Monday, April 17, 2017

Details Emerge On Tibet's H7N9 Cluster

Lhasa Tibet


Ten days ago, we saw the first report that China's H7N9 epidemic had moved into their Xizang Autonomous Region (see Tibet Autonomous Region Statement On Their 1st H7N9 Case) with the announcement that a poultry seller in Lhasa had tested positive. 
Last Friday, the NHFPC notified Hong Kong of two additional cases in Xizang, albeit with no details.  My attempts on Friday to get more information from the Tibet Autonomous Region Health & Family Planning Commission website - which was easily reachable last week -  failed, with their website repeatedly timing out.
After several attempts this morning, I had better luck and retrieved a statement (see below) which indicates two additional poultry sellers from the same market developed fever and flu-like symptoms around the same time as the first case.  While both tested negative when first hospitalized - a week later both tested positive for the virus. 
Health authorities are attributing this three-person cluster to a shared common exposure to infected poultry - not to human-to-human transmission
As we’ve discussed previously, when it comes to proving human-to-human (H-2-H) transmission of an emerging virus, the bar is set pretty high.  When there are other, equally plausible explanations (e.g. shared environmental exposures), then H-2-H cannot be assumed. 

Lhasa two cases of new H7N9 cases

Source: original Published: 2017-04-12 23:07:38
Since April 3, 2017, Lhasa City, confirmed 1 case of infection with H7N9 cases, the regional party committee and government attach great importance to the autonomous region H7N9 UNPROFOR working group members in close cooperation with the positive response, to take full treatment of patients, Market, to suspend live poultry trade; to carry out close contact with patients and high-risk exposure of the follow-up survey and symptom monitoring; to strengthen medical institutions at all levels, clinics, fever and unexplained cases of pneumonia surveillance reports and other effective measures to deal with H7N9 epidemic.

In close contact with patients and high-risk exposure of the follow-up investigation process, found two cases of fever patients Liu Moumou and Ren Moumou. The two patients and the first patient were the same farmer market engaged in live poultry trade, there is a common exposure history.
Autonomous Region Third People's Hospital diagnosed with suspected H7N9 cases, respectively, on April 2 and 3 received admission, isolation treatment. On the day of admission, two patients with H7N9 virus laboratory tests were negative. April 8 and 9, autonomous regions CDC collected two cases of patients with lower respiratory tract specimens, laboratory tests, in two cases of sputum were found in patients with H7N9 virus nucleic acid. Combined with clinical manifestations, laboratory test results and epidemiological history, confirmed two cases of patients with H7N9 cases. The patient is currently in stable condition.

According to epidemiological survey results that the three patients were co-exposed infection, is an occasional case, the occurrence of H7N9 epidemic risk assessment is still very low.null

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