By Michelle Gamage
Local Journalism Initiative Reporter

A teenager from the Fraser Health region is in critical condition due to a bird flu infection, likely caused by the H5N1 virus.

This is the first confirmed case of this type of bird flu where a person caught the virus in Canada, according to the BC Centre for Disease Control.

The only other case of H5N1 in Canada was in Alberta in 2014, where a woman got sick while flying home from Beijing and died in hospital seven days later.

The B.C. teenager is in critical condition and is receiving care at BC Children’s Hospital. They started feeling sick on Nov. 2 and were admitted to hospital Friday, where a test confirmed it was an H5 virus, said provincial health officer Dr. Bonnie Henry.

Henry said that due to the global spread of H5N1 and PCR testing done in B.C., she thinks the teen has contracted H5N1, but it needs to be confirmed by the National Microbiology Laboratory in Winnipeg. This will likely happen in the next few days, she added. Work is also being done to sequence the entire genome of the virus in B.C., she added.

A patient can be infectious two days before they start feeling sick, and 10 days after that, Henry said. During this period the infected teenager did not go to school, she said.

The youth have no underlying health conditions and, prior to infection, was a “healthy teenager,” Henry said. She added she would not provide further details in order to protect the identity of the patient and their family.

There have been no further cases at this time, she said, adding public health teams have identified between 35 and 40 people who may have been exposed to the teen while they were infectious. Those exposed, including health-care workers, have been assessed, tested and offered antivirals. So far, they are healthy, she said.

The big question right now is where the teenager caught the virus. Henry said this is being investigated but added it’s possible we’ll never know.

So far, she said, they know the teen and their family do not live near or work on poultry farms. There are no pet birds in the family and, although one dog the teen came in contact with was sick, it has so far tested negative for bird flu.

Avian influenza viruses occur naturally among wild aquatic birds like geese and ducks but do not make them very sick, Henry said. Those same viruses can pass to poultry, like chickens and turkeys, during annual migrations where millions of wild birds pass through the Lower Mainland. Bird flu can be extremely lethal to chickens, she added.

This is the sixth year of bird flu outbreaks in waterfowl, which has had devastating impacts on Canada’s poultry industry.

Since December 2021 the Canadian Food Inspection Agency has spent around $94 million responding to more than 400 bird flu outbreaks across the country, which had led to more than 11 million birds being destroyed, according to reporting by the Investigative Journalism Foundation and CTV National News.

Most of those outbreaks have been in B.C., Henry said.

Bird flu is known to infect many different kinds of animals and “could become more serious” if the virus develops the ability to spread from human to human, according to the BC Centre for Disease Control.

In March an outbreak of H5N1 in dairy cows in the United States led to at least 46 cases of human infections, Henry said. The milk from an infected cow can be infectious, she said, adding some cats caught the virus after drinking unpasteurized milk.

As of November, there were 15 states with dairy cow outbreaks and 473 herds affected, according to the BCCDC website.

Many of these cases were in Washington, Oregon and California, Henry said, adding that most human cases were in adult dairy workers and were mild.

Henry said the infected teenager did not cross the U.S. border and did not come in contact with any U.S. animals or people.

The BCCDC says there have been no cases reported in dairy cattle and no evidence of bird flu in milk in Canada.

In B.C., H5N1 infections have also been detected in wild skunks and foxes.

There have been around 900 confirmed cases of H5N1 in humans since it first appeared in Hong Kong in 1997, Henry said. Most of these cases are in Southeast and South Asia and the rate of severe illness and death is “quite high,” Henry said.

Most of the cases are in children and are traced back to exposure to an infected animal, she added.

“There’s been very few that might have been transmitted person to person. In some ways, this is reassuring that the virus doesn’t seem to spread easily between people if they get infected, but it also causes very severe illness, particularly in young people,” she said.

Henry said it’s not known why kids get hit hardest but that one hypothesis is that adults who have been vaccinated or infected with H1 flu strains, for example during the 2009 H1N1 pandemic, have some immunity against the virus.

The H5N1 virus is aerosolized and can infect humans when the virus enters their nose, throat, eyes or lungs. Exposure deep in the lungs can lead to more severe illness, Henry said.

Henry said at this time B.C. is not looking at acquiring vaccines for H5N1 and that existing protocols seem to be keeping poultry farmers safe. This includes providing workers with personal protective equipment and antivirals when birds get sick, which has been “quite effective,” Henry said.

To protect yourself against infection, the BCCDC recommends getting the annual flu shot, staying up to date on all vaccinations and steering clear of sick or dying animals and their feces. That includes keeping pets away from them, too.

Even though the annual flu shot does not protect someone against bird flu, it’s important to reduce the chances of a person being infected with two types of influenza at the same time, which could increase the chances of a new type of influenza being created, Henry said. – The Tyee