title: Avian influenza: recent epidemiology, travel-related risk, and management.
abstract: H5N1 influenza continues to smolder in Southeast Asia over the past 5 years, but the emergence of H7N9 in China in 2012 raised concerns for a new avian influenza threat. In contrast with H5N1 with over 650 confirmed cases over 11 years, H7N9 has infected over 450 persons within 2 years. The case fatality rate for H7N9 (35 %) is lower than for H5N1 (60 %) or H10N8 (67 %) but is comparable to that for the Middle East respiratory syndrome coronavirus (MERS CoV), another emerging zoonosis with travel-associated importations. Exposure to poultry and fomites are considered the likely sources of infection for H7N9, H5N1, and H10N8, with limited human-to-human transmission in close contacts. Most cases have occurred in local populations of affected countries, and travel-related risk can be mitigated by avoiding exposure. Vaccines, antivirals, and other therapeutics remain in development stage or of modest benefit for dangerous infections carrying high morbidity and mortality.
authors.affiliation: Department of Infectious Disease, Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Rajeka
authors.initials: R
authors.lastname: Lazarus
authors.forename: Poh Lian
authors.initials: PL
authors.lastname: Lim