EID Weekly Updates:
Emerging and Reemerging Infectious Diseases, Region of the Americas
Vol. 2, No. 9—4 March 2004
Main Updates index
Since our last update of 26 February 2004, 1 new human case of avian influenza has been reported, bringing the total to 33 cases and 22 deaths. To date, 2 Asian countries have reported human cases; and 8 countries, epizootics of Influenza A Subtype H5N1 in birds. The outbreaks detected in the 2 states in the USA and 1 province in Canada are now laboratory confirmed and do not correspond to highly pathogenic Avian Influenza A Subtype H5N1 currently circulating in Asia.
This week, the World Health Organization (WHO) published the WHO Interim Guidelines on Clinical Management of Humans Infected by Influenza A (H5N1), based on present knowledge on avian influenza H5N1 (and subject to modification as more knowledge is gained on how the disease works among humans). The objectives of the guidelines are as follows:
- Early implementation of infection-control precautions to minimize the nosocomial spread of disease.
- Proper case management to prevent severe illness and death.
- Early identification and follow-up of persons at risk of infection, to facilitate early intervention with antiviral therapy, to reduce morbidity and mortality, and to further limit the spread of the disease.
| Table 1: Current Situation of Avian Influenza—Human Cases and Epizootics (as of 4 March 2004) |
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| Country | Epizootics | Virus subtype identified | Number of confirmed human cases | Comments | ||
| Number of provinces affected | Species of birds affected | Cases | Deaths | |||
| Cambodia | 4 out of 19 | Chickens: mostly laying/breeder hens | H5N1 | 0 | 0 | Epizootic out of control. |
| Canada | 1 out of 10 | Chickens | H7N3 | 0 | 0 | Laboratory confirmed. |
| China | 16 out of 31 | Ducks, chickens, geese, one peregrine falcon in Hong Kong | H5N1 | 0 | 0 | Epizootic out of control. |
| Indonesia | 11 out of 26 | Laying and breeding hens. | H5N1 | 0 | 0 | Epizootic widespread, with new affected area in West Kalimanta. |
| Japan | 2 out of 9 | Egg-laying poultry | H5N1 | 0 | 0 | Active outbreaks in Oita and Yamaguchi. |
| Laos | 5 out of 17 | Laying hens | H5 | 0 | 0 | Positive results for Influenza A (H5) in farms from 4 provinces and in Vientinae. |
| Pakistan | 1 out of 7 | Egg-laying poultry | H7 | 0 | 0 | Outbreak confirmed at end of January. |
| South Korea | 6 out of 14 | Chickens, ducks | H5N1 | 0 | 0 | Ongoing investigation. |
| Taiwan | 1 out of 21 | Laying hens, colored-feather native chickens | H5N2 | 0 | 0 | Epizootic out of control. |
| Thailand | 23 out of 76 (in 24 additional outbreaks reported to OIE, localization unavailable) | Chickens (broilers/fryers, laying hens), native poultry, ducks, geese, turkeys, ostrich, quail, peacocks | H5N1 | 10 | 7 | Epizootic out of control. |
| USA | 5 out of 50 | Chickens | H7N2 | 0 | 0 | Low pathogeneity, under control, investigation underway. |
| H5N2 | 0 | 0 | Low pathogeneity, investigation underway. | |||
| Viet Nam | 57 out of 64 | Parent stock for broilers/fryers (chickens) | H5N1 | 23 | 15 | Investigation of family cluster of confirmed cases of subtype H5N1 showed no genetic recombination with human influenza virus. |
| Total | 33 | 22 | ||||
Sources
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Additional information is available at
- World Health Organization (WHO), Avian Influenza. Geneva: WHO.
- World Organization for Animal Health (OIE) (Paris).
- Food and Agriculture Organization of the United Nations (FAO) (Rome).
Sources
- Avian Influenza A (H5N1)—Update 30: Situation (human) in Thailand (27 February 2004). Geneva: World Health Organization (WHO).
- Update on Avian Influenza in Animals in Asia. Alerts—Disease Information. Paris: World Organization for Animal Health (OIE). (page routinely updated)
International Health Regulations
In 1995, the 48th World Health Assembly adopted a resolution calling for a substantial revision of the International Health Regulations (IHR), in view of the resurgence of infectious diseases and the heightened risk of their international spread, caused in particular by the growth of commercial air transport.
During the 41st Meeting of the Organization’s Directing Council (1999), in its document CD41/16 and the corresponding resolution, PAHO urged Member States to strengthen their infrastructure for surveillance, alert and response; to increase subregional mechanisms for information exchange; and to review current policies and regulations on rational use of antimicrobials.
Two years later, the 43rd Meeting of the Directing Council adopted Resolution CD43.R13 in support of the revision of the International Health Regulations, urging Member States to participate actively in the review process both nationally and through the regional integration systems.
A series of subregional workshops will be held in the Americas to ensure that the revised IHR will include criteria of interest to all parties and to finalize the adoption of the document for the 50th World Health Assembly in 2005. The first two of these workshops are scheduled for 5–7 April 2004 for South America, and for 27–29 April 2004 for Central America.
Source (consult for additional information): World Health Organization (WHO), International Health Regulations (IHR). Geneva: WHO.