Human emerging respiratory pathogens bulletin: Issue 46, October 2020

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Organization: Public Health Agency of Canada

Date published: 2020-11-10

Monthly situational analysis of emerging respiratory diseases affecting humans (data to October 31, 2020)

In this bulletin

COVID-2019 update
Avian influenza updates
Swine influenza updates
Middle East respiratory syndrome coronavirus (MERS-CoV) update

Update on human emerging respiratory pathogen public health events (as of October 31, 2020)
Novel influenza^{Table 1 Footnote 1}	Cumulative Case Count^{Table 1 Footnote 2}	Deaths	Case Fatality Rate %^{Table 1 Footnote 3}
A(H7N9)	1,568	615	39%
A(H5N1)	879	461	52%
A(H9N2)	59	1	2%
A(H5N6)	24	7	29%
A(H7N4)	1	0	0%
A(H1N2)	2	0	0%
A(H3N2)v	436	1	<1%
A(H1N2)v	27	0	0%
A(H1N1)v	26	0	0%
MERS-CoV^{Table 1 Footnote 1}	Cumulative Case Count^{Table 1 Footnote 2}	Deaths	Case Fatality Rate %^{Table 1 Footnote 3}
Global Case Count	2,553	872	34%
Saudi Arabia	2,157	794	37%
Table 1 Footnote 1 Date of 1 ^st Reported Case of Human Infection: MERS-CoV: February 2013 (retrospective case finding September 2012). A(H7N9): March 2013. A(H5N1): 1997. A(H9N2): 1998. A(H5N6): 2014. A(H7N4): February 2018. A(H3N2)v with M gene from pH1N1: 2011. A(H1N2)v: 2005. A(H1N1)v: 2005. Table 1 Return to footnote 1 referrer Table 1 Footnote 2 Cumulative Case Counts: updated using data reported by the World Health Organization (avian and swine influenza, MERS CoV), and the United States Centers for Disease Control and Prevention (US CDC) (swine influenza). Table 1 Return to footnote 2 referrer Table 1 Footnote 3 Case Fatality Rate: The proportion of cases that resulted in death. Table 1 Return to footnote 3 referrer

COVID-19 update

On December 31, 2019, cases of a pneumonia of unknown etiology were reported in Wuhan, China. These cases have since been determined to be due to a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). On January 30, 2020, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC).

As of October 31, 2020, 234,511 COVID-19 cases and 10,136 deaths have been reported in Canada.

The Public Health Agency of Canada is monitoring the situation closely.

Avian influenza updates

Avian influenza A(H7N9)

No new H7N9 cases were reported to the WHO in October 2020. The last case was reported by China in April 2019. Two travel-related cases were reported in Canada in January 2015. A total of 1,568 human cases of avian influenza A(H7N9), including at least 615 deaths, have been reported globally since 2013 (Figure 1).

Temporal distribution of human infection with avian influenza A(H7N9), globally, by month and year, January 1, 2013 to October 31, 2020 (n=1568).
Dates	Cases	Deaths
2016	Jun	2	0
Jul	4	0
Aug	0	0
Sep	0	0
Oct	2	0
Nov	10	2
Dec	114	39
2017	Jan	197	29
Feb	93	13
Mar	70	12
Apr	72	24
May	50	6
Jun	19	4
Jul	2	0
Aug	3	2
Sep	1	0
Oct	0	0
Nov	0	0
Dec	1	0
2018	Jan	1	1
Feb	1	0
Mar	0	0
Apr	0	0
May	0	0
June	0	0
July	0	0
Aug	0	0
Sep	0	0
Oct	0	0
Nov	0	0
Dec	0	0
2019	Jan	0	0
Feb	0	0
Mar	0	0
Apr	1	0
May	0	0
June	0	0
July	0	0
Aug	0	0
Sept	0	0
Oct	0	0
Nov	0	0
Dec	0	0
2020	Jan	0	0
Feb	0	0
Mar	0	0
Apr	0	0
May	0	0
June	0	0
July	0	0
Aug	0	0
Sep	0	0
Oct	0	0

Avian influenza A(H9N2)

No new H9N2 cases were reported to WHO in October 2020. The most recent case was reported on August 28, 2020 in China. Globally, 59 human cases, including one death, have been reported since 1998.

Swine influenza updates

Swine origin influenza A(H3N2)v

The most recent case of swine origin influenza H3N2v was reported in July 2020 in the United States and this case was the first human case of A(H3N2)v reported out of the United States since 2018. A total of 436 cases, including one 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

On October 29, 2020, the Public Health Agency of Canada (PHAC) was notified of a confirmed human case of influenza A(H1N2) variant virus, marking the 27th influenza A(H1N2)v case reported to the WHO since 2005 and the first from Canada. The individual developed mild respiratory infection symptoms and presented to an emergency department on October 7, 2020, at which time specimen collection took place. The case was not hospitalized. Testing at the provincial laboratory identified an influenza A(H1N2)v virus of swine origin and the specimen was sent to the National Microbiology Laboratory (NML) for confirmation, viral culture, and additional genetic, antigenic, and antiviral susceptibility testing. The case was isolated at home for 10 days following onset of illness and has since recovered. One household contact had mild symptoms shortly after the case but was not tested, was isolated, and has recovered. No other household contacts reported illness prior to or following the case's illness. Most H1N2v infections result in mild illness. Based on a preliminary investigation, the case has had no known animal or sick human exposure. Epidemiologic, animal health and virological investigations are ongoing and PHAC continues to monitor the situation and provide assistance where needed.

Swine origin influenza A(H1N1)v

The most recent case of swine origin influenza A(H1N1) infection was detected in Germany in June 2020. This case presented with influenza-like illness after contact with pigs during a farm visit. To date, reported H1N1v infections have been associated with mild illness.

A figure indicating the spatial distribution of human cases of avian and swine influenza reported globally in October 2020 (n=1). — **Figure 2. Spatial distribution of human cases of avian and swine influenza reported globally in October 2020 (n=1).**

Middle East respiratory syndrome coronavirus (MERS-CoV) update

No new cases of MERS-CoV were reported in October 2020. A total of 2,553 laboratory-confirmed cases of MERS-CoV, including 872 deaths, have been reported globally since 2012 by the WHO. No cases have been reported in Canada.

A figure indicating the temporal distribution of MERS-CoV cases, globally, January 1st, 2018 – October 31st, 2020. — **Figure 3. Temporal distribution of human cases of MERS-CoV reported to the WHO, globally, by month and year, January 1, 2018 to October 31, 2020 (n=398).**

Temporal distribution of human cases of MERS-CoV reported to the WHO, globally, by month and year, January 1, 2018 to October 31, 2020 (n=398).
Dates	Cases	Deaths
2018	Jan	17	11
Feb	14	2
Mar	17	4
Apr	8	5
May	13	2
June	10	1
July	7	3
Aug	6	2
Sep	14	6
Oct	9	2
Nov	7	1
Dec	5	0
2019	Jan	19	5
Feb	76	14
Mar	29	3
Apr	22	7
May	14	4
June	7	1
July	9	4
Aug	6	1
Sep	4	1
Oct	14	6
Nov	15	2
Dec	4	2
2020	Jan	17	2
Feb	19	3
Mar	15	5
Apr	2	0
May	1	1
June	0	0
July	0	0
Aug	0	0
Sep	0	0
Oct	0	0

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Date modified:: 2020-11-10

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