Avian Influenza Weekly Update Number 702 16 August 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 9 August and 15 August 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 15 August 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 15 August 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 9 August and 15 August 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 23 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 702 | 2 Human infection with avian influenza A(H7N4) virus in China Between 9 August and 15 August 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 9 August and 15 August 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 15 August 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 9 August and 15 August 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 702 | 3 Animal infection with avian influenza virus Between 9 August and 15 August 2019, two new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2) in Taiwan, China On 12 August 2019, two new outbreaks of highly pathogenic avian influenza A(H5N2) among poultry were reported to OIE from Taiwan, China. In Yunlin County, 275 chickens died among 6,664 susceptible birds in one farm since 29 July. In Taipei city there were 3 cases among 44 susceptible native chickens in a slaughterhouse since 25 July. All remaining 6,433 birds were culled. (source) For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 3 July 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 703 23 August 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 16 August and 22 August 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 22 August 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 15 August 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 16 August and 22 August 2019, one new case of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. The case was notified to WPRO on 19 August 2019 from Beijing, China. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 703 | 2 Human infection with avian influenza A(H7N4) virus in China Between 16 August and 22 August 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 16 August and 22 August 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 22 August 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 16 August and 22 August 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 703 | 3 Animal infection with avian influenza virus Between 16 August and 22 August 2019, 3 new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2) in Taiwan, China On 21 August 2019, three outbreaks of highly pathogenic avian influenza A(H5N2) were reported to OIE from Taiwan, China. On 4 August in Taipei City, Wanhua District, there was one case and two susceptible cases in native chicken in a slaughter house, and both susceptible cases were culled. On 5 August in Taixi Township, Yunlin County, there were 266 susceptible meat geese of which all were culled. On 10 August in Dacheng Township, Changhua County, there were 883 A(H5N2) cases among native chickens on a farm of which 882 died and the remaining 19181 were culled. (Source) For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 704 30 August 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 23 August and 29 August 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 29 August 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 15 August 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 23 August and 29 August 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 704 | 2 Human infection with avian influenza A(H7N4) virus in China Between 23 August and 29 August 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 23 August and 29 August 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 29 August 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 23 August and 29 August 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 704 | 3 Animal infection with avian influenza virus Between 23 August and 29 August 2019, no new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 705 6 September 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 30 August and 5 September 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 5 September 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 September 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 30 August and 5 September 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory- confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 705 | 2 Human infection with avian influenza A(H7N4) virus in China Between 30 August and 5 September, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 30 August and 5 September 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 5 September2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 30 August and 5 September 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 705 | 3 Animal infection with avian influenza virus Between 30 August and 5 September 2019, no new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017 Avian Influenza Weekly Update Number 705 | 4
Avian Influenza Weekly Update Number 706 13 September 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 6 September and 12 September 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 12 September 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 September 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 6 September and 12 September 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory- confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 706 | 2 Human infection with avian influenza A(H7N4) virus in China Between 6 September and 12 September, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 6 September and 12 September 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 5 September2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 6 September and 12 September 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 706 | 3 Animal infection with avian influenza virus Between 6 September and 12 September 2019, two new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2) in Taiwan, China On 6 September 2019, an outbreak of highly pathogenic avian influenza A(H5N2) among birds was reported in Xikou Township, Chiayi County, Taiwan, China. 