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@#Avian influenza subtype A(HxNy) viruses are zoonotic and may occasionally infect humans through direct or indirect contact, resulting in mild to severe illness and death. Member States in the Western Pacific Region (WPR) communicate and notify the World Health Organization of any human cases of A(HxNy) through the International Health Regulations (IHR 2005) mechanism. This report includes all notifications in the WPR with illness onset dates from 1 November 2003 to 31 July 2022. During this period, there were 1972 human infections with nine different A(HxNy) subtypes notified in the WPR. Since the last report, an additional 134 human avian influenza infections were notified from 1 October 2017 to 31 July 2022. In recent years there has been a change in the primary subtypes and frequency of reports of human A(HxNy) in the region, with a reduction of A(H7N9) and A(H5N1), and conversely an increase of A(H5N6) and A(H9N2). Furthermore, three new subtypes A(H7N4), A(H10N3) and A(H3N8) notified from the People’s Republic of China were the first ever recorded globally. The public health risk from known A(HxNy) viruses remains low as there is no evidence of person-to-person transmission. However, the observed changes in A(HxNy) trends reinforce the need for effective and rapid identification to mitigate the threat of a pandemic from avian influenza if person-to-person transmission were to occur.
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Abstract@#Since the first confirmed human infection with avian influenza A(H5N1) virus was reported in Hong Kong SAR (China) in 1997, sporadic zoonotic avian influenza viruses causing human illness have been identified globally with the World Health Organization (WHO) Western Pacific Region as a hotspot. A resurgence of A(H5N1) occurred in humans and animals in November 2003. Between November 2003 and September 2017, WHO received reports of 1838 human infections with avian influenza viruses A(H5N1), A(H5N6), A(H6N1), A(H7N9), A(H9N2) and A(H10N8) in the Western Pacific Region. Most of the infections were with A(H7N9) (n = 1562, 85%) and A(H5N1) (n = 238, 13%) viruses, and most (n = 1583, 86%) were reported from December through April. In poultry and wild birds, A(H5N1) and A(H5N6) subtypes were the most widely distributed, with outbreaks reported from 10 and eight countries and areas, respectively. Regional analyses of human infections with avian influenza subtypes revealed distinct epidemiologic patterns that varied across countries, age and time. Such epidemiologic patterns may not be apparent from aggregated global summaries or country reports; regional assessment can offer additional insight that can inform risk assessment and response efforts. As infected animals and contaminated environments are the primary source of human infections, regional analyses that bring together human and animal surveillance data are an important basis for exposure and transmission risk assessment and public health action. Combining sustained event-based surveillance with enhanced collaboration between public health, veterinary (domestic and wildlife) and environmental sectors will provide a basis to inform joint risk assessment and coordinated response activities.
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West Africa is currently experiencing the largest outbreak of Ebola virus disease (EVD) in history with intense transmission in several affected countries. For non-affected countries, the best protective measures are adequate levels of preparedness including vigilant surveillance to detect cases early and well-prepared health systems to ensure rapid containment of the virus and to avoid further spread. The World Health Organization Regional Office for the Western Pacific recently conducted two activities: a web-based EVD preparedness survey and an EVD simulation exercise to determine the overall level of EVD preparedness in the Region. The survey and exercise together demonstrate there is a good overall level of preparedness for a potential imported case of EVD in the Western Pacific Region. However, a number of areas still require further strengthening before the Region can efficiently and effectively respond to potential EVD events, including laboratory testing arrangements; clinical management and infection prevention and control; and public health intervention measures, particularly at points of entry. Importantly, the survey and exercise also highlight the unique situation in Pacific island countries and emphasize that special considerations are needed to better support these countries in EVD preparedness.
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On 31 March 2013, the National Health and Family Planning Commission, China notified the World Health Organization of three cases of human infection with avian influenza A(H7N9) from Shanghai and Anhui.1 By 8 May, 131 cases, including 26 deaths, had been notified from 11 provinces/municipalities.1,2 The majority (81%) of reported cases were from Shanghai municipality and Zhejiang and Jiangsu provinces. Available data indicate that more than three quarters of cases (59/77, 76%) had recent exposure to animals. Among these, 58% (34/59) had direct contact with chickens and 64% (38/59) visited a live bird market (LBM).3 Provincial and national authorities in China have collected more than 80 000 samples from LBMs, poultry slaughter houses, poultry farms, wild bird habitats, pig slaughter houses and their environments. As of 7 May, 50 samples were positive for avian influenza A(H7N9): 39 samples from poultry from LBMs in Anhui, Jiangsu, Jiangxi, Guangdong, Shanghai and Zhejiang provinces/municipalities (26 chickens, three ducks, four pigeons, six unknown) and 11 environmental samples from LBMs in Shanghai, Henan and Shandong provinces.4 None of the samples from poultry farms or pigs were positive