WHO will be collaborating closely with health authorities in Thailand in responding to this situation.
Avian influenza A(H5N1)- update 7
24 January 2004
Two further cases confirmed in Viet Nam
Laboratory tests have confirmed two additional human cases of H5N1 avian influenza in Viet Nam. The cases, both in Ho Chi Minh City, are two children, an 8-year-old girl and a 13-year-old boy. The boy died on 22 January. The girl is hospitalized in stable, but critical condition.
The two cases are the first to be confirmed in the south of the country. They bring the total number of confirmed H5N1 cases in Viet Nam to seven, including five in Hanoi. Of the seven cases in Viet Nam, six (five children and one 30-year old woman) have died since 30 December 2003.
A WHO team is in Viet Nam working closely with health authorities to assess the current situation, conduct epidemiological investigations, and identify the most appropriate control measures.
Overview of the current situation
Yesterday, health authorities in Thailand announced laboratory confirmed H5N1 infection in two boys. Additional patients with respiratory symptoms that might signal H5N1 infection are being tested, and results are expected next week.
At present, Viet Nam and Thailand are the only two countries in which human cases of H5N1 avian influenza are known to have occurred in the current outbreak. The first recorded outbreak of H5N1 infection in humans occurred in Hong Kong in 1997, when 18 persons developed serious disease and six died.
The present human cases in Viet Nam and Thailand coincide with an historically unprecedented spread of highly pathogenic H5N1 avian influenza in the poultry populations of Asian countries. Since mid-December 2003, outbreaks of H5N1 disease in poultry have been confirmed in the Republic of Korea, Viet Nam, Japan, Thailand, and Cambodia. Additional countries have detected deaths in poultry flocks, and the cause is currently under investigation.
In Viet Nam, H5N1 infection in poultry has now been detected in 23 of the countrys 61 provinces. Since 23 December 2003, about 2.9 million poultry stock have either died or been destroyed because of the disease.
WHO has identified the rapid culling of H5N1 infected or exposed poultry as the major line of defence for preventing further human cases and possibly averting the emergence of a new influenza virus capable of causing an influenza pandemic.
At present, WHO has no evidence that person-to-person transmission is occurring.
Laboratories in the WHO Global Influenza Surveillance Network are characterizing avian and human viruses obtained from the current outbreaks. Preliminary results indicate that these viruses are significantly different from other H5N1 strains isolated in Asia in the recent past, thus necessitating the development of a new prototype strain for use in vaccine manufacturing.
Viruses are needed from all areas currently experiencing outbreaks in either infected birds or humans. Information from these viruses will then be used by WHO network laboratories to develop H5N1 prototype strains for vaccine manufacturers. Information about viruses from all outbreak sites is needed to ensure that the vaccine composition recommended by WHO will protect humans against all currently circulating H5N1 strains.
Implications for food safety
Since 1997, when the H5N1 avian influenza virus strain is first known to have caused infections in humans, fewer than 30 laboratory-confirmed cases have been documented worldwide. The 1997 outbreak in Hong Kong has been extensively studied. However, data about this disease in humans and its modes of transmission are limited by the small number of cases.
Investigations of the Hong Kong outbreak determined that close contact with live infected poultry was the source of human infection in all 18 cases. For this reason, the practice of marketing live poultry directly to consumers should be discouraged in areas currently experiencing outbreaks of highly pathogenic H5N1 avian influenza among poultry.
While trade restrictions have been put in place by some countries to protect animal health, on the basis of presently available data, WHO does not conclude that any processed poultry products (whole refrigerated or frozen carcasses and products derived from them) and eggs in or arriving from areas currently experiencing outbreaks of avian influenza H5N1 in poultry flocks pose a risk to public health.
It is well known that influenza viruses are killed by adequate heat. WHO continuously emphasizes, and in this particular situation reiterates, the importance of good hygiene practices during handling of poultry products, including hand washing, prevention of cross-contamination and thorough cooking (70°C).
