The story of a BC teen who battled severe illness as Canada’s first confirmed human case of bird flu was shared with the world this week in a prominent medical journal.
The 13-year-old girl who became sick in November has now left intensive care after a four-week stay, according to a letter to the editor in the December 31 edition of the New England Journal of Medicine. She needed dialysis and supplemental oxygen therapy until mid-December.
The girl’s illness is the first documented case of a critically ill child with avian flu in North America. The letter’s authors say her story highlights the need for influenza surveillance as the highly pathogenic virus circulates in the US and Canada — emerging as a threat to human health.
The girl’s family first took her to a BC emergency room on November 4 with pinkeye in both eyes and a fever. She was sent home to rest, but her family brought her back three days later when she began coughing and vomiting.
Doctors admitted her to hospital noting that her heart wasn’t getting enough blood to her organs. The next day she was transferred to the intensive care unit at BC Children’s Hospital with breathing assistance from a bilevel positive airway pressure apparatus. She was in respiratory failure and dealing with pneumonia, acute kidney injury, low platelets, and depleted white blood cell levels.
The girl tested positive for avian flu at BC Children’s, where she began receiving anti-viral flu medication. Chest X-rays confirmed she had progressed to acute respiratory distress syndrome.
By November 9 she was intubated for help breathing with an ECMO machine. She also started on a special type of dialysis because her kidneys weren’t working properly.
The girl’s care team noted she was dealing with a high viral load when she was admitted. Her only underlying conditions were having mild asthma and an “elevated body mass index.” Body mass index is an imperfect measurement that takes into account weight and height but not body composition.
Luckily the girl’s health improved with time and she was breathing on her own again by late November. She was transferred out of intensive care and back to the pediatric ward on December 4. She stopped dialysis on December 9 and received supplementary oxygen therapy until December 18.
Correspondence: Critical Illness in an Adolescent with Influenza A(H5N1) Virus Infection https://t.co/ho2KxXcGH9
— NEJM (@NEJM) December 31, 2024
The girl’s critical illness was the subject of public addresses by BC’s Provincial Health Officer. Dr. Bonnie Henry said teams worked hard to trace the source of the girl’s illness. The virus that infected the girl most closely genetically matched virus samples from wild geese in the Fraser Valley. It’s not known how the girl contracted the virus, but one theory is that it came from a pet dog the family recently adopted.
Thankfully no one else in the girl’s family became sick.
Henry advised British Columbians not to touch or handle birds while avian flu is circulating among wild birds and some poultry farms. It also is not a good time to handle domestic birds at petting zoos, she said. Finally, Henry cautioned against going in ponds frequented by waterfowl — since the avian influenza virus can survive for periods of time in water.