Fujian Province – Credit Wikipedia
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Fujian Province, which recorded its first H7N9 case two days ago (see H7N9: Fujian Province Reports First Case) reports a second infection today on their Provincial Health Department website.
Fujian new case of human infection of H7N9 avian influenza confirmed cases
Fujian Provincial Health Bureau Bulletin, April 28, Fujian new case of human infection of H7N9 avian influenza confirmed cases as of April 28 at 18 pm. Up to now, the province has found two cases of human infection with the H7N9 avian influenza confirmed cases with no deaths. Not found an epidemiological association between the two cases.
Newly discovered patients are as follows:
Patients travel a male, aged 80, Fuzhou,, Yang Fuqing City, the town of farmers. At 9:40 on April 27 patients chief complaint of "repeated coughing for 10 days, two days of fever, wheezing, shortness of breath long time" treatment in Fuqing City Hospital.
At 14:40 on the 28th, Fujian Center for Disease Control reports the results of laboratory tests for the H7N9 avian influenza virus nucleic acid positive. In accordance with the relevant requirements, in the afternoon of the 28th, the Fujian Provincial Health Bureau organized the provincial-level expert group to discuss the cases, the experts based on the clinical performance of laboratory testing and epidemiological data, the diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases . At present, the case is in critical condition, being active treatment.
After investigation, the close contacts of the cases of a total of 33 people, abnormalities were found so far. (Provincial Health Department Information Office)
One of the unknowns in China’s surveillance is exactly what criteria is being used to decide whether to test patients for the H7N9 virus. We’ve seen some media reports of people being refused testing, because they didn’t fit the `case definition’.
It is always a balancing act.
If you try to test everyone with flu-like symptoms, you risk inundating your testing facilities.
If you test based on severity, or patient contact history, then you risk missing mild (or atypical) cases.
Another unknown is exactly how samples are being collected (throat swab or sputum), and how rigorous the testing really is. In Indonesia, we often saw repeated negative H5N1 test results before a patient was finally proved infected.
Yesterday, Taiwan announced new, more stringent testing recommendations after their first patient tested negative twice before finally producing a positive result.
Also new, is the announcement that the incubation period for this virus may be as great as 10 days, roughly three times longer than typically seen with seasonal flu.
This from the Taipei Times.
CDC updates testing directives for H7N9 avian flu
UPDATED:Based on international research, the incubation time of the H7N9 avian influenza has been increased to 10 days from the previous seven days, a physician said
By Alison Hsiao / Staff reporter
The Centers for Disease Control (CDC) yesterday updated H7N9 avian influenza virus testing directives for hospitals following the first confirmed H7N9 infection in Taiwan, whose throat swab samples tested negative twice for the virus before the infection was finally confirmed via sputum specimen testing.
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CDC physician Philip Yi-chun Lo said the center now advises hospitals to obtain sputum samples from suspected cases that have coughed up phlegm, recently had pneumonia or exhibited other symptoms.
Lo said that based on the latest international research on H7N9 avian influenza, the virus’ estimated incubation period has been increased to 10 days from seven days.
“This change will affect the time needed to conduct self-health management for those who have come into close contact with an infected patient. They now have to be followed closely by health authorities until Tuesday, three days longer than the previously stated,” Lo said, adding that the three contacts who exhibited upper respiratory symptoms are recovering and all the other contacts have not exhibited any symptoms.