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ต้องขอโทษด้วยนะครับที่แยกมาเป็นสองอัน
ตอนจะโพสอันสุดท้ายมันทำไม่ได้
สรุปว่า ขณะนี้มีรายงานในคนในเวียดนาม กับ ไทย
ส่วนใหญ่เป็นคนที่สัมผัสกับสัตว์โดยตรง ยังไม่มีรายงานคนไปคน
เชื้อไวรัสอยู่ในอุจจาระสัตว์พวก poultry ที่ติดเชื้อ
ตรงที่คนกลัวกันก็คือ การที่ไวรัสติดเชื้อในคนบ่อยๆ แล้วอาจมีแจคพอต สักคนที่มีการกลายพันธุ์ของไวรัส แล้วจะเป็นการติดต่อแบบ pandemic ได้ แต่ก็ยังไม่เกิด
ผมคิดว่ารัฐบาล และสื่อมาถูกทางแล้วครับ คือต้องให้คนทุกคนตระหนักถึงปัญหา แล้วจะได้ไปถูกทางครับ (เกี่ยวกับการทำลายสัตว์ และ การป้องกันการติดเชื้อจากสัตว์)
ตอนจะโพสอันสุดท้ายมันทำไม่ได้
สรุปว่า ขณะนี้มีรายงานในคนในเวียดนาม กับ ไทย
ส่วนใหญ่เป็นคนที่สัมผัสกับสัตว์โดยตรง ยังไม่มีรายงานคนไปคน
เชื้อไวรัสอยู่ในอุจจาระสัตว์พวก poultry ที่ติดเชื้อ
ตรงที่คนกลัวกันก็คือ การที่ไวรัสติดเชื้อในคนบ่อยๆ แล้วอาจมีแจคพอต สักคนที่มีการกลายพันธุ์ของไวรัส แล้วจะเป็นการติดต่อแบบ pandemic ได้ แต่ก็ยังไม่เกิด
ผมคิดว่ารัฐบาล และสื่อมาถูกทางแล้วครับ คือต้องให้คนทุกคนตระหนักถึงปัญหา แล้วจะได้ไปถูกทางครับ (เกี่ยวกับการทำลายสัตว์ และ การป้องกันการติดเชื้อจากสัตว์)
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Avian influenza A(H5N1) in humans - update 9
27 January 2004
Situation in Thailand
The Ministry of Public Health in Thailand has today confirmed a second death caused by human infection with the H5N1 strain of avian influenza virus.
The fatal case is a 6-year-old boy from Sukhothai province, whose infection with H5N1 was confirmed yesterday. He died today. He was Thailands third confirmed case of H5N1 avian influenza and the countrys second death from this disease.
The other fatal case in Thailand was another 6-year-old boy from Kanchanaburi province. He died on 25 January.
Overview of the current situation
To date, only two countries, Viet Nam and Thailand, have reported laboratory confirmed cases of H5N1 infection in humans. Viet Nam has reported 7 cases, 6 of them fatal. Thailand has reported 3 cases, 2 of them fatal.
The cases and deaths in humans coincide with outbreaks of highly pathogenic H5N1 avian influenza in poultry populations in these two countries and several others in Asia. The disease in poultry is widespread in both Viet Nam and Thailand. WHO teams, drawn from the Global Outbreak Alert and Response Network, are in both countries to support national authorities. Laboratories in the WHO Global Influenza Surveillance Network have been providing diagnostic and investigative support. WHO is collaborating closely with FAO and the World Organisation for Animal Health (OIE).
Over the past few days, several countries in Asia have detected deaths in poultry flocks, and testing to determine the causative agent is under way.
The possible transmission of highly pathogenic H5N1 avian influenza from animals to humans is of great concern. Testing for the presence of this particular strain takes several days and must be performed in specially equipped laboratories.
Avian influenza A(H5N1) in China - update 10
27 January 2004
The Ministry of Health in China has today confirmed the presence of highly pathogenic H5N1 avian influenza in poultry in the southern province of Guangxi. The H5N1 strain was detected in samples taken from a duck farm.
