PremiumAn 11-year-old boy was diagnosed with acute myelogenous leukemia (AML) in the Paediatrics department, All India Institute of Medical Sciences (AIIMS), Delhi in June last month. He developed symptoms of fever, cough, coryza, and breathing difficulty, soon after induction therapy for AML.
He was diagnosed with AML with febrile neutropenia with pneumonia and shock, which progressed to acute respiratory distress syndrome (ARDS). He was admitted to AIIMS, New Delhi on 2 July. The boy suffered from multi-organ dysfunction and died on 12 July.
Department of Microbiology AIIMS received the Bronchoalveolar lavage (BAL) for respiratory panel testing on 7 and 11 July. The sample has tested positive for both Influenza A and Influenza B. It was also negative for SARS COV-2 and other respiratory viruses. Subtyping for Influenza A remained inconclusive with available reagents for H1N1 and H3N2 at AIIMS. So, the samples were sent to NIV on 13 July.
At NIV, both the samples were tested for Influenza A and Influenza B along with Influenza A seasonal (H1N1, H1N1 pdm09 and H3N2), non-seasonal avian subtypes (H5, H7, H9 and H10) by Real-time PCR. The result showed that the sample is positive for A/H5 and Type B Victoria lineage. Whole-genome sequencing and Virus isolation are in process.
“National Central for Disease Control (NCDC), Delhi received information on Friday July 16th, 2021 from AIIMS, Delhi along with a lab report from NIV Pune. The information was communicated to the IDSP State Surveillance Unit (SSU), Haryana to initiate an epidemiological investigation into the case," the union health ministry said in a statement.
The matter was also reported to the Animal Husbandry Department. A team from NCDC composed of Epidemiologists & Microbiologists was constituted and the team immediately visited AIIMS, New Delhi and Gurugram for undertaking an epidemiological assessment. The State health department and the animal husbandry department officials are also involved in the investigation, it said.
Based on the available information, the team of doctors and nurses treating the patient are being monitored since 16th July 2021 for development of any influenza like illness with no one reported symptomatic till date. Contact tracing was undertaken and family members, close contacts and health care workers are under close surveillance. None of the close contacts have any symptoms.
“Contact tracing, an active search for any symptomatic case has been carried out in the hospital and area where the case resided. Information Education Communication (IEC) activities carried out for the general public with an advice to report any symptomatic case to the health authorities. There are no symptomatic individuals in the area at present.
The Animal Husbandry Department has not found any suspected cases of bird flu in the area and has enhanced surveillance in a 10 km zone as a precautionary measure. Further, an epidemiological investigation by NCDC, involving animal husbandry department and State government surveillance unit, is underway and appropriate public health measures have been instituted, the government said.
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