Global spread of H5N1 in 2006

Main article: Global spread of H5N1
Cumulative Human Cases of and Deaths from H5N1
As of April 11, 2007

Notes:

The global spread of (highly pathogenic) H5N1 in birds is considered a significant pandemic threat.

While prior H5N1 strains have been known, they were significantly different from the current H5N1 strain on a genetic level, making the global spread of this new strain unprecedented. The current H5N1 strain is a fast-mutating, highly pathogenic avian influenza virus (HPAI) found in multiple bird species. It is both epizootic (an epidemic in non-humans) and panzootic (a disease affecting animals of many species especially over a wide area). Unless otherwise indicated, "H5N1" in this article refers to the recent highly pathogenic strain of H5N1.

In the first two months of 2006 H5N1 spread to Africa and Europe in wild bird populations possibly signaling the beginning of H5N1 being endemic in wild migratory bird populations on multiple continents for decades, permanently changing the way poultry are farmed. In addition, the spread of highly pathogenic H5N1 to wild birds, birds in zoos and even sometimes to mammals (example: pet cats) raises many unanswered questions concerning best practices for threat mitigation, trying to balance reducing risks of human and nonhuman deaths from the current nonpandemic strain with reducing possible pandemic deaths by limiting its chances of mutating into a pandemic strain. Not using vaccines can result in the need to kill significant numbers of farm and zoo birds, while using vaccines can increase the chance of a pandemic.

By April 2006, scientists had concluded that containment had failed due to the role of wild birds in transmitting the virus and were now emphasizing far more comprehensive risk mitigation and management measures.[1]

In June 2006 the World Health Organization predicted an upsurge in human deaths due to H5N1 during late 2006 or early 2007. In July and August 2006, significantly increased numbers of bird deaths due to H5N1 were recorded in Cambodia, China, Laos, Nigeria, and Thailand while continuing unabated a rate unparalleled in Indonesia. In September, Egypt and Sudan joined the list of nations seeing a resurgence of bird deaths due to H5N1; followed by Vietnam and South Korea in December.

January

January 5, 2006

January 7, 2006

January 8, 2006

January 10, 2006

January 16, 2006

January 18, 2006

January 21, 2006

January 29, 2006

January 30, 2006

The Ministry of Health in Iraq has confirmed the country's first case of human infection with the H5N1 avian influenza virus. The case occurred in a 15-year-old girl who died on 17 January following a severe respiratory illness. Her symptoms were compatible with a diagnosis of H5N1 avian influenza. Preliminary laboratory confirmation was provided by a US Naval Medical Research Unit located in Cairo, Egypt. The girl's 39-year-old uncle, who cared for her during her illness, developed symptoms on 24 January and died of a severe respiratory disease on 27 January. Both patients resided in the town of Raniya near Sulaimaniyah in the northern part of the country, close to the border with Turkey. Poultry deaths were recently reported in their neighbourhood, but H5N1 avian influenza has not yet been confirmed in birds in any part of the country. Poultry samples have been sent for testing at an external laboratory. A history of exposure to diseased birds has been found for the girl. The uncle's source of infection is under investigation. The Ministry of Health has further informed WHO of a third human case of respiratory illness that is under investigation for possible H5N1 infection. The patient is a 54-year-old woman, from the same area, who was hospitalized on 18 January. Specimens are on their way to a WHO collaborating laboratory in the United Kingdom for diagnostic confirmation and further analysis. An international team, including representatives of other UN agencies, is being assembled to assist the Ministry of Health in its investigation of the situation and its planning of an appropriate public health response. WHO staff within Iraq have been directly supporting the government's operational response, which was launched shortly after the girl's death. Iraq is the seventh country to report human H5N1 infection in the current outbreak. The first human case occurred in Viet Nam in December 2003.[8]

February

February 4, 2006

February 6, 2006

February 7, 2006

February 8, 2006

February 9, 2006

February 10, 2006

February 11, 2006

February 12, 2006

February 13, 2006

February 14, 2006

February 15, 2006

February 17, 2006

February 18, 2006

February 19, 2006

February 20, 2006

February 21, 2006

"This is a disease which doesn't go away so we are going to be living with H5N1 in Western Europe, I believe, in wild bird populations - even endemic in wild bird populations - for decades perhaps, or even sporadically in those populations every year."[24]
"The virus is highly likely to become endemic, says Peter Openshaw, head of the respiratory viral infections section at the National Heart and Lung Institute in London, UK. We have to change the way poultry are farmed. [...] Jan Slingenbergh, an animal health expert at the United Nation's Food and Agriculture Organization (FAO) in Rome, Italy, points out that H5N1 may survive in icy lake waters over European winters, potentially infecting any migratory birds that subsequently arrive. The virus could also become established in permanently resident European birds; Openshaw notes that H5N1 has so far been able to infect a wide range of species. If this happens, farming practices will have to be changed, says Neil Ferguson, an epidemiologist at Imperial College London, UK, who is advising the British government on how to deal with possible future outbreaks."[25]

February 23, 2006

February 25, 2006

February 27, 2006

February 28, 2006

March

March 1, 2006

March 2, 2006

March 3, 2006

March 4, 2006

March 5, 2006

March 6, 2006

March 8, 2006

March 9, 2006

March 10, 2006

March 12, 2006

March 14, 2006

March 15, 2006

March 16, 2006

March 17, 2006

March 18, 2006

March 19, 2006

March 20, 2006

March 21, 2006

March 24, 2006

March 26, 2006

March 29, 2006

March 30, 2006

March 31, 2006

April

April 3, 2006

April 4, 2006

April 5, 2006

April 6, 2006

April 10, 2006

April 11, 2006

April 12, 2006

April 18, 2006

May

May 5, 2006

May 11, 2006

May 13, 2006

May 15, 2006

May 16, 2006

May 21, 2006

May 24, 2006

May 25, 2006

May 30, 2006

June

June 2, 2006

June 17, 2006

June 23, 2006

June 30, 2006

  1. The number of new countries reporting human cases increased from 4 to 9 after October 2005, following the geographical extension of outbreaks among avian populations.
  2. Half of the cases occurred in people under the age of 20 years; 90% of cases occurred in people under the age of 40 years.
  3. The overall case-fatality rate was 56%. Case fatality was high in all age groups but was highest in persons aged 10 to 39 years.
  4. The case-fatality profile by age group differs from that seen in seasonal influenza, where mortality is highest in the elderly.
  5. The overall case-fatality rate was highest in 2004 (73%), followed by 63% to date in 2006, and 43% in 2005.
  6. Assessment of mortality rates and the time intervals between symptom onset and hospitalization and between symptom onset and death suggests that the illness pattern has not changed substantially during the three years.
  7. Cases have occurred all year round. However, the incidence of human cases peaked, in each of the three years in which cases have occurred, during the period roughly corresponding to winter and spring in the northern hemisphere. If this pattern continues, an upsurge in cases could be anticipated starting in late 2006 or early 2007."[96]

July

July 5, 2006

July 7, 2006

July 22, 2006

July 26, 2006

July 28, 2006

August

August 5, 2006

August 10, 2006

August 12, 2006

August 18, 2006

August 25, 2006

September

September 7, 2006

September 13, 2006

September 25, 2006

September 27, 2006

October

October 4, 2006

October 11, 2006

October 16, 2006

October 31, 2006

November

November 2, 2006

November 13, 2006

December

December 12, 2006

December 18, 2006

December 19, 2006

December 24, 2006

See also

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