By NewsDesk  @infectiousdiseasenews

In a follow-up on reports (HERE and HERE) on a human H5N1 avian influenza case in India, the World Health Organization (WHO) on Monday published a Disease Outbreak News (DON) that offered some more details of the case:

Public domain photo/Robin klein

On 21 July 2021, the National IHR focal point of India notified WHO of one human case of avian Influenza A(H5N1) from Haryana state, northern India. This is the first reported case of human infection of influenza A(H5N1) virus in India.

The patient was a boy under 18 years of age with a recently diagnosed underlying illness in June 2021. Shortly after immunosuppressive treatment was initiated at the hospital, he presented with fever, cough, upper respiratory symptoms and breathing difficulty on 12 June. His condition progressed to acute respiratory distress syndrome and he was mechanically ventilated but died on 12 July. In the past year, the boy resided with a family member who owned a butchery in Haryana state. Based on initial investigations, there were no reports of poultry sickness or deaths from a nearby poultry farm in the village where he resided. The source of infection is unknown at this time and none of his family members have shown similar symptoms thus far.

On 7 and 11 July 2021, respiratory samples from the patient tested positive by reverse transcriptase -polymerase chain reaction (RT-PCR) at the All India Institute of Medical Science hospital for influenza A and influenza B viruses but negative for SARS-CoV-2 and other respiratory viruses. On 13 July, the samples were sent to National Institute of Virology, a WHO reference laboratory for influenza, for subtyping. Samples were tested for seasonal viruses of influenza A and influenza B, as well as avian influenza subtypes H5, H7, H9 and H10 by RT-PCR. On 15 July, the samples tested positive for influenza A(H5N1) and influenza B/Victoria lineage viruses. Whole genome sequencing and virus isolation is ongoing.

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H5N1 avian influenza
Image/Cynthia Goldsmith/ Jackie Katz

Available information and initial field investigations suggest that no additional cases have been suspected, indicating a low likelihood of human-to-human transmission. Further sporadic cases of human infection with avian influenza A(H5) viruses may be reported because these viruses have been occasionally detected in poultry populations in India. The risk assessment will be reviewed as necessary, should further epidemiological or virological information become available.

India has reported outbreaks of avian influenza A(H5N1) in poultry farms every year since it was first reported in a poultry farm in Maharashtra State in February 2006. In January and February 2021, Haryana state reported an outbreak of avian influenza A(H5N8) in Panchkula district, which severely affected poultry in the area. In that outbreak, samples collected from birds from four poultry farms tested positive for avian influenza A(H5N8).