Testing is under way of samples from poultry outbreaks in the adjacent Hunan and Hubei provinces. Ducks are involved in the outbreak in Hunan, and chickens are involved in Hubei.
Strict measures to control all outbreaks, including culling and quarantine, have been undertaken.
No cases of human illness linked to these outbreaks have been detected to date.
27 January 2004
Situation in Thailand
The Ministry of Public Health in Thailand has today confirmed a second death caused by human infection with the H5N1 strain of avian influenza virus.
The fatal case is a 6-year-old boy from Sukhothai province, whose infection with H5N1 was confirmed yesterday. He died today. He was Thailands third confirmed case of H5N1 avian influenza and the countrys second death from this disease.
The other fatal case in Thailand was another 6-year-old boy from Kanchanaburi province. He died on 25 January.
Overview of the current situation
To date, only two countries, Viet Nam and Thailand, have reported laboratory confirmed cases of H5N1 infection in humans. Viet Nam has reported 7 cases, 6 of them fatal. Thailand has reported 3 cases, 2 of them fatal.
The cases and deaths in humans coincide with outbreaks of highly pathogenic H5N1 avian influenza in poultry populations in these two countries and several others in Asia. The disease in poultry is widespread in both Viet Nam and Thailand. WHO teams, drawn from the Global Outbreak Alert and Response Network, are in both countries to support national authorities. Laboratories in the WHO Global Influenza Surveillance Network have been providing diagnostic and investigative support. WHO is collaborating closely with FAO and the World Organisation for Animal Health (OIE).
Over the past few days, several countries in Asia have detected deaths in poultry flocks, and testing to determine the causative agent is under way.
The possible transmission of highly pathogenic H5N1 avian influenza from animals to humans is of great concern. Testing for the presence of this particular strain takes several days and must be performed in specially equipped laboratories.
Avian influenza A(H5N1) in China - update 10
27 January 2004
The Ministry of Health in China has today confirmed the presence of highly pathogenic H5N1 avian influenza in poultry in the southern province of Guangxi. The H5N1 strain was detected in samples taken from a duck farm.
Testing is under way of samples from poultry outbreaks in the adjacent Hunan and Hubei provinces. Ducks are involved in the outbreak in Hunan, and chickens are involved in Hubei.
Strict measures to control all outbreaks, including culling and quarantine, have been undertaken.
No cases of human illness linked to these outbreaks have been detected to date.
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Avian influenza A(H5N1) in humans - update 11
28 January 2004
Note to national authorities
WHO is concurrently reporting on the outbreaks of H5N1 avian influenza in poultry and human in Asian countries, and normal human influenza activity involving currently circulating H3N2 strains. These two events are separate. Reports on normal influenza activity during seasonal epidemics are regularly and routinely issued by WHO and published in the Weekly Epidemiological Record.
Situation in Viet Nam
Laboratory testing has confirmed an eighth case of human infection with H5N1 avian influenza in Viet Nam. The case is a 4-year-old boy, who fell ill on 22 December 2003 and was hospitalized in Hanoi on 29 December. He has fully recovered and been discharged from hospital.
Altogether, Viet Nam has reported 8 laboratory-confirmed cases, 6 of which have been fatal. An 8-year-old girl, whose infection was reported earlier, remains hospitalized in Ho Chi Minh City.
Two deaths in Viet Nam currently under investigation have been prematurely reported as laboratory confirmed. Test results are inconclusive. Further testing is under way at WHO influenza reference laboratories in Hong Kong. Information from these tests should allow conclusive identification of the causative agent.
To date, highly pathogenic H5N1 avian influenza has been detected in poultry in 28 of the countrys 64 provinces. Around 3.7 million poultry are reported to have died or been slaughtered as a result.
