Wednesday, July 27, 2016

Two Out-Of-Season H7N9 Cases - Beijing & Henan Province

 Credit WHO


Over its 4 year history, mid-summer (epi weeks 24-36) has been a dead zone for H7N9 reports coming out of China, with just 5 cases falling within that time span since 2013. Most years, the H7N9 season ends on or around week 20 (mid May).

Although the numbers remain low, the summer of 2016 is proving to be a bit different, as we've continued to see reports of H7N9 activity throughout June and now into late July.

This unseasonable H7N9 activity - including outbreaks in Hong Kong and Macao Live Bird Markets -  last month prompted Hong Kong's CHP to publicly warn:

"In view of additional human cases reported in the Mainland with detections of human cases in previously unaffected areas in warmer months, as well as the recent local positive sample of faecal droppings of live poultry, the public should remain vigilant."

Today we've reports of two recent H7N9 cases, both very much out of season, and one in a province (Henan) that hasn't reported a case since the first wave (April of 2013).

In an epidemiology report for the month of June, they reveal a new case, with an apparent onset on June 9th.  This report is dated July 20th.

June 2016 before the outbreak of notifiable infectious diseases in Henan Province
Published: 2016-07-20 

2016 Nian . 6 months (2016 Nian . 6 Yue 1 RiMidnight to. 6 Yue 30 Ri24 ), the province reported a total of notifiable infectious diseases 49366 cases of death 131 cases. 


On June 9, the second people's hospital reported the province, Fuyang city people infected H7N9 avian influenza 1, Zhang, female, 54 years old, farmer, xincai, and as confirmed cases.

In response, today Taiwan's CDC issued the following statement:

County, Henan province, health and family planning Committee in the province first H7N9 flu cases this year, based on local environmental exposure risk, CDC Department announced that promote tourism in the province outbreak Taipei proposed to the second-level alert (Alert), and has notified the Mainland Affairs Council. Frequent cross-strait exchanges and falls during the summer, calls on travel plans to the region and local Taiwanese, be sure to pay attention to personal hygiene and diet, and avoiding contact with poultry and live bird markets in order to reduce the risk of infection.

CDC says the case for 54 years old female farmer, xincai, poultry or live poultry market exposure is not known. China city since to (2015) years autumn yilai cumulative at least 116 cases H7N9 flu cases, this popular quarter outbreak obviously below Qian three quarter, only June announced cases number more Shang quarter slightly increased, and in past no outbreak of provinces found cases; existing evidence displayed H7N9 flu still is limitations people descendants, case more for 50 age above, and with poultry class or live poultry market exposed history.

Hospitalized in Beijing (h/t Sharon Sanders for the Beijing CDC link), we have a new case that has been making headlines in the Chinese media for the past couple of hours.

The city has found a case of human infection with the H7N9 avian influenza
Published: 2016-07-27

July 26, 2016, the city found a case of human infection with H7N9 avian influenza. Accounting for some patients, male, 36 years old, current address Langfang City, Hebei Province Yanjiao a district. In the provinces before the onset of suspicious live poultry exposure history. July 26, the Beijing Municipal Center for Disease Control reviewed detected as H7N9 avian influenza virus nucleic acid positive. Currently, patients are being treated in isolation in a hospital in Beijing, a critical condition.

Up to now, the city has reported 2016 3 H7N9 bird flu cases confirmed cases of human infection. This case is only sporadic cases in the city causing widespread risk of transmission is very low. Although our country there have been cases of avian influenza reported, but now that people are not susceptible to avian influenza virus. Poultry, sale, slaughter, Wildfowl and other people exposed to the virus because the probability of a large increase in the risk of infection.

Currently, etiology characterized H7N9 avian influenza virus transmission and propagation mode currently did not change significantly, China's urban and rural areas live poultry market transactions ubiquitous phenomenon backyard poultry in the short term it is difficult to eliminate. Therefore, it is expected there will still be human infection of H7N9 bird flu epidemic still on distributing state, there will be a small number of clusters of disease.

The city remains the illegal small-scale trading of live poultry and live birds enter the presence of other provinces the situation. Therefore, do not rule out the possibility the city residents infected with H7N9 avian influenza virus. In addition, many medical institutions in the city, a large number of foreign patients to seek treatment for the city, does not exclude foreign imported cases to the city medical institution may be diagnosed.
       (continue . . . )

Hong Kong's CHP hasn't taken notice of either of these cases yet, although I suspect when they do they will reiterate their warning about this uptick in warm weather H7N9 reports.

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