Tuesday, December 20, 2016

Hong Kong CHP Update On Imported H7N9 Case

Credit HK CHP


Amid media reports of another possible H7N9 case (as yet, unconfirmed) in Anhui Province, we get an update from Hong Kong's CHP on their recently imported case from Guangdong Province.
Contrary to earlier reports, the CHP is now reporting the patient had contact with poultry at a wet market prior to falling ill.

First today's update, and then I'll return with a bit more from the WHO:

     The Centre for Health Protection of the Department of Health today (December 20) reported an update on the first imported human case of avian influenza A(H7N9) in Hong Kong this winter.
     Upon further enquiries, the male patient aged 75 revealed that he had visited a wet market in Sukeng, Changping, Dongguan, where he had bought dressed chicken.
     Contact tracing has so far identified 51 close contacts and the CHP is counting the number of other contacts.
     Close contacts include the patient's home contacts as well as relevant in-patients and healthcare workers (HCWs) of North District Hospital. Among them, an HCW with mild upper respiratory symptoms in stable condition has been admitted for observation, pending laboratory testing. The others have remained asymptomatic. They will be given antiviral prophylaxis with oseltamivir (Tamiflu) for five days, advised to wear a mask and put under medical surveillance for 10 days since their last exposure to the patient.
     Other contacts are personnel involved upon the patient's arrival in Hong Kong and ambulance personnel in patient transfer. All have remained asymptomatic. They will be advised to wear a mask and will be put under medical surveillance for 10 days since their last exposure to the patient. For those in-patients with underlying illnesses or higher risk of complications, as a precautionary measure, they will also be given Tamiflu for five days, advised to wear a mask and put under medical surveillance for 10 days since their last exposure, even if they have been identified as other contacts.
     Epidemiological investigations and contact tracing are ongoing.

Ends/Tuesday, December 20, 2016

Issued at HKT 18:30

Late yesterday the World Health Organization published two H7N9 updates on cases 6 cases in Mainland China and last week's case in Macao.  
19 December 2016
Human infection with avian influenza A(H7N9) virus – China

19 December 2016
Human infection with avian influenza A(H7N9) virus – China

All 7 cases were previously announced and the Mainland China update offers little more than we already knew. The narrative on the Macao case - and a shared risk assessment - follow:

Human infection with avian influenza A(H7N9) virus – China
Disease outbreak news
19 December 2016

On 14 December 2016, the Health Bureau, Macao Special Administrative Region (SAR) (China) confirmed a case of human infection with avian influenza A(H7N9) virus affecting a 58-year old male.

On 13 December 2016, a batch of poultry from Guangdong province in China was found positive for the H7 antigen in a wholesale market in Macao SAR (China) during routine inspection. Following protocol, an epidemiological investigation commenced and two close human contacts of the infected poultry were identified, including a poultry vendor and driver. The poultry vendor discharged the concerned batch of poultry from the truck in the early morning of 13 December.

The vendor was referred to hospital for further investigation. He tested positive for avian influenza A(H7N9) by RT-PCR in three specimens at the public health laboratory. He has not had any influenza-like symptoms so far. He is under observation and being treated with antivirals at a government hospital. His wife who also works in the same wholesale market was identified as a close contact of the case. She tested negative and is under observation for the next 10 days.

To date, a total of 807 laboratory-confirmed human infections with avian influenza A (H7N9) virus have been reported through IHR notification since early 2013.
Public health response

Authorities in Macao SAR (China) have taken the following measures:

    Conducted a risk assessment.
    Management of the case and observation of close contacts.
    Communicated with authorities in mainland China to follow-up on the driver identified as a close contact of infected poultry.
    Enhanced surveillance of individuals working in the wholesale market where the case works.
    Provided health education in the wholesale market where the case works.
    Held a press conference to share information on the situation and response.

WHO risk assessment

Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, further human cases can be expected. Although small clusters of human cases with avian influenza A(H7N9) virus have been reported including those involving healthcare workers, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore further community level spread is considered unlikely.

Human infections with the avian influenza A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and/or its transmission behaviour to humans as the virus may have a serious public health impact.

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