Jan 06 Health Alerts
Avian influenza - situation in China - update
Monday, 25th January 2006
Source: World Health Organisation
The Ministry of Health in China has confirmed the country’s tenth case of human infection with the H5N1 avian influenza virus.
The case occurred in a 29-year-old woman from Chengdu City in the south-central province of Sichuan. She developed fever on 12 January and was hospitalized with symptoms of pneumonia. Authorities say her condition deteriorated rapidly, and she died on 23 January.
Information provided to WHO indicates that she was self-employed in a shop selling dry goods. No information on possible exposure to diseased birds as the source of her infection is presently available, but an investigation is under way. Close contacts have been placed under medical observation.
This is the second human case reported this year in China, both from Sichuan Province. The two Sichuan cases occurred in different prefectures located around 150 km apart. A confirmed outbreak of H5N1 in poultry began in late December in another part of the province. No outbreaks have been confirmed in the areas where the two human cases resided.
During 2005, Chinese agricultural authorities reported 32 outbreaks in poultry in 12 provinces, resulting in the culling of more than 24 million birds. The appearance of human cases in areas without reported poultry outbreaks is a cause for concern. WHO recommends that, in China, testing for possible H5N1 infection should be undertaken in all cases of severe respiratory disease having no alternative diagnosis, even when no poultry outbreak has been reported in the patient's area of residence.
Of the ten cases confirmed in China, seven have been fatal. The cases have occurred in 7 provinces and regions: Anhui, Guangxi, Liaoning, Jiangxi, Fujian, Hunan, and Sichuan. No poultry outbreaks have been officially reported in two of these provinces.
Indonesia – update
Monday, 23th January 2006
Source: World Health Organisation
The Ministry of Health in Indonesia has confirmed an additional 2 cases of human infection with the H5N1 avian influenza virus. Both cases were fatal. The first patient was a 13-year-old girl who developed symptoms on 6 January and died on 14 January. The second patient was her four-year-old brother. He developed symptoms on 8 January and died on 17 January. Two other family members remain hospitalized with respiratory symptoms and samples from these cases are being tested.
Investigations conducted by the Ministry of Health and WHO found evidence of a large poultry outbreak in the family's neighbourhood. All family members had close contact with the diseased chickens and assisted in the removal of dead birds. Contacts have been traced, blood samples have been taken, and monitoring for signs of influenza like illness continues. The authorities began culling operations in the area over the weekend.
The newly confirmed cases bring the total in Indonesia to 19. Of these cases, 14 were fatal.
Further case of Human H5N1 infection in China confirmed
Monday, 23th January 2006
China's Ministry of Health on Wednesday announced another human case of bird flu, bringing the country's death toll from the disease to six. The infected was a 35-year-old woman poultry butcher from Zhoujiaxiang Village of Jianyang City, southwest China's Sichuan Province. The patient showed symptoms on Jan. 3 and was hospitalised on Jan. 10 with fever and pneumonia. She died on Jan. 11. Investigation showed that from Dec. 25, 2005 to Jan. 5, 2006, eight households living in the same courtyard with Wei had found some of their poultry sick and dead.
It is thought that the woman had been involved in culling activities but this has not been confirmed.
Avian Influenza Indonesia update
Monday, 16th January 2006
The World Health Organisation reported on 14 January that the Ministry of Health in Indonesia has confirmed another human H5N1 infection.
The patient was a 29-year old midwife working in a Jakarta hospital who developed symptoms on 31 December and died on 11 January. Contact tracing has been extensive as the woman worked two shifts at the hospital at the time of symptom onset. At this stage there is no evidence that she transmitted the infection to any patients under her care or to colleagues at the hospital. Similarly, there are no signs of illness in family members or neighbours. Monitoring of contacts will continue until the maximum incubation period has ended.
There is evidence of poultry deaths in her neighbourhood in the two weeks prior to onset of her illness and investigations indicate that she had visited a live-bird market to select and purchase freshly slaughtered chicken in the days immediately prior to the onset of symptoms.