Rapid - and safe - culling of infected poultry: the first line of defence for protecting international public health
As a follow-up to yesterday's joint FAO/WHO press release, WHO has issued a document explaining why the unprecedented recent outbreaks of avian influenza in Asian countries represent a serious threat to international public health. The document also outlines specific measures that should be taken on an urgent basis to prevent further human cases and reduce opportunities for a new pandemic virus to emerge. Foremost among these measures is the rapid - and safe - culling of all infected or exposed poultry in countries experiencing outbreaks of highly pathogenic H5N1 avian influenza.
28 January 2004
Note to national authorities
WHO is concurrently reporting on the outbreaks of H5N1 avian influenza in poultry and human in Asian countries, and normal human influenza activity involving currently circulating H3N2 strains. These two events are separate. Reports on normal influenza activity during seasonal epidemics are regularly and routinely issued by WHO and published in the Weekly Epidemiological Record.
Situation in Viet Nam
Laboratory testing has confirmed an eighth case of human infection with H5N1 avian influenza in Viet Nam. The case is a 4-year-old boy, who fell ill on 22 December 2003 and was hospitalized in Hanoi on 29 December. He has fully recovered and been discharged from hospital.
Altogether, Viet Nam has reported 8 laboratory-confirmed cases, 6 of which have been fatal. An 8-year-old girl, whose infection was reported earlier, remains hospitalized in Ho Chi Minh City.
Two deaths in Viet Nam currently under investigation have been prematurely reported as laboratory confirmed. Test results are inconclusive. Further testing is under way at WHO influenza reference laboratories in Hong Kong. Information from these tests should allow conclusive identification of the causative agent.
To date, highly pathogenic H5N1 avian influenza has been detected in poultry in 28 of the countrys 64 provinces. Around 3.7 million poultry are reported to have died or been slaughtered as a result.
Rapid - and safe - culling of infected poultry: the first line of defence for protecting international public health
As a follow-up to yesterday's joint FAO/WHO press release, WHO has issued a document explaining why the unprecedented recent outbreaks of avian influenza in Asian countries represent a serious threat to international public health. The document also outlines specific measures that should be taken on an urgent basis to prevent further human cases and reduce opportunities for a new pandemic virus to emerge. Foremost among these measures is the rapid - and safe - culling of all infected or exposed poultry in countries experiencing outbreaks of highly pathogenic H5N1 avian influenza.
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Avian influenza A(H5N1) in humans - update 12
29 January 2004
Prevention of further cases of H5N1 disease in humans
In response to outbreaks of highly pathogenic H5N1 avian influenza in poultry, several countries are currently conducting the mass slaughter of millions of chickens. Such action is the major line of defence for preventing further human cases of H5N1 infection and possibly averting the emergence of a new influenza virus with pandemic potential.
WHO continues to stress the need for personal protection of these workers, who are at high risk of exposure to a virus that has demonstrated its capacity to cause severe disease and deaths in humans. Recommendations about safety measures that should be in place before the mass destruction of poultry begins have been issued. Adherence to these recommendations will reduce the likelihood that measures aimed at preventing the further spread of H5N1 infection in poultry might lead to increased transmission of the virus to humans.
Those organizing culling operations in affected countries need to ensure that WHO recommendations are followed as strictly as possible. The recommendations spell out the appropriate personal protective equipment, which includes goggles and preferably N95 respirator masks, as well as specific types of protective clothing that can be either disinfected or discarded after use. Frequent handwashing is strongly recommended.
WHO also recommends that effective antiviral drugs be readily available for the treatment of suspected H5N1 respiratory infections in cullers and farm workers.
N95 masks and prophylactic treatment with antiviral drugs were used to protect thousands of poultry workers and cullers during an outbreak of highly pathogenic H7N7 avian influenza in the Netherlands in 2003. During that outbreak, nearly 30 million poultry were destroyed. Although avian influenza virus caused mild illness in 89 poultry workers and members of their families, the single death in that outbreak occurred in a veterinarian who was not adequately protected.