2,500 birds died among 48,684 susceptible birds since 29 August. All remaining 46,184 birds were culled. (source) Highly pathogenic avian influenza A(H5N6) in Viet Nam On 8 September 2019, a new outbreak of highly pathogenic avian influenza A(H5N6) among birds was reported in Thanh Thoi B village, Ben Tre province Viet Nam. 138 birds died among 1,026 susceptible birds since 18 August 2019. All remaining 888 birds were culled. (source) For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 707 20 September 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 13 September and 19 September 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 19 September 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 September 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 13 September and 19 September, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory- confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 707 | 2 Human infection with avian influenza A(H7N4) virus in China Between 13 September and 19 September2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory- confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 13 September and 19 September 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 5 September2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 13 September and 19 September 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 707 | 3 Animal infection with avian influenza virus Between 6 September and 12 September 2019, 11 new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2) in Taiwan, China On 16 September 2019, 6 outbreaks of highly pathogenic avian influenza A(H5N2) among poultry were reported from Changhua County, Taipei City, Yunlin County and Pingtung County. Of 42,744 susceptible birds, 3223 died and the remaining were culled (source). On 18 September 2019, 4 outbreaks of highly pathogenic avian influenza A(H5N2) among poultry were reported in Yunlin County. Of 48,873 susceptible birds, 1,340 died and the remaining were culled.(source) Highly pathogenic avian influenza A(H5N5) in Taiwan, China On 17 September 2019, media reported the Bureau of Animal and Plant Health Inspection and Quarantine in Taiwan, China detected the highly pathogenic avian influenza A(H5N5) among poultry in Cishan District, Kaoshiung city on 12 September. This is the first reported detection of H5N5 in Taiwan, China, resulting 3,583 ducks were culled. Five surrounding farms were investigated and on additional cases of H5N5 were detected. Information has not been available in OIE yet. (source) For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 708 27 September 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 20 September and 26 September 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 26 September 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 September 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 20 September and 26 September, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory- confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 708 | 2 Human infection with avian influenza A(H7N4) virus in China Between 20 September and 26 September2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory- confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 20 September and 26 September 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 5 September2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 20 September and 26 September 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 708 | 3 Animal infection with avian influenza virus Between 20 September and 26 September 2019, 2 new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2) in Taiwan, China On 25 September 2019, two outbreaks of highly pathogenic avian influenza A(H5N2) among poultry were reported to OIE from Taiwan, China. In Changhua County, six poultry died among 18 susceptible in a backyard farm. In Yunlin County, 1070 chickens died among 22,126 susceptible. The remaining 21,068 poultry were culled.(source) For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 709 04 October 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 27 September and 03 October 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 03 October 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 September 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 27 September and 03 October 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory- confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 708 | 2 Human infection with avian influenza A(H7N4) virus in China Between 27 September and 03 October 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory- confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 27 September and 03 October 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 5 September2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 27 September and 03 October 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 708 | 3 Animal infection with avian influenza virus Between 27 September and 03 October 2019, no new outbreak of avian influenza has been reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 710 10 October 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 04 October and 10 October 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 10 October 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 September 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 04 and 10 October 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 710 | 2 Human infection with avian influenza A(H7N4) virus in China Between 04 and 10 October 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 04 and 10 October 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 10 October 2019, a total of 1,568 laboratory- confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 04 and 10 October 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 710 | 3 Animal infection with avian influenza virus Between 4 and 10 October 2019, no new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 711 18 October 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 11 October and 17 October 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 17 October 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 17 October 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 11 and 17 October 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 711 | 2 Human infection with avian