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Human emerging respiratory pathogens bulletin: Issue 66, June 2022

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Organization: Public Health Agency of Canada

Published: 2022-07-12

Monthly situational analysis of emerging respiratory diseases affecting humans (data to June 30, 2022).

In this bulletin

Update on human emerging respiratory pathogen public health events as of June 30, 2022)Footnote 1
Novel influenzaFootnote 1 Cumulative Case CountFootnote 2 Deaths Case Fatality Rate %Footnote 3
A(H7N9) 1,568 615 39%
A(H5N1) 883 462 52%
A(H9N2) 102 2 2%
A(H5N6) 80 33 41%
A(H5N8) 7 0 0%
A(H7N4) 1 0 0%
A(H1N2)Footnote 4 2 0 0%
A(H10N3) 1 0 0%
A(H3N8) 2 0 0%
A(H3N2)v 441 1 <1%
A(H1N2)v 40 0 0%
A(H1N1)v 39 0 0%
A(H1NX)vFootnote 5 1 1 100%
Eurasian avian-like A(H1N1) 10 0 0%
MERS-CoVFootnote 1 Cumulative Case CountFootnote 2 Deaths Case Fatality Rate %Footnote 3
Global Case Count 2,579 882 34%
Saudi Arabia 2,178 803 37%
Table 1 Footnote 1

Date of 1st 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(H10N3): May 2021. A(H3N8): April 2022. 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.

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. For events with active cases, may be updated retrospectively as final disposition is known.

Table 1 Return to footnote 3 referrer

Table 1 Footnote 4

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

Table 1 Return to footnote 4 referrer

Table 1 Footnote 5

A(H1NX)v: virus is a novel influenza A(H1) virus with pending neuraminidase results.

Table 1 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 eleven (11) 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)

Three (3) new cases of A(H9N2) were reported in June 2022, all from China. The cases range in age from 1 year old to 5 years old. All (3/3; 100%) of the reported cases were male. They were reported from three (3) different provinces: Sichuan, Guizhou, and Hunan. Two (2) cases developed mild illness, while disease severity for the remaining case was not reported. Information on case recovery was provided for one (1) case who experienced mild illness and this case recovered. Two (2) of the cases had a history of exposure to live poultry. Exposure information for the remaining case was not provided. Including these three (3) cases, 16 cases of avian influenza A(H9N2) were reported worldwide in 2022. 

Since the emergence of this virus in the human population in 1998, 102 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)

One (1) human case of avian influenza A(H5N6) was reported from China in June 2022. The case was a 58 year-old male from Jiangxi Province with an illness onset date of June 2nd, 2022. He was hospitalized on June 5th and was in critical condition as of the time of last report. The case had exposure to a wet market and slaughtered poultry prior to illness onset. At the time of reporting, no close contacts had developed symptoms.

A total of 80 laboratory-confirmed human cases of avian influenza A(H5N6), including at least 33 deaths (CFR: 41%) have been reported globally since 2014. Since January 2021, 54 cases of avian influenza A(H5N6) have been reported globally (Figure 2); 53 A(H5N6) cases were reported from China and one (1) case was reported from Lao PDR (Figure 3). So far, 22 A(H5N6) human cases have been reported worldwide in 2022. No cases have been reported in Canadian residents.

Avian influenza A(H3N8)

The most recent human case of avian influenza A(H3N8) was reported in May 2022 from China.

Since the emergence of this virus in the human population in 2022, two (2) cases have been reported, both from China. The CFR is 0%; however, with only two human cases to date, the full spectrum of disease is highly uncertain.

Avian influenza A(H5N1)

The most recent human case of avian influenza A(H5N1) was reported in April 2022 from the United States.

There have been 883 human cases of A(H5N1) reported globally since 1997, with a CFR of 52% (Figure 4). Two (2) A(H5N1) cases have been reported worldwide in 2022. No domestically acquired A(H5N1) infections have ever been reported in Canada. 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

The most recent human case of swine origin influenza A(H1N2)v was reported in February 2022 from the US.

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 human 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 human case of swine origin influenza A(H1N1)v was reported in May 2022 from Germany.

Globally, 39 human cases of A(H1N1)v have been reported since 2005, with no associated fatalities. Two (2) A(H1N1)v cases have 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 June 2022 (n=4).
Figure 1. Text version below.

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. This map reflects data available through these publications as of June 30, 2022.

Figure 1 - Text description
  • Three A(H9N2) cases were reported in China.
  • One A(H5N6) case was reported in China.
Figure 2. Temporal distribution of human cases of A(H5N6) influenza reported, globally, by month, January 1, 2021 to June 30, 2022 (n=54).
Figure 2. Text version below.

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 June 30, 2022.

Figure 2 - Text description
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
  Mar 3
  Apr 3
  May 1
  June 1
Figure 3. Spatial distribution of human cases of A(H5N6) influenza reported and Lao People's Democratic Republic from January 1, 2021, to June 30, 2022 (n=54).
Figure 3. Text version below.

