Source: CDCTitle: Transmission electron micrograph ofswine influenza virus.Description: Transmission electronmicrograph of swine influenza virus.
Source: CDC/Dr. Erskine PalmerTitle: Transmission electron micrograph ofinfluenza C virus.Description: Transmission electronmicrograph of influenza C virus.
Note: GIDEON does not follow routine country reports on human Influenza, because the scope and nature of these data areoften diffuse, sporadic or inconsistent. Atypical infections and unusually severe outbreaks are summarized below and in therelevant country notes.
Historical background:The first known influenza epidemic was recorded in Europe during 1173 to 1174. 1
- A subsequent outbreak was recorded in 1580.- Four pandemics were recorded during 1830 to 1848: 1830 to 1831, 1833, 1836 to 1837 and 1847 to 1848. 2 3
- Case-fatality rates during the "Russian pandemic" of 1889 were comparable to those of the pandemics of 1957 and 1968. 4
- 21 million deaths were estimated for an H1N1 pandemic ("The Spanish Flu") during 1918 to 1919. Some estimate thenumber as high as 50 million deaths. 6 7 8 9 10 11 12 13 14 15 16 17 18
- The "Asian flu" (H2N2, 1957) and "Hong Kong flu" (H3N2, 1968) pandemics each resulted in 1 to 4 million deaths.19 20 21 22 23 24 25 26
- An additional pandemic ("Russian Flu") was reported during 1989 to 1994. 27
- An additional 27 pandemics had been documented as of 2003. 28
- Excess deaths attributable to influenza in the United States numbered 603,600 during the epidemics of 1918 to 1919, 1957to 1958 and 1968 to 1969.- An additional 600,000 were estimated to have died in non-pandemic years during 1957 to 1990.- A pandemic of H1N1 influenza during 2009 to 2010 involved over 200 countries (see below).
Influenza is transmitted through inhalation; however, direct contact with infected secretions has also been implicated.- Acquisition of infection has been documented during international air travel. 29
- Patients remain infectious for 5 to 7 days, with the greatest degree of infectivity occurring during the first 24 hours ofillness.
Influenza strains differ from one another according to the nature of two surface proteins: hemagglutinin (H) andneuraminidase (NA).- Strains constantly evolve through a mechanism of reassortment, resulting in "antigenic drift" and "antigenic shift." 30 31
32
- Of the 15 H-subtypes, H-5 and H-7 are the most virulent to man.
Swine Influenza: 33 34 35 36 37 38 39 40 41 42
- There is evidence for the occurrence of a swine influenza outbreak in England in 1892. 43
- 50 cases of swine influenza virus infection (most H1N1) were reported in humans during 1958 to 2005 44 ; 73 (7 fatal) asof August 2010. 45
- A total of 46 cases of human infection by swine influenza viruses had been reported worldwide to 2008: 31 in the UnitedStates, 6 Czechoslovakia, 4 Netherlands, 3 Russia, 1 Canada and 1 Hong Kong. 46 These figures include an outbreak (12cases, 1 fatal) at a military facility in New Jersey, United States in 1976- Two cases (non-fatal) of swine (H3N2) influenza virus infection were reported in the United States in 2009. 47 48
- Thirteen infections with a swine-origin H3N2 reassortant strain that includes the M gene from the 2009 pandemic H1N1(pH1N1) virus were reported in the United States during 2011 to 2012. The true number was estimated at 2,055 cases. 49
- Four cases of infection by H3N2 virus which carries the pandemic gene of 2009 H1N1 virus were acquired at a pig fair inUnited States in 2012. 83 84 15 additional cases were reported at agricultural fairs in the United States in 2013. 85 86 87
88 89 ; and infected pigs were identified at a state fair in the United States in 2014. 90 Subsequent cases of humaninfection were reported in 2014 91 and 2015. 92 93
2009 to 2010 H1N1 influenza ("swine flu" 94 95 ) - An outbreak of H1N1 pdm09 influenza was reported. Context: Apandemic of H1N1 Influenza virus A (H1N1) pdm09 96 infection occurred. 97 98 99 100 101 102 103 104 105 106 107 108
221 222 223 224 225 226 227 228 Over 600,000 cases had been officially-reported worldwide as of March, 2010. 229 230
231 18,449 fatal cases were reported to August 1, 2010 (true number for first 12 months estimated at 293,500 232 233 ).234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259
260 Indigenous populations from Australia, Canada, the United States and New Zealand were found to have at least a 3-foldgreater death rate than others in their countries. 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277
278 279 280 281 282 283 284 285 Reporting of case-number summaries was suspended by WHO as of July 6 286 ; and onAugust 10, the pandemic was declared to have ended. 287 288 The pandemic began in Mexico, spreading rapidly to theUnited States and Canada. Swine were not implicated in the transmission of disease. 289 290 291 292 Human-to-swinetransmission was confirmed in Argentina 293 , Brazil 294 , Cambodia 295 296 , Sri Lanka 297 298 , Vietnam 299 300 , Italy301 and Canada during the outbreak 302 303 304 305 306 307 308 309 310 311 312 313 314 ; and infected swine wereidentified in Argentina 315 316 317 , Australia 318 319 320 , Brazil 321 322 , Cameroon 323 324 , China 325 326 327 328 ,Cuba 329 , Denmark 330 , Finland 331 332 , Germany 333 334 , Greece 335 , Hungary 336 , Iceland 337 , India 338 ,Indonesia 339 , Ireland 340 , Italy 341 342 , Japan 343 344 , England 345 , Mexico 346 , Northern Ireland 347 , Norway 348
