#Canada, Media #update on #Andes #hantavirus situation: diagnostic tests confirmed the case announced yesterday (PHAC, May 17 '26)

 

Statement | May 17, 2026 | Ottawa, ON

    The Public Health Agency of Canada (PHAC) has confirmed a case of Andes hantavirus in Canada through laboratory testing. 

    This case was reported by the British Columbia Provincial Health Officer on May 16 and was among the passengers on the MV Hondius cruise ship.

    Samples from British Columbia were sent to PHAC’s National Microbiology Laboratory (NML) in Winnipeg for confirmatory testing. 

    One individual’s sample was confirmed positive for hantavirus on May 16. 

    A second individual who was a travelling partner of the confirmed case was confirmed negative by the NML. 

    There have been no further cases identified at this time. 

    All high-risk contacts are isolating and will continue to be monitored closely by local public health.

    PHAC, the province of British Columbia, and local public health are working together to ensure all public health measures continue to be followed to protect the health of Canadians.

    The overall risk to the general population in Canada from the Andes hantavirus outbreak linked to the MV Hondius cruise ship remains low at this time. 

    All confirmed cases to date have been passengers or crew on the MV Hondius cruise ship. 

    Given the severity of this virus, we are taking a precautionary approach to ensure Canadians are protected.

    PHAC provided the information about the positive case to the World Health Organization as part of the International Health Regulations and will share information to support the ongoing global investigation of the outbreak.

    “We want to thank public health authorities and frontline staff in British Columbia for the dedicated care that they are providing and for their ongoing management of the situation, and the passengers for their cooperation with public health direction to help keep others safe," said Dr. Joss Reimer, Chief Public Health Officer of Canada.

    PHAC will continue to actively monitor the situation, provide guidance and support to provincial and territorial public health partners, and share updates as needed.

Contacts: Media Relations, Public Health Agency of Canada, 613-957-2983, media@hc-sc.gc.ca

Source: 

Link: https://www.canada.ca/en/public-health/news/2026/05/media-update-on-andes-hantavirus-situation1.html

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Media #update on #Andes #hantavirus situation (Public Health Agency Canada, May 16 '26): one new case confirmed

 

Statement | May 16, 2026 | Ottawa, ON

    On May 16, 2026, the British Columbia Provincial Health Officer reported that one of the four high risk individuals who was self-isolating and being monitored for symptoms has tested presumptive positive for Andes hantavirus. 

    The person was transported to hospital for assessment and care on May 14 along with their spouse who also has mild symptoms. 

    The couple were passengers on the MV Hondius. 

    Both will remain in isolation in hospital. 

    Out of an abundance of caution, a third individual who was in secure lodging for isolation has been transferred to hospital for assessment and testing.

    All infection prevention and control protocols are being followed, including the use of personal protective equipment by healthcare workers and personnel involved in the repatriation. 

    Those involved in the repatriation are not considered at risk given the public health protective measures that were in place, in addition to the length of time between repatriation and the onset of symptoms.

    Samples have arrived at the Public Health Agency of Canada’s National Microbiology Laboratory (NML) in Winnipeg for confirmatory testing. Results are expected in the next two days.

    The Public Health Agency of Canada, the province of British Columbia, and local public health are working together to ensure all public health measures continue to be followed to protect the health of Canadians.

    The overall risk to the general population in Canada from the Andes hantavirus outbreak linked to the MV Hondius cruise ship remains low at this time. 

    But, given the severity of this virus, we are taking a precautionary approach to ensure Canadians are protected.

    The Public Health Agency of Canada will continue to actively monitor the situation, provide guidance and support to provincial/territorial public health partners and share updates as needed.

