Current Avian influenza (H5N1) affected areas
Human infection with avian influenza H5N1 viruses
Human infection with the H5N1 virus remains a rare event. Direct contact with infected poultry, or surfaces and objects contaminated by their faeces, is presently considered the main route of human infection. Exposure is considered most likely during slaughter, defeathering, butchering, and preparation of poultry for cooking.
There is no evidence to suggest that the avian influenza virus can be transmitted through the consumption of poultry and poultry products as long as standard precautions regarding food storage, handling, preparation are followed. Consumers should ensure that poultry is thoroughly cooked (juice runs clear and no visible pink meat). Internal temperatures for whole chicken and parts should reach 82°C-85°C, and eggs should be cooked until the yolk is no longer running. For poultry preparation guidelines please visit: http://www.hc-sc.gc.ca/fn-an/securit/animal/avia-poul/index_e.html. 
Table 1, below, provides an up-to-date list of countries experiencing human cases of H5N1 avian influenza.
In recent months, the Asian strain of avian influenza H5N1 virus has been confirmed in wild birds in several countries in the following regions: Asia, Europe, and Africa. While this demonstrates the rapid and ongoing geographical spread of the virus, information to date has shown that the greatest risk to humans arises when the virus become established in small backyard poultry flocks, which allow continuing opportunities for close human contact, exposures, and infections to occur. To date, almost all cases have been linked to close contact to diseased household poultry flocks. As a general precaution, always avoid unnecessary contact with domestic poultry and wild birds.
Table 2 below, provides an up-to-date list of countries experiencing cases of H5N1
avian influenza in domestic poultry. For more detailed information, as well as cases of H5N1 avian influenza in wild birds, please refer to this website:
http://www.oie.int/downld/AVIAN%20INFLUENZA/A_AI-Asia.htm.
TABLE 1: Confirmed Cases of Human Avian Influenza (H5N1)
Avian influenza (H5N1)
Third Wave (Dec 2004 - present) |
WHO Confirmed human cases
(Updated 29 November 2006) |
Location |
Total # of human cases |
Total deaths |
| Cambodia |
6 |
6 |
| Thailand |
8 |
5 |
| Vietnam |
66 |
22 |
| Indonesia |
74 |
57 |
| China |
21 |
14 |
| Turkey |
12 (9)* |
4 |
| Iraq |
3 |
2 |
| Azerbaijan |
8 |
5 |
| Egypt |
15 |
7 |
| Djibouti |
1 |
0 |
Note: this table will be updated as new information becomes available.
*These cases have been confirmed by the Ministry of Health in Turkey and in situation updates by the WHO. Only 12 of the cases have been officially verified by the WHO collaborating laboratory in the UK.
For additional information, please refer to the Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO |
TABLE 2: Countries with OIE Confirmed Oubreaks of Highly Pathogenic Avian Influenza H5N1 in Poultry
OIE* Confirmed Outbreaks: 1 Jul 2006 to present
(Updated 16 November 2006) |
| Affected Country |
First date of outbreak
(as of 1 July 2006) |
Most recent date of outbreak |
Total # of confirmed outbreaks in poultry |
Egypt |
29 Aug 2006 |
6 Sept 2006 |
8 |
Sudan |
8 Sept 2006 |
8 Sept 2006 |
6 |
Russia1 |
3 Aug 2006 |
3 Aug 2006 |
1 |
Vietnam |
6 Aug 2006 |
26 Aug 2006 |
3 |
Thailand |
24 Jul 2006 |
24 Jul 2006 |
1 |
Indonesia |
10 Jul 2006 |
9 Aug 2006 |
5 |
China1 |
14 Jul 2006 |
27 Sept 2006 |
3 |
Laos |
24 Jul 2006 |
24 Jul 2006 |
1 |
Cambodia |
1 Aug 2006 |
24 Aug 2006 |
2 |
* World Organisation for Animal Health
1 H5N1 has also been identified in wild birds in areas of this country. |
Recognition, reporting and testing of Severe Respiratory Illness (SRI), including severe influenza-like illness (severe ILI)
Health Care Providers:
Continued vigilance is recommended for the surveillance, recognition, reporting and prompt investigation of patients with severe influenza-like illness (severe ILI*) and/or unexpected outcomes of severe ILI who are linked to H5N1 avian flu-affected areas (Table 1). For specific recommendations regarding screening, laboratory investigations and reporting, please consult your local or provincial/territorial health authorities.
Hospitals:
Enhanced SRI surveillance in hospitals is aimed at early detection of a re-emergence of SARS as well as other emerging respiratory infections, including novel influenza viruses of pandemic potential. Presently, enhanced surveillance is recommended for severe respiratory illness (including severe ILI) in persons linked to H5N1 avian flu-affected areas as well as SARS-affected areas. For detailed background and recommendations on enhanced SRI surveillance in hospitals, please consult your local or provincial/territorial health authorities. Also see Health Canada’s enhanced surveillance for Severe or Emerging Respiratory Illness. 
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* Influenza-like illness (ILI) in the general population (FluWatch national case definition): Acute onset of respiratory illness with fever and cough and with one or more of the following - sore throat, arthralgia, myalgia, or prostration which could be due to influenza virus. In children under 5, gastrointestinal symptoms may also be present. In patients under 5 or 65 and older, fever may not be prominent.
Severe ILI may include complications such as: pneumonia, Acute Respiratory Distress Syndrome (ARDS), encephalitis and other severe and life threatening complications requiring hospitalization or resulting in death of otherwise healthy individuals.
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