An 11-year-old child has been reported as the first human case of H5Nx from Gurugram, Haryana.
The male child was diagnosed with AML in Paediatrics department, AIIMS, Delhi on June 2021. He developed symptoms of fever, cough, coryza, and breathing difficulty, soon after induction therapy for AML. He was diagnosed as AML with febrile neutropenia with pneumonia and shock, which progressed to ARDS. He was admitted to AIIMS, New Delhi on 2nd July, 2021. The boy suffered from multi-organ dysfunction and died on July 2021.
Department of Microbiology AIIMS received the Bronchoalveolar lavage (BAL) for respiratory panel testing on 7 and 11 July 2021. The sample has tested Positive for both Influenza A and Influenza B. It was also negative for SARS COV-2 and other respiratory viruses. Subtyping for Influenza A remained inconclusive with available reagents for H1N1 and H3N2 at AIIMS. So, the samples were sent to NIV on 13 July, 2021
At NIV, both the samples were tested for Influenza A and Influenza B along with Influenza A seasonal (H1N1, H1N1 pdm09 and H3N2), non-seasonal avian subtypes (H5, H7, H9 and H10) by Real time PCR. The result showed that the sample is positive for A/H5 and Type B Victoria lineage. Whole genome sequencing and Virus isolation is in process.
NCDC, Delhi received information on Friday July 16th, 2021 from AIIMS, Delhi along with a lab report from NIV Pune. The information was communicated to the IDSP State Surveillance Unit (SSU), Haryana to initiate an epidemiological investigation into the case. The matter was also reported to the Animal Husbandry Department. A team from NCDC composed of Epidemiologists & Microbiologists was constituted and the team immediately visited AIIMS, New Delhi and Gurugram for undertaking an epidemiological assessment. The State health department and the animal husbandry department officials are also involved in the investigation.
Based on the available information, the team of doctors and nurses treating the patient are being monitored since 16th July 2021 for the development of any influenza-like illness with no one reported symptomatic till date. Contact tracing was undertaken and family members, close contacts and health care workers are under close surveillance. None of the close contacts have any symptoms. Contact tracing, an active search for any symptomatic case has been carried out in the hospital and area where the case resided. IEC activities carried out for the general public with an advice to report any symptomatic case to the health authorities. There are no symptomatic individuals in the area at present.
The Animal Husbandry Department has not found any suspected cases of bird flu in the area and has enhanced surveillance in a 10 km zone as a precautionary measure. Further, epidemiological investigation by NCDC, involving animal husbandry department and State government surveillance unit, is underway and appropriate public health measures have been instituted.