influenza A(H7N4) virus in China Between 11 and 17 October 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 11 and 17 October 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 17 October 2019, a total of 1,568 laboratory- confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 11 and 17October 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 711 | 3 Animal infection with avian influenza virus Between 11 and 17 October 2019, two new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic influenza virus (H5N2) in Taiwan, China On 14 October 2019, one new outbreak of highly pathogenic avian influenza A(H5N2) among poultry was reported to OIE from Taiwan, China. In Taxi Township, Yunlin County, 991 chickens died among 35,336 susceptible birds in one farm since 28 September. All remaining 34,345 birds were culled. Source Highly pathogenic influenza virus (H5N6) in Viet Nam On 16 October 2019, one new outbreak of highly pathogenic avian influenza A(H5N6) among poultry was reported to OIE from Viet Nam. In Dak Kan, Ngoc Hoi, Kon Tum, all 980 susceptible birds in one village were culled. Source For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18‒21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 712 25 October 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 18 October and 24 October 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 24 October 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 24 October 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 18 and 24 October 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 712 | 2 Human infection with avian influenza A(H7N4) virus in China Between 18 and 24 October 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 18 and 24 October 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 24 October 2019, a total of 1,568 laboratory- confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 18 and 24 October 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 712 | 3 Animal infection with avian influenza virus Between 18 and 24 October 2019, no new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 713 1 November 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 25 October and 31 October 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 31 October 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 31 October 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 25 and 31 October 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 713 | 2 Human infection with avian influenza A(H7N4) virus in China Between 25 and 31 October 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 25 and 31 October 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 31 October 2019, a total of 1,568 laboratory- confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 25 and 31 October 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 713 | 3 Animal infection with avian influenza virus Between 25 and 31 October 2019, one new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic influenza virus (H5N2) in Taiwan, China On 28 October 2019, one new outbreak of highly pathogenic avian influenza A(H5N2) among poultry was reported to OIE from Taiwan, China. In Mailiao Township, Yunlin County, all 1,201 susceptible birds in one farm were culled. Source For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 689 17 May 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 10 May and 16 May 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 16 May 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (1 case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 9 May 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 9 April 2019, there were 860 cases of human infection with avian influenza A(H5N1) virus reported from 16 countries worldwide. Of these 860 cases, 454 were fatal (CFR of 53%). The last case was reported from Indonesia on 26 September 2017 (source). There has been one new human case of A(H5N1) reported from Nepal, with confirmation on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 10 May and 16 May 2019, no new cases of human infection avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 23 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 689 | 2 Human infection with avian influenza A(H7N4) virus in China Between 10 May and 16 May 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 10 May and 16 May 2019, no new cases of human infection with avian influenza A(H7N9) virus was reported to WHO in the Western Pacific Region. As of 16 May 2019, a total of 1,568 laboratory- confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 10 May and 16 May 2019, no new cases of human infection with avian influenza A(H9N2) virus was reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 689 | 3 Animal infection with avian influenza virus Between 10 May and 16 May 2019, two new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2), Taiwan, China On 14 May 2019, two new outbreak of highly pathogenic avian influenza A(H5N2) among poultry were reported. One in Yunlin county at a farm involving 14,336 susceptible birds, 816 died and the remaining were culled. The second was in Kaohsiung City at a slaughter involving 5,675 susceptible birds, 210 died and remaining were culled. For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 9 April 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 8 May 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 714 08 November 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 1 and 7 November 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 7 November 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 7 November 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 24 June 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 1 and 7 November 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 714 | 2 Human infection with avian influenza A(H7N4) virus in China Between 1 and 7 November 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 1 and 7 November 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 7 November 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 1 and 7 November 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 714 | 3 Animal infection with avian influenza virus Between 1 and 7 November 2019, no new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza OFFLU: Animal Influenza Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 H7N9 situation update (FAO). 