Friday, January 10, 2014

Global Impact: Canadian Tourist Who Just Returned from Beijing Dies from H5N1

According to, a strain of avian influenza that has sickened nearly 650 people in China and neighboring regions has now been confirmed in North America. 
The H5N1 bird flu strain, which has also killed 385 people worldwide, was discovered on January 1, 2014 in a Canadian tourist who had recently returned from China.

A Chinese website located in Toronto has reported that the Canadian victim was a 20-year-old woman.
The patient, who died on January 3 due to complications of the illness, had been in China from December 6-27 and was symptomatic during the trip home, experiencing malaise and fever. Two other individuals who traveled with the patient have so far shown no flu symptoms.
Canadian health officials made the report to the World Health Organization (WHO), saying the patient was previously healthy with no existing medical conditions. A laboratory test conducted at the Alberta Provincial Lab determined the illness to be H5N1, and it was later confirmed by Canada’s National Microbiology Laboratory.
According to AFP, Canada Health Minister Rona Ambrose said during a news briefing that this was the first identified case of H5N1 in North America, stressing that this was an “isolated case.”
COMMENT: “I want to reassure the public this is an isolated case and the risk of H5N1 to Canadians is very low. There is no evidence of sustained human-to-human transmission,” the minister noted.
While the victim’s travel partner was showing no signs of illness, the Health Ministry said it was urgently contacting all airline passengers on the victim’s flights. 
It is not yet known how the victim contracted the disease, but given that it mainly comes from live poultry, officials surmise that this was the most likely mode of transmission in this patient. However, it was reported that the victim was not in contact with any person with a known illness and had not been in contact with live animals.
The victim began to feel ill during the flight home on December 27 and was admitted to a hospital on January 1, 2014; the patient died two days later after falling in and out of consciousness as symptoms worsened.
A specimen that was taken while the patient was still alive was identified as H5N1. The victim’s travel partners will be kept under close surveillance, despite showing no signs or symptoms of flu. Health officials said they will be kept under quarantine for 10 days, which is double the usual time it takes for the virus to manifest itself.
As well as the victim’s travel partners, family members are also being monitored and have so far shown no signs or symptoms of flu.
Canadian health officials have alerted China, but said that because there is a lack of data on how the person was infected, it will not likely to be of any value to Chinese health officials. The victim only visited Beijing during the trip, a region that has been thought to be H5N1-free previously.
Despite an urgent rush by health officials to contact all airline passengers who were on the same flights as the victim, Talbot maintained that there is no evidence that anyone else was likely to have been infected by the victim.
Avian flu is generally not transmissible between birds and humans, though there are rare instances when strains can mutate and make the move to humans. H5, H7 and H9, as well as a recent case of H10, strains have all mutated and jumped to humans, but mainly through direct contact with infected live poultry. 
None of these strains have yet to mutate to the point where they can easily transmit between humans.

H5N1, or avian flu, is not part of the seasonal flu that circulates in Canada each year.

WHO says that as of mid-December 2013, there have been 648 laboratory-confirmed human cases of H5N1 flu, reported in 15 countries. Of that total, 384 infections have been fatal.

The unidentified woman began to fall ill on a flight from Beijing to Vancouver, on Air Canada flight number 030, and Vancouver to Edmonton, Air Canada flight 244, on December 27.

From what is known about H5N1, human-to-human transmission is very rare and, if it occurs, is confined to close family contacts. It is, therefore, extremely unlikely that any passengers or casual contacts would have been at risk. 

The patient’s family is not showing any signs of illness, he said.

To contract H5N1 a person has to come into direct contact with dead or infected birds or bird feces, usually during butchering, defeathering or food preparation. Humans cannot contract H5N1 by eating infected poultry or eggs if the food is properly cooked.

Since 2003, there have been 641 cases of H5N1 worldwide, causing 380 deaths. Most of the fatalities have been in Indonesia, Egypt and Vietnam.