The main recommendations to fight human infections caused by avian influenza A (H5) and the way forward in Ecuador : IJS Global Health

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The main recommendations to fight human infections caused by avian influenza A (H5) and the way forward in Ecuador

Akilimali, Aymar MDa,b,; Oduoye, Malik Olatunde MBBSc,d; Biamba, Chrispin MDb,e; Cakwira, Hugues MDb,f; Onesime, Jones MDb,g; Lopez, Karla MDh; Elembwe, Hardy MDb,e; Kibukila, Fabrice MDa,b

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International Journal of Surgery: Global Health 6(2):p e129, March 2023. | DOI: 10.1097/GH9.0000000000000129
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Dear Editor,

Influenza viruses are one of the viruses of public health importance because of their propensity of causing epidemics and pandemics. Waterfowls have been shown to be the main natural reservoirs of influenza viruses and humans, as the hosts are often infected with avian influenza viruses such as avian influenza A (H5)1.

Last year, November 30, 2022, the health authorities of Ecuador declared a health emergency of 3 months outbreak of avian influenza A (H5) virus in their country, and an epidemiological alert in December 2022 was indicated after the detection of an outbreak of avian flu in poultry farms in the Andean province of Cotopaxi, Ecuador. This outbreak has extended to January 2023, thus prompting them to inform the World Health Organization about the scourge of avian influenza A H5 infection. They reported a case of human infection with avian influenza A (H5) in a 9-year-old girl from a rural area in Ecuador on January 9, 2023. So far, this is the first case of human infection caused by the avian influenza A (H5) virus reported in Ecuador but also in Latin America. This case of human infection has been linked to exposure to poultry animals2.

Human cases of infection with avian influenza viruses are usually the result of exposure to life or dead infected poultry as well as contaminated environments3. Currently, bird flu is an incurable disease without treatment. At this stage, there is in fact no sufficiently effective vaccine with marketing authorization2. Hence, posing more public health challenges to the Ecuadorian communities and the world at large.

The public health measures such as; health education about the signs and symptoms of avian influenza virus A (H5), good hand hygiene practices, good food handling, etc., should be well implemented at both the rural and urban centres in Ecuador. Emergency preparedness, surveillances and disease control strategies should be closely observed to avoid further infections of avian influenza A H5 and a pandemic that may arise. Also, at each entry and exit points in the country, surveillance, and control strategies should be imposed among travelers as well as restrictions on commercial travel. Also, rapid detection of infection should be done immediately there is a suspected case of avian influenza A H5 in the country. Travelers should avoid contact with animals in markets and should also avoid frequenting places or places that appear to be contaminated with animal faeces. Travelers should strictly adhere and comply to barrier measures, such as; washing their hands often with soap and water or with hydroalcoholic solutions, covering their mouth and nose, avoiding touching their eyes frequently. They should also practice good food safety and personal hygiene measures. These measures would serve to preventing a future pandemic or even an epidemic of avian influenza A (H5).

Finally, the Government of Ecuador through its Ministry of Public Health in collaboration and in partnership with the World Health Organization (WHO) and the Centre for Disease Control (CDC) as well as the Food and Agriculture Organization (FAO) should put more efforts in strengthening the health facilities and equipments in Ecuador. Such facilities would include; mobile clinics, diagnosis for rapid detection of infection for a close surveillance of avian influenza in the country.

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Author contribution

A.A.: conceptualization of ideas and manuscript preparation. A.A., M.O.O., C.B., H.C., J.O., K.L., H.E., F.K.: writing. M.O.O.: supervision; review and comments; and data curation.

Conflicts of interest disclosure

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Research registration unique identifying number (UIN)



Aymar Akilimali.

Provenance and peer review

Not commissioned, externally peer reviewed.


The authors gratefully acknowledge the staff of Medical Research Circle for excellent technical support.


1. Spackman E. A brief introduction to the avian influenza virus. Methods Mol Biol 2008;436:1–6.
2. World Health Organization. Disease Outbreak News; human infection caused by avian influenza A (H5), Ecuador. 2023. Accessed January 19, 2023.
3. Li YT, Linster M, Mendenhall IH, et al. Avian influenza viruses in humans: lessons from past outbreaks. Br Med Bull 2019;132:81–95.
Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of IJS Publishing Group Ltd.