Monday, January 16, 2017

H7N9: Muddled Media Reports & A Hong Kong Update


After last week's flurry of H7N9 reports (see HK CHP: China Reports An Additional 83 H7N9 Cases For December), official reports have become few and far between, but we continue to see vague, often muddled, media reports suggesting new cases continue to turn up.

The problem is, we have so few details on the earlier cases that it makes it nearly impossible to tell whether `new' cases in the media are really new, or simply a rehashing of old reports.   I suspect it is a combination of both.

Trying to make sense of all of this (and with a patience far beyond what I could muster), is Sharon Sanders of FluTrackers, whose H7N9 case list provides the best conservative listing of cases (with links to reports) publicly available. 

Over the past few days, FT has added 8 cases to their list:

#940 - Female, 72, hospitalized January 8 in Zhongshan, traveled to Macao and hospitalized again January 10, Zhongshan, Guangdong province

#941-944 - This line adds 4 cases. Anhui province announced 14 cases for December and we have 10 of those cases listed above. Anhui province

#945 - Male, 36, [Zhang], onset December 25, died January 11, 2017 in Jiangsu province, traveled though Henan province, duck trader from Zhejiang province

#946 - Male, 35, hospitalized in critical condition, Wuhan City, Hubei province

#947 - Patient, 79, Kaili City, Guizhou province

Given China's habit of making `belated' bird flu announcements, it seems likely (based on the volume of cases reported in December), that this under represents the current level of activity.   While things seem slow right now, at some point the dam will probably bust again, and we'll get a new flurry of case reports to analyze.

Today, Hong Kong's CHP has posted an update which confirms cases #946 and #947 above, and once again warns the public of the risks of live bird exposure and avian flu.

     The Centre for Health Protection (CHP) of the Department of Health is today (January 16) closely monitoring two additional human cases of avian influenza A(H7N9) in Guizhou and Hubei, 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 Guizhou Province, the patient, aged 79 from Qiandongnan Prefecture, has been hospitalised.
     The Health and Family Planning Commission of Hubei Province reported that the male patient, aged 38 from Wuhan and in a critical condition, had exposure to a poultry market.
     From 2013 to date, at least 906 human H7N9 cases have been reported by the Mainland health authorities, 131 of which have been recorded from November 2016 thus far, including 57 in Jiangsu, 22 in Zhejiang, 15 in Guangdong, 14 in Anhui, seven in Jiangxi, four in Shanghai, three each in Fujian, Guizhou and Hunan, two in Shandong and one in Hubei. Four cases (imported) and two cases were respectively recorded in Hong Kong and Macau.
     "We strongly urge the public to avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel, particularly in the upcoming Lunar New Year holidays. If feeling unwell, such as having a 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 actively inform the doctors of their travel history for prompt diagnosis and treatment," a spokesman for the CHP said.
     "Adults and parents should also look after children with extra care in personal, hand, food and environmental hygiene against infections during travel," the spokesman said.
     "While local surveillance, prevention and control measures are in place, we will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," the spokesman said.
     As the H7N9 virus continues to be detected in animals and environments in the Mainland, additional human cases are expected in affected and possibly neighbouring areas. In view of the heavy trade and travel between the Mainland and Hong Kong, further sporadic imported human cases in Hong Kong every now and then are expected, especially in the coming few months.
     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: 

  • Avoid touching poultry, birds, animals or their droppings;
  • When buying live chickens, do not touch them and 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 the 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, when going to a hospital or clinic, or while taking care 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/Monday, January 16, 2017

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