50% fatality rate: UN and WHO recommend that some people should be vaccinated

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50% fatality rate: UN and WHO recommend that some people should be vaccinated

50% fatality rate: UN and WHO recommend that some people should be vaccinated.

Eight years later, another case of H5N1 highly pathogenic avian influenza (HPAI) occurred in Cambodia, resulting in one death and one asymptomatic infection.

Is the H5N1 disease burden large? Why is H5N1 so concerned? How to reduce the risk of H5N1? Is there a H5N1 vaccine available? After reading this article, you will understand.

Human H5N1 case recurrence

50% fatality rate: UN and WHO recommend that some people should be vaccinated.

There are 22 chickens and 3 ducks in their family.

On February 16, in a village in Prey Veng Province in southern Cambodia, an 11-year-old girl developed flu-like symptoms and was treated locally. Later, a more serious condition (severe pneumonia) appeared and was sent to Cambodia A hospital in the capital Phnom Penh for treatment.

At first, the girl’s symptoms didn’t seem serious—a temperature of 102°F (38.9°C), a cough, a sore throat, and no other obvious symptoms.

After sequencing the samples, it was determined that the girl was infected with the H5N1 avian influenza virus, which belongs to the 2.3.2.1c evolutionary branch, which is similar to the 2.3.2.1c evolutionary branch virus that has been circulating in poultry in Southeast Asia since 2014.

The girl tragically passed away last Wednesday after being diagnosed with H5N1 bird flu. In addition, his father was also found to be infected with H5N1 after testing, but fortunately, the 49-year-old man was only asymptomatic. However, according to Reuters news reports, at least 12 people in Cambodia have been tested.

As for the source of the virus this time, after investigation, it was judged locally that it originated from a small amount of poultry raised in their home. And these poultry, and even some of the surrounding birds, have died.

In addition to some local action, the Ho Chi Minh City People’s Committee on Sunday called for close monitoring of arrivals from areas where the H5N1 bird flu outbreak has occurred because Vietnam shares a border with Cambodia’s Prey Veng province.

It seems that whether it is Cambodia or Vietnam, both sides have become very nervous because there are only 2 infected people.

Less morbidity , higher mortality

Why is H5N1 getting so much attention?

It has been almost 10 years (2014) since the last case in Cambodia. In the past 10 years, Cambodia has not seen any cases of human infection with bird flu. Going back even further, Cambodia has reported only 128 human cases of H5N1 since 2003.

In the past 20 years, there have been less than 130 infected people, and an average of only 6.5 people have been infected every year. Is it necessary to make such a fuss about H5N1?

Then let’s look at H5N1 from another angle——

From 2003 to February 25, 2023, a total of 873 H5N1 human cases and 458 deaths were reported in 21 countries around the world, with a case fatality rate of 52.5% (458/873); only in one country, Cambodia, during this time frame 128 cases of H5N1 infection were reported, 64 of them died, the case fatality rate was 50% (64/128).

Although it is not like rabies, once the case fatality rate is close to 100%, for H5N1, which is almost equivalent to a foot that has stepped into the underworld after infection, such a threat is enough to be frightening.

Will H5N1 become a pandemic?

image
Interspecies transmission of influenza A, source: doi: 10.1128/CMR.00037-06

Perhaps this is a comforting answer: not yet.

Although the case fatality rate of H5N1 is as high as 50%, and in this Cambodian case, not only the girl was diagnosed, but her father was also confirmed to be infected, but this does not mean that human-to-human transmission of H5N1 has occurred.

From 1959 to 1990, there were 17 outbreaks of highly pathogenic avian influenza in the world, 5 involving turkeys and 12 involving chickens, and these were effectively controlled by culling poultry.

Since then, the first H5N1 highly pathogenic avian influenza outbreak occurred in Hong Kong in 1997, and 6 of the 18 confirmed cases died. The virus was finally identified as the “goose influenza” virus (A /goose/Guangdong/1/1996 (Gs/GD/96)).

Since then, the “goose flu” virus lineage has been detected in more than 70 countries and regions, but the cases are relatively small, and from the current point of view, the person-to-person transmission of H5N1 is very limited. Not enough evidence.

Of course, there is only a lack of evidence of human-to-human transmission at present, just like the lack of evidence for the COVID-19 at the beginning, what will happen in the future still needs to be watched more closely.

The attitude of international organizations

After the H5N1 cases were reported in Cambodia, the World Health Organization (WHO) issued information on 26 February 2023 notifying the incident, stating that “an outbreak investigation is ongoing, including determination of exposure to the virus in these two reported cases.”

For the prevention and control of bird flu, the World Health Organization has also emphasized several recommendations. A brief description includes:

1. Continue to monitor information on the epidemiology, clinical and human impact of avian influenza viruses and share them in a timely manner;

2. Sampling and culling of poultry in areas where cases have occurred, relevant personnel should take protective measures and be closely monitored;

3. Thorough epidemiological investigations should be conducted on suspected or confirmed cases, and relevant samples should be tested and further identified at the same time as the WHO Collaborating Center.

In addition, the World Health Organization also mentioned information about the H5N1 vaccine, which mainly includes two points:

1. At present, there is a H5N1 bird flu vaccine to deal with the pandemic, but it has not been widely used in the population;

2. People who come into contact with or work with poultry should be vaccinated against seasonal influenza to reduce risks. In fact, many countries and regions, including some countries, have the R&D and production capacity of H5N1 vaccines. some countries has also used H5N1 inactivated vaccines for strategic reserves before, but it has not (and is not necessary) universally vaccinated. After the WHO released the above information, the United Nations (UN) also synchronized the information on the bird flu cases in Cambodia and forwarded the recommendation of “recommending relevant populations to be vaccinated against seasonal influenza”.

50% fatality rate: UN and WHO recommend that some people should be vaccinated. Source: https://news.un.org/en/story/2023/02/1133922

For the general public who generally do not have “close contact” with poultry, they do not need to pay too much attention to the threat of bird flu—at least not in the short term.

In the face of the recent menacing influenza A (mainly H1N1 and H3N2, in fact H5N1 is also a type of influenza A), perhaps many people should also realize that not only people who come into contact with poultry should be vaccinated against influenza, but in the face of this global pandemic Diseases to which the population is susceptible require vaccination.

Still the same sentence: In the flu epidemic, it is better to be late than never; for flu vaccination, it is better to be late than not to get vaccinated.

50% fatality rate: UN and WHO recommend that some people should be vaccinated.

(source:internet, reference only)

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