349 350 351 , Republic of Korea 352 353 , Reunion Island 354 , Russian Federation 355 , Scotland 356 , Taiwan 357 ,Thailand 358 359 360 , the United Kingdom 361 362 and the United States. 363 364 365 366 367 368 369 370 371
Infected turkeys were subsequently identified in Canada 372 373 374 , Chile 375 376 377 378 379 , France 380 the United
Kingdom 381 382 and the United States. 383 384 Infection was reported in cats 385 386 387 388 389 390 391 392 393 394
395 396 397 , ferrets 398 399 400 401 402 403 , a badger (Taxidea taxus) , a captive Bornean binturong (Arctictis binturongpenicillata) 404 405 , giant pandas in China 406 , elephant seals (Mirounga angustirostris) 407 408 and a cheetah 409 410 inthe United States 411 412 413 414 415 416 417 ; skunks in Canada 418 ; dogs in Italy 419 and China 420 421 ; farmedAmerican mink (Neovison vison) in the Netherlands 422 ; and in dogs and swine in the United States, Hong Kong andmainland China. 423 424 425
- Reporting dates vary by country. The following updates include incidence data as of December 31, 2010. 426 427 :Afghanistan (17 fatal) 428 429 , Albania (6 fatal), Algeria (57 fatal cases), American Samoa (94 - 0 fatal), Andorra (1),Angola (37) 430 , Anguilla (14), Antigua and Barbuda (0 fatal), Argentina (626 fatal) 431 432 433 434 435 436 437 438 439
1323 1324 1325 , United Arab Emirates (6 fatal) 1326 1327 1328 1329 , United Kingdom (474 fatal: at least 142 in England,38 in Scotland - including the first fatal case in Europe 1330 1331 1332 , 21 in Wales and 13 in Northern Ireland) 1333 1334
Notes on Avian influenza in humans: 1625 1626 1627 1628 1629
H5N1 mutates rapidly and has a propensity to acquire genes from other animal species. Birds may excrete the virus frommouth and cloaca for up to ten days.- H5N1 virus was found to survive in bird feces for at least 35 days at low temperature (4 degrees C) and for 6 days at 39degrees C. 1630 At a much higher temperature (37 degrees C or 98.6 degrees F), H5N1 viruses have been shown to survive,in fecal samples, for 6 days.- The clinical spectrum of H5N1 virus infection ranges from asymptomatic infection to fatal pneumonitis and multiple organfailure.- Reactive hemophagocytic syndrome is the most characteristic pathological finding and may contribute to the lymphopenia,liver dysfunction, and abnormal clotting profiles observed among patients with severe infection.- Approximately 90% of patients with H5N1 infection have been below age 40. 1631
- There is evidence that sub-clinical infection may occur. 1632
- 106 cases of human infection by avian influenza virus H7 were reported during 1996 to 2007.- Seropositivity toward avian Influenza virus types H5, H6 and H7 was demonstrated among American veterinarians during2002 to 2004. 1633
H5N6Six cases (2 fatal) of H5N6 infection were reported in China during 2014 to December 2015 1634 1635 1636 1637 1638 1639
- A fatal case of H5N6 infection was reported in Hong Kong in 2015. 1645
H6N12013 - A non-fatal case of human infection by Avian influenza virus H6N1 was reported in Taiwan. The patient did not have ahistory of poultry contact. 1646 1647 1648
- H6 infection had not been reported in humans in China as of 2015; however seropositivity toward this strain is widespread.1649 1650
H11N9 and H7Seropositivity toward H5 and H9 types was demonstrated among poultry workers in China during 2007 to 2008. 1651
- Seropositivity toward avian influenza virus type H11N9 was demonstrated among hunters in the United States in 2009.- Seropositivity toward H7 was demonstrated in Italian poultry workers during 2008 to 2010. 1652
H7N9721 cases (283 fatal to February 2016) of human infection by Avian influenza virus A(H7N9) were reported in China; with
an 20 additional cases in Hong Kong (13), Taiwan (4), Canada (2) and Malaysia (1). There was some evidence for human-to-human transmission. 1653 1654 1655 1656 1657 1658 1659 1660 1661 1662 1663 1664 1665 1666 1667 1668 1669 1670
1786 1787 1788 Asymptomatic infection was common among poultry workers 1789 1790 1791 1792 1793 and close contactsof patients. 1794 Nosocomial spread has been documented in some cases. 1795
Fatal Avian influenza virus A(H7N9) infection was confirmed in a Taiwanese worker who returned to Taiwan from China1796 1797 , and in a Chinese tourist in Taiwan. 1798 1799 1800 An Indonesian worker and a Chinese traveler were found tobe infected with A(H7N9) infection after arriving to Hong Kong from China. 1801 1802 1803 1804 1805 1806 1807 1808 1809
