The HPSC is monitoring the situation regarding Avian Influenza
The WHO has confirmed a family cluster of H5N1 avian influenza cases in the Karo District, of Northern Sumatra, Indonesia. On the 23rd May 2006, the Ministry of Health in Indonesia confirmed the seventh member of an extended family to become infected with the H5N1 virus and the sixth to die. The first member of this family to fall ill died of respiratory disease on the 4th May. No specimens were taken prior to her burial and the cause of her death cannot be determined. However, as her clinical course was compatible with H5N1 infection, epidemiologists at the outbreak site include this woman as the initial case in the cluster. The newly confirmed case, is a brother of the initial case, and was closely involved in caring for his 10-year-old son, who died of H5N1 infection on the 13th May and this contact is considered a possible source of infection.
All confirmed cases in this family cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing.
Both the Ministry of Health in Indonesia and WHO are concerned about the situation in Northern Sumatra and have intensified investigation and response activities. Priority is now being given to the search for additional cases of influenza-like illness in other family members, close contacts, and the general community. To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred.
WHO H5 reference laboratories in Hong Kong and the USA have completed full genetic sequencing of two viruses isolated from cases in this cluster. There is no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations. The human viruses from this cluster are genetically similar to viruses isolated from poultry in Northern Sumatra during a previous outbreak. For further information, please consult the WHO website.
H5N1 avian influenza remains predominantly a disease of birds. A small number of human cases have been reported in South East Asia, Africa and Eastern Europe, all of which have been associated with close contact with dead or dying poultry. In all human cases to date there has been no evidence of efficient human-to-human transmission. Human infections remain a rare event.
The advice from the Department of Agriculture and Food in Ireland is not to handle dead wild birds unless necessary. For further information please consult the Department of Agriculture and Food website. For queries relating to dead birds please contact the Department of Agriculture and Food on the Avian Influenza Hotline: 1890 252 283.
At present, recommendations on travel, personal protection and food safety remain unchanged. Current travel advice is available here. The WHO level of pandemic alert remains unchanged at phase 3. This is defined as a virus new to humans that is causing infections, but does not spread easily from one person to another. The latest updates from the WHO are available on the WHO website.
Further information on avian influenza is also available on the HPSC website.