Avian Influenza A (H5N1) : Human Activity in Asia

The Public Health Agency of Canada continues to closely monitor occurrences of avian influenza A (H5N1) or “bird flu” outbreaks in several Asian countries.

On March 07, 2005 the World Health Organization reported that the Ministry of Health in Vietnam confirmed four additional cases of human infection with H5N1 avian influenza with symptom onset between February 14, 2005 and February 21, 2005. Additionally, a fatal case in Vietnam dating back to February of 2004 was diagnosed retrospectively.

Most recently, on March 11, 2005, an additional 10 cases of human infection with H5N1 were confirmed by the Ministry of Health in Vietnam. Details of the cases have yet to be released, however, it is known that some cases are recent having occurred in March 2005, while others were reported retrospectively. Additional details will be provided once they are made available.

Source: World Health Organization (WHO)

Laboratory Confirmed Human Case Count as of March 07, 2005

Please note: the above chart does not include the 10 confirmed human cases released on March 11, 2005. The chart will be updated once details are reported.

Recommendations

As a precautionary measure, it would be prudent that travellers to Thailand, China, Cambodia, Vietnam, 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.

The World Health Organization has developed an avian influenza fact sheet

For information on human cases of A (H5N1), visit the World Health Organization's page on Confirmed Human Cases of Avian Influenza A (H5N1)

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