Travel Health Advisory
Avian Influenza A (H5N1):
Human Activity in Asia
Updated: April 1, 2005
The Public Health Agency of Canada continues to closely monitor
occurrences of avian influenza A (H5N1) or "bird flu" outbreaks
in several Asian countries.
The Democratic People's Republic of Korea ( North
Korea ) - Outbreak in Poultry
An outbreak of avian influenza among poultry has officially been reported
by state run media in the Democratic People's Republic of Korea. At this time, outbreaks have been reported at large scale commercial
poultry farms, including one in the capital city of Pyongyang.
Government officials have assured the World Health Organization (WHO)
that all measures are being undertaken to prevent further transmission
including the mass culling.
Vietnam - Human Cases
The Ministry of Health in Vietnam confirmed three additional cases
of human infection with H5N1 avian influenza. The cases involved:
- a 5-year-old boy from the central province of Quang Binh ;
- a 17-year-old girl from the northern province of Nam Dinh (fatal);
and
- and a 40-year-old woman from the northern province of Quang Ninh.
Furthermore an earlier case has also been confirmed, although no additional
information has been provided.
To date, Vietnam has reported a total of 28 confirmed human cases of
avian influenza since mid-December.
Cambodia - Human Case
The Ministry of Health in Cambodia has confirmed a second human case
of avian influenza. The fatal case involved a 28-year-old man from Kampot
Province.
To date, Cambodia has reported a total of two confirmed human cases
of avian influenza, both of which have been fatal.
Thailand - Human Cases
To date, Thailand has reported a total of 17 cases, including 12 deaths
during its past outbreaks. The last reported case in Thailand occurred
in October 2004.
Source: World Health Organization (WHO)
Recommendations
As a precautionary measure, it would be prudent that travellers to
Thailand, China, Cambodia, Vietnam, the Democratic People's
Republic of Korea ( North Korea ), South Korea, Japan, Indonesia,
and Laos, where avian influenza A (H5N1) outbreaks have been reported,
consider the following measures:
The Public Health Agency of Canada advises that travellers to the countries
mentioned above, not consume undercooked fowl, raw eggs, or lightly cooked
egg products (such as runny eggs). Travellers should ensure that all
food products listed above be well cooked before being consumed, as evidence
suggests the virus becomes inactive when cooked. While to date there
has been no evidence that the virus is transmitted through contaminated
food, the above precautionary measure should be followed until further
information is available.
Normal precautions regarding food storage, handling and preparation
should be followed. Travellers are further advised to maintain high standards
of hygiene, including thorough hand washing, particularly after having
contacted eggs or undercooked fowl and egg products and to avoid cross
contamination with other food products. Using hot, soapy water and lathering
for at least 20 seconds is the single most important procedure for preventing
infections. This is because disease-causing micro-organisms can frequently
be found on the hands. Alternatively, travellers can use waterless, alcohol-based
antiseptic hand rinses. If there is visible soiling, hands should be
washed with soap and water before using waterless antiseptic hand rinses.
If soap and water are unavailable, cleanse hands first with detergent-containing
towelettes to remove visible soil.
The Public Health Agency of Canada recommends that travellers avoid
unnecessary contact with live fowl. This includes poultry farms as well
as markets where live animals such as chickens and ducks are sold, as
these animals have been found to be carriers of the avian influenza virus.
Travellers should be aware that it is possible for the avian influenza
virus to stick to hair and clothing, and may be inhaled. Research has
shown that the risk of direct transmission of H5N1 infection from birds
to humans is greatest in persons having close contact with live, infected
poultry.
Travellers are advised not to bring fowl or egg products from these
affected countries into Canada.
As is routinely done, the Public Health Agency of Canada recommends
that travellers to Asia seek an individual risk assessment consultation
with their personal physician or travel medicine clinic at least 6 to
8 weeks prior to travel. The Public Health Agency of Canada also recommends
that travellers obtain the influenza vaccine before travel.
The Public Health Agency of Canada recommends that travellers who become
sick or feel unwell with respiratory or flu-like symptoms on their return
seek a medical assessment with their personal physician. Travellers should
inform their physician without being asked, that they have been travelling
or living outside of Canada, and where they have been.
Canadian Food Inspection Agency recommendations to prevent the introduction of avian flu into Canada's animal population:
- Travellers who have visited a farm while in an affected country should ensure that clothing and footwear worn on the farm are free from soil and manure before entering Canada. Clothing should be laundered and footwear should be disinfected after arrival. More information is available at the Canadian Food Inspection Agency.
Additional Information
or more information on Avian Influenza A (H5N1) f rom the Public Health Agency of Canada:
- FAQ on Avian Influenza.
- For previous avian influenza travel health advisories, visit the Travel Medicine Program's Travel Advisory Archives.
- The Public Health Agency of Canada produces weekly FluWatch reports, summarizing influenza surveillance activities in Canada and abroad.
For additional information on Avian Influenza A (H5N1) f rom the World
Health Organization (WHO) visit the WHO
Avian Influenza Disease Page
For international reports of the flu, visit the World Health Organization influenza web site
For international reports of infected animals by country, visit the World Organization for Animal Health
Updated: April 1, 2005
[Information for Travellers] [Information for Travel Medicine Professionals]
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