7 August 2019 TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 715 15 November 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 8 and 14 November 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 14 November 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 14 November 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 14 November 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 8 and 14 November 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 715 | 2 Human infection with avian influenza A(H7N4) virus in China Between 8 and 14 November 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 8 and 14 November 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 14 November 2019, a total of 1,568 laboratory- confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 8 and 14 November 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and four cases thus far in 2019. A total of 26 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 715 | 3 Animal infection with avian influenza virus Between 8 and 14 November 2019, no new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. For more information on animal infection with avian influenza viruses with potential public health impact, visit: World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza OFFLU: Animal Influenza Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 H7N9 situation update (FAO). 7 August 2019 TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 716 22 November 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 15 and 21 November 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 21 November 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 21 November 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 21 November 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 15 and 21 November 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 716 | 2 Human infection with avian influenza A(H7N4) virus in China Between 15 and 21 November 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 15 and 21 November 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 21 November 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 15 and 21 November 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and five cases thus far in 2019. A total of 27 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 716 | 3 Animal infection with avian influenza virus Between 15 and 21 November 2019, one new outbreak of avian influenza was reported to OIE from the Western Pacific Region. Highly pathogenic influenza virus (H5) in Taiwan China On 20 November 2019, one new outbreak of highly pathogenic avian influenza A (H5) among poultry was reported to OIE from Taiwan, China. In Puzi city, Chiayi County, 2899 chickens died among 3,000 susceptible birds in one farm since 27 October. All remaining 101 birds were culled. Source For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 7 August 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 678 1 March 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 22 February and 28 February 2019, no new cases of human infection with avian influenza A(H5N1) virus were reported to WHO in the Western Pacific Region. As of 12 February 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (1 case, no death). Table 1: Cumulative number laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 12 February 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 12 February 2019, there were 860 cases of human infection with avian influenza A(H5N1) virus reported from 16 countries worldwide. Of these 860 cases, 454 were fatal (CFR of 53%). The last case was reported from Indonesia on 26 September 2017 (source). Human infection with avian influenza A(H5N6) virus Between 22 February and 28 February 2019, no new cases of human infection avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 23 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 678 | 2 Human infection with avian influenza A(H7N4) virus in China Between 22 February and 28 February 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory- confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 22 February and 28 February 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 28 February 2019, a total of 1,567 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013, including 40 instances of 2-3 person clusters. Included in this total are 32 human cases of HPAI A(H7N9) virus all reported during the 5th wave (1 October 2016 to 30 September 2017). These 32 cases were from Fujian, Guangdong, Guangxi, Hebei, Henan, Hunan, Shaanxi, Taiwan, China (the case had travel history to Guangdong), and Yunnan. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent sixth wave (1 October 2017 to 30 September 2018). Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A (H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 22 February and 28 February 2019, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and two cases thus far in 2019. A total of 25 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 678 | 3 Animal infection with avian influenza virus Between 22 February and 28 February 2019, five new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic avian influenza A(H5N2) virus infection in birds in Taiwan, China On 26 February 2019, four new outbreaks of highly pathogenic avian influenza A(H5N2) in Yunlin and Changhua county were reported to OIE. Of 65 496 susceptible poultry, 4 260 died and the remaining was culled. http://www.oie.int/wahis_2/public/wahid.php/Reviewreport/Review?page_refer=MapFullEventReport& reportid=29398 Highly pathogenic avian influenza A(H5N6) virus infection in birds in Yunnan Province, China On 27 February 2019, one outbreak of highly pathogenic avian influenza A (H5N6) in Yunnan, China was reported to OIE. Of 56 380 susceptible birds, 463 died and the remaining was culled. http://www.oie.int/wahis_2/public/wahid.php/Reviewreport/Review?page_refer=MapFullEventReport& reportid=29699 For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 12 February 2019. • Recommended composition of influenza virus vaccines for use in the 2019 southern hemisphere influenza season. 