Eight Additional Cases of Human Infection with H7N9 Virus are Reported to WHO

On Feb. 13, 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.

Details of the cases notified are as follows:

An 84-year-old farmer from in Jinhua City, Zhejiang Province, who became ill on February 6 and was admitted to the hospital on February 10. He is currently in critical condition. The patient has a history of exposure to live poultry.

A 58-year-old farmer from Hangzhou City, Zhejiang Province, who became ill on January 29 and was admitted to the hospital on the same day and transferred to another hospital on February 8. He is currently in severe condition. The patient has a history of exposure to live poultry.

A 46-year-old farmer from Hangzhou City, Zhejiang Province, who became ill on February 4 and was admitted to the hospital on February 9. He is currently in severe condition. The patient has a history of exposure to live poultry.

An 8-year-old boy from Zhaoqing City, Guangdong Province, who became ill on February 6 and was admitted to the hospital on  February 7. He is currently in a mild condition. The patient has a history of exposure to live poultry.

A 46-year old farmer from Guangzhou City, Guangdong Province, who became ill on February 4 and was admitted to the hospital on February 7 and transferred to another hospital on February 10. He is currently in critical condition. The patient has a history of exposure to live poultry.

A 65-year old farmer from Guangzhou City, Guangdong Province, who became ill on February 3 and was admitted to the hospital on February 9. He is currently in critical condition. The patient has a history of exposure to live poultry

A 19-year-old man from Loudi City, Hunan Province, who became ill on January 28 and was admitted to the hospital on February 9. He is currently in severe condition. The patient has a history of exposure to live poultry.

In addition, on Feb. 12, 2014, the Ministry of Health (MOH) Malaysia reported a human case of avian influenza A(H7N9) virus. A 67-year-old woman tourist from Guangdong Province, China, arrived in Malaysia on February 3 in a tour group of 17 persons, including relatives, and stayed overnight in Kuala Lumpur, Malaysia. The tour group then went on a visit to Sabah, Malaysia February 4-6. On February 7, she was admitted to hospital and later transferred to another hospital in Sabah. The patient is currently in stable condition.  Four days prior to traveling to Malaysia,  she was treated in China for symptoms of fever, cough, flu, fatigue and joint pain. Given the onset of symptoms, and travel dates, the most likely exposure occurred before arrival in Malaysia. The Malaysia Ministry of Health is conducting an investigation including contact tracing and is also coordinating information sharing with the Chinese government.

The Chinese government has taken the following surveillance and control measures:  strengthen surveillance and situation analysis; reinforce case management and treatment; and conduct risk communication with the public and release information;
 
While the recent report of avian influenza A(H7N9) virus detection in live poultry exported from mainland China to Hong Kong SAR shows the potential for the virus to spread through movement of live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred. However as the virus infection does not cause signs of disease in poultry, continued surveillance is needed.

Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. If this were to occur, community level spread is unlikely as the virus does not have the ability to transmit easily among human. Until the virus adapts itself for efficient human-to-human transmission, the risk of ongoing international spread of H7N9 virus by travellers is low. The overall risk assessment has not changed.

Further sporadic human cases of avian influenza A(H7N9) infection are expected in affected and possibly neighboring areas, especially given expected increases in the trade and transport of poultry associated with the 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