Wednesday, February 24, 2016

HK CHP Updates On Imported H7N9 Case









# 11,054


Hong Kong's CHP has released two new epidemiological updates on yesterday's reported (imported) H7N9 case - that of a 60 y.o. man from Jiangsu Province -  along with a detailed letter to local doctors advising them of the situation.


The first (very brief) update concerns the man's son, who was isolated and tested for the virus due to complaining of a sore throat.  Although his initial tests are negative, as a close contact he will continue to be closely monitored for signs of infection.

24 February 2016
Update on imported human case of avian influenza A(H7N9) 

The Centre for Health Protection (CHP) of the Department of Health today (February 24) reported an update on the first imported human case of avian influenza A(H7N9) this winter affecting a man aged 60.

The patient's afebrile son, who has had a sore throat since February 22, was admitted to the Hospital Authority Infectious Disease Centre in Princess Margaret Hospital for observation yesterday evening (February 23). His nasopharyngeal aspirate tested negative for influenza A virus upon testing by the CHP's Public Health Laboratory Services Branch.

Epidemiological investigations and contact tracing are ongoing.

Ends/Wednesday, February 24, 2016

The second update describes 165 contacts (43 considered close), and the CHP's plans to manage and monitor them. 



24 February 2016
Update on imported human case of avian influenza A(H7N9) (2) 

The Centre for Health Protection of the Department of Health today (February 24) reported further updates on the first imported human case of avian influenza A(H7N9) this winter.

The male patient aged 60 remains under isolation and management in the Hospital Authority Infectious Disease Centre in Princess Margaret Hospital and is in a stable condition.

To date, 43 close and 123 other contacts of the patient have been identified.

A. Close contacts

According to the management of close contacts recommended by the CHP's Scientific Committee on Emerging and Zoonotic Diseases which came into effect in March 2015, based on risk assessment, antiviral prophylaxis with oseltamivir (Tamiflu) will be given to close contacts for five days and they will be put under medical surveillance for 10 days after the last exposure to the patient.

The 43 close contacts include:

* The patient's son with sore throat (influenza A negative) and asymptomatic wife;
* Twelve in-patients of the same cubicle as the patient in Pamela Youde Nethersole Eastern Hospital (PYNEH), of which one was symptomatic (H7 negative, H1 positive) and the rest were asymptomatic; and
* Four relevant PYNEH visitors and 25 clinic contacts who were all asymptomatic.
 
B. Other contacts


The 123 asymptomatic other contacts will be under medical surveillance. They include relevant PYNEH visitors, healthcare workers and clinic contacts.

Epidemiological investigations and contact tracing are ongoing.

Ends/Wednesday, February 24, 2016
       

And lastly, a 3-page letter (see A Confirmed Imported Case of Human Infection with Avian Influenza A(H7N9) Virus) to local doctors providing information on this current case, a review of previously imported H7N9 cases, and a quick overview of two reports from China of probable nosocomial transmission of the virus. 

You'll find details on these nosocomial events in: 
NEJM: Probable Hospital Cluster of H7N9 - China, 2015
Study: Probable Nosocomial Transmission Of H7N9 In China

The letter reminds clinicians:

A published scientific report further suggested nosocomial transmission from a H7N9 patient to two attending physicians who had close contact with the index patient in Guangdong in early 2015. The use of personal protective equipment by the physicians while caring for the index patient could not be verified.3 In view of the above, it is important to strictly observe infection control practices in healthcare settings to prevent possible nosocomial spread.



At this time, with no evidence of local transmission of the virus, the government's Response Level under the Government's Preparedness Plan for Influenza Pandemic remains unchanged.

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