27 September 2018 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 6 February 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 717 29 November 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 22 and 28 November 2019, no new cases of human infection with avian influenza A (H5N1) virus were reported to WHO in the Western Pacific Region. As of 28 November 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 28 November 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 28 November 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 22 and 28 November 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 717 | 2 Human infection with avian influenza A(H7N4) virus in China Between 22 and 28 November 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 22 and 28 November 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 28 November 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 22 and 28 November 2019, one new case of human infection with avian influenza A(H9N2) virus was reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and six cases thus far in 2019. A total of 28 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 717 | 3 Animal infection with avian influenza virus Between 22 and 28 November 2019, two new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic influenza virus (H5N5) in Taiwan, China On 22 November 2019, one new outbreak of highly pathogenic avian influenza A (H5N5) among poultry carcasses was reported to OIE from Taiwan, China. In Wanhua District, Taipei City, suspected signs were observed in chicken carcasses during post-mortem inspection in one abattoir on 10 November. All remaining 10 carcasses were destroyed. Source Highly pathogenic influenza virus (H5N2) in Taiwan China On 22 November 2019, one new outbreak of highly pathogenic avian influenza A (H5N2) among poultry was reported to OIE from Taiwan, China. In Baozhong Township, Yunlin Country, 100 chickens died among 13,320 susceptible birds in one farm since 13 November. All remaining 13,220 were culled. Source For more information on animal infection with avian influenza viruses with potential public health impact, visit: World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza OFFLU: Animal Influenza Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 H7N9 situation update (FAO). 6 November 2019 TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 718 6 December 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 29 November and 5 December 2019, no new cases of human infection with avian influenza A (H5N1) virus were reported to WHO in the Western Pacific Region. As of 5 December 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumulative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 5 December 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 5 December 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 29 November and 5 December 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory- confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 718 | 2 Human infection with avian influenza A(H7N4) virus in China Between 29 November and 5 December 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory- confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 29 November and 5 December 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 5 December 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 29 November and 5 December 2019, no new cases of human infection with avian influenza A(H9N2) virus was reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and six cases thus far in 2019. A total of 28 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 718 | 3 Animal infection with avian influenza virus Between 29 November and 5 December 2019, one new outbreak of avian influenza was reported to OIE from the Western Pacific Region. Highly pathogenic influenza virus (H5N5) in Taiwan, China On 29 November 2019, one new outbreak of highly pathogenic avian influenza A (H5N5) among poultry carcasses was reported to OIE from Taiwan, China. In Wanhua District, Taipei City, suspected signs were observed in chicken carcasses during post-mortem inspection in one abattoir in Taipei City on 13 November. All remaining 11 carcasses were destroyed. Source For more information on animal infection with avian influenza viruses with potential public health impact, visit: • World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza • Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza • OFFLU: Animal Influenza • Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates • WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. • Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 • WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 • Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 • H7N9 situation update (FAO). 6 November 2019 • TIPRA Frequently Asked Questions. March 2017
Avian Influenza Weekly Update Number 719 13 December 2019 Human infection with avian influenza A(H5) viruses Human infection with avian influenza A(H5N1) virus Between 6 and 12 December 2019, no new cases of human infection with avian influenza A (H5N1) virus were reported to WHO in the Western Pacific Region. As of 12 December 2019, a total of 238 cases of human infection with avian influenza A(H5N1) virus were reported from four countries within the Western Pacific Region since January 2003 (Table 1). Of these cases, 134 were fatal, resulting in a case fatality rate (CFR) of 56%. The last case was reported from China, with an onset date of 27 December 2015 (one case, no death). Table 1: Cumul ative number of laboratory-confirmed human cases (C) and deaths (D) of influenza A(H5N1) virus infection reported to WHO, by date of onset (January 2003 to 12 December 2019), Western Pacific Region. Country 2003-2009 2010-2014 2015 2016 2017 2018 2019 Total C D C D C D C D C D C D C D C D Cambodia 9 7 47 30 0 0 0 0 0 0 0 0 0 0 56 37 China 38 25 9 5 6 1 0 0 0 0 0 0 0 0 53 31 Lao PDR 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 2 Viet Nam 112 57 15 7 0 0 0 0 0 0 0 0 0 0 127 64 Total 161 91 71 42 6 1 0 0 0 0 0 0 0 0 238 134 Globally, from January 2003 to 12 December 2019, there were 861 cases of human infection with avian influenza A(H5N1) virus reported from 17 countries. Of