Wednesday, May 17, 2017

H7N9: Shanxi Province Reports Their First Case

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#12,464

Overnight Shanxi Province (not to be confused with Shaanxi province, which reported their first case two weeks ago) announced their first human infection with the H7N9 virus.

Shanxi is bordered on the west by Shaanxi (reporting 4 cases), the north by Inner Mongolia (so far, only in poultry), the east by Hebei (16 cases), and the south by Henan (22 cases) - putting it squarely in the middle of this year's late season bird flu activity.

Two reports, then I'll return with a bit more.  First, from Hong Kong's CHP:

     The Centre for Health Protection (CHP) of the Department of Health is today (May 17) closely monitoring the first human cases of avian influenza A(H7N9) in Shanxi, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

     According to the Health and Family Planning Commission of Shanxi Province, the patient is a woman, aged 66, in Datong. She is in a serious condition.

     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.
         (Continue . . . )

A second report, this time from Xinhua.
  
      First H7N9 case reported in north China province 
Source: Xinhua| 2017-05-17 13:06:39|Editor: Zhang Dongmiao

TAIYUAN, May 17 (Xinhua) -- North China's Shanxi province reported its first H7N9 case of the year on Tuesday evening.

A 66-year-old woman surnamed Zhang from Datong City tested positive by the city's center for disease and prevention (CDC), the Shanxi provincial CDC and the Chinese CDC in the past three days.

She is now in the hospital and described as in "serious but stable condition," said the Shanxi provincial health and family planning commission.

Experts from the Chinese CDC and the provincial CDC were sent to Datong to help with treatment of the patient as well as investigation and prevention work for the disease.

So far those who had contact with Zhang didn't show any symptoms of infection.

Nationwide, a total of 96 people were reportedly infected by the H7N9 virus in March, leaving 47 dead, according to the national health and family planning commission.


The geographic expansion of the H7N9 virus during this 5th epidemic wave continues, with the following regions (cities, municipalities, provinces) reporting their first human cases since October of 2016.
Macao      
Chongqing Municipality
Sichuan
Gansu
Shaanxi
Shanxi
Tibet Autonomous Region
Yunnan

This expansion not only endangers more of China, it puts the virus uncomfortably close to China's borders with other countries, including Russia, Mongolia, and North Korea to their north, Vietnam, Laos, and Cambodia to their south, and Nepal, Bhutan, India and Pakistan to their west.
The emergence of a new, HPAI version of H7N9 earlier this year - and its continued expansion (see CHINA: HPAI H7N9 Expands Its Range) - only serves to compound the risk.
Since it first emerged in the spring of 2013, H7N9 - except for a handful of exported cases - has only been detected in China.   Unlike H5N1, H5N8, and H5N6, it hasn't yet hitched a ride on migratory birds and spread globally.

H7N9's recent evolution, expansion, and surge has the attention of some of the world's best scientists (see NPR: A Pessimistic Guan Yi On H7N9's Evolution).


And rightfully so. 

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