1810 1811 1812 1813 1814 1815 A total of three imported cases (from the mainland) were reported in Hong Kong to January2015. 1816
2014 - 306 cases (124 fatal) of H7N9 influenza were reported in China. 1817 1818 1819 1820 1821 1822 1823 1824 1825
of A(H7N9) infection in Hong Kong followed travel in China 1868 1869 1870 1871 1872 1873 1874 1875 , a traveler from HongKong was hospitalized for the infection in China 1876 ; a Chinese tourist developed H7N9 infection after arriving to Malaysiafrom China. 1877 1878 1879 ; two Taiwanese travelers were hospitalized for H7N9 infection following return from China 1880
1881 1882 ; and a traveler from Hong Kong was hospitalized for the infection in China 1883
- Seroprevalence rates of 6.3% were demonstrated among asymptomatic poultry workers in China. 1884 1885 There is someevidence that H7N9 virus could be transmitted in human feces. 1886
1897 Two travelers from Hong Kong acquired H7N9 infection in China 1898 1899 1900 1901 ; and two travelers from Canadaacquired H7N9 infection in China. 1902 1903 1904 1905 1906
2016 - 28 cases (8 fatal) of H7N9 influenza were reported in China in January. 1907 1908 1909
H9N2Cases of human H9N2 infection were reported in Hong Kong in 1999 (2 cases), 2003 (1), 2007 (1) and 2013 (1) 1910 1911
1912 1913 ; in Bangladesh in 2011 1914 1915 ; in China during 1998 to 1999; and in Egypt in 2015. 1916 1917
- H9N2 infection has been identified in farmed minks in China. 1918
H10N82013 to 2014 - Three cases (2 fatal) of H10N8 infection were reported in China. 1919 1920 1921 1922 1923 1924 1925 1926
1927 1928 1929 1930 1931 1932 1933 Asymptomatic infection (seropositivity) was subsequently demonstrated in animalworkers. 1934 1935
Chronology - humans:(Note that official figures reported by W.H.O. and reporting countries vary). 1936
1996 - A single case of human H7N7 infection (conjunctivitis) was reported in England. 1937 1938
1997 to 1998 - An outbreak (18 cases, 6 fatal) of human infection by the avian (chicken) strain H5N1 was reported in HongKong. 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959
1960 The virus was also found in ducks and geese. 1961 1962 Transmission was predominantly bird-to-man, with sporadiccases acquired from patients. The clinical spectrum of H5N1 virus infection ranged from asymptomatic infection to fatalpneumonitis and multiple organ failure. Reactive hemophagocytic syndrome was the most characteristic pathological findingand might have contributed to the lymphopenia, liver dysfunction, and abnormal clotting profiles that were observed amongpatients with severe infection. Antibody was demonstrated in 17.2% of poultry workers during the outbreak. Approximately1.5 million chickens and other birds were slaughtered in attempts to control the outbreak.
1999 - An outbreak (2 children hospitalized) of H9N2 infection was reported in Hong Kong. 1963 1964 1965 1966 4% ofchickens tested during 1997 had been infected with this strain; and 49% of poultry workers were seropositive at thetime. There was no evidence for human-to-human transmission. H5N1 virus was isolated from a goose.
2002 - A single case of human H7N2 infection (respiratory) was reported in the United States. 1967
2002 to 2003 - Seven cases of human H7N3 infection (conjunctivitis and respiratory) were reported in Italy. 1968 1969
1970 1971 1972 1973
2003 - A single case of human H7N2 infection (respiratory) was reported in the United States. 1974 1975
- An outbreak of avian infection (HPAI = H7N7) was reported in Germany, Belgium and the Netherlands; including cases ofhuman infection (conjunctivitis and or respiratory disease) in Belgium and the Netherlands. 1976 1977
- 453 cases of human infection (1 fatal) were reported in the Netherlands at the time. 1978 1979 1980 1981 1982 1983 1984
1985 1986 1987
- Seroconversion was documented in 33 household members of patients, with documentation of H7N7 conjunctivitis in four.1988
- One case of human H5N1 (fatal) was reported in China (confirmation released only in 2006) 1989 1990 and 3 (fatal) inVietnam.
2004 - 17 cases of human H5N1 infection (12 fatal) were reported in Thailand 1991 1992 1993 1994 , and 29 (20 fatal) inVietnam. 1995 1996
- By late February, the number of new human H5 cases being reported in Thailand and Viet Nam slowed and then stopped.Within a month, countries in Asia were reporting that the avian influenza outbreak among poultry had been contained.- Asymptomatic human infection by H5N1 virus was associated with avian infections in the Republic of Korea during 2003 to2004. 1997 1998 1999
- Two cases of human H7N3 infection (conjunctivitis) were reported in Canada. 2000 2001 2002 2003 2004 2005 2006
2005 - 4 cases (4 fatal) of human H5N1 infection were reported in Cambodia 2007 2008 , 8 (5 fatal) in China 2009 , 20 (13fatal) in Indonesia 2010 , 5 (2 fatal) in Thailand, and 61 (19 fatal) in Vietnam. 2011 2012 2013
- One case is Thailand appeared to have been acquired through person-to-person transmission; and 5 asymptomaticindividuals in Japan were found to be seropositive.