Contacts: Media Relations, Public Health Agency of Canada, 613-957-2983, media@hc-sc.gc.ca

Source: 

Link: https://www.canada.ca/en/public-health/news/2026/05/media-update-on-andes-hantavirus-situation0.html

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#Management of #critical illness in an #adolescent caused by highly pathogenic avian #influenza #H5N1 virus infection in #BC, #Canada

 

Summary

Highly pathogenic avian influenza A(H5N1) viruses have been circulating among wild birds and are enzootic in poultry in some areas of the world with spillover to a wide range of terrestrial and marine mammals. Since 1997, sporadic animal to human, primarily poultry to human, transmission of highly pathogenic avian influenza A(H5N1) viruses has been reported in 25 countries. More recently there have been locally acquired infections in the Americas due to the 2.3.4.4b clade of the virus. Most of the recently detected human infections in the USA have been relatively mild but there have been cases of critical illness reported in several countries. In this Grand Round we present the first locally acquired highly pathogenic avian influenza A(H5N1) virus infection in Canada, which was in a 13-year-old female, who developed severe disease requiring prolonged critical care. She was infected with a clade 2.3.4.4b, genotype D1.1 virus and developed evidence of cytokine storm and received several modalities of care including combination antiviral therapy, renal replacement therapy, therapeutic plasma exchange, and invasive mechanical ventilation support with veno-venous extracorporeal life support. She recovered and was discharged home without requirement for additional support. This Grand Round describes important clinical and management considerations for critically ill patients infected with highly pathogenic avian influenza A(H5N1) virus.

Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00773-X/abstract?rss=yes

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#Critical #Illness in an #Adolescent with #Influenza A(#H5N1) Virus #Infection

To the Editor:

Highly pathogenic avian influenza A(H5N1) viruses are circulating among wild birds and poultry in British Columbia, Canada.1 These viruses are also recognized to cause illness in humans. Here, we report a case of critical illness caused by influenza A(H5N1) virus infection in British Columbia.

On November 4, 2024, a 13-year-old girl with a history of mild asthma and an elevated body-mass index (the weight in kilograms divided by the square of the height in meters) of greater than 35 presented to an emergency department in British Columbia with a 2-day history of conjunctivitis in both eyes and a 1-day history of fever. She was discharged home without treatment, but cough, vomiting, and diarrhea then developed, and she returned to the emergency department on November 7 in respiratory distress with hemodynamic instability. On November 8, she was transferred, while receiving bilevel positive airway pressure, to the pediatric intensive care unit at British Columbia Children’s Hospital with respiratory failure, pneumonia in the left lower lobe, acute kidney injury, thrombocytopenia, and leukopenia (...). A nasopharyngeal swab obtained at admission was positive for influenza A but negative for A(H1) and A(H3) by the BioFire Respiratory Panel 2.1 assay (BioFire Diagnostics). Reflex testing of the specimen with the Xpert Xpress CoV-2/Flu/RSV plus assay (Cepheid) revealed an influenza A cycle threshold (Ct) value of 27.1. This finding indicates a relatively high viral load for which subtyping would be expected; the lack of subtype identification suggested infection with a novel influenza A virus. Oseltamivir treatment was started on November 8 (Table S2), and the use of eye protection, N95 respirators, and other precautions against droplet, contact, and airborne transmission were implemented.

A reverse-transcriptase–polymerase-chain-reaction (RT-PCR) test specific for influenza A(H5)2 was positive on the day of admission. The patient had signs of respiratory deterioration — chest radiographs were consistent with progression to acute respiratory distress syndrome (...) — which prompted tracheal intubation and initiation of venovenous extracorporeal membrane oxygenation (ECMO) on November 9. Continuous renal replacement therapy was initiated on November 10. Combination antiviral treatment with amantadine (initiated on November 9) and baloxavir (initiated on November 11) was added to ongoing treatment with oseltamivir. Bacterial cultures of blood (samples obtained at admission) and endotracheal aspirate (obtained after intubation) yielded no growth.

