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Published Date: 2013-02-19 12:09:24
Subject: PRO/AH/EDR> Avian influenza, human (09): Cambodia, Egypt, China, WHO
Archive Number: 20130219.1549714

AVIAN INFLUENZA, HUMAN (09): CAMBODIA, EGYPT, CHINA, WHO
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Date: Fri 15 Feb 2013
Source: WHO, Influenza at the human-animal interface [edited]
http://www.who.int/influenza/human_animal_interface/Influenza_Summary_IRA_HA_interface_15Feb13.pdf

Summary and assessment as of 15 Feb 2013. Human infection with avian influenza A(H5N1) viruses and associated animal health events
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From 2003 through 15 Feb 2013, 620 laboratory-confirmed human cases with avian influenza A(H5N1) virus infection have been officially reported to WHO from 15 countries, of which 367 died. Since the last update on 16 Jan 2013, 10 new laboratory-confirmed human cases with influenza A(H5N1) virus infection were reported to WHO.

Since 16 Jan 2013, Cambodia reported 7 [and a suspected 8th case -- see Avian influenza, human (08): Cambodia (KC) susp. 20130218.1548448] new human cases with influenza A(H5N1) virus infection including 6 fatal cases. These cases come from 4 provinces all located in southern Cambodia. These cases do not seem to be linked epidemiologically, and most had contact with sick poultry in the village. Enhanced surveillance has been put in place and did not detect additional cases linked to these cases. Current evidence does not support human-to-human transmission. It has been suggested that the A(H5N1) virus is endemic in poultry in Cambodia [see Sorn S, Sok T, Ly S, et al: Dynamic of H5N1 virus in Cambodia and emergence of a novel endemic sub-clade. Infect Genet Evol. 2012; http://www.sciencedirect.com/science/article/pii/S1567134812002158] and that there is more poultry and human movement around the Lunar New Year. As such, additional sporadic human cases might be expected.

Egypt has reported one new human case with influenza A(H5N1) virus infection in Behera Governorate. The A(H5N1) virus is also endemic in poultry in some areas of Egypt, and additional sporadic human cases are possible.

On 10 Feb 2013, China reported 2 new human cases of influenza A(H5N1) virus infection. Both remain in critical condition. The cases come from the same province but do not seem to be epidemiologically linked. Neither had documented contact with sick or dead poultry. Contact tracing and follow up is ongoing but no additional cases have been identified. The last official report of A(H5N1) in poultry in mainland China was from Guangdong Province in September 2012.

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[Only the Egyptian case has not previously ben reported in ProMED-mail. An updated table of the individual human cases of avian A(H5N1) influenza virus infection confirmed from 16 Jan to 8 Feb 2013 can be accessed via the source URL above.

The Total Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO since the onset of the outbreak 2003 to 2013 can be accessed at http://www.who.int/influenza/human_animal_interface/H5N1_cumulative_table_archives/en/index.html.

The current public health risk assessment of avian influenza A(H5N1) viruses at present is: Any time influenza viruses are circulating in poultry, sporadic infections or small clusters of human cases are possible especially in people exposed to infected poultry kept in households. However, currently, this H5N1 virus does not appear to transmit easily among people and therefore the risk of community level spread of this virus remains low. Therefore, the public health risk associated with this virus remains unchanged. - Mod.CP

HealthMap/ProMED-mail interactive maps can be accessed at
http://healthmap.org/r/1iGB for Cambodia, http://healthmap.org/r/54TE for Egypt, and http://healthmap.org/r/1zaU for China. - Sr.Tech.Ed.MJ]

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