Global Outbreak Update: Avian influenza A (H5N8) infection in humans. Russian Federation

Clade 2.3.4.4b of avian influenza A(H5Nx) viruses outbreak in a poultry farm in Astrakhan Oblast. First reported detection of A(H5N8) in humans. Risk of human-to-human transmission remains low.

• Update Date: 26 February 2021
   
• Time frame and cases: On 18 February 2021, the National IHR Focal Point for the Russian Federation notified WHO of detection of avian influenza A(H5N8) in seven human clinical specimens. These are the first reported detection of avian influenza A(H5N8) in humans. Positive clinical specimens were collected from poultry farm workers who participated in a response operation to contain the outbreak. The age of seven positive cases ranged between 29 to 60 years and five were female. Based on currently available information, the risk of human-to-human transmission remains low.
   
• Regions: A poultry farm in Astrakhan Oblast in the Russian Federation. In 2020, avian influenza A (H5N8) viruses were also detected in poultry or wild birds in Bulgaria, the Czech Republic, Egypt, Germany, Hungary, Iraq, Japan, Kazakhstan, the Netherlands, Poland, Romania, the United Kingdom, and the Russian Federation.
   
• Virus / Vector / Disease Information: Influenza A(H5N8) viruses isolated from this poultry outbreak in Astrakhan belonged to clade 2.3.4.4b of avian influenza A(H5Nx) viruses.
   
• Response: Between 11 and 18 December 2020, several measures including culling and disposing of poultry, eggs, litter and disinfection of contaminated premises were taken. Whole Genome Sequencing of avian influenza A (H5N8) viruses isolated from poultry and from one of the seven human cases was performed and uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) database on 20 February 2021. On 20 February, a special briefing by the head of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing was organized to inform the public about these cases and the implications.
   
• Recommendation: People involved in specific, high-risk tasks (sampling sick birds, culling and disposing of infected birds, eggs, litter and cleaning of contaminated premises) should be trained on protection and proper use of PPE. Based on the currently available information, no special traveler screening at points of entry or restrictions on travel and/or trade with the Russian Federation is necessary.

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