As we discussed yesterday, Macao reported its first human infection with the H7N9 virus after detecting HPAI for the third time this year in locally sold poultry. The Special Administrative Region of Macao - which lies only an hour's ferry ride from Hong Kong - and also happens to be the most densely populated region on earth.
Both Hong Kong and Macao import live poultry from the Chinese Mainland, are major centers of commerce and trade, receive tens of thousands of visitors every day, and lie adjacent to Guangdong Province on opposite sides of the Pearl River Estuary (see map above).
And Guangdong province - which is a major producer of poultry - happens to have reported the 2nd highest number of human H7N9 infections (n=196) and the highest number of H5N6 cases (n=7) since each virus emerged.
All of which makes Macao and Hong Kong particularly vulnerable to infectious disease threats like avian influenza. Hong Kong has dealt successfully with 16 imported cases of H7N9 over the past 4 years, but both regions are well aware of how quickly SARS spread in 2003.
Reports indicate the infected poultry vendor and his wife are both asymptomatic, have been isolated in a local hospital, and are receiving antivirals.
We only rarely learn of mild or asymptomatic H7N9 cases, since generally only the `sickest of the sick' present at local hospitals and are tested. The ability to observe this patient, and see if he has passed the virus on to others, may provide additional insight on how the virus is transmitted.
In the meantime, Hong Kong - with 14 times the population of Macao - is gearing up to deal with what has turned into an annual winter avian influenza threat (H7N9, H5N6, and H5N1) from the mainland.
The Centre for Health Protection (CHP) of the Department of Health received notification of the first human case of avian influenza A(H7N9) from the Health Bureau of Macao in the small hours today (December 14), and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.
The male asymptomatic patient aged 58 is a wholesaler who had contact with silky fowls in a wholesale poultry market in Macau whose specimen was detected with avian influenza A(H7) antigen last night (December 13). He and his wife have been hospitalised for isolation and quarantine respectively.
"Recently, Guangdong reported the first human case of avian influenza A(H7N9) in this winter. Human H7N9 cases have also been detected in Zhejiang, Jiangsu and Fujian while human H5N6 cases in Hunan and Guangxi since November. Locally, four faecal dropping samples of birds collected from Mai Po Nature Reserve in late November were detected with H5N6 virus. Our risk assessment shows that the activity of avian influenza viruses is expected to increase in winter based on their 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 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 your 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 underway. 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 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 Report, global statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.Ends/Wednesday, December 14, 2016