B.C. teen out of PICU after contracting bird flu in November

By Charlie Carey

The B.C. teenager who was Canada’s first human case of avian influenza is no longer requiring supplemental oxygen and has been transferred out of an Intensive Care Unit.

That’s according to a letter published on Tuesday to the New England Journal of Medicine from multiple doctors and researchers at the B.C. Children’s Hospital, the B.C. Centre for Disease Control, and the Public Health Agency of Canada.

In the case summary of the letter, the 13-year-old girl, who has a history of asthma and an “elevated body-mass index,” first went to an emergency department on Nov. 4 with a fever and a two-day history of conjunctivitis in both eyes. Doctors discharged her at the time, but she then developed a cough, vomiting, and diarrhea.

She went back to the ER on Nov. 7 in what the doctors describe as “respiratory distress with hemodynamic instability,” where the body’s cardiovascular system isn’t delivering enough blood to the body’s organs.

A day later, on Nov. 8, the teen was transferred to the pediatric intensive care unit (PICU) at the B.C. Children’s Hospital. Doctors say she was suffering from respiratory failure, pneumonia, acute kidney injury, and other conditions.

The teen’s condition further deteriorated, and she was given three different antiviral medications, along with being intubated and attached to an ECMO oxygenation machine where blood is pumped outside of the body. The machine then removes carbon dioxide and sends oxygen-rich blood back into the body.

Due to her kidney damage, the teen was also undergoing continuous renal replacement therapy, a form of dialysis.

According to the study, the girl didn’t deteriorate further, and swabs showed a decline in viral loads. By Nov. 22, the teen was well enough to be taken off the ECMO machine and she was later extubated on Nov. 28.

On Nov. 29, doctors deemed the teen to be no longer infectious. On Dec. 4, she was well enough to be transferred out of the hospital’s PICU unit and placed in a general ward. By Dec. 18, the girl was no longer requiring extra oxygen.

“To date, no source of H5N1 virus exposure for the patient has been identified. … No secondary cases of transmission of H5N1 in the patient’s home or hospital have been identified at this time,” the doctors stated.

According to tests, the genotyping found in the girl’s swabs is the same genotype of the virus that has been circulating among wild birds and poultry in B.C. and Washington since October 2024.

Teen was ‘extraordinarily ill,’ infectious disease expert says

Speaking to 1130 NewsRadio, infectious disease specialist Dr. Isaac Bogoch says the teen’s case of H5N1 is “terrible.”

“[It is] a bit concerning that there were no obvious exposures to this virus, and this person suffered a critical illness as a result of it,” he explained.

“This individual had, initially, a rather mild illness, and was appropriately sent home from medical care, but then returned … and had quite a rapid decline.”

Bogoch says that the need for the use of an ECMO machine outlines just how ill the teenager was.

“It is another indicator that this person was extraordinarily ill and required very significant measures to oxygenate the blood so that the person could bring oxygen to the tissues all over the body. If people are on ECMO, it is a sign of critical illness,” he said.

However, Bogoch believes that while this case of human bird flu is “tragic,” it might not tell us much more than what we already know about the virus.

“We have a 20-year history of understanding that H5N1 can pose very, very significant illness in people,” he explained.

“The take-home for me is that we always have to respect that this virus has epidemic and pandemic potential and that while currently in early January 2025, it is not readily transmitted from human to human, the issue is if we have more mammals, either humans or other mammals impacted by this, the virus has the potential to mutate and adapt to mammalian hosts, so it is more readily transmitted.”

Bogoch says the key is to ensure any outbreaks among poultry or migratory birds are quelled as soon as possible.

“In an agricultural setting, we [must] protect humans from this infection by ensuring that they have the appropriate PPE when dealing with animals that may have the virus,” he added.

There’s not much the general public can do at this point in time, but Bogoch affirms that “common sense prevails.”

“If there’s a sick or dying bird or animal, be it domestic or wild, you’ve got to stay away from them or use significant protection if you’re in close contact with them,” he said.

“There are lessons that we can learn from this, but it just adds to a growing body of evidence of what we already know — we have got to take this pretty seriously.”

Meanwhile, the Canadian Food Inspection Agency says the first detection of avian influenza of the new year has happened at a poultry facility in the Fraser Valley.

The agency says the bird flu was confirmed at a commercial facility in Abbotsford on Wednesday.

The latest data posted to the CFIA website says the number of birds impacted in the province now stands at more than 8.5 million.

The federal agency has said the virus does not pose food safety concerns as it’s not transmitted to humans through cooked poultry and eggs.

You can watch CityNews 24/7 live or listen live to 1130 NewsRadio Vancouver to keep up to date with this story. You can also subscribe to breaking news alerts sent directly to your inbox.

With files from Anthony Atanasov and The Canadian Press.

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