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Health Alert

Avian Influenza (H5N1): Global Update

Updated: April 21, 2015

Travel Health Notice

Avian influenza (H5N1), commonly known as “bird flu”, is a viral infection that can spread easily and quickly among birds. Travellers are reminded that countries around the world, in particular, countries in Asia, the Middle East, Europe and Africa continue to report cases of avian influenza (H5N1).

While avian influenza (H5N1) commonly causes sickness in birds, in rare cases, it can infect people. People who contract avian influenza (H5N1) can get very ill, and more than half die from it. The risk of human-to-human transmission is very low.

In January 2014, the Public Health Agency of Canada confirmed a case of H5N1 in an Alberta resident who returned from a trip to China. This is the first confirmed human case of H5N1 in North America.

Travellers going to regions where avian influenza (H5N1) is present can reduce their risk by following the recommendations listed below.

Where is avian influenza (H5N1) a concern?

• Risk of humans contracting avian influenza (H5N1) exists in countries with outbreaks of the viral infection in poultry. Asia, the Middle East, Europe and Africa have all had outbreaks of avian influenza (H5N1) in poultry since 1997.
• Since the beginning of 2015, human cases of H5N1 were reported in Egypt, China and Indonesia, with the large majority of the cases (over 95%) reported from Egypt.
• Since 2003, there have been more than 800 confirmed human cases in 16 countries: Azerbaijan, Bangladesh, Burma (Myanmar), Cambodia, Canada, China, Djibouti, Egypt, Indonesia, Iraq, Laos, Nigeria, Pakistan, Thailand, Turkey and Vietnam.
• Since 2003, over 400 people have died worldwide from avian influenza (H5N1).

The World Health Organization posts information on the total number of human cases of avian influenza  and maps of where human cases of avian influenza have occurred.

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

1. Avoid the risk of infection:
   • If you are travelling to an area where avian influenza is a concern, particularly one of the countries mentioned above:
     • avoid high-risk areas such as poultry farms and live animal markets including areas where poultry may be slaughtered.
     • avoid contact with birds (alive or dead), including chickens, ducks and wild birds
     • avoid surfaces that may have bird droppings or secretions on them
     • ensure that all poultry dishes, including eggs, are well cooked
2. Wash your hands frequently:
   • Wash your hands with soap under warm running water for at least 20 seconds, as often as possible.
   • Alcohol-based hand sanitizer can also be used if soap and water are not available. It’s a good idea to always keep some with you when you travel.
3. Practise proper cough and sneeze etiquette:
   • Cover your mouth and nose with your arm to reduce the spread of germs. If you use a tissue, dispose of it as soon as possible and wash your hands afterwards.
4. Monitor your health:
   • If you have developed flu-like symptoms and you have been travelling or living in an area where avian influenza is a concern:
     • Upon arrival in Canada, tell a border services officer or a quarantine officer.
     • If you develop symptoms after your return to Canada, you should see a health care provider immediately and tell them where you have been travelling or living.