The news for Macao's first H7N9 case remains good as both he and his wife remain asymptomatic, as do more than 90 others who may have been exposed.
While most of the human infections we've seen from H7N9 have resulted in severe - often life threatening - illness, the truth is we have no idea how many mild or asymptomatic cases really occur.
Mild cases rarely seek medical care, and so only the `sickest of the sick' - and their close contacts - are usually tested and picked up by surveillance.
H7N9 can produce a wide spectrum of symptoms, ranging from mild or asymptomatic, to severe and/or life threatening. We've seen estimates (see Lancet: Clinical Severity Of Human H7N9 Infection) that the actual number of H7N9 cases in China may be many times greater than reported.
While mild or asymptomatic infections are a `good thing' for the individual who is infected, they may provide a way for the virus to spread unnoticed in the community, giving it more opportunities to adapt to human physiology.
And it could also provide an opportunity for H7N9 (or any other novel flu) to co-infect a human who already has a seasonal influenza virus, potentially creating a reassortant `hybrid' virus (see EID Journal: Human Co-Infection with Avian and Seasonal Influenza Viruses, China).
Today's (translated) update from Macao follows:
The first case of human infection with the H7N9 bird flu virus confirmed cases and their close contacts are now in good health2016-12-16
Health Bureau said on December 14 in the morning confirmed the first case of human infection with influenza A H7N9 Macau avian influenza virus 58-year-old male wholesale stall, still Conde S. Januario Hospital isolation ward voluntary incommunicado and antiviral therapy. And it is defined as close contacts wife also being Conde S. Januario Hospital isolation ward voluntarily accepted medical observation alone, both in good health. In addition, other poultry wholesale market practitioners Guangdong, HAD poultry culling officers and firefighters pick confirmed cases, a total of 95 positive contacts general medical observation. Until now, they did not have any symptoms.Health Bureau, said the government has set a response to avian influenza contingency plans and make adequate preparations, including antiviral drugs, personal protective equipment, facilities, equipment, and other reserves. Health Bureau will continue and the country and neighboring areas in the health sector, World Health Organization keep in close contact, monitoring of the situation around and Macau, through cross-sectoral cooperation and public and private organizations, as bird flu or Macau neighborhood once preventive and Ready to work. However, according to past experience, the health bureau is expected some time next neighborhood H7N9 avian influenza virus activity more active, made the following appeal to the whole Australian public precautions: Avoid visiting places recent influenza A H7N9 bird flu downtown areas, farms have to sell or display birds; Avoid contact with birds and their secretions, excretions; if contact should wash their hands immediately; Do not buy, carry without quarantine birds; Do not eat undercooked poultry meat, offal, blood products and eggs; Note Gerenweisheng, wash hands frequently; symptoms such as fever, cough, breathing difficulties, should wear a mask and seek medical advice as soon as possible, and to detailing the history of travel and animal contact history doctor.For more information on Influenza A H7N9 avian influenza, can be found in the Health Bureau website (www.ssm.gov.mo) or call the hotline 28700800 Health Department infectious disease within Bangongshijian.