This is the 17th confirmed case in Indonesia and the 12th fatality.
H5N1 human infections update Turkey, China.
Tuesday, 10th January 2006
Situation in Turkey
Tests conducted in Turkish laboratories have confirmed the country's 15th case of human infection with the H5N1 avian influenza virus. The patient is a 37-year-old woman with a history of exposure to diseased chickens in the central province of Sivas, the seventh province to report cases. Several new outbreaks are under investigation in new parts of the country. All evidence to date indicates that patients have acquired their infections following close contact with diseased birds.
Situation in China
The Ministry of Health in China has confirmed the country's eighth case of human infection with the H5N1 avian influenza virus. The patient is a six-year-old boy from the southern province of Hunan. Initial investigation has identified recent poultry deaths in the family flock as the likely source of exposure. This is the second confirmed case from Hunan Province. The earlier case, which was one of the first two reported in China in mid-November 2005, lived around 300 kilometres away from the present case. In addition to Hunan, provinces and regions reporting human cases of H5N1 infection include Anhui, Guangxi, Liaoning, Jiangxi, and Fujian. Of the eight confirmed cases in China, five have now died.
Avian influenza – situation in Turkey – update
Monday, 9th January 2006
Laboratory tests conducted in Turkey have confirmed detection of the H5 subtype of avian influenza virus in samples from an additional 10 patients. Five of these cases were announced by the Ministry of Health yesterday and an additional five were announced today. Most patients are children and all have been hospitalized for treatment and evaluation.
This brings the total number of cases in Turkey, confirmed by laboratory tests there, to 14. Of these patients, two have died. WHO will add these numbers to its cumulative total following further verification by an external H5 reference laboratory.
The quality of laboratory testing at Turkey’s National Influenza Centre in Ankara is high. Results from tests conducted there last week were fully confirmed by a WHO collaborating laboratory in the United Kingdom.
The initial investigation has found no evidence that the virus has increased its transmissibility or is spreading from person to person. Most persons under investigation are children, often from the same family, and almost all have a documented link to dead or diseased poultry.
Outbreaks in poultry are now known to be occurring in several parts of the country. In recent days, the Ministry of Agriculture has confirmed H5N1 outbreaks in birds in 10 of the country’s 81 provinces. Extensive culling is under way, and several other possible outbreaks are under investigation.
© World Health Organization 2006. All rights reserved
Cases in Turkey confirmed as Avian Influenza
Monday, 9th January 2006
The World Health Organisation collaborating laboratory in the United Kingdom has now confirmed detection of the H5N1 virus in samples taken from the two fatal cases in Turkey. The number of cases identified by Turkish laboratories has reached 5 (all children) and some 30 more are suspected. To date, all evidence indicates that patients have acquired their infections following close contact with diseased poultry. Contact between people and poultry has likely increased during the present cold weather when the custom among many rural households is to bring poultry into their homes. Tests have shown that the virus can survive in bird faeces for at least 35 days at low temperatures. It has also been suggested that the high incidence and mortality in children is a consequence of rearing domestic fowls in small hen houses with entrances only accessible to children.
Human cases of Avian influenza in Turkey
Thursday, 5 January 2006
The Turkish Minister of Health, Recep Akdag, is quoted as saying that two cases of human infection by avian influenza have been confirmed, and a third is suspected. One of these cases, a 14 year old boy has died. He and two sisters from the town of Dogubeyazit in the southern Van province (near Mt Ararat) were recently admitted to hospital with high fevers and respiratory symptoms and because they were in close contact with sick birds were investigated for the H5N1 avian flu infection.
The Minister's statement contradicts earlier reports which stated that investigations had shown the infection not to be due to avian influenza virus. The statement also said that "experts" were still examining whether H5N1 was the cause of the boy's death and that samples were being sent to European laboratories for further tests so the situation remains somewhat confused. Further news will be published as it comes to hand from official sources.
