Increased summer influenza surveillance due to bird flu

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Written By Rivera Claudia

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Stockholm/Berlin – In light of the outbreak of highly pathogenic avian influenza in dairy cows in the US, the European disease protection agency has recommended increased vigilance and increased influenza surveillance in the summer months.

The current situation is being closely monitored in the European Union (EU) and around the world, there is reason for greater attention, but not for greater concern, said the director of the European Centre for Disease Prevention and Control ().ECDC), Pamela Rendi-Wagner, earlier this week.

“This threat to human health should not be underestimated and it is important that we remain vigilant and proactive in our collaboration.”

ECDC: If suspected, test for avian influenza at a lower threshold

As part of early detection efforts, ECDC highlights recently updated recommendations for influenza surveillance in the summer months, when virus activity is typically very low.

It is recommended that the threshold for testing avian influenza in humans be lowered in order to be able to detect possible sporadic severe cases in humans in the hospital setting. The ECDC notes that existing sentinel surveillance systems are not sensitive enough to identify an emerging virus such as avian influenza in the general population early enough for control measures to be implemented in time.

Specifically, the authority advises that patients presenting to hospital with respiratory or other possibly appropriate symptoms should be questioned about contact with live or dead birds/poultry or other animals in the two weeks prior to the onset of symptoms.

Furthermore, according to the recommendation, testing for influenza A/B should be considered for all hospitalizations due to symptoms suggestive of avian influenza. This should also be considered in the case of unexplained viral encephalitis/meningoencephalitis, since H5N1 has had such consequences in several mammalian species.

Influenza A-positive samples that are negative for seasonal viruses would need to be further examined – because without subtyping or specific testing, H5N1 infections could go undetected. Member States would need to ensure that they have sufficient laboratory capacity to meet these and future needs.

RKI provides information for Germany

The Robert Koch Institute (RKI) sends a Online notice As far as the recommended approach in this country is concerned, the situation regarding avian influenza in animals in Germany is currently calm. “For patients admitted for acute respiratory symptoms, influenza testing should also be considered as a differential diagnosis.”

A suspected case of zoonotic influenza were samples “that tested positive for influenza A virus but negative for A(H1N1)pdm09 or A(H3N2)”. These samples are requested to be sent to the following consultation National Reference Center for Influenza Virus to be sent for further examination, subtyping and genetic analysis. Instructions for sending samples can be found on the website.

What symptoms of bird flu are possible in humans?

The ECDC writes that evidence of the circulation of clade 2.3.4.4b viruses is still limited. Avian influenza infections in humans can generally be asymptomatic but can also be severe.

Affected individuals may present with upper and lower respiratory tract symptoms, but also atypical non-respiratory signs of illness, such as conjunctivitis or neurological symptoms. Affected individuals in the US so far have complained of conjunctivitis, but in one case also of respiratory symptoms.

In more severe cases of avian influenza, rapid development of severe pneumonia, sepsis with shock, acute respiratory distress syndrome and encephalitis with fatal outcomes has been reported, summarizes the ECDC.

In contrast to the United States, no human infections with H5N1 have been reported in the EU or the European Economic Area. In the US, four people have so far been confirmed to have contracted H5N1 after contact with infected dairy cows and have been tested since the outbreak began in the spring. at least 60 people.

ECDC stressed that it is important to continue raising awareness among healthcare professionals about the possibility of human infections, so that potential cases are not overlooked or delayed in diagnosis.

The ECDC has so far assessed the risk to the general population as low, but as low to moderate to people who might be exposed to the virus at work, for example. The authority also believes that compliance with biosecurity and personal protective measures in places with an increased risk of avian influenza is crucial to minimise the risk of spillovers to humans. © ggr/aerzteblatt.de

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