Canadian teenager with suspected bird flu in critical condition

A British Columbia (BC) teenager from the Fraser Health region who was hospitalized with a previously announced suspected positive H5 bird flu infection is in critical condition, the province’s top health official said today.

In a media briefing streamed live on Canadas Global newsBonnie Henry, MD, BC’s health officer, shared the latest study findings, noting that the patient’s symptoms began on November 2 and he or she was seen that day in a hospital emergency room. She said initial symptoms included conjunctivitis, fever and cough.

After symptoms worsened, the patient was admitted to BC Children’s Hospital on the evening of November 8. Henry said the patient, who has no underlying medical conditions, is experiencing acute respiratory distress and has been receiving intravenous antiviral therapy. She added that the patient was tested for influenza and other respiratory viruses as part of routine disease surveillance.

Although people infected with H5 bird flu in the United States over the past several months have had mild symptoms, Henry said health officials worry that the disease could be more severe in younger people. She noted that early scientific findings suggest that adults who have been exposed to previous seasonal H1N1 flu viruses may have some partial protection against the current H5 strain.

About 36 people tested so far

Henry said the investigation involves careful and challenging work, and she praised the patient’s family for their help at a time when they are struggling with a critical illness of a loved one. However, she warned that there is a chance that investigators will not be able to determine how the teenager contracted the virus.

So far, no other infections have been reported in the patient’s contacts. Henry said about 36 people have been tested and the patient had not been in school during the contagious period. Contacts have been offered oseltamivir (Tamiflu) for prophylactic (preventive) use.

Investigators are still working to determine how the patient was exposed to the virus, she said, reiterating that animal exposure is likely, although an environmental source is also possible.

Investigate other animal exposures, virus functions

Although about 25 outbreaks of avian influenza have recently been reported in British Columbia poultry, the patient has no connections to an affected farm or to poultry. He or she was exposed to family pets and pets in other homes, which included dogs, cats and reptiles, Henry said.

One dog was sick, but tests were negative, she said, adding that investigations into potential animal sources are still ongoing.

Confirmatory testing is still underway at the National Microbiology Laboratory in Winnipeg. Henry said scientists will work to further characterize the virus, including determining the neuraminidase (the “N” part of the virus name), the clade and the genotype. Henry also added that wastewater monitoring in BC has been conducted, although the method cannot determine whether the source is from an animal or a human.