Epidemiological parameter changes of global Avian Influenza H5N1 over two decades, from 1997 to 2017

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Ramand M. Haji Muhammed Babakir-Mina Mohammed I. M. Gubari


Influenza virus (H5N1) is highly contagious disease, which attacks the respiratory tract in humans. The deaths of six people in Hong Kong in 1997 from an H5N1 virus infection was the first indication that a purely avian influenza virus could cause respiratory disease and death in human. The aim of current study was to observe changes of epidemiological parameters of the infected patients, and the behaviour of virus outbreak over two decades of avian influenza virus (H5N1) from 1997 to April 2017. Data of the current study was obtained from WHO (World Health Organization) daily outbreak reports and then computerized and analyzed. It included 826 cases from 1997 to last case in April 2017 for this study. Most of the studied cases, their ages were less than 16 years (n=366), and spread in 16 countries, the top three countries prevalence were Egypt (n= 356), Indonesia (n= 175), and Vietnam (n=87) respectively. The most years of cases incidence were 2015 (n= 147) and 2006 (n=122). Most of cases were recorded in January (n=180), February (n=149), and March (n=143) respectively. Case fatality rates were 50.7%. In conclusion most cases were in second decade than first decade of (H5N1) outbreak, but death were more in first decade, Also most cases were in low temperature seasons and in very young children but death were more in adults. In first decade, morbidity were more in Asia countries like China, Vietnam, and Indonesia but in second decade, mortality were more  in North Africa (Egypt). However, cases were more in Egypt than Indonesia but deaths were more in Indonesia. H5N1 virus must be currently studied and its controlling is highly requested.


Avian influenza, (H5N1), Epidemiological parameter, Global Avian Influenza, Bird influenza, 1997 to 2017 and H5N1 influenza.


