13 More Cases of Human Infection with H7N9 Virus are Reported to WHO

On Jan. 30, 2014, the National Health and Family Planning Commission (NHFPC) of China notified the World Health Organization (WHO) of seven additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus including one death.

Details of the cases are as follows:

- A 75-year-old farmer from Ningpo City, Zhejiang Province, who became ill on January 21 and was admitted to the hospital on 24 January. He is currently in critical condition The patient has a history of exposure to a live poultry market.

- A 76 year-old man from Ningpo City, Zhejiang Province, who became ill on January 21 and was admitted to the hospital on January 24 and transferred to another hospital on January 27. He is currently in critical condition. He has a history of exposure to a poultry market.

- A 78-year-old farmer from Hangzhou City, Zhejiang Province, who became ill on January 25 and was admitted to the hospital on January 27 and transferred to another hospital on January 29. He is currently in critical condition. The patient has a history of exposure to a live poultry market.

- A 64-year-old man from Ningpo City, Zhejiang Province, who became ill on January 13 and was admitted to the hospital on January 16. He is currently in critical condition. The patient has a history of exposure to a live poultry market.

- A 75-year-old woman from Nanjing City, Jiangsu Province, who became ill on January 18 and was admitted to the hospital on January 25. She is currently in critical condition. The patient has a history of exposure to a live poultry market.

- A 67-year-old woman from Jiangmen City, Guangdong Province, who became ill on January 24 and was admitted to the hospital on January 25. She died on January 28. The patient had a history of exposure to live poultry.

- A 56 year-old woman from Hezhou City, Guangxi Province, who became ill on January 20 and was admitted to the hospital on Januar 27. She is currently in critical condition. The patient has a history of exposure to a live poultry market.

On Jan. 29, 2014, the National Health and Family Planning Commission (NHFPC) of China, and the Centre for Health Protection (CHP), Hong Kong SAR, China notified WHO of six additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus including one death.

Details of the five additional cases as notified by NHFPC of China are as follows:
- A 37-year-old farmer from Wenzhou City, Zhejiang Province, who became ill on January 19. He was admitted to the hospital on January 27 and was transferred to another hospital on Januar 28. He is currently in critical condition. The patient has a history of exposure to a live poultry market.

- A 60-year-old man from Hangzhou City, Zhejiang Province, who became ill on January 23. He was admitted to the hospital on January 28 and is currently in serious condition. The patient has a history of exposure to poultry.

- A 63-year-old man from Hangzhou City, Zhejiang Province, who became ill on January 24. He was admitted to the hospital on January 27 and is currently in serious condition. He has a history of exposure to a live poultry market.

- A 2-year-and-8-month-old boy from Xiamen City, Fujian Province, who became ill on January 26. He was admitted to the hospital on January 28 and has a mild illness.

- A 17-year-old man from Guangzhou City, Guangdong Province, who became ill on January 22. He was admitted to the hospital on January 27 and is currently in serious condition.

Details of the case as notified by the CHP, Hong Kong SAR:

- A 75-year-old man with underlying illnesses who traveled alone to Shenzhen January 20-26 became ill while in Shenzhen on  January 26. He was admitted to hospital in Hong Kong on January 28 and died on January 29. During his stay in Shenzhen it is reported that he stayed with relatives who lived close to a live poultry market. His five home contacts in Hong Kong have remained asymptomatic but have been admitted to hospital for observation. Further investigations into the mans travel and exposure histories are ongoing, in parallel with tracing of other contacts of the case, including four patients with whom he shared a hospital room, and healthcare and ambulance staff. Preliminary findings suggest that the man was infected outside of Hong Kong SAR.

So far, there is no evidence of sustained human-to-human transmission.

The Chinese government continues to take the following surveillance and control measures: strengthen surveillance and situation analysis; reinforce case management and treatment; conduct risk communication with the public and release information; strengthen international collaboration and communication; and conduct scientific studies.
 
While the recent report of avian influenza A(H7N9) virus being detected in live poultry imported from the mainland to Hong Kong SAR, shows the potential for the virus to spread through live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred through humans or animals.

Further sporadic human cases of A(H7N9) infection are expected in affected and possibly neighbouring areas, especially given expected increases in the trade and transport of poultry associated with the upcoming Lunar New Year.

WHO advises that travelers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travelers should follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.

As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

Source: WHO