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🧐 Highly Pathogenic Avian Influenza (HPAI) A (H5N1) emerged in 1997. Since then, it has spread globally via migratory birds, infecting animals on all continents.

👉 On the last day of 2024, Jassem AN et al. from the British Columbia Centre for Disease Control, Vancouver, BC, Canada, published a case report of a 13-year-old girl with mild asthma and obesity who presented with conjunctivitis and fever, with rapid progression to acute respiratory failure with severe ARDS.

👉 She was intubated and required veno-venous extracorporeal membrane oxygenation (V-V ECMO).

👉 She recovered after treatment, including oseltamivir, amantadine, and baloxavir.

👉 Genotype D1.1 was detected, and sequencing of lower respiratory tract isolates collected 8 days after the onset of symptoms revealed three mutations potentially associated with increased virulence and adaptation to the human organism: E627K in the basic polymerase (PB2) gene product and E186D and Q222H in the H5 hemagglutinin gene.

🤔 It is unclear whether these mutations were present in the infecting virus or whether they arose during the patient's illness.

🧐 The case in question merited an editorial that raises several points regarding the risk of this type of virus to human health. The mutations in the Canadian case highlight the urgent need for rigorous surveillance of emerging mutations and assessing the risk of human-to-human transmission.

😉 We at XLUNG understand that healthcare professionals who care for patients with acute respiratory failure on the front lines in emergency rooms and ICUs must be alert to viral conditions, including the possibility of agents such as the H5N1 virus and others.

😉 Notifying and communicating with infectologists and local or regional epidemiological surveillance networks can make a big difference in preventing and controlling new epidemics or even pandemics.

Below is the link to the publication.

Critical Illness in an Adolescent with Influenza A(H5N1) Virus Infection Published December 31, 2024

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