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 June 30, 2022.

Figure 3 - Text description
  • Four cases were reported out of Yongzhou, Hunan Province, People's Republic of China.
  • Three cases were reported out of Guilin, Guangxi Zhuang Autonomous Region, People's Republic of China.
  • Three cases were reported out of Huizhou, Guangdong Province, People's Republic of China.
  • Three cases were reported out of Liuzhou, Guangxi Zhuang Autonomous Region, People's Republic of China.
  • Two cases were reported out of Baise, Guangxi Zhuang Autonomous Region, People's Republic of China.
  • Two cases were reported out of Chengdu, Sichuan Province, People's Republic of China.
  • Two cases were reported out of Chenzhou, Hunan Province, People's Republic of China.
  • Two cases were reported out of Dongguan, Guangdong Province, People's Republic of China.
  • Two cases were reported out of Guangxi Zhuang Autonomous Region, People's Republic of China.
  • Two cases were reported out of Hechi, Guangxi Zhuang Autonomous Region, People's Republic of China.
  • Two cases were reported out of Hengyang, Hunan Province, People's Republic of China.
  • Two cases were reported out of Sichuan Province, People's Republic of China.
  • Two cases were reported out of Tongnan District, Chongqing Municipality, People's Republic of China.
  • Two cases were reported out of Zhenjiang, Jiangsu Province, People's Republic of China.
  • One case was reported out of Anhui Province, People's Republic of China.
  • One case was reported out of Bazhong, Sichuan Province, People's Republic of China.
  • One case was reported out of Changde, Hunan Province, People's Republic of China.
  • One case was reported out of Deyang City, Sichuan Province, People's Republic of China.
  • One case was reported out of Fuzhou, Fujian Province, People's Republic of China.
  • One case was reported out of Ganzhou City, Jiangxi Province, People's Republic of China.
  • One case was reported out of Guizhou Province, People's Republic of China.
  • One case was reported out of Hangzhou, Zhejiang Province, People's Republic of China.
  • One case was reported out of Jiangxi Province, People's Republic of China.
  • One case was reported out of Kaijiang County, Sichuan Province, People's Republic of China.
  • One case was reported out of Laibin, Guangxi Zhuang Autonomous Region, People's Republic of China.
  • One case was reported out of Langzhong City, Sichuan Province, People's Republic of China.
  • One case was reported out of Luang Prabang Province, Lao People's Democratic Republic (the).
  • One case was reported out of Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China.
  • One case was reported out of Puyang City, Henan Province, People's Republic of China.
  • One case was reported out of Xuanhan County, Sichuan Province, People's Republic of China.
  • One case was reported out of Yangzhou, Jiangsu Province, People's Republic of China.
  • One case was reported out of Yibin, Sichuan Province, People's Republic of China.
  • One case was reported out of Yongchuan District, Chongqing Municipality, People's Republic of China.
  • One case was reported out of Zhejiang Province, People's Republic of China.
  • One case was reported out of Zigong City, Sichuan Province, People's Republic of China.
Figure 4. Temporal distribution of human cases of A(H5N1) influenza reported globally, by year, January 1, 1997 to June 30, 2022 (n=883).
Figure 4. Text version below.

Note: Graph was prepared by the Centre for Immunization and Respiratory Infectious Diseases (CIRID) using data from the WHO EIS postings, the US CDC’s Health Alert Network (HAN), and WHO cumulative case counts. This graph reflects data available as of June 30, 2022.

Figure 4 - Text description
Number of Cases Deaths Survived
1997 18 6 12
1998 0 0 0
1999 0 0 0
2000 0 0 0
2001 0 0 0
2002 0 0 0
2003 4 4 0
2004 46 32 14
2005 98 43 55
2006 115 79 36
2007 88 59 29
2008 44 33 11
2009 73 32 41
2010 48 24 24
2011 62 34 28
2012 32 20 12
2013 39 25 14
2014 52 22 30
2015 145 42 103
2016 10 3 7
2017 4 2 2
2018 0 0 0
2019 1 1 0
2020 1 0 1
2021 2 1 1
2022 2 0 2

Middle East respiratory syndrome coronavirus (MERS-CoV) update

The most recent case of MERS-CoV was reported in May 2022 from Oman.

A total of 2,579 laboratory-confirmed cases of MERS-CoV, including 882 deaths, have been reported globally since 2012 by the WHO (CFR: 34%). Three (3) MERS-CoV cases have been reported worldwide in 2022. No cases have been reported in Canada.

Figure 5. Temporal distribution of human cases of MERS-CoV reported to the WHO, globally, by month and year, January 1, 2019 to June 30, 2022 (n=297).
Figure 5. Text version below.

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 June 30, 2022.

Figure 5 - Text description
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 3 1
2022  Jan 0 0
Feb 0 0
Mar 0 1
Apr 1 0
May 0 1
June 0 0

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