2006 - Eight cases (5 fatal) of human H5N1 infection were reported in Azerbaijan 2014 2015 2016 2017 2018 , 2 (fatal) inCambodia 2019 2020 2021 , 13 (8 fatal) in China 2022 2023 2024 2025 2026 , 1 (nonfatal) in Djibouti 2027 , 18 (10 fatal) inEgypt 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 , 55 (45 fatal) in Indonesia 2038 2039 2040 2041 2042 2043
2149 2150 , 1 (nonfatal) in Myanmar 2151 , 1 (fatal) in Nigeria 2152 2153 2154 , 3 (1 fatal) in Pakistan 2155 2156 2157 , and8 (5 fatal) in Vietnam. 2158 2159 2160 2161
- In one case, a patient in Pakistan was infected through contact with another human who had been involved in cullingpoultry. 2162 2163 2164 A case of human to human transmission was also documented in China. 2165
- A case of human infection due to H9N2 virus was reported in Hong Kong. 2166
- Twelve cases (4 confirmed) of probable human infection by H7N2 virus (conjunctivitis and flu-like symptoms) were reportedin the United Kingdom. 2167 2168 2169 2170 2171 2172 2173 2174 2175
2008 - One case (nonfatal) of human H5N1 infection was reported in Bangladesh 2176 2177 2178 2179 , 1 (nonfatal) inCambodia 2180 2181 2182 , 4 (all fatal) in China 2183 2184 2185 2186 2187 , 8 (4 fatal) in Egypt 2188 2189 2190 2191 2192
- A case of human H9 influenza virus infection was imported into Hong Kong from Guangdong 2309 ; and a local childacquired H9N2 virus infection (non-fatal). 2310
2010 - Three cases (fatal) of human H5N1 infection were reported in Cambodia 2311 2312 2313 ; 2 (1 fatal) in China 2314
- An outbreak of low pathogenicity avian influenza A (H10N7) was reported in a poultry abattoir. Seven workers developedinfection characterized by minor upper respiratory tract symptoms and conjunctivitis. 2367
2011 - Two cases (nonfatal) of human H5N1 infection were reported in Bangladesh 2368 2369 ; 8 (8 fatal) in Cambodia 2370
2371 2372 2373 2374 2375 2376 2377 2378 2379 ; 1 (fatal) in China 2380 2381 2382 ; 40 (15 fatal) in Egypt 2383 2384 2385
Cambodia 2431 2432 2433 2434 2435 ; 11 (5 fatal) in Egypt 2436 2437 2438 2439 2440 2441 2442 2443 ; 1 (nonfatal, patientarriving from China) in Hong Kong 2444 2445 2446 , 9 (fatal) in Indonesia 2447 2448 2449 2450 2451 2452 2453 2454 2455
2456 2457 2458 2459 2460 ; and four (2 fatal) in Vietnam. 2461 2462 2463 2464 2465 2466 2467
- During the course of an outbreak of Avian influenza H5N2 among birds in Taiwan, seropositive poultry workers wereidentified. 2468 Two poultry workers developed conjunctivitis due to Avian influenza H7N3 during an outbreak among poultryin Mexico. 2469 2470 2471 2472 2473 2474
2013: - One case (fatal) of human H5N1 infection was reported in Bangladesh 2475 2476 ; 24 (12 fatal) in Cambodia 2477
2478 2479 2480 2481 2482 2483 2484 2485 2486 2487 2488 2489 2490 2491 2492 2493 2494 2495 ; one (fatal) in Canada(imported from China) 2496 2497 2498 2499 2500 2501 ; 2 (2 fatal) in China. 2502 2503 2504 2505 2506 ; 3 (3 fatal) in Egypt2507 2508 2509 2510 2511 2512 2513 ; 3 (fatal) in Indonesia 2514 2515 2516 2517 ; and 2 (1 fatal) in Vietnam. 2518
- 144 cases (46 fatal) of human infection by Avian influenza virus A(H7N9) were reported in China. 2519 2520 2521 2522
2638 2639 2640 2641 2642 2643 2644 2645 2646 2647 2648 2649 2650 2651 2652 2653 2654 Avian influenza virus A(H7N9)infection (fatal) was confirmed in a Taiwanese worker who returned to Taiwan from China 2655 2656 2657 2658 , and in aChinese tourist (fatal) in Taiwan. 2659 2660 ; and seroprevalence rates of 6.3% were demonstrated among asymptomaticpoultry workers in China. 2661 2662
- A non-fatal case of human infection by Avian influenza virus H6N1 was reported in Taiwan. The patient did not have ahistory of poultry contact. 2663 2664 2665 An Indonesian worker and a Chinese traveler were found to be infected withA(H7N9) infection after arriving to Hong Kong from China. 2666 2667 2668 2669 2670 2671 2672 2673 2674 2675 2676 2677
- Three cases of human infection (conjunctivitis) by Avian influenza virus H7N7 were reported in Italy. 2678 2679 2680
2014: - Nine cases (4 fatal) of human H5N1 infection were reported in Cambodia 2681 2682 2683 2684 2685 2686 ; 2 (0fatal) in China; 31 (18 fatal) in Egypt 2687 2688 2689 2690 2691 2692 2693 2694 2695 2696 2697 2698 2699 2700 2701 2702
2703 2704 ; 2 (fatal) in Indonesia 2705 2706 ; and 2 (2 fatal) in Vietnam. 2707
- 144 cases (46 fatal) of human infection by Avian influenza virus A(H7N9) 2708 2709 2710 2711 2712 2713 2714 2715 2716
2748 Eight cases (1 fatal) of A(H7N9) infection in Hong Kong followed travel in China 2749 2750 2751 2752 2753 2754 2755 ;two Taiwanese travelers were hospitalized for A(H7N9) infection following return from China. 2756 2757 2758 ; a Chinesetourist developed H7N9 infection after arriving to Malaysia from China 2759 2760 ; and a traveler from Hong Kong washospitalized for the infection in China 2761
