Update on influenza A(H5N8) reported from Mpumalanga Province


Two poultry farms in Mpumalanga are presently experiencing an outbreak of avian influenza A(H5N8). The Department of Agriculture, Forestry and Fisheries together with stakeholders are implementing control measures.  The NICD together with the National Department of Health, provincial authorities and farm owners, has implemented surveillance for human infection in accordance with international practice.

Amongst 120 farm workers, 22 with any symptoms of upper or lower respiratory tract illness (cough, runny nose, conjunctivitis or fever) gave specimens for testing. All samples tested negative for influenza A(H5N8) and seasonal influenza. Surveillance activities are ongoing.  No documented cases of human illness due to influenza A(H5N8) have been reported in outbreaks elsewhere, including Europe and North Africa.

The risk of transmission of influenza A(H5N8) to humans is extremely low. The most common route of transmission is airborne, through aerosolisation of virus particles from live birds or during culling. Poultry products including commercially available eggs, fresh and frozen chicken are safe to consume. Persons who are in contact with live or dead birds, especially those in the poultry industry are advised to wear personal protective equipment including gloves, disposable aprons/clothing and masks capable of preventing inhalation of aerosolised virus particles.

Handwashing with disinfectant soap after contact with birds is essential. Any persons with known or suspected close contact with dead or ill birds that have confirmed A(H5N8) infection and who present with upper or lower respiratory tract symptoms (cough, runny nose, scratchy throat, or pneumonia) and/or conjunctivitis should be investigated.  Clusters of three or more cases of severe respiratory illness (hospitalisation or death) which are epidemiologically linked should also be investigated even if there is no documented bird exposure.

Clinicians who suspect infection in their patients should contact the National Institute for Communicable Diseases (NICD) doctor on call (Hotline number 0828839920) to discuss the case before a sample is collected. A nasopharyngeal swab or a nasal+ oropharyngeal swab (a flocked swabs with a plastic shaft) should be collected from the patient, placed in viral or universal transport media, and submitted on ice to (NICD) for testing.

The Department of Agriculture, Forestries and Fisheries (DAFF) is providing veterinary support including diagnostics, surveillance and control measures.  Farmers who suspect infection in their poultry should notify the local State Vet office or Extension officer who will visit the farm, investigate the incident and collect samples from the birds to rule out the disease.