Abstract
Since the first confirmed human infection with avian influenza A(H5N1) virus was reported in Hong Kong Special Administrative Region in 1997, sporadic zoonotic avian influenza viruses causing illness in humans have been identified globally, with the WHO Western Pacific Region as one of the hotspots. From November 2003, when a resurgence of H5N1 virus activity in humans and animals occurred, through September 2017, 1,838 human infections with avian influenza viruses in the region were reported to WHO. Viruses infecting humans were A(H5N1), A(H5N6), A(H6N1), A(H7N9), A(H9N2) and A(H10N8). The vast majority of infections were with H7N9 (n=1,562) and H5N1 (n=238) viruses, and most (n=1583, 86%) were reported from December through April. In poultry and wild birds, H5N1 and H5N6 subtypes were the most widely distributed, with outbreaks reported from ten and eight countries and areas, respectively. Regional analyses of human infections with avian influenza subtypes revealed distinct patterns and variations in epidemiology across countries, age, and time. Such epidemiologic patterns may not be apparent from aggregated global summaries or isolated country reports; regional assessment can offer additional insight that can inform risk assessment and response efforts. As infected animals and contaminated environments are the primary source of human infections, regional analyses that bring together surveillance data from human and animal health sectors are an important basis for exposure and transmission risk assessment and public health action. A One Health approach combining sustained event-based surveillance with enhanced collaboration between the human, animal (domestic and wildlife), and environmental sectors will provide a basis to inform joint risk assessment and coordinated response capacities
Highlights
Since the first confirmed human infection with avian influenza A(H5N1) virus was reported in Hong Kong SAR (China) in 1997, sporadic zoonotic avian influenza viruses causing human illness have been identified globally with the World Health Organization (WHO) Western Pacific Region as a hotspot
From November 2003 through September 2017, 1838 human infections with six avian influenza viruses in the Western Pacific Region were reported to WHO
While this seasonality was largely driven by A(H7N9) and A(H5N1) cases, most A(H5N6) and A(H9N2) cases (n = 22, 65%) and all three A(H10N8) cases were reported during this period (Fig. 2)
Summary
Since the first confirmed human infection with avian influenza A(H5N1) virus was reported in Hong Kong SAR (China) in 1997, sporadic zoonotic avian influenza viruses causing human illness have been identified globally with the World Health Organization (WHO) Western Pacific Region as a hotspot. Regional analyses of human infections with avian influenza subtypes revealed distinct epidemiologic patterns that varied across countries, age and time Such epidemiologic patterns may not be apparent from aggregated global summaries or country reports; regional assessment can offer additional insight that can inform risk assessment and response efforts. Avian influenza viruses occur naturally among wild aquatic birds and cause occasional outbreaks in domestic poultry and other animal species.[1] They do not normally infect humans, though certain subtypes, such as avian influenza A(H5), A(H7) and A(H9) have caused sporadic human infections. The public availability of these data contributes to the compilation, analysis, interpretation and dissemination of information on avian influenza viruses in humans and animals In addition to these international frameworks, the WHO Global Influenza Surveillance and Response System (GISRS) is a laboratory network that collects data on influenza viruses circulating globally to inform vaccine composition recommendations, conduct risk assessments and monitor antiviral susceptibility.[17].
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