- Three cases (2 fatal) of H5N6 infection were reported in China. 2762 2763 2764 2765 2766 2767
2015: - Five cases (1 fatal) of human H5N1 infection were reported in China 2768 2769 2770 2771 ; 145 (40 fatal) in Egypt.2772 2773 2774 2775 2776 2777 2778 2779 2780 2781 2782 2783 2784 2785 2786 2787 2788 2789 2790 2791 2792 2793 2794
2795 ; and 2 (fatal) in Indonesia.- 241 cases (97 fatal to December) of human infection by Avian influenza virus A(H7N9) were reported in China. 2796 2797
2798 2799 2800 2801 2802 2803 2804 2805 2806 2807 Three cases (1 fatal) of H7N9 infection were imported into Hong Kong2808 2809 2810 ; and two other cases were imported into Canada. 2811 2812
- Four cases (2 fatal) of H5N6 infection were reported in China 2813 2814 2815 ; three cases of H9N2 infection in Egypt 2816
2817 and one case of H9N2 infection in Bangladesh. 2818
2016: - One case (nonfatal) of human H5N1 infection was reported in Bangladesh; 1 (nonfatal) in China. 2819
- Ten cases (2 fatal) of human H5N6 infection were reported in China 2820 2821 2822 ; 28 cases (8 fatal) of H7N9 influenzawere reported in China 2823 2824 , including two cases of nosocomial acquisition. 2825 A Taiwanese businessman died ofH7N9 infection in China. 2826 2827 2828 2829
- 1959 to 2003 - 21 outbreaks of HPAI were reported worldwide - the majority in Europe. Of these, only five outbreaks werewidespread, and only one involved more than one country.- 1997 to 2003 - 14 outbreaks of H5 or H7 were reported in poultry, of which three also involved human infection.- 2003 to February 2009 - Outbreaks of H5N1 infection in poultry were reported in 62 countries. 2851
- 2004 - Beginning in late June 2004, new lethal outbreaks of H5N1 among poultry and other birds were reported by several
countries in Asia: Cambodia, China, India, Indonesia, Malaysia, Russian Republic, Thailand and Viet Nam.- 2003 to 2005 - Outbreaks of highly pathogenic avian influenza A (H5N1) occurred among poultry in 8 countries in Asia(Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand and Viet Nam) during late 2003 and early 2004.- 2003 to 2008 - Highly pathogenic avian influenza A (H5N1) was reported in wild birds and / or poultry in 61 countries.2852 H5N1 infection was reported in 11 African countries during 2005 to early 2008. 2853
- 2003 to 2010 - Outbreaks had been reported in a total of 63 countries. 2854 2855
Chronology - birds:Detailed time-line available at 2856 2857 2858
59 countries reported outbreaks of H5N1 avian influenza among birds during 2003 to May 2007 2859 2860 2861 2862 2863
2864 ; 63 countries as of June 2010. 2865
As of 2011, repeated H5N1 avian influenza outbreaks had been reported primarily in six countries: Bangladesh, China, Egypt,India, Indonesia and Vietnam. 2866 2867
1959 - An outbreak of H5N1 infection among chickens in Scotland 2868
1963 - An outbreak of H7N3 infection among turkeys in England1966 - An outbreak of H5N9 infection among turkeys in Canada1976 - An outbreak of H7N7 infection among chickens in Australia1979 - An outbreak of H7N7 infection among chickens in Germany1979 - An outbreak of H7N7 infection among turkeys in England 2869
1983 to 1985 - An outbreak of H5N2 infection among chickens in the United States1983 - An outbreak of H5N8 infection among turkeys in Ireland 2870
1985 - An outbreak of H7N7 infection among chickens in Australia 2871
1991 - An outbreak of H5N1 infection among turkeys in England 2872 2873
1992 - An outbreak of H7N3 infection among chickens in Australia 2874
1993 to 1995 - An outbreak of H5N2 infection among chickens in Mexico 2875 2876 2877
1994 - An outbreak of H7N3 infection among chickens in Australia 2878
1994 - An outbreak of H7N3 infection among chickens in Pakistan1996 - H5N1 virus is isolated from a farmed goose in Guangdong Province, China.1997 - An outbreak of H7N4 infection among chickens in Australia 2879
1997 to 1998 - An outbreak of H5N1 infection was reported among chickens, ducks and geese in Hong Kong. 2880 2881
2882 2883 2884 2885
1997 - An outbreak of H5N2 infection among chickens in Italy. 2886 2887
1997 to 1998 - An outbreak of H7N2 infection was reported among chickens in the United States. 2888 2889 2890 2891
1998 - Avian H9N2 influenza virus was identified in poultry in Iran. 2892
1998 to 1999 - An outbreak of avian influenza (H7N1) was reported among turkeys and farmed ostriches in Italy. 2893
2894 2895 No human cases were reported. 2896
1999 (publication year) - H9N2 virus was reported among poultry in Pakistan. 2897