Investigation of the origins of the current outbreaks in poultry
Countries currently experiencing outbreaks of highly pathogenic H5N1 avian influenza in poultry have provided numerous samples and viruses to laboratories in the WHO Global Influenza Surveillance Network. WHO is grateful for the high level of international collaboration of all affected countries and influenza experts around the world.
Laboratory characterization of several viruses from humans and different species of birds has helped to compare, retrospectively, H5N1 viruses taken from infected birds and humans in January 2004 with viruses obtained from birds several months ago. Results indicate that the virus now causing severe disease in poultry and some humans has been circulating in parts of Asia for longer than initially presumed.
Presently available evidence from these studies is not sufficient to support any speculations about the geographical origins of the current outbreaks of highly pathogenic H5N1 avian influenza.
Up to now, laboratories in the WHO network have analyzed viruses from the current outbreaks made available by authorities in Cambodia, Japan, South Korea, and Viet Nam. Viruses from the outbreaks in Indonesia, Laos, and Thailand are expected to be available for analysis soon.
Avian influenza A(H5N1) - update 13
30 January 2004
China confirms spread of infection in poultry
Health and agricultural authorities in China have today informed WHO of further outbreaks of highly pathogenic H5N1 avian influenza in poultry. The outbreaks, which are laboratory confirmed, have been detected in Hunan and Hebei provinces.
A confirmed outbreak of highly pathogenic H5N1 avian influenza at a duck farm in Guangxi province was announced on 27 January.
As announced today, outbreaks of disease in poultry have also been detected at farms in Anhui, Shanghai, and Guangdong provinces. According to the authorities, highly pathogenic H5N1 avian influenza is the suspected cause. Samples from birds in these outbreaks are being tested, in China, to confirm the causative agent.
Local authorities in the affected provinces have undertaken immediate culling operations and quarantining of farms. Compulsory vaccination of poultry is being introduced.
At present, no human cases of H5N1 infection have been detected in China.
Development of an H5N1 vaccine for humans: need for samples and viruses
With the confirmed spread of H5N1 infection in poultry in China, WHO is again stressing the need for access to samples and viruses from all countries currently experiencing H5N1 outbreaks. Such materials are needed to support laboratory studies being conducted by the WHO Global Influenza Surveillance Network.
Up to now, laboratories in the WHO network have analyzed viruses from the current outbreaks made available by authorities in Cambodia, Japan, the Republic of Korea, and Viet Nam. Viruses from the outbreaks in Indonesia, Laos, and Thailand are expected to be available for analysis soon.
Network laboratories are now working to develop a prototype virus that can be recommended by WHO for use by companies in the production of a human vaccine effective against H5N1 influenza strains. Both human and avian viruses are needed. Information from these viruses will help WHO and its partners ensure that a fully tested and licensed vaccine for humans is available as soon as possible.
Protection of workers involved in culling operations
As more countries announce plans for the mass slaughter of poultry, WHO continues to stress the need for personal protection of these workers. Targeted administration of seasonal influenza vaccine to high-risk groups, such as cullers and poultry workers, is being recommended as one of several measures that reduce opportunities for the emergence of a new influenza virus subtype with pandemic potential. Guidelines for the use of seasonal influenza vaccine in humans at risk of H5N1 infection have been issued today.
29 January 2004
Prevention of further cases of H5N1 disease in humans
In response to outbreaks of highly pathogenic H5N1 avian influenza in poultry, several countries are currently conducting the mass slaughter of millions of chickens. Such action is the major line of defence for preventing further human cases of H5N1 infection and possibly averting the emergence of a new influenza virus with pandemic potential.
WHO continues to stress the need for personal protection of these workers, who are at high risk of exposure to a virus that has demonstrated its capacity to cause severe disease and deaths in humans. Recommendations about safety measures that should be in place before the mass destruction of poultry begins have been issued. Adherence to these recommendations will reduce the likelihood that measures aimed at preventing the further spread of H5N1 infection in poultry might lead to increased transmission of the virus to humans.