these 861 cases, 455 were fatal (CFR of 53%). The last case was reported from Nepal on 30 April 2019 (source). Human infection with avian influenza A(H5N6) virus Between 6 and 12 December 2019, no new cases of human infection with avian influenza A(H5N6) virus were reported to WHO in the Western Pacific Region. To date, a total of 24 laboratory-confirmed cases of human infection with influenza A(H5N6) virus, including seven deaths at time of IHR report, have been reported to WHO from China since 2014. Public health risk assessment for human infection with avian influenza A(H5) viruses Whenever avian influenza viruses are circulating in poultry, there is a risk for sporadic infection and small clusters of human cases due to exposure to infected poultry or contaminated environments. Therefore, sporadic human cases are not unexpected. With continued incidence of avian influenza due to existing and new influenza A(H5) viruses in poultry, there is a need to remain vigilant in the animal and public health sectors. Community awareness of the potential dangers for human health is essential to prevent infection in humans. Surveillance should be continued to detect human cases and early changes in transmissibility and infectivity of the viruses. For more information on confirmed cases of human infection with avian influenza A(H5) virus reported to WHO, visit: http://www.who.int/influenza/human_animal_interface/en/ For information on monthly risk assessments on Avian Influenza, visit: http://www.who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/ Avian Influenza Weekly Update Number 719 | 2 Human infection with avian influenza A(H7N4) virus in China Between 6 and 12 December 2019, no new cases of human infection with avian influenza A(H7N4) virus were reported to WHO in the Western Pacific Region. To date, only one laboratory-confirmed case of human infection with influenza A(H7N4) virus has been reported to WHO. This case was reported from China on 14 February 2018. Human infection with avian influenza A(H7N9) virus in China Between 6 and 12 December 2019, no new cases of human infection with avian influenza A(H7N9) virus were reported to WHO in the Western Pacific Region. As of 12 December 2019, a total of 1,568 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported to WHO since early 2013. Among them, 33 cases were infected with HPAI A(H7N9) virus, which have mutations in the hemagglutinin gene indicating a change to high pathogenicity in poultry. These 33 cases were from Taiwan (the case had travel history to Guangdong), Guangxi, Guangdong, Hunan, Shaanxi, Hebei, Henan, Fujian, Yunnan, Inner Mongolia. No increased transmissibility or virulence of the virus within human cases has been detected related to the HPAI A(H7N9) virus (source). WHO is continuing to assess the epidemiological situation and will conduct further risk assessments as new information becomes available. The number and geographical distribution of human infections with avian influenza A(H7N9) viruses in the fifth epidemic wave (1 October 2016 to 30 September 2017) was greater than previous waves and the subsequent waves. Further sporadic human cases of avian influenza A(H7N9) virus infection are expected in affected and possibly neighbouring areas. Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. However, if this were to occur, community level spread is considered unlikely as the virus does not have the ability to transmit easily among humans. To date, there is no evidence of sustained human-to-human transmission of avian influenza A(H7N9) virus. Human infections with the A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and transmission behaviour to humans as this may have serious public health impacts. For more information on human infection with avian influenza A (H7N9) virus reported to WHO: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/ Human infection with avian influenza A(H9N2) in China Between 6 and 12 December 2019, no new cases of human infection with avian influenza A(H9N2) virus was reported to WHO in the Western Pacific Region. In 2018 there were seven human cases of avian influenza A(H9N2) reported from China to WHO and six cases thus far in 2019. A total of 28 cases of human infection with avian influenza A(H9N2) in China have been reported since December 2015. Avian Influenza Weekly Update Number 719 | 3 Animal infection with avian influenza virus Between 6 and 12 December 2019, two new outbreaks of avian influenza were reported to OIE from the Western Pacific Region. Highly pathogenic influenza virus (H5N2) in Taiwan, China On 10 December 2019, two new outbreaks of highly pathogenic avian influenza A(H5N2) among poultry were reported to OIE from Taiwan, China. One was reported from a farm in Dongshi Township, Yunlin County, 125 birds died among 13,270 susceptible birds since 27 November. All remaining 13,145 were culled. The second was reported from a farm in Zhutang Township, Changhua County, 1,131 birds died among 26,111 susceptible birds since 27 November. All remaining 24,980 birds were culled. Source For more information on animal infection with avian influenza viruses with potential public health impact, visit: World Organization of Animal Health (OIE) web page: Weekly disease information and Latest report on Avian Influenza Food and Agriculture Organization of the UN (FAO) webpage: Avian Influenza OFFLU: Animal Influenza Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases (EMPRES) Other updates WHO Risk Assessment of human infection with avian influenza A virus. 24 June 2019 o Risk assessment summary: The overall public health risk from currently known influenza viruses at the human-animal interface has not changed, as further human infections with viruses of animal origin are expected, and the likelihood of sustained human-to-human transmission of these viruses remains low. Recommended composition of influenza virus vaccines for use in the 2020 southern hemisphere influenza season. 27 September 2019 WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2019-20 Northern Hemisphere Influenza Season. 18-21 February 2019 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines. 21 February 2019 H7N9 situation update (FAO). 6 November 2019 TIPRA Frequently Asked Questions. March 2017