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FluTrackers.com Risk Assessment of H5N1 type influenza in China
The FluTrackers Team
January 24, 2012
We feel that we can not say with 100% certainly what the exact situation is but this is our opinion based on the facts as we ascertain them as of this date and time.
Humans are at continuous risk of exposure to H5N1 poultry.
1) China has an endemic H5N1 problem in poultry. We know this for several reasons:
a) There have been warnings over the years to clean eggs shells due to surface contamination including H5N1:
China - Experts Call for More Stringent Standards for Cleaning Eggs - Avian Flu Mentioned As Risk May 2011
China - Nutrition Society warns on poultry egg shells, meat, and storage due to avian influenza H5N1 contamination January 2012
2) There are numerous H5N1 drills to train emergency personnel how to react to human and poultry outbreaks. A sample of recent drills includes:
China - Human Bird Flu H5N1 Drill held in Qinzhou, Guangxi province – January 2012
China - CDC Holds Suspected Human H5N1 Emergency Drill in Binzhou City, Shandong province December 2011
China - Emergency Poultry Bird Flu Drill Held in Rizhao City, Shandong province December 2011
China - Major H5N1 Poultry Farm Drill Held in Jangmen, Guangdong province November 2011
3) There are recent H5N1 poultry outbreaks in countries that border China: Tibet, Vietnam (Human), Vietnam (poultry), Hong Kong (wild bird), Hong Kong (poultry), Bhutan, & Nepal
4) The Russian health minister warned citizens on January 4, 2012 to be vigilant about H5N1 when traveling in China here.
5) Other hints and tips in the Chinese press regarding H5N1 status:
China - "Raw" poultry not allowed on trains in Shenzhen due to bird flu fears January 15, 2012
Ministry of Health: human infection of highly pathogenic avian influenza surveillance will be strengthened for the sporadic cases January 2012
China - Shanghai public health requires all medical institutions to monitor carefully for unexplained pneumonia November 2011
6) No country, where H5N1 has become endemic in the environment, has been able to successfully eliminate this disease. Indonesia, Vietnam, and Egypt, each experiencing current poultry and human H5N1 cases, are the most outstanding examples of this unfortunate phenomena. Therefore, despite the fact that China is not reporting any current H5N1 outbreaks in poultry we believe they occur and this is a constant threat to human health.
We see no evidence of sustained and efficient H5N1 infection between humans in China. However, we feel this risk is unknown since China is not forthcoming, generally, about its disease status. On June 14, 2011 the Ministry of Health announced a creation of a “black list” for media that do not report government sanctioned information. We feel this represents a risk to human health, in general, in China.
The risk of human contamination from H5N1 positive wild birds is unknown in China. Hong Kong reports sporadic cases of H5N1 in wild birds but there are no corresponding human infections that result from contact with such wild birds.
The risk of human contamination from animals (other than poultry), or the environment, in general, is not known. Many studies have demonstrated that animals can harbour the H5N1 virus, including domestic cats and dogs. In an H5N1 endemic environment, it should be assumed that there are many possible vectors for infection.
It is unclear how the most recent human cases of H5N1 were infected here and here. The government of China denied any human-to-human transmission in the Shenzhen case. The government also denied H5N1 poultry as the source. There were some press announcements that contact with a wild bird may have been the cause of the human case in Shenzhen. If this is true, then, logically, there must be many human cases of H5N1 in China amongst people who frequent parks and other outdoor venues. We feel this scenario, while possible, is not likely.
In conclusion, we feel there is a risk to the human population in China from H5N1 type influenza. A culture of hand washing, avoidance of wild birds and poultry, sanitary contact with domestic pets, and social distancing in public is advisable.
The FluTrackers Team
January 24, 2012
We feel that we can not say with 100% certainly what the exact situation is but this is our opinion based on the facts as we ascertain them as of this date and time.
Humans are at continuous risk of exposure to H5N1 poultry.
1) China has an endemic H5N1 problem in poultry. We know this for several reasons:
a) There have been warnings over the years to clean eggs shells due to surface contamination including H5N1:
China - Experts Call for More Stringent Standards for Cleaning Eggs - Avian Flu Mentioned As Risk May 2011
China - Nutrition Society warns on poultry egg shells, meat, and storage due to avian influenza H5N1 contamination January 2012
2) There are numerous H5N1 drills to train emergency personnel how to react to human and poultry outbreaks. A sample of recent drills includes:
China - Human Bird Flu H5N1 Drill held in Qinzhou, Guangxi province – January 2012
China - CDC Holds Suspected Human H5N1 Emergency Drill in Binzhou City, Shandong province December 2011
China - Emergency Poultry Bird Flu Drill Held in Rizhao City, Shandong province December 2011
China - Major H5N1 Poultry Farm Drill Held in Jangmen, Guangdong province November 2011
3) There are recent H5N1 poultry outbreaks in countries that border China: Tibet, Vietnam (Human), Vietnam (poultry), Hong Kong (wild bird), Hong Kong (poultry), Bhutan, & Nepal
4) The Russian health minister warned citizens on January 4, 2012 to be vigilant about H5N1 when traveling in China here.
5) Other hints and tips in the Chinese press regarding H5N1 status:
China - "Raw" poultry not allowed on trains in Shenzhen due to bird flu fears January 15, 2012
Ministry of Health: human infection of highly pathogenic avian influenza surveillance will be strengthened for the sporadic cases January 2012
China - Shanghai public health requires all medical institutions to monitor carefully for unexplained pneumonia November 2011
6) No country, where H5N1 has become endemic in the environment, has been able to successfully eliminate this disease. Indonesia, Vietnam, and Egypt, each experiencing current poultry and human H5N1 cases, are the most outstanding examples of this unfortunate phenomena. Therefore, despite the fact that China is not reporting any current H5N1 outbreaks in poultry we believe they occur and this is a constant threat to human health.
We see no evidence of sustained and efficient H5N1 infection between humans in China. However, we feel this risk is unknown since China is not forthcoming, generally, about its disease status. On June 14, 2011 the Ministry of Health announced a creation of a “black list” for media that do not report government sanctioned information. We feel this represents a risk to human health, in general, in China.
The risk of human contamination from H5N1 positive wild birds is unknown in China. Hong Kong reports sporadic cases of H5N1 in wild birds but there are no corresponding human infections that result from contact with such wild birds.
The risk of human contamination from animals (other than poultry), or the environment, in general, is not known. Many studies have demonstrated that animals can harbour the H5N1 virus, including domestic cats and dogs. In an H5N1 endemic environment, it should be assumed that there are many possible vectors for infection.
It is unclear how the most recent human cases of H5N1 were infected here and here. The government of China denied any human-to-human transmission in the Shenzhen case. The government also denied H5N1 poultry as the source. There were some press announcements that contact with a wild bird may have been the cause of the human case in Shenzhen. If this is true, then, logically, there must be many human cases of H5N1 in China amongst people who frequent parks and other outdoor venues. We feel this scenario, while possible, is not likely.
In conclusion, we feel there is a risk to the human population in China from H5N1 type influenza. A culture of hand washing, avoidance of wild birds and poultry, sanitary contact with domestic pets, and social distancing in public is advisable.