Friday, April 14, 2017

HK CHP Notified Of Another 14 New H7N9 Cases From The Mainland

FAO - April 12th

EDITOR'S NOTE:  I'll be away from my desk for the next couple of days, and so I probably won't be updating this blog until Sunday Night or Monday Morning. As always, between Crof at Crofsblog, the newshounds at FluTrackers, and gang at CIDRAP NEWS, you should find all of your infectious disease needs well covered.


For the second Friday in a row Hong Kong's CHP has been notified by the NHFPC of 14 new H7N9 cases from the Mainland.  Of particular interest, this is the 4th week in a row the Mainland is reporting no new cases from Hong Kong's closest neighbor; Guangdong Province. 
While the ordered closure of live poultry markets two months ago in affected areas has brought down the rate of new infections, it has not had as dramatic of an impact as in previous years (see  The Lancet: Poultry Market Closure Effect On H7N9 Transmission).

Today's reports means that since October 2016, 587 cases have been reported by  Mainland China (plus another 8 outside: 5 in Hong Kong, 2 in Macao, 1 in Taiwan).  While we've no evidence of sustained or efficient transmission of the virus between humans, this is the largest epidemic outbreak of avian flu we've seen. 

Of the 14 cases in today's report, three were from Sichuan, two cases each from Henan, Shandong, and Xizang, and one case each from Anhui, Beijing, Hunan, Tianjin and Zhejiang.

Although the information provided is scant, six of these cases standout in particular. First, Sichuan Province - which prior to this winter's epidemic had never reported an H7N9 infection - has now clocked an impressive 14 cases
More curious, however, is the announcement today of 2 cases from Xizang - which is another name for Tibet Autonomous Region - which reported their first case only last Friday. 
My attempts this morning to get more information from the Tibet Autonomous Region Health & Family Planning Commission website - which was easily reachable last week -  have failed, with their website repeatedly timing out. 
The circumstances leading to two additional cases in Tibet (and the reason behind their change in naming convention for the Province) remain open questions.  Hopefully the Tibet HFPC website will be back up soon, and we'll get some clarification.

And lastly, Tianjin - the fourth largest City in China - reports their first H7N9 case of this epidemic wave, and only their 3rd case since the virus emerged in 2013.
This 5th epidemic wave continues to be notable not only for the sharp increase in the number of cases reported this winter and the emergence of new lineages and strains of H7N9, but for the geographic expansion of the virus into new areas of China as well.
This update from Hong Kong's CHP.

     The Centre for Health Protection (CHP) of the Department of Health today (April 14) received notification of 14 additional human cases of avian influenza A(H7N9), including two deaths, from the National Health and Family Planning Commission, and strongly urged the public to maintain strict personal, food and environmental hygiene both locally and during travel, particularly in Easter. 

     The eleven male and three female patients, aged from 39 to 81, had onset from March 27 to April 11, including three from Sichuan, two each from Henan, Shandong and Xizang, and one each from Anhui, Beijing, Hunan, Tianjin and Zhejiang. Among them, 13 had exposure to poultry, poultry markets or mobile stalls. 

     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 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 Reportglobal statistics and affected areas of avin influenza, the Facebook Page and the YouTube Channel.
Ends/Friday, April 14, 2017

Issued at HKT 19:10

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