Human emerging respiratory pathogens bulletin: Issue 41, May 2020

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Organization: Public Health Agency of Canada

Date published: 2020-06-25

Monthly situational analysis of emerging respiratory diseases affecting humans (data to May 31, 2020)

In this bulletin

COVID-2019 update
Avian influenza updates
Swine influenza updates
Middle East respiratory syndrome coronavirus (MERS-CoV) update

Update on human emerging respiratory pathogen public health events (as of May 31, 2020)
Novel influenza^{Table 1 Footnote 1}	Cumulative Case Count^{Table 1 Footnote 2}	Deaths	Case Fatality Rate %^{Table 1 Footnote 3}
A(H7N9)	1,568	615	39%
A(H5N1)	879	461	52%
A(H9N2)	58	1	2%
A(H5N6)	24	7	29%
A(H7N4)	1	0	0%
A(H1N2)	2	0	0%
A(H3N2)v	435	1	<1%
A(H1N2)v	26	0	0%
A(H1N1)v	23	0	0%
MERS-CoV^{Table 1 Footnote 1}	Cumulative Case Count^{Table 1 Footnote 2}	Deaths	Case Fatality Rate %^{Table 1 Footnote 3}
Global Case Count	2,552	871	34%
Saudi Arabia	2,156	793	37%
Table 1 Footnote 1 Date of 1st Reported Case of Human Infection: MERS-CoV: February 2013 (retrospective case finding September 2012). A(H7N9): March 2013. A(H5N1): 1997. A(H9N2): 1998. A(H5N6): 2014. A(H7N4): February 2018. A(H3N2)v with M gene from pH1N1: 2011. A(H1N2)v: 2005. A(H1N1)v: 2005. Table 1 Return to footnote 1 referrer Table 1 Footnote 2 Cumulative Case Counts: updated using data reported by the World Health Organization (avian and swine influenza, MERS CoV), and the United States Centers for Disease Control and Prevention (US CDC) (swine influenza). Table 1 Return to footnote 2 referrer Table 1 Footnote 3 Case Fatality Rate: The proportion of cases that resulted in death. Table 1 Return to footnote 3 referrer

COVID-19 update

On December 31, 2019, cases of a pneumonia of unknown etiology were reported in Wuhan, China which has since been determined to be due to a novel coronavirus (2019-nCoV). On January 30, 2020, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC).

As of May 31, 2020, 90,516 cases of COVID-2019 have been reported in Canada. Globally, 5,934,936 cases and 367,166 deaths have been reported. The highest number of cases were reported from the Americas (2,743,793 cases and 157,702 deaths). The Public Health Agency of Canada is monitoring the situation closely.

Avian influenza updates

Avian influenza A(H7N9)

No new H7N9 cases were reported to the WHO in May 2020. The last case was globally reported in April 2019. Two travel-related cases were reported in Canada in January 2015. A total of 1568 human cases of avian influenza A(H7N9), including at least 615 deaths, have been reported globally since 2013 (Figure 1).

Dates	Cases	Deaths
2016	Jun	2	0
Jul	4	0
Aug	0	0
Sep	0	0
Oct	2	0
Nov	10	2
Dec	114	39
2017	Jan	197	29
Feb	93	13
Mar	70	12
Apr	72	24
May	50	6
Jun	19	4
Jul	2	0
Aug	3	2
Sep	1	0
Oct	0	0
Nov	0	0
Dec	1	0
2018	Jan	1	1
Feb	1	0
Mar	0	0
Apr	0	0
May	0	0
June	0	0
July	0	0
Aug	0	0
Sep	0	0
Oct	0	0
Nov	0	0
Dec	0	0
2019	Jan	0	0
Feb	0	0
Mar	0	0
Apr	1	0
May	0	0
June	0	0
July	0	0
Aug	0	0
Sept	0	0
Oct	0	0
Nov	0	0
Dec	0	0
2020	Jan	0	0
Feb	0	0
Mar	0	0
April	0	0
May	0	0

Avian influenza A(H9N2)

Two new cases of H9N2 were reported in May 2020, both from China. The first case was a 6 year old boy from Weihai City, Shandong Province. The second case was a 10 month old boy from Xiamen, Fujian Province. Both cases had exposure to poultry or a live bird market, mild illness, and have recovered. Globally, 58 human cases, including one death, have been reported since 1998.

Avian influenza A(H5N1)

No new H5N1 cases were reported to WHO in May 2020. The most recent case was reported in March 25, 2019 in Nepal. A total of 879 cases including 461 deaths have been reported globally since 1997. One fatal travel-related case of H5N1 was reported in Canada in January 2014.

Avian influenza A(H5N6)

No new cases of H5N6 were reported to the WHO in May 2020. The most recent case of H5N6 was reported in China in August 2019. There have been a total of 24 cases, including 7 deaths, reported globally since 2014, all in China.

Avian influenza A(H7N4)

No new cases of H7N4 were reported to the WHO in May 2020. On February 14, 2018, the WHO was notified of the first known human case of H7N4. The case was associated with poultry exposure. No cases have been reported since.

Swine influenza updates

Swine origin influenza A(H3N2)v

The most recent case of swine origin influenza H3N2v was reported in June 2018 in the United States. The case reported exposure to swine at an agricultural fair. A total of 435 cases, including 1 death, have been reported globally since 2011. One locally-acquired case of H3N2v was reported in Canada in December 2016.

Swine origin influenza A(H1N2)v

The most recent case of swine origin influenza H1N2v was reported in August 2018 in the United States. The case reported exposure to swine at an agricultural fair. A total of 26 confirmed cases of H1N2v have been reported in the United States since 2005. Most of the reported cases resulted in mild illness.

Swine origin influenza A(H1N1)v

The most recent case of swine origin influenza H1N1v was reported in May 2019 in the United States. The case was over 65 years old, had no history of swine exposure, and has fully recovered. A total of 23 cases have been reported globally since 2005. To date, the reported H1N1v infections have been associated with mild illness.

**Figure 2. Spatial distribution of human cases of avian and swine influenza reported globally in May 2020 (n=2).**

Middle East respiratory syndrome coronavirus (MERS-CoV) update

In May 2020, no new cases of MERS-CoV were reported. A total of 2552 laboratory-confirmed cases of MERS-CoV, including 871 deaths, have been reported globally since 2012 by the WHO. No cases have been reported in Canada.

**Figure 3. Spatial distribution of human cases of MERS-CoV reported in May 2020 (n=0).**

**Figure 4. Temporal distribution of human cases of MERS-CoV reported to the WHO, globally, by month and year, January 1, 2018 to May 31, 2020 (n=397).**

Date	Cases	Deaths
2018	Jan	17	11
Feb	14	2
Mar	17	4
Apr	8	5
May	13	2
June	10	1
July	7	3
Aug	6	2
Sep	14	6
Oct	9	2
Nov	7	1
Dec	5	0
2019	Jan	19	5
Feb	76	14
Mar	29	3
Apr	22	7
May	14	4
June	7	1
July	9	4
Aug	6	1
Sep	4	1
Oct	14	6
Nov	15	2
Dec	4	2
2020	Jan	17	2
Feb	19	3
Mar	15	5
April	2	0
May	0	0

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Date modified:: 2020-06-25

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