Friday, February 03, 2017

HK CHP Notified of Another 57 H7N9 Cases

Credit HK CHP


Today Hong Kong's Centre for Health Protection has been notified by Mainland authorities of an additional 57 H7N9 cases on the mainland - all recorded between January 16th - 29th -  and hailing from 9 different provinces. 

While individual case details are not provided, from the summary we learn:
  1.  Cases are reported from Jiangsu (13), Guangdong (10 ), Zhejiang (8), Hunan (7), Jiangxi (7), Anhui (6), Fujian (4), Hubei (1), and Sichuan (1) provinces.
  2. Jiangsu Province - with 104 cases since November - leads the rest of the provinces by far, with the second most active province (Zhejiang) reporting a little more than half that number (n=53).
  3. Cases continue to be skewed towards older males, with the youngest case reported to be 26, and 79% of cases (n=45) being male. 
  4. 56%  (n=32) reported recent exposure to poultry or poultry markets, while the rest are under investigation
  5. And finally, the onset dates for some of these cases in this announcement go back nearly a month (Jan 4th is cited), suggesting there may be additional January cases in the pipeline that have not been confirmed or reported.
According to Hong Kong's tally, this brings this year's total to 304 (298 from the Mainland, 4 from Hong Kong, 2 from Macao) - a scant 16 cases short of the record set during China's 2nd H7N9 epidemic in 2014.  While January was the biggest volume month in 2014, that epidemic that did not wind down completely until May (see chart below).

Credit WHO - Jan 16th Report

While there are some areas of concern in this report (Jiangsu's spike, 44% without reported poultry exposure, this year's early start and overall volume of cases, etc.), so far we've not seen any indication of large clusters, or sustained human-to-human transmission.  
The caveat being we are more than a little hobbled by a lack of individual case data, we're not privy to the results of Mainland epidemiological investigations, and we continue to see delays in reporting of cases from Mainland China.
Hong Kong's stance, however, remains unchanged.  They remain at the Alert level, they've not reported any new imported cases in several weeks, and none of the close contacts of 6 cases reported this year in Macao and Hong Kong have become infected. All reassuring signs.

The full HK report follows:

      The Centre for Health Protection (CHP) of the Department of Health today (February 3) received notification from the National Health and Family Planning Commission that 57 additional human cases of avian influenza A(H7N9), including nine deaths, were recorded from January 16 to 29. The CHP strongly urges the public to maintain strict personal, food and environmental hygiene both locally and during travel.

      The 45 male and 12 female patients aged from 26 to 84 had their onset from January 4 to 29. The cases were from Jiangsu (13 cases), Guangdong (10 cases), Zhejiang (eight cases), Hunan (seven cases), Jiangxi (seven cases), Anhui (six cases), Fujian (four cases) and one case each in Hubei and Sichuan. Among them, 32 reported exposure to poultry or poultry markets while the source of infection of 21 cases was still under investigation.

      "Since November 2016, the Mainland health authorities have already recorded 298 human H7N9 cases thus far. We would also like to remind the public that human H7N9 cases continue to occur in neighbouring Guangdong and the positive percentage for H7 virus of environmental samples is substantial. We again urge the public to pay special attention to health risks of the places of visit," a spokesman for the CHP 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.

      "Therefore, we strongly urge the public to avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel. 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," the spokesman added.

     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;
  • Wen 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/Friday, February 3, 2017

Issued at HKT 12:15

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