Because of concern for cytokine-mediated hemodynamic instability, plasma exchange was performed daily from November 14 through November 16. Serial influenza A–specific RT-PCR tests showed increasing Ct values, which suggested a decline in the viral RNA load in serum and a decline in viral RNA in upper- and lower-respiratory specimens shortly after the initiation of antiviral treatment, with the first negative RT-PCR result for serum obtained on November 16 (...). It is notable that lower-respiratory specimens consistently yielded lower Ct values than upper-respiratory specimens, a finding that suggested higher viral levels in the lower-respiratory tract (...).

Influenza A(H5N1) virus was cultured from respiratory specimens obtained between November 8 and November 12 but not from subsequent respiratory specimens or from any serum specimens (...). No evidence of reduced susceptibility to any of the three antiviral agents used in treatment was observed in serial respiratory specimens by either genomic analysis or phenotypic testing with the NA-Star influenza neuraminidase inhibitor resistance detection kit (ThermoFisher Scientific) (...). The patient’s respiratory status improved, ECMO was discontinued on November 22, and the patient’s trachea was extubated on November 28.

The viral genome sequence obtained from a tracheal-aspirate specimen collected on November 9 (8 days after the onset of symptoms) was reconstructed as described previously.3 The virus was typed as clade 2.3.4.4b, genotype D1.1,4 most closely related to viruses detected in wild birds in British Columbia around the same time (...). Markers of adaptation to humans were detected in the tracheal-aspirate specimen collected on November 9: the E627K mutation was detected (52% allele frequency) in the polymerase basic 2 (PB2) gene product, and analysis of the H5 hemagglutinin (HA) gene yielded ambiguous calls in the codons for amino acid residues E186 (E190 according to H3 mature HA numbering) — 28% allele frequency for E186D — and Q222 (Q226 according to H3 mature HA numbering) — 35% allele frequency for Q222H. The mutations in the H5 HA gene have previously been shown to increase binding to α2-6–linked sialic acids, which act as receptors that facilitate viral entry into cells in the human respiratory tract and enable viral replication.5

Highly pathogenic avian influenza A(H5N1) virus infection acquired in North America can cause severe human illness. Evidence for changes to HA that may increase binding to human airway receptors is worrisome.

Agatha N. Jassem, Ph.D., British Columbia Centre for Disease Control, Vancouver, BC, Canada; Ashley Roberts, M.D., British Columbia Children’s Hospital, Vancouver, BC, Canada; John Tyson, Ph.D., James E.A. Zlosnik, Ph.D., Shannon L. Russell, Ph.D., British Columbia Centre for Disease Control, Vancouver, BC, Canada; Jessica M. Caleta, M.Sc., Public Health Agency of Canada, Winnipeg, MB, Canada; Eric J. Eckbo, M.D., British Columbia Centre for Disease Control, Vancouver, BC, Canada; Ruimin Gao, Ph.D., Taeyo Chestley, Ph.D., Public Health Agency of Canada, Winnipeg, MB, Canada; Jennifer Grant, M.D., British Columbia Centre for Disease Control, Vancouver, BC, Canada; Timothy M. Uyeki, M.D., M.P.H., Centers for Disease Control and Prevention, Atlanta, GA; Natalie A. Prystajecky, Ph.D., British Columbia Centre for Disease Control, Vancouver, BC, Canada; Chelsea G. Himsworth, D.V.M., Ph.D., British Columbia Ministry of Agriculture and Food, Abbotsford, BC, Canada; Elspeth MacBain, M.D., British Columbia Children’s Hospital, Vancouver, BC, Canada; Charlene Ranadheera, Ph.D., Public Health Agency of Canada, Winnipeg, MB, Canada; Lynne Li, M.D., British Columbia Children’s Hospital, Vancouver, BC, Canada; Linda M.N. Hoang, M.D., British Columbia Centre for Disease Control, Vancouver, BC, Canada; Nathalie Bastien, Ph.D., Public Health Agency of Canada, Winnipeg, MB, Canada; David M. Goldfarb, M.D., British Columbia Children’s Hospital, Vancouver, BC, Canada.

Source: New England Journal of Medicine, https://www.nejm.org/doi/full/10.1056/NEJMc2415890

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