Avian Influenza A (H5N1): Activity in Asia

Updated: May 24, 2005

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

The current human outbreak of Avian Influenza A(H5N1) has affected three countries (Vietnam, Thailand, and Cambodia) and is characterized by three distinct periods or waves of activity, since late-December 2003, when human cases were first reported.

Wave 1 - December 26, 2003 to March 10, 2004

35 cases, including 24 deaths

Wave 2 - July 19, 2004 to August 10, 2004

9 cases, including 8 deaths

Wave 3 - December 16, 2004 to present

53 cases, including 21 deaths

The World Health Organization has developed a chart depicting human case counts by region and time period. The case counts contained within this chart may differ slightly from the cumulative figures reported in past advisories, as case counts have been amended to account for figures recently provided to the WHO from Vietnam.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO

Summary

Vietnam - Human Cases

Wave 1: 23 cases, including 16 deaths

Wave 2: 4 cases, including 4 deaths

Wave 3: 49 cases, including 17 deaths

To date, Vietnam has reported a total of 76 human cases of avian influenza infection, including 37 deaths.

Cambodia - Human Cases

Wave 1: nil

Wave 2: nil

Wave 3: 4 cases, including 4 deaths.

To date, Cambodia has reported a total of 4 human cases of avian influenza infection, all of which have been fatal.

Thailand - Human Cases

Wave 1: 12 cases, including 8 deaths

Wave 2: 5 cases, including 4 deaths

Wave 3: nil

To date, Thailand has reported a total of 17 human cases of avian influenza infection, including 12 deaths. The last reported case in Thailand occurred in October of 2004.

Source: World Health Organization

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.

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

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	Last Updated: 2005-05-24		Important Notices