1999 to 2000 - An outbreak of H7N1 infection among turkeys and farmed ostriches in Italy. 2898 2899 2900
2002 - H5N1 infection was reported among chickens in Chile 2901 2902 and Hong Kong. 2903 2904
2003 - An outbreak of H5N1 infection began among poultry in Korea and spread to several Asian countries. 2905 2906
2003 - H7N7 virus was reported among chickens in Belgium and the Netherlands 2907 2908 2909 2910 2911 2912 ; H7N3virus in Italy and the Netherlands 2913 , with low levels of seroconversion in human contacts. 2914
2004 - Avian and human infection by Influenza virus A (H10N7) was reported in Egypt.2004 - Two cases of human infection by H7N3 from an avian source were reported in Canada. 2915 2916
2004 - Outbreaks of H5N2 among ducks 2917 and H9N8 among chickens in Republic of Korea. 2918 ; H5N2 among ducksin China 2919 and ostriches in South Africa. 2920
2004 - Outbreaks of H5N2 and H7N2 infection among poultry in the United States. 2921 2922 2923 2924
2004 to 2005 - Outbreaks of H5N1 infection among chickens and ducks in Cambodia, China 2925 2926 2927 , Indonesia2928 , Japan 2929 Laos, Malaysia, Mongolia 2930 , Pakistan, Thailand 2931 2932 2933 2934 , and Viet Nam; outbreaks ofH3N8 infection were reported among ducks in China. 2935
2005 - Outbreaks of H7 infection among chickens in North Korea. 2936 2937 2938
2005 - Outbreaks of H5N2 infection were reported among chickens in Japan 2939 , chickens in Mexico. 2940 and ostrichesin Zimbabwe. 2941
2005 - H5N1 infection was reported among poultry and water fowl in China 2942 2943 2944 , swans in Croatia 2945 , aduck in Italy. 2946 , geese in Kazakhstan. 2947 , a flamingo in Kuwait. 2948 , ducks in Romania 2949 2950 2951 , fowl inRussia 2952 2953 2954 , a wild falcon in Saudi Arabia. 2955 2956 , turkeys in Turkey 2957 2958 2959 2960 , birds in Ukraine2961 and ducks in the United States. 2962
2005 - An outbreak of H9N2 infection among chickens in Colombia. 2963
2005 - H7N3 virus was identified in the droppings of migratory birds in Taiwan. 2964
2005 - Avian influenza H5N9, H5N2 and H5N3 in wild birds in Canada. 2965 2966 2967 2968
2005 to 2006 - Outbreaks of avian influenza (H5N2) were reported among ostriches in South Africa 2969 2970 2971 2972
2973 and birds in Japan. 2974
2006 to 2009 - Sporadic cases of H3N2 infection were reported among ducks in China. 2975
2006 - H5N1 virus confirmed in poultry in Nigeria. 2976 2977 2978 2979 2980 2981 This was the first confirmation of thisstrain in Africa. 2982 2983 2984 2985 2986
2006 - H5N1 virus was confirmed in wild birds and / or poultry in 48 additional countries 2987 2988 : Afghanistan, Albania2989 , Austria 2990 2991 , Azerbaijan 2992 2993 , Bosnia & Herzegovina 2994 2995 , Burkina Faso 2996 2997 , Cambodia2998 2999 3000 , Cameroon 3001 , China 3002 3003 3004 3005 3006 3007 , Croatia 3008 , Cyprus, Czech Republic 3009
2006 - H5 virus was reported among in birds in Denmark 3086 , Georgia, Italy 3087 and the Philippines. 3088 ; H7N3virus was reported in domestic fowl in England 3089 3090 3091 ; H3N3 among farmed birds in Denmark 3092 ; H7N7 amongpoultry in the Netherlands. 3093 3094
2006 - Avian influenza caused by a "low pathogenic strain" was reported in birds in Bulgaria. 3095 3096 3097
2007 - Avian influenza (H5N1) was confirmed in wild birds and / or poultry in 29 countries 3098 3099 : Afghanistan 3100
2007 - H5N2 virus was reported in birds in the United States 3244 3245 , Italy 3246 , Dominican Republic 3247 , andPortugal. 3248 3249 H7N2 virus was reported among fowl in Italy 3250 3251 ; and in England 3252 3253 3254 and Wales3255 - with 12 cases (4 confirmed) of human disease (conjunctivitis and flu-like illness). 3256 3257 3258 3259 3260
3261 H7N3 virus infection was reported among poultry in Canada 3262 3263 3264 3265 3266 3267 , Italy 3268 3269 andVietnam. 3270 H7N8 virus infection was reported among fowl in Republic of Korea. 3271 3272
2008 - Avian influenza (H5N1) was confirmed in wild birds and / or poultry in 25 countries 3273 : Bangladesh 3274 3275
2008 - Avian influenza (H7) was reported among ducks in Bulgaria 3403 3404 and chickens in Denmark 3405 3406 ; H7N7among chickens in the United Kingdom. 3407 3408 3409 3410 3411 ; H5N2 among poultry in Haiti 3412 , Taiwan 3413 3414
3415 and Republic of Korea 3416 3417 ; H7N3 among chickens and swans in the United States. 3418 3419 ; H5 infectionamong poultry in Belgium 3420 and Benin 3421 ; H5N8 in a pheasant in the United States. 3422 ; H9 among chickens in Iraq.3423 ; H5N3 among fowl in Germany. 3424 3425 3426 3427 3428 ; H9N2 among chickens in the Republic of Korea. 3429
3430 3431
2009 - Avian influenza (H5N1) was confirmed in wild birds and / or poultry in 14 countries: Bangladesh 3432 3433 3434
