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Last Wednesday we learned of Malaysia’s first recorded H7N9 case, that of a woman tourist from Guangdong Province, China who had been in country several days before being hospitalized (see Malaysian MOH Statement On Imported H7N9).
Aside from imported cases in Hong Kong (n=5) and Taiwan (n=2), this was the first case detected beyond Mainland China.
This morning the World Health Organization has released a GAR (Global Alert & Response) update on this Malaysian case, which confirms earlier reports that this woman fell ill and sought medical care several days before leaving mainland China.
Human infection with avian influenza A(H7N9) virus – update
Disease outbreak news
17 February 2014 - On 12 February 2014, The Ministry of Health (MOH) Malaysia reported a human case of avian influenza A(H7N9) virus.
Details of the case are as follows:
A 67 year old woman tourist from Guangdong Province, China, arrived in Malaysia on 3 February in a tour group of 17 persons, including relatives, and stayed overnight in Kuala Lumpur, Malaysia. The tour group then went on a visit to Sabah, Malaysia from 4 to 6 February. On 7 February, she was admitted to hospital and later transferred to another hospital in Sabah. The patient is currently in a stable condition.
Four days prior to travelling to Malaysia, on 30 January 2014, she was treated in China for symptoms of fever, cough, flu, fatigue and joint pain. Given the onset of symptoms, and travel dates, the most likely exposure occurred before arrival in Malaysia.
The Malaysia Ministry of Health is conducting an investigation including contact tracing and is also coordinating information sharing with the Chinese Government.
Sporadic human cases
While the recent report of avian influenza A(H7N9) virus detection in live poultry exported from mainland China to Hong Kong SAR shows the potential for the virus to spread through movement of live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred. However as the virus infection does not cause signs of disease in poultry, continued surveillance is needed.
Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. If this were to occur, community level spread is unlikely as the virus does not have the ability to transmit easily among human. Until the virus adapts itself for efficient human-to-human transmission, the risk of ongoing international spread of H7N9 virus by travellers is low. The overall risk assessment has not changed.
Further sporadic human cases of avian influenza A(H7N9) infection are expected in affected and possibly neighbouring areas, especially given expected increases in the trade and transport of poultry associated with the Lunar New Year.
WHO advice
WHO advises that travellers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travellers should follow good food safety and good food hygiene practices.
Travellers should follow good food safety and good food hygiene practices.
WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.
As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.
WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.
This morning the WHO also released a separate H7N9 update on human infections reported in Mainland China as of February 13th.
Human infection with avian influenza A(H7N9) virus – update
Disease outbreak news
17 February 2014 - On 13 February 2014, the National Health and Family Planning Commission (NHFPC) of China notified WHO of seven additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus.
All the cases are male, the age range is 8 to 84 years old. Cases were reported from Zhejiang (3), Guangdong (3) and Hunan (1). Currently, three cases are in a critical condition, three cases are in a severe condition and one case is in a mild condition. All cases are reported to have had a history of exposure to live poultry.
