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Human emerging respiratory pathogens bulletin: Issue 62, February 2022

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Organization: Public Health Agency of Canada

Date published: 2022-03-08

Monthly situational analysis of emerging respiratory diseases affecting humans (data to February 28, 2022)

In this bulletin

Update on human emerging respiratory pathogen public health events (as of February 28, 2022)Footnote 1
Novel influenza Footnote 1 Cumulative Case Count Footnote 2 Deaths Case Fatality Rate % Footnote 3
A(H7N9) 1,568 615 39%
A(H5N1) 882 462 52%
A(H9N2) 96 2 2%
A(H5N6) 72 30 42%
A(H5N8) 7 0 0%
A(H7N4) 1 0 0%
A(H1N2) Footnote 4 2 0 0%
A(H3N2)v 441 1 <1%
A(H1N2)v 40 0 0%
A(H1N1)v 38 0 0%
A(H1NX)v Footnote 5 1 0 0
A(H10N3) 1 0 0%
Eurasian avian-like A(H1N1) 10 0 0%
MERS-CoV Footnote 1 Cumulative Case Count Footnote 2 Deaths Case Fatality Rate % Footnote 3
Global Case Count 2,576 880 34%
Saudi Arabia 2,178 802 37%
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(H5N8): December 2020. A(H7N4): February 2018. A(H1N2): March 2018. A(H3N2)v with M gene from pH1N1: 2011. A(H1N2)v: 2005. A(H1N1)v: 2005. EA A(H1N1): 1986, but the above table counts cases from January 2021. A/Denmark/1/2021: February 2021

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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).

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Footnote 3

Case Fatality Rate: The proportion of cases that resulted in death. For events with active cases, may be updated retrospectively as final disposition is known.

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Footnote 4

A(H1N2): virus is a seasonal reassortant of the A(H1N1)pdm09 and A(H3N2) seasonal strains.

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Footnote 5

A(H1Nx)v: virus is a novel influenza A(H1) virus with pending neuraminidase results.

Return to footnote 5 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) first declared the outbreak a Public Health Emergency of International Concern (PHEIC). On March 11, 2020, the WHO characterized the outbreak as a global pandemic. The WHO Director-General convened the International Health Regulations (IHR) Emergency Committee (EC) on COVID-19 ten (10) times through 2020 to 2022, continually assessing that COVID-19 constitutes a PHEIC.

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

Avian influenza updates

Avian influenza A(H9N2)

Five (5) new cases of avian influenza A(H9N2) were reported in February 2022, all from China. The cases range in age from 1 year old to 51 years old. Most (3/5; 60%) of the reported cases were female. They were reported from four (4) different provinces: Anhui, Sichuan, Hubei, and Jiangxi. One case was hospitalized for pneumonia while the remaining cases developed mild illness. Information on case recovery was provided only for the patient hospitalized with pneumonia and this case recovered. Four (4) of the cases had a history of poultry exposure prior to illness onset. Three (3) of the  cases had an onset of illness in 2022, the first such cases in 2022.

Since the emergence of this virus in the human population in 1998, 96 cases have been reported worldwide, with a case fatality rate (*CFR) of 2%. No cases have been reported in Canada.

*CFR: case fatality rate. Note that this rate is dependent on accurately reported deaths. For events with active cases, this value may be updated retrospectively as final disposition of the cases is known.

Avian influenza A(H5N6)

Six (6) human cases of avian influenza A(H5N6) were reported in February 2022. They all reported contact with poultry prior to illness onset. The median age of these cases was 40.5 years (age range: 6-50 years) and most (5/6; 83%) of the reported cases were male. One (1) death was reported and the rest of the cases (5/6; 83%) were in critical condition at the time of last report. These 6 cases were detected across four (4) different regions in China: Jiangsu Province, Guangxi Zhuang Autonomous Region, Sichuan Province, and Fujian Province. None of the cases were known to be connected to each other or to previously reported cases.

A total of 72 laboratory-confirmed human cases of avian influenza A(H5N6), including at least 30 deaths (CFR: 42%) have been reported globally since 2014. Since January 2021, 46 cases of avian influenza A(H5N6) have been reported globally (Figure 2); 45 A(H5N6) cases were reported from China and one (1) case was reported from Lao People’s Democratic Republic (Figure 3). So far, 14 A(H5N6) cases have been reported worldwide in 2022. No cases have been reported in Canadian residents.

Avian influenza A(H5N1)

The most recent case of avian influenza A(H5N1) was reported in January 2022 from the United Kingdom.

There have been 882 human cases of A(H5N1) reported globally since 1997, with a CFR of 52%. One (1) A(H5N1) case has been reported worldwide in 2022. In 2014, Canada (Alberta) reported one single fatal case of A(H5N1) in a resident returning from travel in China.

Swine influenza updates

Swine origin influenza A(H1N2)v

In February 2022, the US Centers for Disease Control and Prevention (CDC) reported one (1) new A(H1N2)v case in California. The case, ≥18 years of age, was not hospitalized and has recovered from their illness. The case had direct contact with swine prior to illness onset. Respiratory illness was reported among contacts of the case, however no specimens from these contacts were received for testing. No ongoing human-to-human transmission was identified in association with this case.

A total of 40 A(H1N2)v cases have been reported globally since 2005, with a 0% case fatality rate. One (1) A(H1N2)v case has been reported worldwide in 2022.  Three (3) A(H1N2)v detections have been reported in Canadian residents since reporting began in 2005, and the latest case in Canada was reported in November 2021 from Manitoba.

Swine origin influenza A(H3N2)v

The most recent case of swine origin influenza A(H3N2)v was reported in October 2021 from the US.

