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January 18, 2023

Jen Radlinsky, EMH2 Team

Salomon Montaguth, Editor; Deepankar Patil, Senior Editor

Bolivar Province, Ecuador[1]

Event: On January 9, 2023, Ecuadorian health officials reported an avian influenza A (H5) case in a nine-year-old from Bolivar Province to the World Health Organization (WHO). The child’s symptoms began in late December 2022 and deteriorated over the next few weeks resulting in hospitalization and treatment with antiviral medications. An investigation into the origin of the child’s illness revealed that recently-acquired poultry in the house’s backyard had died. There is no official cause of the poultry deaths yet, but the community reported similar occurrences. This is the first human infection in Latin America associated with this viral strain. The specific group that the organism originated from is unknown, and no vaccines are approved to prevent influenza A (H5) in humans.[2]

Significance: The avian influenza transmission risk will likely infect poultry farm workers and other individuals who do not exercise cleaning and hygiene precautions and come in contact with sick or dead animals. Serious disease and death will very likely result from delays in diagnosis and treatment in remote communities with reduced healthcare access. International exporting of potentially infected poultry will very likely spread the virus beyond Ecuador. Those working in the poultry industry will have the highest chance of infection, but it is unlikely the virus will spread from human to human. The virus will likely transmit from home-raised chickens to larger poultry farms via secondary wild animal infection and will likely require mitigation attempts such as culling flocks, likely reducing poultry supply in the marketplace and temporarily increasing prices.


  • Ecuadorian health officials should coordinate a response with WHO and continue to collect and analyze data to ensure focused mitigation plans to address a potential outbreak.

  • Local public health educators, under the guidance of epidemiologists and health care providers, should launch a campaign to educate poultry farm owners and workers on proper hygiene techniques to avoid contamination and spread of the virus.

  • Travelers should exercise caution when visiting remote areas of Ecuador with reduced access to healthcare, and avoid contact with live poultry.

  • Research and development should focus on preventative vaccines for avian influenza and its emerging variants in humans.

  • If there is any additional and or critical information please contact us at The Counterterrorism Group (CTG) by Telephone 202-643-2848 or email


[1]Bolivar Province, Ecuador” by Google Maps

[2] Human infection caused by avian influenza A(H5) - Ecuador, WHO, January 18, 2023,



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