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Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 1061
H5N6 influenza infection, update on information on neurological problem

1 Sanitation1 Medical Academic Center, Bangkok, Thailand
2 Hainan Medical University, Hainan, China

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Date of Web Publication5-Oct-2017

How to cite this article:
Joob B, Wiwanitkit V. H5N6 influenza infection, update on information on neurological problem. Ann Trop Med Public Health 2017;10:1061

How to cite this URL:
Joob B, Wiwanitkit V. H5N6 influenza infection, update on information on neurological problem. Ann Trop Med Public Health [serial online] 2017 [cited 2020 Aug 6];10:1061. Available from:

In 2014, the new atypical influenza infection first occurred in China.[1] This infection is related to the finding of new re-assortment H5N6 avian influenza virus.[2],[3],[4],[5] Till date, there are four human infected cases with H5N6 influenza virus. The infection is usually severe and there is a high mortality. Generally, the important consideration of the new atypical influenza infection is the nonrespiratory clinical presentation. In many new atypical influenza infections, the neurological problem becomes as an important issue in clinical practice.[6],[7]

Focusing on the H5N6 influenza, the main clinical problem is on respiratory tract; however, the nonrespiratory manifestation is still observable. As a new flu, the neurological manifestation can be expected.[6],[7] A high mortality is observed, only one from four cases survived after getting infections.[8] As previously reported, the new atypical influenza usually results in unexpected neurological problems. Nevertheless, for the cases with H5N6 influenza, all cases have only respiratory problem without any neurological problem. Either nonfatal or fatal cases lack for neurological manifestation. Based on a recent available report on pathology study on fatal H5N6-infected cat, there are also no reported data on neuropathological problem.[9] It might simply hypothesize that there is neurological problem due to H5N6 influenza infection. However, this opinion should be criticized. Focusing on the size of H5N6 influenza virus, it is not different from other influenza viruses; hence, the size might not be the obstacle that prevents the virus to cross central nervous system barrier to cause the problem. Also, there is still the lack on data from autopsy and necropsy of fatal human and animal cases. Nevertheless, in all fatal human cases, the multiple organ failure, which might include brain dysfunction problems, can be observed.[2],[3],[4],[5] However, this cannot be said that this is the direct neurological problem due to the infection. Finally, if we considered the prevalence rate of neurological problem in previous new emerging influenza, total of four cases of H5N6 influenza might be too few to allow detection of a case with neurological problem. For further observation, the clinical problem within the future cases with H5N6 influenza can be useful.



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   References Top

Joob B, Wiwanitkit V. H5N6 influenza virus infection, the newest influenza. Asian Pac J Trop Biomed. 2015;5:434-7.  Back to cited text no. 1
Qi X, Cui L, Yu H, Ge Y, Tang F. Whole-genome sequence of a reassortant H5N6 avian influenza virus isolated from a live poultry market in China, 2013. Genome Announc. 2014;2:DOI:10.1128/genomeA.00706-14.  Back to cited text no. 2
Bi Y, Mei K, Shi W, Liu D, Yu X, Gao Z. et al. Two novel reassortants of avian influenza A (H5N6) virus in China. J Gen Virol. 2015;DOI:10.1099/vir.0.000056  Back to cited text no. 3
Wu H, Lu R, Peng X, Xu L, Cheng L, Lu X. et al. Novel reassortant highly pathogenic H5N6 avian influenza viruses in poultry in China.. Infect Genet Evol. 2015;31:64-7.  Back to cited text no. 4
Pan M, Gao R, Lv Q, Huang S, Zhou Z, Yang L. et al. Human infection with a novel highly pathogenic avian influenza A (H5N6) virus: Virological and clinical findings. J Infect 2015.  Back to cited text no. 5
Joob B, Wiwanitkit V. H7N9 bird flu: Emerging of psychological problem. Arq Neuropsiquiatr 2014;72:257.  Back to cited text no. 6
Wiwanitkit V, Neurological manifestation of Swine flu: A brief note.. Acta Neurol Taiwan 2010;19:145-7.  Back to cited text no. 7
Yang ZF, Mok CK, Peiris JS, Zhong NS. Human infection with a novel avian influenza A (H5N6) virus.. N Engl J Med 2015;373:487-9.  Back to cited text no. 8
Yu Z, Gao X, Wang T, Li Y, Li Y, Xu Y. et al. Fatal H5N6 avian influenza virus infection in a domestic cat and wild birds in China. Sci Rep 2015;5:10704.  Back to cited text no. 9

Correspondence Address:
Beuy Joob
Sanitation1 Medical Academic Center, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.196604

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