Those organizing culling operations in affected countries need to ensure that WHO recommendations are followed as strictly as possible. The recommendations spell out the appropriate personal protective equipment, which includes goggles and preferably N95 respirator masks, as well as specific types of protective clothing that can be either disinfected or discarded after use. Frequent handwashing is strongly recommended.
WHO also recommends that effective antiviral drugs be readily available for the treatment of suspected H5N1 respiratory infections in cullers and farm workers.
N95 masks and prophylactic treatment with antiviral drugs were used to protect thousands of poultry workers and cullers during an outbreak of highly pathogenic H7N7 avian influenza in the Netherlands in 2003. During that outbreak, nearly 30 million poultry were destroyed. Although avian influenza virus caused mild illness in 89 poultry workers and members of their families, the single death in that outbreak occurred in a veterinarian who was not adequately protected.
Investigation of the origins of the current outbreaks in poultry
Countries currently experiencing outbreaks of highly pathogenic H5N1 avian influenza in poultry have provided numerous samples and viruses to laboratories in the WHO Global Influenza Surveillance Network. WHO is grateful for the high level of international collaboration of all affected countries and influenza experts around the world.
Laboratory characterization of several viruses from humans and different species of birds has helped to compare, retrospectively, H5N1 viruses taken from infected birds and humans in January 2004 with viruses obtained from birds several months ago. Results indicate that the virus now causing severe disease in poultry and some humans has been circulating in parts of Asia for longer than initially presumed.
Presently available evidence from these studies is not sufficient to support any speculations about the geographical origins of the current outbreaks of highly pathogenic H5N1 avian influenza.
Up to now, laboratories in the WHO network have analyzed viruses from the current outbreaks made available by authorities in Cambodia, Japan, South Korea, and Viet Nam. Viruses from the outbreaks in Indonesia, Laos, and Thailand are expected to be available for analysis soon.
Avian influenza A(H5N1) - update 13
30 January 2004
China confirms spread of infection in poultry
Health and agricultural authorities in China have today informed WHO of further outbreaks of highly pathogenic H5N1 avian influenza in poultry. The outbreaks, which are laboratory confirmed, have been detected in Hunan and Hebei provinces.
A confirmed outbreak of highly pathogenic H5N1 avian influenza at a duck farm in Guangxi province was announced on 27 January.
As announced today, outbreaks of disease in poultry have also been detected at farms in Anhui, Shanghai, and Guangdong provinces. According to the authorities, highly pathogenic H5N1 avian influenza is the suspected cause. Samples from birds in these outbreaks are being tested, in China, to confirm the causative agent.
Local authorities in the affected provinces have undertaken immediate culling operations and quarantining of farms. Compulsory vaccination of poultry is being introduced.
At present, no human cases of H5N1 infection have been detected in China.
Development of an H5N1 vaccine for humans: need for samples and viruses
With the confirmed spread of H5N1 infection in poultry in China, WHO is again stressing the need for access to samples and viruses from all countries currently experiencing H5N1 outbreaks. Such materials are needed to support laboratory studies being conducted by the WHO Global Influenza Surveillance Network.
Up to now, laboratories in the WHO network have analyzed viruses from the current outbreaks made available by authorities in Cambodia, Japan, the Republic of Korea, and Viet Nam. Viruses from the outbreaks in Indonesia, Laos, and Thailand are expected to be available for analysis soon.
Network laboratories are now working to develop a prototype virus that can be recommended by WHO for use by companies in the production of a human vaccine effective against H5N1 influenza strains. Both human and avian viruses are needed. Information from these viruses will help WHO and its partners ensure that a fully tested and licensed vaccine for humans is available as soon as possible.
Protection of workers involved in culling operations
As more countries announce plans for the mass slaughter of poultry, WHO continues to stress the need for personal protection of these workers. Targeted administration of seasonal influenza vaccine to high-risk groups, such as cullers and poultry workers, is being recommended as one of several measures that reduce opportunities for the emergence of a new influenza virus subtype with pandemic potential. Guidelines for the use of seasonal influenza vaccine in humans at risk of H5N1 infection have been issued today.
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