as a source of income and food. Close human contact with poultry is extensive. No clear information about the source of the Nigerian outbreak is presently available, but the country is known to lie along a flight route for birds migrating from central Asia. This is consistent with our understanding that the H5N1 virus has established itself within global bird populations, and its spread around the globe is to be expected.

Situation in Indonesia WHO update

6 February 2006

The Ministry of Health in Indonesia has confirmed an additional four cases of human infection with the H5N1 avian influenza virus. Two of these cases were fatal.
The first fatal case was a 22-year-old man from West Java who died on 26 January. He worked as a banana vendor at a market in East Jakarta where poultry meat was sold. Neighbours near his home reported poultry deaths prior to his onset of symptoms.
The second fatal case was a 15-year-old boy from West Java who died on 1 February. Deaths in chickens near his home were reported in the week prior to symptom onset.
The third case is a nine-year old girl from West Java who was hospitalized on 19 January and has since recovered. She lived in a village neighbouring that of the two fatal cases in siblings confirmed on 23 January. Investigation of those cases resulted in the girl’s prompt hospitalization and treatment. She has now fully recovered. Poultry deaths were reported in her village prior to symptom onset.
The fourth case is a five-year-old boy from Lampung Province who developed symptoms in October of last year and has since fully recovered. The child is the brother of a previously confirmed case, a 20-year-old man who developed symptoms in late September and likewise fully recovered. Both the child and his brother had direct exposure to diseased chickens during slaughtering. As initial diagnostic tests produced inconclusive results, retrospective confirmation of the child’s infection relied on antibody levels in acute blood samples taken during his illness and convalescent samples taken following recovery.
All three cases with recent symptom onset resided in West Java, where a resurgence of virus activity in birds has been reported.
The newly confirmed cases bring the total in Indonesia to 23. Of these cases, 16 were fatal.

Iraq case confirmed

3rd February 2006

The notification of a case of H5N1 infection in a 14-year-old girl by the Iraq department of health has been confirmed by the World Health Organisation collaborating laboratory in the UK. The patient came from the area of Sulaimaniya in northern Iraq near the Turkish border. The girl's uncle also died of suspected infection and a 54 year old woman is being investigated. As yet there have been no notifications of bird flu in poultry in Iraq