Subject: To NFPs and OCPs for information: Importance of testing, typing and subtyping to detect potential zoonotic influenza human cases in the EU/EEA
From: "ECDC respiratory viruses" <[email-masked]>
Cc: "ECDC Info" <[email-masked]>
Date: Tue, 24 Sep 2024 12:42:57 +0300

Tähelepanu! Tegemist on väljastpoolt asutust saabunud kirjaga. Tundmatu
saatja korral palume linke ja faile mitte avada. 	
  
To:         National Focal Points for Viral Respiratory Diseases,
Operational Contact Points for influenza
Cc:         National Coordinators  
 
Dear Colleagues,
 
Highly pathogenic avian influenza (HPAI) A(H5N1) viruses continue to be
detected in wild and domestic birds and mammals globally, leading to
occasional cases in humans. Public updates for ongoing zoonotic influenza
events (including the US A(H5N1) cattle transmission event and associated
human cases) are provided regularly through the weekly ECDC Communicable
Disease Threats Report (CDTR) here. The EpiPulse item tracking the US
situation is at: Avian influenza A(H5N1) human cases – United States –
2024 and Long-term monitoring item covering global detections is at:
Influenza A(H5N1) - Multi-country (World) - Monitoring human cases. ECDC
also publishes together with EFSA and the EU Reference Laboratory for
Avian Influenza a quarterly avian influenza monitoring report with more
information on the epidemiological situation and human cases globally. The
latest report can be found here and the next one will be published in
October. 
 
With this email we would like to raise your attention to the need for
enhanced surveillance, including typing and subtyping of influenza
viruses. The importance of this has been highlighted by the latest
detection of a human A(H5N1) case in Missouri, USA, based on routine
influenza surveillance. We would like to remind you about the continued
need to type and subtype all influenza-positive samples from sentinel
surveillance sites at primary and secondary care level, and about our
earlier guidance on avian flu targeted testing during the autumn-winter
season. ECDC is planning to soon update some of the key messages although
the principles outlined in the guidance from last year still remain valid.
 
During the upcoming months when seasonal influenza viruses will likely be
circulating increasingly in the population, a risk-based approach is thus
suggested for influenza testing outside the sentinel surveillance scheme,
which means that typing and subtyping for avian influenza virus would need
to be proportionate to the epidemiological situation and the capacities of
reference laboratories. Raising awareness among healthcare workers
(including primary care workers) and communicating the epidemiological
situation is also very important, particularly in the context of any
ongoing avian influenza outbreak in animals, in order not to miss or delay
diagnosis of potential human cases. Clinicians should be informed about
clinical presentations compatible with avian influenza infections (e.g.
conjunctivitis) and testing of symptomatic persons with a history of
exposure as proposed in the published ECDC guidance documents
‘Investigation protocol of human cases of avian influenza virus infections
in EU/EEA’ and ‘Testing and detection of zoonotic influenza virus
infections in humans in the EU/EEA, and occupational safety and health
measures for those exposed at work’.
 
Furthermore, the published case investigation protocol sets out measures
for the follow-up (between 10 to 14 days after last exposure) and
management of individuals exposed to infected animals and human cases of
avian influenza, and for the public health management of possible and
confirmed human cases of avian influenza. If individuals develop symptoms,
immediate testing should be undertaken, and the individuals should
isolate. Testing of asymptomatic individuals who have been exposed may be
conducted on a case-by-case basis, taking into account the level of
exposure. 
 
More information regarding One Health mitigation measures for avian
influenza can be found in the ECDC/EFSA joint document: ‘Drivers for a
pandemic due to avian influenza and options for One Health mitigation
measures’.
 
If you need more information or support, please contact
[email-masked]
 
Best regards,
 
The ECDC Respiratory Viruses and Legionella group

 	European Centre for Disease Prevention and Control (ECDC) 
Gustav III:s boulevard 40, 169 73 Solna, Sweden	
Phone &#43;46 (0)8 58 60 10 00	
www.ecdc.europa.eu	

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