Globally, 441 A(H3N2)v cases have been reported since 2005, with <1% case fatality rate. No A(H3N2)v cases have been reported worldwide in 2022. Two (2) A(H3N2)v detections have been reported in Canadian residents since reporting began in 2005, with the latest case reported in June 2021.

Swine origin influenza A(H1N1)v

The most recent case of swine origin influenza A(H1N1)v was reported in January 2022 from Denmark.

Globally, 38 human cases of A(H1N1)v have been reported since 2005, with no associated fatalities. One (1) A(H1N1)v case has been reported worldwide in 2022. Two (2) A(H1N1)v detections have been reported in Canadian residents since reporting began in 2005, with the latest case reported in April 2021.

Figure 1. Spatial distribution of human cases of avian and swine influenza reported globally in February 2022 (n=12).

Figure 1

Note: Map was prepared by the Centre for Immunization and Respiratory Infectious Diseases (CIRID) using data from the latest WHO Event Information Site (EIS) postings and Weekly US Influenza Surveillance Reports (FluView). This map reflects data available through these publications as of February 28, 2022.

Figure 1 - Text equivalent
  • Six A(H5N6) cases were reported in China.
  • Five A(H9N2) cases were reported in China.
  • One A(H1N2)v case was reported in the United States of America.
Figure 2. Temporal distribution of human cases of A(H5N6) influenza reported, globally, by month, January 1, 2021 to February 28, 2022 (n=46).

Figure 2

Note: Graph was prepared by the Centre for Immunization and Respiratory Infectious Diseases (CIRID) using data from the WHO EIS postings and the Hong Kong Centre for Health Protection (CHP) press releases. This graph reflects data available as of February 28, 2022.

Figure 2 - Text equivalent
Month Cases
2021 Jan 1
Feb 2
Mar 2
Apr 0
May 0
June 1
July 4
Aug 6
Sep 6
Oct 4
Nov 0
Dec 6
2022 Jan 8
Feb 6
Figure 3. Spatial distribution of human cases of A(H5N6) influenza reported and Spatial distribution of human cases of A(H5N6) influenza reported and Lao People’s Democratic Republic from January 1, 2021, to February 28, 2022 (n=46).

Figure 3

Note: Map was prepared by the Centre for Immunization and Respiratory Infectious Diseases (CIRID) using data from the WHO EIS postings and the Hong Kong Centre for Health Protection (CHP) press releases. This map reflects data available through these publications as of February 28, 2022.

Figure 3 - Text equivalent
  • One case was reported out of Yongchuan, Chongqing Municipality.
  • One case was reported out of Guizhou Province.
  • One case was reported out of Anhui Province.
  • Two cases were reported out of Guangxi Zhuang Autonomous Region.
  • Two case was reported out of Chengdu, Sichuan Province.
  • One case was reported out of Bazhong, Sichuan Province.
  • One case was reported out of Kaijiang, Sichuan Province.
  • Two cases were reported out of Tongnan, Chongqing Municipality.
  • One case was reported out of Xuanhan, Sichuan Province.
  • Three cases were reported out of Guilin, Guangxi Zhuang Autonomous Region.
  • One case was reported out of Yibin, Sichuan Province.
  • Two cases were reported out of Huizhou, Guangdong Province.
  • Two cases were repored out of Dongguan, Guangdong Province.
  • One case was reported out of Laibin, Guangxi Zhuang Autonomous Region.
  • Two cases were reported out of Chenzhou, Hunan Province.
  • Four cases were reported out of Yongzhou, Hunan Province.
  • One case was reported out of Changde, Hunan Province.
  • One case was reported out of Zigong, Sichuan Province.
  • One case was reported out of Nanning, Guangxi Zhuang Autonomous Region.
  • Two cases were reported out of Hengyang, Hunan Province.
  • One case was reported out of Baise, Guangxi Zhuang Autonomous Region.
  • One case was reported out of Zhenjiang, Jiangsu Province.
  • One case was reported out of Fuzhou, Fujian Province.
  • One case was reported out of Yangzhou, Jiangsu Province.
  • One case was reported out of Hechi, Guangxi Zhuang Autonomous Region.

Middle East respiratory syndrome coronavirus (MERS-CoV) update

The most recent cases of MERS-CoV were reported in December 2021 from the Kingdom of Saudi Arabia.

A total of 2,576 laboratory-confirmed cases of MERS-CoV, including 880 deaths, have been reported globally since 2012 by the WHO (CFR: 34%). No MERS-CoV cases have been reported worldwide in 2022. No cases have been reported in Canada.

Figure 4. Temporal distribution of human cases of MERS-CoV reported to the WHO, globally, by month and year, January 1, 2019 to February 28, 2022 (n=294).

Figure 4

Note: Graph was prepared by the Centre for Immunization and Respiratory Infectious Diseases (CIRID) using data from the WHO Disease Outbreak News and Saudi Arabia’s Ministry of Health. This graph reflects data available as of February 28, 2022.

Figure 4 - Text equivalent
Date Deaths Survived
2019 Jan 5 14
Feb 14 62
Mar 3 26
Apr 7 15
May 4 10
June 1 6
July 4 5
Aug 1 5
Sep 1 3
Oct 6 8
Nov 1 11
Dec 3 2
2020 Jan 2 15
Feb 3 16
Mar 5 10
Apr 0 2
May 1 0
June 0 0
July 0 0
Aug 0 0
Sep 0 0
Oct 0 0
Nov 0 1
Dec 0 3
2021 Jan 0 0
Feb 3 3
Mar 1 1
Apr 0 0
May 1 0
June 0 1
July 0 2
Aug 1 0
Sep 0 0
Oct 0 1
Nov 0 1
Dec 2 2
2022 Jan 0 0
Feb 0 0

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2022-10-26