Human Emerging Respiratory Pathogens Bulletin: Issue 28, April 2019

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Organization: Public Health Agency of Canada

Published: 2019-05-14

Monthly situational analysis of emerging respiratory diseases affecting humans (data to April 30, 2019)

In this bulletin

• Novel Influenza Updates
• Swine Influenza Updates
• Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Updates

Avian Influenza Updates

Avian influenza A(H7N9)

In April 2019, a new human infection with H7N9 was reported from China. The case is an 82 year old male from Gansu province, but with suspected exposure in Inner Mongolia, China. The case was hospitalized with severe pneumonia. Further information on the source of exposure and the case outcome is expected. This is the first case reported since February 2018. A total of 1568 human cases of avian influenza A(H7N9), including at least 615 deaths, have been reported globally since 2013, with 1564 cases reported in wave 5, three cases reported in wave 6 and one case reported in the current wave 7 (Figure 1). Two travel-related cases were reported in Canada in January 2015.

Avian Influenza A(H9N2)

No new cases of H9N2 were reported to the WHO in April 2019. The most recent case was reported in March 2019 in China. Globally, 51 cases, including 1 death, have been reported since 1998.

Avian Influenza A(H5N6)

The most recent case of H5N6 was reported in November 2018 in China. The source of exposure was unknown. There have been a total of 23 cases, including 15 deaths, reported globally since 2014, all in China.

Avian Influenza A(H7N4)

On February 14, 2018, the WHO was notified of the first known human case of H7N4. The case was associated with poultry exposure. No cases have been reported since.

Swine Influenza Updates

Swine Origin Influenza A(H3N2)v

The most recent case of swine origin influenza H3N2v was reported in June 2018 in the United States. The case reported exposure to swine at an agricultural fair. A total of 435 cases, including 1 death, have been reported globally since 2011. One locally-acquired case of H3N2v was reported in Canada in December 2016.

Swine Origin Influenza A(H1N2)v

The most recent case of swine origin influenza H1N2v was reported in August 2018 in the United States. The case reported exposure to swine at an agricultural fair. A total of 26 confirmed cases of H1N2v have been reported in the United States since 2005. Most of the reported cases resulted in mild illness.

Swine Origin Influenza A(H1N1)v

The most recent case of swine origin influenza H1N1v was reported in January 2018 in Switzerland. The case was associated with swine exposure. A total of 22 cases have been reported globally since 2005. H1N1v infection is associated with mild illness.

Middle East Respiratory Syndrome Coronavirus Updates

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

In April 2019, 22 new cases of MERS-CoV, including 7 deaths, were reported in Saudi Arabia (Figure 3). This is a decrease from the number of cases reported in earlier months this year. Approximately 91% (20/22) of these cases were male, and the median age was 56 years (range: 28-83 years). Two cases had reported camel exposure, eight were classified as primary cases with unknown camel exposure and 12 were classified as secondary cases. A total of 2428 laboratory-confirmed cases of MERS-CoV, including 835 deaths, have been reported globally since 2012 by the WHO and the Kingdom of Saudi Arabia (Figure 4). No cases have been reported in Canada.