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On March 4, 2014, the Centre for Health Protection (CHP) of the Department of Health, Hong Kong SAR, China, notified the World Health Organization (WHO) of an additional laboratory-confirmed case of human infection with avian influenza A(H7N9) virus.
The patient is an 18-month-old girl who developed mild fever. She was seen by a doctor on February 28, was admitted to a hospital on March 1 and was discharged from the hospital on March 3 in stable condition. Following laboratory-confirmation with avian influenza A(H7N9) virus infection on 4 March, the patient was admitted to another hospital. She is currently asymptomatic, with no fever. Initial epidemiological investigation revealed that the patient travelled to Foshan, Guangdong province February 5-27, where she visited a wet market with her mother. Further investigations into her travel and exposure history are ongoing, including tracing of all close contacts.
Also on March 4, 2014, the National Health and Family Planning Commission (NHFPC) of China notified WHO of an additional laboratory-confirmed case of human infection with avian influenza A(H7N9) virus. The patient is a 59-year-old man from Zhuhai City, Guangdong Province. He became ill on February 26, was admitted to a hospital on March 1 and died on March 2. The patient has a history of exposure to live poultry.
The previous 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.
Further sporadic human cases of avian influenza A(H7N9) infection are expected in affected and possibly neighboring areas.
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 humans. Until the virus adapts itself for efficient human-to-human transmission, the risk of ongoing international spread of H7N9 virus by travelers is low.
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 feces from poultry or other animals. Travelers 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.