Thursday, February 16, 2017

HK CHP Notified Of 61 Addtional Mainland H7N9 Cases












#12,235


Hong Kong's Centre For Health Protection  has been notified of an additional 61 H7N9 cases on the Mainland, reported to the NHFPC from 10 provinces -  Hubei (11 cases), Zhejiang (10 cases), Jiangsu (9 cases), Guangdong ( 7 cases), Anhui ( 6 cases), Hunan (6 cases), Fujian (5 cases), Jiangxi (5 cases), Shandong (1) and Yunnan (1) - all over a seven day period (Feb 6th-12th). 

During the previous week (Jan 30th-Feb 5th), the NHFPC reported 45 cases.

As onset dates are not provided, we don't know how many of these cases might have fallen ill in January. Regardless, we don't appear to be seeing any slacking in the number of new cases.

Worth noting: While many cases are still under investigation, much as we saw reported last week - where only 1/3rd were known to have had contact with poultry - the percentage of cases this week's release listed with known poultry exposure is 40%; well below what is normally cited.  

Whether this is a trend - or simply an artifact due to incomplete or chaotic reporting - is impossible to say.  It is something we will be watching.  For now - despite this year's record numbers - we've seen no evidence of sustained or efficient human-to-human transmission of the virus. 
That said, the previous record was set in H7N9's 2nd wave (winter-spring 2014), with 320 cases.  Today's report brings this year's tally (since November) to 419 cases, with this winter's epidemic season with several more months to run.
As always, only the `sickest of the sick' - those ill enough to be hospitalized - are being tested.   How many mild and moderate cases are flying beneath the surveillance radar is unknown. 

 
     The Centre for Health Protection (CHP) of the Department of Health today (February 16) received notification from the National Health and Family Planning Commission that 61 additional human cases of avian influenza A(H7N9), including seven deaths, were recorded from February 6 to 12. The CHP strongly urges the public to maintain strict personal, food and environmental hygiene both locally and during travel.

     The 43 male and 18 female patients aged from 22 to 85 had their onset from January 6 to February 8. The cases were from Hubei (11 cases), Zhejiang (10 cases), Jiangsu (nine cases), Guangdong (seven cases), Anhui (six cases), Hunan (six cases), Fujian (five cases), Jiangxi (five cases), and one case each in Shandong and Yunnan. Among them, 25 reported exposure to poultry or poultry markets while the source of infection of 35 cases was still under investigation.

     In addition, the CHP is closely monitoring one additional human H7N9 case reported in Beijing. According to the Beijing Municipal Commission of Health and Family Planning, a male patient aged 48 with exposure to poultry had onset in Xingcheng City, Liaoning. He was then sent to Beijing for treatment and is now in serious condition.

     "The number of human H7N9 cases reported in the Mainland has also hugely increased since the end of last year, with 419 cases recorded since last November. The number of cases in this wave so far has been much higher than that in the same period last winter. This shows that the situation is abnormal. Hong Kong, Macau and Taiwan also found cases imported from Guangdong," a spokesman for the CHP said.
 
     "According to the Chinese Center for Disease Control and Prevention, about 90 per cent of the patients in the Mainland reported exposure to live poultry, mostly with exposure to live poultry markets (LPMs). There was also an increase in environmental contamination with H7N9 virus as reflected by the positive rate of environmental samples collected from LPMs or other live poultry-related environments in affected provinces," the spokesman said.
 
      In view of the current situation, there is a likely risk that environments with live poultry in the Mainland might be contaminated with avian influenza viruses. Travellers to the Mainland or other affected areas must avoid visiting wet markets, poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchase of live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.
 
      Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.
 
     While local surveillance, prevention and control measures are in place, the CHP will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments.

     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 Reportglobal statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.
 
Ends/Thursday, February 16, 2017

Issued at HKT 15:53