There have been a series of human cases, alerts and exercises associated with H5N1 in several countries in Asia recently. These include:
- Indonesia: Cases of H5N1 in humans
- Mainland China: Alert regarding H5N1 human to human spread
- Hong Kong, China: H5N1 exercise
- Taiwan: H5N1 exercise
In Indonesia, a one year old girl in Jakarta became sick on August 8, 2011 with H5N1. She she died on August 25, 2011 (WHO).
A five year old girl in Bali became ill with H5N1 on September 27, 2011. She died on October 9, 2011. Her 10 year old brother became ill on September 30, 2011. He died on October 10, 2011 (WHO). The mother of these children also died (The Beat). This was reported on October 18, 2011. She had previously been considered to be a suspected case, but was not officially reported as a confirmed case. This cluster almost certainly represents human to human spread of H5N1 and possibly human to human to human spread.
There were a number of other suspected H5N1 cases in Indonesia. In addition, precautions against human to human spread of the virus appear to be stepped up (see Indonesia thread at PFI for more details) [hat-tip to the Indonesia newshounds, especially dbg, mojo and Pixie].
Hong Kong reported that it was holding an H5N1 outbreak exercise on October 27, 2011 (Global Times).
Taiwan reported an H5N1 pandemic exercise, also on October 27, 2011 (United Daily News).
Human clusters of H5N1 have occurred in Indonesia before. Further, H5N1 is endemic in China and is likely causing similar, but unreported, human clusters there. So, why is China and its neighbors taking nearly simultaneous steps to prepare for pandemic H5N1?
There have been no reports that sustained spread of H5N1 is occurring. However, if the source of such a pandemic is in China, it is unlikely that we will hear about it until many people have been infected. Certainly, this was the case with SARS and previous outbreaks of H5N1. Our first warning is likely to be unusual activity by governments in the region. Hence, the current situation bears watching.