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Eastern Europe Updated:
October 14, 2005
The Public Health Agency of Canada continues to closely monitor occurrences of avian influenza A (H5N1), or “bird flu”, in birds and in humans in Asia and in birds in Eastern Europe. One additional human case confirmed in Indonesia Indonesia's Ministry of Health has confirmed another human case of avian influenza H5N1. The patient, a 21-year-old man from Lampung, Sumatra, developed symptoms on September 20 and was hospitalized on September 24. He remains hospitalized in a stable condition. Initial investigation has revealed that the man had direct exposure to diseased and dying chickens in his household shortly before the onset of illness. Source: WHO Avian influenza H5N1 detected in birds in Turkey A European Union laboratory confirmed, on October 13, the presence of avian influenza H5N1 in samples taken from diseased domestic birds in Turkey. Source: EU - Europa Human Cases Human cases of avian influenza A (H5N1) have been reported in Vietnam, Thailand, Cambodia, and most recently Indonesia. The spread in humans has occurred in three distinct periods or waves of activity, since late-December 2003, when human cases were first reported. Summary of Laboratory Confirmed Human Cases since December 2003
Note: Any significant change in this outbreak situation (i.e. geographic region, a large increase in case numbers, etc.) will result in the release of an updated advisory; however, minor situational changes will be updated periodically. Outbreak in Poultry Since mid-December 2003, several Asian countries have reported avian influenza A ( H5N1 ) outbreaks in poultry; the disease has also been reported in wild birds and pigs. According to the World Organization for Animal Health and based on criteria established in the Terrestrial Animal Health Code (2005), H5N1 infection in birds continues to persist in Cambodia, China, Indonesia, Thailand, Vietnam, Laos, Russia, Kazakhstan, and Mongolia. The virus has also recently been confirmed, in birds, in the previously unaffected country of Turkey. Source: World Health Organization, World Organization for Animal Health, EU - Europa Information on Avian Influenza A (H5N1) Avian influenza A (H5N1) is a contagious viral infection that is thought to affect all species of birds; although rare, infection in humans can occur. The first documented infection of humans with the avian influenza A (H5N1) v irus occurred in Hong Kong in 1997, when the strain caused severe respiratory disease in 18 humans, six of whom died. The infection in humans coincided with an epidemic of H5N1 in Hong Kong's domestic poultry population. Investigation into human cases of H5N1 suggests that direct contact with infected poultry has been the primary, if not the exclusive, means of infection; although, in a small number of instances a link to direct contact with infected poultry was not identifiable. In a few cases it would appear that human-to-human transmission may have occurred. However, such cases involved extended close personal contact with an infected individual (i.e. providing bedside care for an infected relative) and no further transmission occurred. At this time, there is no vaccine that protects against the avian influenza A (H5N1) virus. While the current seasonal flu shot does not protect against the H5N1 virus, immunization with it may be of benefit for travellers to geographic regions where human cases of H5N1 are being reported. Individuals who are immunized with the seasonal influenza vaccine are less likely to contract seasonal influenza; this in turn reduces the likelihood of an immunized individual becoming infected with both human and avian forms of influenza at the same time. Should a person be infected with both viruses at the same time, there is a possibility that the two viruses could “mix” and mutate into a new virus that could spread efficiently and against which humans would have no immunity. Several anti-viral drugs are available for the prevention and treatment of seasonal influenza in Canada. Although, none of the anti-viral drugs have been shown to prevent H5N1, studies done through the WHO Global Influenza Surveillance Network have shown that the anti-viral Oseltamivir may be effective in the treatment of A (H5N1).Recommendations As a precautionary measure, the Public Health Agency of Canada recommends that it would be prudent that travellers to Cambodia, China, Indonesia, Thailand, Vietnam, Laos, Russia , Kazakhstan, Mongolia, and Turkey, where avian influenza A ( H5N1 ) outbreaks in fowl are confirmed, consider the following measures:
Canadian Food Inspection Agency recommendations to prevent the introduction of avian flu into Canada's animal population:
As a reminder… The Public Health Agency of Canada routinely recommends that Canadian international travellers seek the advice of their personal physician or travel clinic prior to international travel, regardless of destination, for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication, and personal protective measures.
The Public Health Agency of Canada recommends, as well, that travellers who become sick or feel unwell on their return to Canada should 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. Additional Information Information on Avian Influenza from the Public Health Agency of Canada Information on Influenza from the Public Health Agency of Canada
Other related information from the Public Health Agency of Canada
External Sources of Information For additional information on Avian Influenza A (H5N1) f rom the World Health Organization (WHO) visit the WHO Avian Influenza Disease Page For an updated account of human cases of H5N1by region and time period, visit the following: Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO 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: 2005-10-14 | ![]() |