First Human Case of A(H5N1) Imported into the Western Hemisphere

Influenza A(H5N1) jumped to humans for the first time in 1997 and since then more than 650 confirmed cases of H5N1 have been reported. These cases have been reported from 15 countries in Asia, Africa, Europe, but none from countries in the Western Hemisphere.

On January 8, Canadian public health officials announced that a woman, in her late 20s, from Red Deer, Alberta, died from H5N1 on Jan 3, 2014. She had returned from the People’s Republic of China via Beijing after visiting for three weeks within China. She apparently fell ill on the return flight to North America. Although it is likely she was infected in China in late December 2013, this is the first confirmed case of H5N1 reported in North America. (link below)

Should you be concerned if you live in North America?

This single case does not indicate that there is an H5N1 outbreak in North America. A single imported case in Canada should not spark pandemic hysteria. Even though over the years researchers have speculated that H5N1 could be the next pandemic virus, this case does not signal the start of a pandemic.

Of more immediate concern for people in North America is seasonal Influenza. Seasonal influenza is particularly virulent this 2013-2014 flu season. Rather than worrying about H5N1, people should educate themselves about different ways of protecting themselves from the seasonal flu varieties that are now widely circulating.

The best course of action is to monitor your local public health agencies for updates and heed any recommendations for minimizing exposure to all infectious disease.

Canada - H5N1 death in Alberta after travel from China - died from meningoencephalitis

Memorializing the First Confirmed Case of A(H7N9)

Since February 2013, a novel avian influenza virus, A (H7N9), has infected more than  130 individuals in the People’s Republic of China and Taiwan. At least 44 of these infected individuals have died.  In a current article in the journal Respiratory Care, Chinese medical specialists report on the case-patient details of the first officially confirmed case from March 2013.[1]  Even with treatment, The 87-year-old man died a few days after admission to the hospital on March 4, 2013.

 

The authors state

 . . . we identified the world’s first human case of avian influenza A H7N9 virus infection. When we first admitted this patient, there were no health care guidelines that we could follow. Even in the absence of a definite diagnosis of influenza infection, we actively carried out isolation protection in accordance with the  standard  hospital  infection-protection  protocols  while  closely coordinating the activities of different departments and ensuring the protection of the medical  supplies.  In  addition,  we  organized  the  training  for  respiratory  infectious disease  protection  in  the  nursing  department.  We  believe  that  first-line  health  care providers  should  be  highly  aware  of  the   appropriate  infection-prevention  measures before  determining  whether  the  pathogen  has  the  capability  for  human-to-human transmission.

 

This individual is a member of a family cluster identified as the Shanghai Family Cluster.[2]   The two sons of this man were retrospectively reported as a confirmed and suspected case. Based on the onset dates, the son who died on February 28^th may have been the index case in this cluster.

Each novel disease outbreak starts with an officially confirmed initial case. If A(H7N9) becomes a pandemic virus, the article in  Respiratory Care will be one of the first footnotes in a future history of such a pandemic.

 

[1] Management of the First Confirmed Case of avian Influenza A H7N9

[2] Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China