MO DHSS Health Advisory: Recommendations for Evaluation and Reporting of Suspected Cases of Avian Influenza A (H5N1)

Missouri Department of Health & Senior Services
For Immediate Release:
Feburary 18, 2004

Contact:
Office of the Director
912 Wildwood
P.O. Box 570
Jefferson City, MO 65102
Telephone: (800) 392-0272
Fax: (573) 751-6041
Web site: www.dhss.state.mo.us

During December 2003 - February 2004, outbreaks of highly pathogenic avian influenza A (H5N1) among poultry were reported in Cambodia , China , Indonesia , Japan , Laos , South Korea , Thailand , and Vietnam . As of February 18, 2004, a total of 31 cases of laboratory-confirmed influenza A (H5N1) virus infections in humans, resulting in 22 deaths, has been reported in Thailand and Vietnam . In addition, a number of suspected cases in humans are under investigation by national health authorities in Thailand and Vietnam .

The majority of the human H5N1 cases are apparently associated with direct exposure to infected birds or to surfaces contaminated with excretions from infected birds. While no evidence for sustained person-to-person transmission of influenza A (H5N1) has been identified, previous experiences with avian influenza viruses suggest that limited person-to-person transmission of the current H5N1 viruses could occur. In addition, influenza viruses have the capacity to change quickly. Although no evidence of genetic reassortment between avian H5N1 viruses and human influenza viruses has been identified, if such reassortment were to occur, the likelihood that the H5N1 virus could be transmitted more readily from person to person would increase. Continued monitoring for new transmission patterns is an important aspect of the current investigation, and the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and national health authorities in Asian countries are continuing to assess and monitor the situation. It is important to note that there have been no avian or human cases of influenza A (H5N1) reported in the United States .

This Health Advisory provides recommendations from CDC for medical providers and laboratories regarding influenza A (H5N1) surveillance, diagnosis, and testing. The final page summarizes information (as of February 9, 2004) about the human infections and avian outbreaks in Asia .

Suspected cases of influenza A (H5N1) should be reported immediately to the local public health agency, or the Missouri Department of Health and Senior Services at 800/392-0272 (24 hours a day – 7 days a week). More information on avian influenza is found on CDC's influenza web site at http://www.cdc.gov/flu/ . Specific questions on avian influenza should be directed to Dr. Howard Pue, State Public Health Veterinarian, at PueH@dhss.mo.gov , or 573/751-6141.

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