World Health Organisation confirms human case of bird flu in India IMAGE

The World Health Organization (WHO) has confirmed a case of avian influenza, commonly known as bird flu, in a four-year-old child from West Bengal, India. This marks the second human infection with a H9N2 strain of bird flu reported in India since 2019.This marks the second human case of avian influenza A (H9N2) reported to WHO from India, following the first case in 2019.

Kolkata: The World Health Organisation has confirmed the human case of bird flu in India, after the H9N2 virus was detected in a four-year child in West Bengal.

Overall, this is the second human infection of avian influenza A (H9N2) notified to WHO from India, with the first being done in 2019.

The child has recovered and was discharged from the hospital.

WHO received a notification from the International Health Regulations (IHR) National Focal Point (NFP) for India, regarding a human case of avian influenza A(H9N2) virus infection in West Bengal, the health body said in a press release.

“The patient is a 4-year-old child residing in West Bengal state. The case, previously diagnosed with hyperreactive airway disease, initially presented to the paediatrician with fever and abdominal pain on 26 January 2024.

He developed seizures on January 29 after which he was brought to the same paediatrician. The patient was admitted to the pediatric intensive care unit (ICU) of a local hospital due to the persistence of severe respiratory distress, recurrent high-grade fever and abdominal cramps.

The patient tested positive for influenza B and adenovirus.

He was discharged from the hospital on February 28 but with a recurrence of severe respiratory distress, he was referred to another government hospital and was admitted to the pediatric ICU and intubated on March 3.

His nasopharyngeal swab was sent to the Kolkata Virus Research and Diagnostic Laboratory and tested positive for influenza A (not sub-typed) and rhinovirus.

On April 26, the sample was sub-typed as influenza A(H9N2) through a real-time polymerase chain reaction. The patient was discharged from the hospital with oxygen support on May 1.

WHO said that the infected patient had exposure to poultry at home and in the surroundings.

It, however, also affirmed there were no known persons reporting symptoms of respiratory illness in the family, the neighbourhood, or among healthcare workers at health facilities attended by the case at the time of reporting.

The health body further warned that sporadic human cases could occur in the future as this virus is “one of the most prevalent avian influenza viruses circulating in poultry in different regions.”

Animal influenza viruses normally circulate in animals but can also infect humans. Infections in humans have primarily been acquired through direct contact with infected animals or through indirect contact with contaminated environments. Depending on the original host, influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses, the WHO stated in the release.

The health body further said that it is providing continued support to the government of India through technical advice, updates on risk assessment and updating contingency plans- both in the human and animal sectors in line with the global guidance.Bird FluThis is the second human case of H9N2 strain of bird flu reported from India — the first having been reported in 2019. (Representational Photo: Reuters)

A four-year-old child from West Bengal was diagnosed with bird flu in late January this year, was admitted to a hospital’s intensive care unit for treatment twice for acute respiratory distress and was discharged finally in May, according to the World Health Organisation.

This is the second human case of H9N2 strain of bird flu reported from India — the first having been reported in 2019.

What do we know about the case from Bengal?

The child was first taken to a paediatrician with fever, abdominal pain and later seizures. The patient was admitted to the ICU of a local hospital due to persisting severe respiratory distress, recurrent high fever and abdominal cramps. The child was discharged from the hospital in February end but was re-admitted on

March 3 due to severe respiratory distress. A swab sample collected was sent to National Institute of Virology, and the virus was sub-typed to be H9N2. The child was finally discharged from the hospital with oxygen support on May 1.

The patient is likely to have contracted the disease from poultry at home and in the surrounding area.

What led to increased monitoring of avian influenza?

There has been an increased focus on bird flu this year after three dairy farm workers from the US were reported to have been infected with highly pathogenic avian influenza A (H5N1).

“There are two types of H5N1 — low and highly pathogenic. While the low pathogenic type is usually seen in birds in the region — and has in fact caused at least two outbreaks in birds in Kerala — the highly pathogenic type is not commonly seen in birds, let alone animals,” said Dr E Sreekumar, director of the Institute of Advanced Virology-Thiruvananthapuram.

How to prevent the infection?

With most cases of bird flu being reported by people who handle poultry, it is important that animals and poultry are handled with care. People need to minimise contact with animals and poultry and areas contaminated with their faeces. Contact should be avoided with dead animals.

Those at high risk of severe disease such as children, older people, and pregnant women should avoid participating in slaughtering, collecting eggs, or preparation of these foods. And, everyone should wash their hands thoroughly with soap and water as often as possible, especially before and after handling animals.

Can it cause the next pandemic?

Dr Sreekumar had said earlier that priority has to be to prevent infection spread. “However, it is important to keep an eye on the pathogen for changes that can make it more transmissible.”

 

The WHO has called for strengthened surveillance in both animal and human populations through “investigation of every zoonotic infection and pandemic preparedness planning.”

Why is this concerning?

One, with the virus circulating in poultry, WHO expects to see sporadic cases of the infection. In its risk assessment, the inter-governmental agency said: “Most human cases of infection with H9N2 viruses are exposed through contact with infected poultry or contaminated environment… Given the continued detection of the virus in poultry populations, sporadic human cases can be expected.”

Human infection with H9N2 tends to be mild, but there have been some cases where hospitalisation was required like the one from West Bengal. There have been two deaths reported from across the world due to the infection. The WHO added that the current evidence suggests that the virus hasn’t acquired the ability to transmit from human-to-human yet.Two, a case of bird flu reported by Australia is thought to have been exposed to the virus in Kolkata in February this year. The strain of virus in both cases, however, are different — H5N1 in the Australian case and H9N2 in the Indian case — indicating different sources of infection.

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