Friday, March 31, 2017

HK CHP Notified Of 17 New H7N9 Cases From The Mainland

H7N9 Waves - Credit FAO - March 29th Update


Hong Kong's CHP has announced their notification of an additional 17 H7N9 cases from the mainland, one less than they reported last week.  Of particular note, this is the second week in a row the Mainland is reporting no new cases from Hong Kong's closest neighbor; Guangdong Province.

This welcomed March slowdown is likely due to the temporary closure of live poultry markets in affected regions ordered 6 weeks ago (see  Beijing Orders Closure Of Live Bird Markets To Control H7N9).

Despite these market closures, the (roughly) 80 cases reported (so far) this March exceeds the combined March totals for 2014, 2015, and 2016. Their epidemic dampening effect this year hasn't seemed nearly as immediate or dramatic as in years past (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission).

Whether this indicates a change in the virus, continued illicit trade in poultry, or some other confounding factor is unknown.

In case you missed it, yesterday's Eurosurveillance: Preliminary Epidemiology & Analysis Of Jiangsu's 5th H7N9 Wave, suggested several behavior changes may be occurring in the virus this year, including increase virulence resulting in `accelerated disease progression', and possibly increased tolerance to higher ambient temperatures.

While both are concerning, any change in the virus that would extend the traditional `cold weather' season of H7N9  into the warmer summer months would pose significant challenges.

Concerns we discussed last summer in Hong Kong's Bird Flu Dilemma and China: An Unusual June Surge In H7N9 cases. Right now, all we have are the barest hints of a trend, but we'll be watching this summer's H7N9 activity with particular interest.

Beyond that, the skewing of age and gender continues this week, with the youngest patient listed as 35, and 82% of the cases male. Onsets are said to range from March 6th to the 24th.

As always, the big unknown is how many cases are going undetected.  H7N9 can produce a wild range of illness, ranging from asymptomatic or mild, to severe and life threatening. Only the `sickest of the sick' are likely to hospitalized and tested, so the true number of cases could be substantially higher than reported (see Beneath The H7N9 Pyramid).

This from Hong Kong's CHP.

     The Centre for Health Protection (CHP) of the Department of Health today (March 31) received notification from the National Health and Family Planning Commission that 17 additional human cases of avian influenza A(H7N9), including three deaths, were recorded from March 24 to 30. The CHP strongly urges the public to maintain strict personal, food and environmental hygiene both locally and during travel.
     The 14 male and three female patients, aged from 35 to 81, had their onset from March 6 to 24. The cases were six cases from Hunan, three cases each in Jiangsu and Guangxi, two cases each from Fujian and Guizhou, and one case in Zhejiang. Among them, 16 were known to have exposure to poultry or poultry markets.
     Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid the 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 of potential diseases. 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 Report, global statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.
Ends/Friday, March 31, 2017

Issued at HKT 15:55

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