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[1] I. Stephenson and J. Democratis, "Influenza: current threat from avian influenza," Br Med Bull, vol. 75-76, pp. 63-80, 2005.
[2] N. Cox, F. Fuller, N. Kaverin, H. Klenk, R. Lamb, B. Mahy, et al., "Orthomyxoviridae," Virus taxonomy. Seventh report of the international committee on taxonomy of viruses, pp. 585-597, 2000.
[3] R. A. Fouchier, V. Munster, A. Wallensten, T. M. Bestebroer, S. Herfst, D. Smith, et al., "Characterization of a novel influenza A virus hemagglutinin subtype (H16) obtained from black-headed gulls," Journal of virology, vol. 79, pp. 2814-2822, 2005.
[4] D. J. Alexander, "An overview of the epidemiology of avian influenza," Vaccine, vol. 25, pp. 5637-5644, 2007.
[5] K. M. Sturm-Ramirez, D. J. Hulse-Post, E. A. Govorkova, J. Humberd, P. Seiler, P. Puthavathana, et al., "Are ducks contributing to the endemicity of highly pathogenic H5N1 influenza virus in Asia?," J Virol, vol. 79, pp. 11269-79, Sep 2005.
[6] E. C. Claas, A. D. Osterhaus, R. Van Beek, J. C. De Jong, G. F. Rimmelzwaan, D. A. Senne, et al., "Human influenza A H5N1 virus related to a highly pathogenic avian influenza virus," The Lancet, vol. 351, pp. 472-477, 1998.
[7] S. Lai, Y. Qin, B. J. Cowling, X. Ren, N. A. Wardrop, M. Gilbert, et al., "Global epidemiology of avian influenza A H5N1 virus infection in humans, 1997–2015: a systematic review of individual case data," The Lancet Infectious Diseases, vol. 16, pp. e108-e118, 2016.
[8] T. M. Uyeki, "Global epidemiology of human infections with highly pathogenic avian influenza A (H5N1) viruses," Respirology, vol. 13, 2008.
[9] "Human cases of influenza at the human-animal interface, 2013," Wkly Epidemiol Rec, vol. 89, pp. 309-20, Jul 11 2014.
[10] WHO. (2 March 2017, 19 July). Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines, September 2015. Available: http://www.who.int/entity/influenza/vaccines/virus/201509_zoonotic_vaccinevirusupdate.pdf?ua=1
[11] G. Smith, T. Naipospos, T. Nguyen, M. De Jong, D. Vijaykrishna, T. Usman, et al., "Evolution and adaptation of H5N1 influenza virus in avian and human hosts in Indonesia and Vietnam," Virology, vol. 350, pp. 258-268, 2006.
[12] M. T. Le, H. F. Wertheim, H. D. Nguyen, W. Taylor, P. V. Hoang, C. D. Vuong, et al., "Influenza A H5N1 clade 2.3. 4 virus with a different antiviral susceptibility profile replaced clade 1 virus in humans in northern Vietnam," PloS one, vol. 3, p. e3339, 2008.
[13] L.-Q. Fang, S. J. de Vlas, S. Liang, C. W. Looman, P. Gong, B. Xu, et al., "Environmental factors contributing to the spread of H5N1 avian influenza in mainland China," PloS one, vol. 3, p. e2268, 2008.
[14] H. Tian, S. Zhou, L. Dong, T. P. Van Boeckel, Y. Cui, S. H. Newman, et al., "Avian influenza H5N1 viral and bird migration networks in Asia," Proceedings of the National Academy of Sciences, vol. 112, pp. 172-177, 2015.
[15] L. O. Durand, P. Glew, D. Gross, M. Kasper, S. Trock, I. K. Kim, et al., "Timing of influenza A (H5N1) in poultry and humans and seasonal influenza activity worldwide, 2004–2013," Emerging infectious diseases, vol. 21, p. 202, 2015.
[16] X. Li, Z. Zhang, A. Yu, S. Y. Ho, M. J. Carr, W. Zheng, et al., "Global and local persistence of influenza A (H5N1) virus," Emerging infectious diseases, vol. 20, p. 1287, 2014.
[17] M. B. Mathur, R. B. Patel, M. Gould, T. M. Uyeki, J. Bhattacharya, Y. Xiao, et al., "Seasonal patterns in human A (H5N1) virus infection: analysis of global cases," PLoS One, vol. 9, p. e106171, 2014.
[18] K. Chaichoune, W. Wiriyarat, A. Thitithanyanont, R. Phonarknguen, L. Sariya, S. Suwanpakdee, et al., "Indigenous sources of 2007–2008 H5N1 avian influenza outbreaks in Thailand," Journal of General Virology, vol. 90, pp. 216-222, 2009.
[19] P. M. Rabinowitz, D. Galusha, S. Vegso, J. Michalove, S. Rinne, M. Scotch, et al., "Comparison of human and animal surveillance data for H5N1 influenza A in Egypt 2006–2011," PloS one, vol. 7, p. e43851, 2012.
[20] S. Refaey, E. Azziz-Baumgartner, M. M. Amin, M. Fahim, K. Roguski, H. A. E. A. Elaziz, et al., "Increased number of human cases of influenza virus A (H5N1) infection, Egypt, 2014–15," Emerging infectious diseases, vol. 21, p. 2171, 2015.
[21] "Human cases of influenza at the human-animal interface, January 2014-April 2015," Wkly Epidemiol Rec, vol. 90, pp. 349-62, Jul 10 2015.
[22] WHO. (09 April 2015, 19 July). Avian influenza A(H5N1) in Egypt, 9 April 2015. Available: http://www.emro.who.int/surveillance-forecasting-response/surveillance-news/avian-influenza-ah5n1-in-egypt-9-april-2015.html
[23] WHO. (3 March 2015, 19 July). Influenza at the human–animal interface: summary and assessment as of 3 March 2015. Available: http://www.who.int/entity/influenza/human_animal_interface/Influenza_Summary_IRA_HA_interface_3_March_2015.pdf?ua=1
[24] A. Kandeel, S. Manoncourt, E. A. el Kareem, A.-N. M. Ahmed, S. El-Refaie, H. Essmat, et al., "Zoonotic transmission of avian influenza virus (H5N1), Egypt, 2006–2009," Emerging infectious diseases, vol. 16, p. 1101, 2010.
[25] R. B. Patel, M. B. Mathur, M. Gould, T. M. Uyeki, J. Bhattacharya, Y. Xiao, et al., "Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases," PLoS One, vol. 9, p. e91630, 2014.
[26] W. Adisasmito, P. K. S. Chan, N. Lee, A. F. Oner, V. Gasimov, F. Aghayev, et al., "Effectiveness of antiviral treatment in human influenza A (H5N1) infections: analysis of a Global Patient Registry," The Journal of infectious diseases, vol. 202, pp. 1154-1160, 2010.
[27] P. K. Chan, N. Lee, M. Zaman, W. Adisasmito, R. Coker, W. Hanshaoworakul, et al., "Determinants of antiviral effectiveness in influenza virus A subtype H5N1," The Journal of infectious diseases, vol. 206, pp. 1359-1366, 2012.
[28] WHO. (15 August 2007, 19 July). Clinical management of human infection with avian infl uenza A (H5N1) virus. Aug 15, 2007. Available: http://www.who.int/influenza/resources/documents/clinical_management_h5n1_15_08_2007/en/
[29] D. Swayne, G. Pavade, K. Hamilton, B. Vallat, and K. Miyagishima, "Assessment of national strategies for control of high-pathogenicity avian influenza and low-pathogenicity notifiable avian influenza in poultry, with emphasis on vaccines and vaccination," Revue Scientifique et Technique-OIE, vol. 30, p. 839, 2011.
[30] C. Li, Z. Bu, and H. Chen, "Avian influenza vaccines against H5N1 ‘bird flu’," Trends in biotechnology, vol. 32, pp. 147-156, 2014.