Thursday, December 22, 2016

HK CHP: Update On H7N9 Investigation

Credit HK CHP













#12,041

In addition to the Macao and Hong Kong H7N9 cases reported over the past week, yesterday we learned of 7 additional cases on the Mainland (see here and here), some apparently with onsets going back a couple of weeks.

Most (but not all) H7N9 cases have reported recent contact with poultry, which carry the virus asymptomatically. 

Human infections appear to be widely scattered (although 3 are reported from Hefei in Anhui Province), and we've seen no indication of clusters or shared epidemiological links.

While good news, it does indicate how widespread the H7N9 virus is in Chinese poultry - and given the wide spectrum of illness the virus can cause - probably under represents the actual number of human infections. 

All of which is prompting warnings from Hong Kong's CHP, Taiwan's CDC, and other public health agencies to avoid visiting live bird markets when visiting Mainland China, and to practice good hygiene. 

With the upcoming holidays, and more importantly - Chinese New Year's in late January - concerns are heightened over the possibility of infected travelers spreading the virus.

Hong Kong's CHP has published the following update on their recently imported H7N9 case, their contact tracing and surveillance, and on the recent spate of cases reported on the mainland. 

So far, despite a handful of contacts reporting mild respiratory symptoms, all have tested negative for influenza.
 
     The Centre for Health Protection (CHP) of the Department of Health today (December 22) reported an update on the first imported human case of avian influenza A(H7N9) in Hong Kong this winter.
 
     Among the 74 close contacts, a healthcare worker (HCW) of North District Hospital with mild symptoms reported yesterday (December 21) tested negative for influenza virus. Another HCW with mild symptoms is pending testing. Regarding the 151 other contacts, one relevant in-patient with mild symptoms tested negative for influenza virus.
 
     The CHP is also closely monitoring a total of seven additional human cases of avian influenza A(H7N9) in Anhui (five), Shanghai (one) and Fujian (one), and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

     According to the Health and Family Planning Commission of Anhui Province, among the five patients, three were from Hefei (including one death), one was from Lu'an and one who died was from Xuancheng.
 
     In addition, the Shanghai Municipal Commission of Health and Family Planning reported that the male patient aged 45 was from Nantong, Jiangsu. The case was classified as an imported case from Jiangsu. In Fujian, it was reported that the male patient aged 44 was from Xiamen.
 
     "Locally, the first imported human case of avian influenza A(H7N9) in this winter was recently detected while four faecal dropping samples of birds collected from Mai Po Nature Reserve in late November were positive for H5N6 virus. The neighbouring Guangdong and Macau also reported their first human H7N9 cases in this winter. Human H7N9 and H5N6 cases have already been reported in the Mainland in this winter. Our risk assessment shows that the avian influenza activity is expected to increase in winter based on its seasonal pattern," a spokesman for the CHP said.
 
     "The public should avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel, particularly in the upcoming Christmas and New Year holidays. If feeling unwell such as having fever or cough, wear a mask and seek medical advice at once. Travellers returning from affected areas should consult doctors promptly if symptoms develop and let them know their travel history," the spokesman added.
 
     "We will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," the spokesman said.

     The CHP's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up.
 
     The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is under way. The travel industry and other stakeholders are regularly updated on the latest information.

     The public should maintain strict personal, hand, food and environmental hygiene and take heed of the advice below while handling poultry:
 
  • When handling live chickens, do not touch them or their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume them immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs;
  • Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done;
  • Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and
  • Wear a mask if fever or respiratory symptoms develop, going to a hospital or clinic, or while taking caring of patients with fever or respiratory symptoms.

     The public may visit the CHP's pages for more information: the avian influenza page, the weekly Avian Influenza Reportglobal statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.
 
Ends/Thursday, December 22, 2016

Issued at HKT 18:30

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