2009 - Avian influenza (H3N3) was reported among fowl in France 3472 and Germany 3473 ; H5N2 among poultry inCanada. 3474 3475 3476 ; LPNAI H7N6 among quail in Japan 3477 3478 3479 3480 ; LPNAI H5 among fowl in Republic ofKorea 3481 ; LPAI H7N9 among fowl in the United States 3482 3483 3484 3485 ; H7 among fowl in Germany 3486 ; H7N7
among fowl in Spain 3487 3488 ; H5 among birds in Mongolia 3489 ; H5N3 among ducks in the Czech Republic 3490 ; H7N3among poultry in Italy 3491 (seropositive poultry workers identified 3492 ) ; and H6N1 among turkeys in the UnitedKingdom. 3493 3494 3495
2010 - Avian influenza (H5N1) was confirmed in birds and / or poultry in 18 countries: Bangladesh) 3496 3497 3498 3499
3500 , Bhutan 3501 3502 , Bulgaria 3503 3504 3505 , Cambodia 3506 , China 3507 3508 3509 3510 3511 3512 3513 , Egypt3514 3515 3516 3517 3518 3519 3520 , Hong Kong 3521 3522 , Indonesia 3523 3524 3525 3526 , Israel 3527 3528 3529 3530
3531 and the West Bank 3532 3533 , Japan 3534 3535 3536 3537 3538 3539 , Laos 3540 3541 , Mongolia 3542 3543 ,Myanmar 3544 , Nepal 3545 3546 3547 , Republic of Korea 3548 3549 3550 3551 3552 3553 3554 , Romania 3555 3556 3557 ,Russian Federation 3558 and Vietnam. 3559 3560 3561 3562 3563 3564
2010 - Avian influenza H5 was reported among poultry in Bangladesh, Egypt, India 3565 and Indonesia 3566 , wild ducksin Mongolia 3567 and zoo birds in Japan 3568 ; H5N2 among fowl in Canada 3569 3570 , Italy 3571 and Germany 3572 ; H7among poultry in Denmark 3573 and the Netherlands 3574 ; H7N6 3575 3576 , H7N2 3577 and H7N7 among poultry inRepublic of Korea 3578 ; and H5N2 among poultry in Taiwan. 3579
2011 - Avian influenza (H5N1) was confirmed in birds and / or poultry in 13 countries: Bangladesh 3580 3581 3582 3583
2011 - Avian influenza (H5) was confirmed among poultry and wild birds in Myanmar 3663 ; H5N2 among birds in Taiwan3664 , poultry in Italy 3665 and ostriches in South Africa 3666 3667 3668 3669 3670 3671 3672 ; H7N7 among poultry inGermany 3673 3674 3675 3676 ; H7 among poultry in the Netherlands 3677 3678 3679 ; H7N9 3680 ; H7N3 among poultry inthe United States 3681 3682 3683 3684 ; and H9N2 among poultry in Iran. 3685
2012 - Avian influenza (H5N1) was confirmed in birds and / or poultry in eleven countries: Bangladesh 3686 3687 ,Bhutan 3688 3689 , China 3690 3691 3692 3693 3694 3695 3696 , Egypt 3697 3698 3699 , Hong Kong 3700 3701 3702 3703
3704 3705 3706 , India. 3707 3708 3709 , Indonesia 3710 3711 , Israel 3712 3713 3714 (infected cats also reported 3715
3716 ), Myanmar 3717 , Nepal 3718 3719 3720 and Vietnam. 3721 3722 3723 3724 Infected birds were smuggled from Chinainto Taiwan. 3725 3726
2012 - Avian influenza (H5) was identified among birds in Hong Kong 3727 ; H5N2 among birds in Taiwan 3728 3729
(associated with seropositive poultry workers 3730 ) , the Netherlands 3731 3732 3733 , Ireland 3734 , Italy 3735 , RussianFederation 3736 , South Africa 3737 and Sri Lanka. 3738 ; H7N3 among poultry in Mexico 3739 3740 3741 3742 3743 3744 ;H5N3 among poultry in Germany 3745 ; H7 among birds in Australia 3746 3747 ; and H7N7 among birds in the Netherlands.3748
2013 - Avian influenza (H5N1) was confirmed in birds and / or poultry in eight countries: Cambodia 3749 , China 3750 ,Hong Kong 3751 , India 3752 3753 3754 , Indonesia 3755 , Nepal 3756 3757 3758 , North Korea 3759 and Vietnam. 3760
3761 3762 3763
2013 - H5N1 influenza was identified in a consignment of smuggled birds in Austria. 3764
2013 - Avian influenza (H7N3) was confirmed in poultry in Mexico 3765 3766 3767 3768 3769 3770 3771 3772 3773 3774
3775 3776 3777 ; LPAI H5N1 among poultry in Germany 3778 3779 ; H5 among poultry in Australia 3780 and Germany 3781
; H5N2 among poultry in China 3782 3783 ; H7N7 among poultry in Italy 3784 3785 3786 3787 3788 3789 (human infectionalso reported 3790 3791 3792 ) , The Netherlands 3793 3794 3795 3796 3797 , Denmark 3798 , South Africa (ostriches) 3799
3800 , the United States 3801 and Germany 3802 3803 ; H7N1 among poultry in the Netherlands 3804 and Spain 3805 3806
3807 , and ostriches in South Africa 3808 3809 ; H7N2 among poultry in Australia 3810 3811 3812 ; H7 among poultry inDenmark 3813 and Portugal 3814 ; H5N3 among poultry in Germany 3815 and the Netherlands 3816 ; H5N8 among ducks inChina 3817 3818 ; H9N2 among turkeys in Poland 3819 ; and H7N9 in pigeons, quail, chickens and ducks in China. 3820 3821
3993 3994 3995 , and the United States 3996 3997 3998 3999 4000 4001 4002 4003 4004 ; H6N1 in China ; H7N1 in SouthAfrica 4005 ; H7N7 in South Africa 4006 ; H7N9 in China 4007 4008 4009 4010 4011 4012 4013 4014 4015 4016 4017 4018
