SITREP - WHO | Influenza A(H5N1) in Hong Kong Special Administrative Region of China ? Update 2

Influenza A(H5N1) in Hong Kong Special Administrative Region of China ? Update 2

27 February 2003

Disease Outbreak Reported

As of 27 February no further cases of human influenza A(H5N1) have been reported in Hong Kong SAR (see previous report). To date the current outbreak of influenza A(H5N1) in Hong Kong SAR has been limited to two cases, one of whom has died. Both cases were members of the same family who returned to their home in Hong Kong SAR on 8 February after travelling to Fujian province, China. The mother and children were in mainland China for 14 days; the father for 9 days.

The father of the family (a 33 year old man) developed respiratory symptoms on 7 February whilst in Fujian Province, China. He was admitted to hospital in Hong Kong SAR on 11 February with pneumonia but died on 17 February. Influenza A (H5N1) was isolated from post-mortum specimens on 20 February. The man�s 9 year old son also became unwell whilst in Fujian province. He was admitted to hospital in Hong Kong SAR on 12 February with pneumonia. Influenza A (H5N1) was isolated from two nasopharageal aspirates taken from the boy on 19 February. The boy is in a stable condition. Additional family members have also had respiratory symptoms. The boy?s 8 year old sister died on 4 February whilst the family was in Fujian Province, China. The cause of her death is under investigation. The mother has now recovered from what was thought to have been a parainfluenza infection.

An outbreak of atypical pneumonia occurred between November 2002 and February 2003 in Guandong province, China. Health authorities in China investigated the outbreak and identified Chlamydia pneumoniae as the causitive agent. The Ministry of Health in Beijing has informed WHO that the outbreak in Guandong is over and that there is no evidence of a link between the outbreak in Guandong and the H5N1 cases in Hong Kong SAR.

The Department of Health in Hong Kong SAR has intensified its surveillance for influenza among patients with influenza-like symptoms or atypical pneumonia. No unusual increase in influenza activity has been detected over the past few weeks.

WHO is continuing to work closely with health authorities in Beijing, China and Hong Kong SAR. Reagents for laboratory diagnosis of influenza A(H5N1) have been made available to the Ministry of Health in Beijing, the National Influenza Centres and to other members of the WHO Global Influenza Surveillance Network.

WHO Influenza A(H5N1) in Hong Kong Special Administrative Region of China ? Update 2

SITREP - WHO | Influenza A(H5N1) in Hong Kong Special Administrative Region of China - Update

Influenza A(H5N1) in Hong Kong Special Administrative Region of China - Update

20 February 2003

Disease Outbreak Reported

As of 20 February the Department of Health in Hong Kong SAR confirmed that a 33-year-old man, who died in hospital in Hong Kong on February 17, had been infected with a strain of the influenza A(H5N1) virus. ( see previous report ). A nasopharyngeal aspirate taken from the man tested positive for influenza A(H5N1) in the Hong Kong SAR Government Virus Unit.

The 33-year-old man is the second confirmed case of influenza A(H5N1) virus related to this outbreak in Hong Kong SAR. The man is known to have been the father of the 9-year-old boy reported as having tested positive for influenza A(H5N1) yesterday. Both cases had travelled to Fujian Province (China) in January. Two other members of the family who accompanied the cases to Fujian in January have also been unwell. The mother of the family has now made a full recovery; the other affected member of the family (an 8-year-old girl) has died on February 4 in Fujian Province. The health authorities in Hong Kong SAR are continuing laboratory and epidemiological investigations to determine the source of infection of this outbreak. Further laboratory tests, including gene sequencing, are being conducted. The Department of Health in Hong Kong has reported that no unusual increase in influenza activity has been detected over the past few weeks.

The World Health Organization is in close contact with the health authorities in Beijing, China and in Hong Kong, SAR. The WHO Global Influenza Surveillance Network has been alerted and additional reagents for laboratory diagnosis are being made available to National Influenza Centres and other Members of the Global Influenza Surveillance Network.

WHO Influenza A(H5N1) in Hong Kong Special Administrative Region of China - Update

SITREP - WHO | Influenza A(H5N1) in Hong Kong Special Administrative Region of China

Influenza A(H5N1) in Hong Kong Special Administrative Region of China

19 February 2003

Disease Outbreak Reported

As of 19 February results from two laboratories have confirmed the presence of an avian influenza virus in a child in Hong Kong SAR. Tests conducted in two samples from this single patient have identified the virus as the strain of influenza A(H5N1). A similar virus caused an outbreak in Hong Kong SAR in 1997, with 18 cases detected and six deaths.

In the current outbreak, a 9-year-old boy who travelled to Fujian Province (China) in January with his mother and his two sisters became ill on February 9 and was admitted to a Hong Kong hospital on February 12. He has recovered and is in a stable condition. Other members of his family presented with a similar illness. The child?s sister and father have died. The boy?s mother was ill but has recovered.

It is not yet known whether the other family members were also infected with influenza A(H5N1). A medical and epidemiological investigation is ongoing in Hong Kong to determine the cause of those illnesses. Results should be available in the next few days. Investigations are ongoing to determine the source of the infection.

The World Health Organization is collaborating closely with health authorities in Hong Kong SAR and China in investigating the outbreak. The WHO Global Influenza Surveillance network has been alerted.

WHO Influenza A(H5N1) in Hong Kong Special Administrative Region of China

SITREP - WHO | Influenza in the Democratic Republic of the Congo

Influenza in the Democratic Republic of the Congo

12 February 2003

Disease Outbreak Reported

In early January 2003, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of acute respiratory syndrome in Kinshasa. Serum and nasopharyngeal samples from 5 districts from Kinshasa were tested by Institut Pasteur, Paris. Evidence from 16 of the 22 serum samples strongly suggests influenza virus A(H3N2) to be involved in the current outbreak. This virus has been circulating worldwide for several years. Influenza vaccine containing the WHO recommended vaccine strains protect against this influenza virus. Virus isolation and characterization are currently underway.
The Ministry of Health conducted epidemiological studies from December 2002 to mid-January 2003 in health zones and medical institutions in Kinshasa. Fourteen medical institutions reported 3 963 influenza cases including 126 deaths (case-fatality rate of 3.2%) and 33 health zones reported 27 211 cases including 170 deaths (case-fatality rate of 0.6%). The differences in the case-fatality rates can be explained by differences in health and nutritional status and access to health care services. Children under 5 years of age were the most affected.
The epidemiology of this outbreak is still not completely understood as limited resources have impeded a more thorough investigation. However, Epicentre/M�decins sans Fronti�res, France have recently initiated more comprehensive data collection and analysis.

WHO Influenza in the Democratic Republic of the Congo