B.C. teen no longer critical with avian flu, has been taken off oxygen

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B.C. teen no longer critical with avian flu, has been taken off oxygen

We’re learning more about the B.C. teenager who became the first critically ill pediatric patient with avian influenza in North America earlier this fall, including some details about her recovery.

The new information was published in a case summary as a letter to the editor of the New England Journal of Medicine on Tuesday, signed by multiple doctors from the B.C. Centre for Disease Control, BC Children’s Hospital and Public Health Agency of Canada.

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2:06
B.C. teen remains in critical condition with H5N1 avian flu

Prior to the publication of the letter, B.C.’s Ministry of Health had refused to provide updates on the teen’s status or their case “unless there is a need from a public health perspective to do so.”

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According to the case summary, the patient was a 13-year-old girl with a history of mild asthma and an elevated body mass index (BMI) who showed up at a B.C. emergency room with a fever and conjunctivitis in both eyes on Nov. 4.

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She was discharged home without treatment but returned to the ER on Nov. 7 after developing symptoms including a cough, vomiting and diarrhea.

The next day she was transferred to BC Children’s Hospital with rapidly worsening symptoms including respiratory failure, pneumonia and acute kidney injury.

Doctors began administering a trio of antiviral drugs in the days that followed among a suite of treatments including intubation, attachment to an ECMO oxygenation machine and renal replacement therapy.

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1:37
Drop in bird flu cases has B.C. poultry farmers cautiously optimistic

Tests found no sign of resistance to the antiviral drugs, and the girl’s respiratory status improved enough by Nov. 22 to take her off the ECMO machine and by Nov. 28 to remove her intubation.

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She was deemed to be no longer infectious the following day, was moved to the pediatric ward on Dec. 4, and no longer required supplemental oxygen by Dec. 18, according to the case summary.

The doctors say they were never able to identify the source of the girl’s exposure to H5N1, but noted genetic sequencing of the virus revealed “worrisome” mutations that could increase binding to human airway receptors.

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1:57
Uncertainty remains over how B.C. teen contracted H5N1 avian flu

Human infection with avian influenza A(H5N1) is rare and usually occurs after close contact with infected birds, other infected animals or highly contaminated environments.

B.C. Provincial Health Officer Dr. Bonnie Henry has previously said sequencing of the virus the teen contracted revealed it to be H5N1 Clade B.2.3.4.4B, and Genotype D1.1.

Henry said that clade and genotype were the same that have been detected in wild birds in B.C., as well as in outbreaks at poultry farms in the province.

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