4019 4020 4021 4022 4023 4024 4025 4026 4027 4028 4029 4030 4031 4032 4033 4034 4035 4036 4037 4038 and Hong Kong(in a consignment of imported chickens from China) 4039
2015 - Avian influenza (H5N1) was confirmed among poultry or wild birds in 19 countries: Bhutan 4040 , Bulgaria 4041
4164 4165 4166 4167 4168 4169 4170 4171 4172 4173 4174 4175 4176 4177 4178 4179 ; H5N3 among poultry in France 4180
4181 4182 and Taiwan 4183 4184 4185 4186 4187 4188 4189 4190 ; H5N6 among poultry in China 4191 , Laos 4192 andVietnam 4193 4194 4195 4196 4197 4198 4199 , and wild birds in China 4200 4201 and Hong Kong 4202 ; H5N7 amongpoultry in Germany 4203 ; H5N8 among poultry in Hungary 4204 4205 and Taiwan 4206 4207 4208 4209 4210 4211 , wildbirds in Canada 4212 and Japan 4213 4214 , and wild birds and poultry in Sweden 4215 and the United States 4216 4217
4218 4219 4220 4221 4222 4223 4224 ; H5N9 among poultry in France 4225 4226 4227 4228 ; H7 among ostriches in SouthAfrica 4229 ; H7N3 among poultry in Mexico 4230 4231 and the United States 4232 ; H7N7 among poultry in Germany 4233
4234 , the Netherlands 4235 and the United Kingdom. 4236 4237 4238 ; and H7N9 among poultry in China. 4239
2016 - Avian influenza H5N1 infection was reported among poultry or wild birds in four countries: Bangladesh 4240 , India4241 , Nigeria 4242 4243 and Scotland. 4244 4245
2016 - Avian influenza (H5N6) was detected in a wild bird in Hong Kong 4246 , and in poultry in Vietnam. 4247 ; H7N8 inpoultry in the United States. 4248 4249 4250 4251 4252
Influenza in other animals:As of 2009, animal species with confirmed infection included cow (Bos taurus), domestic cat/feral cat (Felis domestica) 4253 ,Cynomolgus macaques (Macaca fascicularis), dog (Canis lupus familiaris), ferret (Mustela putoris furo) 4254 4255 , leopard(Panthera pardus), mink 4256 4257 , rabbits (Oryctolagus cuniculus), palm civet (Chrotogale owstoni Owston) 4258 4259 ,pig (Sus domesticus), raccoon (Procyon lotor) 4260 4261 , rat (Rattus norvegicus), red fox (Vulpes vulpes) , stone marten.4262 and tiger (Panthera tigris). 4263
- Evidence for infection by avian influenza viruses (H5N1 and N9N2) was confirmed in pigs in 2004.- H5N1 virus has also been documented in tigers 4264 , leopards, dogs, civet cats and domestic cats. 4265 4266 4267 4268
4269 4270 4271 4272
- Influenza virus H5N1 was confirmed in pigs in Indonesia in 2005 4273 and 2006 4274 ; cats in Germany 4275 andIndonesia 4276 in 2006 ; and donkeys in Egypt (2010 publication). 4277 4278
- Infected blow flies (Calliphora nigribarbis) were identified in the vicinity of poultry infected with H5N1 influenza virus inJapan. 4279
- H3N2 Influenza virus has been identified in dogs in Republic of Korea 4280 ; pika in China 4281 ; bats (Nyctalus noctula) inKazakhstan 4282 4283 ; and mink in Denmark. 4284
- H1N1 infection was identified in captive giant anteaters (Myrmecophaga tridactyla) in the United States in 2007. 4285
- During the H1N1 pandemic of 2009, infection was confirmed in swine 4286 4287 4288 4289 ,4290 4291 4292 4293 4294
Vaccine recommendations for the 1998 Australian winter (also adopted by South Africa and New Zealand):A/Bayern/07/95(H1N1)-likeA/Sydney/05/97(H3N2)-likeB/Beijing/184/93-like
A/Moscow/10/99 (H3N2)-like virus (eg, A/Panama/2007/99)A/New Caledonia/20/99 (H1N1)-like virusB/Sichuan/379/99-like virus; such as B/Johannesburg/5/99 or B/Victoria/504/2000
Vaccine recommendations for 2002 to 2003: 4339 4340
A/New Caledonia/20/99 (H1N1)-like virusA/Moscow/10/99 (H3N2)-like virus; such as A/Panama/2007/99 (H3N2)-likeB/Hong Kong/330/2001-like virus; such as B/Shandong/7/97-like virus - or B/Hong Kong/1434/2002
Vaccine recommendations for 2003 to 2004: 4341
A/New Caledonia/20/99 (H1N1)-like virusA/Fujian/411/2002 (H3N2)-like virusB/Hong Kong/330/2001-like virus; such as B/Shandong/7/97-like virus - or B/Hong Kong/1434/2002
Vaccine recommendations for 2004 to 2005: 4342 4343
A/New Caledonia/20/99 (H1N1)-like virusA/Wellington/1/2004 (H3N2)-like virusB/Shanghai/361/2002-like virus; such as B/Shanghai/361/2002 - or B/Jilin/20/2003
Vaccine recommendations for 2005 to 2006: 4344
A/New Caledonia/20/99 (H1N1)-like virusA/California/7/2004 (H3N2)-like virusB/Shanghai/361/2002-like virus; such as B/Shanghai/361/2002 - or B/Jilin/20/2003 (B/Malaysia/2506/2004-like virus
recommended for Southern Hemisphere)
Vaccine recommendations for 2006 to 2007: 4345 4346
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H5N1 influenza was reported in birds in 2006. 1 2 3
Notable outbreaks:1969 to 1970 - An outbreak (845,270 cases) of A (H3N2) Hong Kong influenza was reported.2009 to 2010 - An outbreak (6 fatal cases) of H1N1 pdm09 influenza was reported.
