Credit Hong Kong Centre For Health Protection
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Having only emerged in the spring of 2013, H7N9 is only just barely in its second year of circulation, and so we only have one summer season under our belts when it comes to defining its behavior. Last year, as the chart below illustrates, case reports in China all but disappeared after the first week of May, with only three cases reported between mid-May and late September.
Credit ECDC Epidemiological Report Feb 7th, 2014
The return of warm weather, and the closing of live-markets, was credited with this remarkable drop in cases.
This year, while the number of cases being reported remains fairly low (at least compared to the two large winter/spring outbreaks we’ve seen), we haven’t seen the sharp cutoff in cases yet. We continue to see a few human infections – particularly from the more northern provinces (Anhui, Shandong, Jiangsu) trickle in - despite the calendar now reading early June.
Last week, in Shandong Province: Two Related H7N9 Cases, we saw reports of a father-son family cluster, with the father dying from the virus, while the WHO reported on 3 cases from Anhui province from earlier in the month.
Today Hong Kong’s CHP is reporting on 4 new cases from the Mainland; 2 from Shandong province, and 2 from Jiangsu. Today’s update doesn’t provide us with much in the way of epidemiological information on these cases, other than one fatal case had poultry exposure.
CHP notified of four additional human cases of avian influenza A(H7N9) in Mainland
The Centre for Health Protection (CHP) of the Department of Health (DH) today (June 4) received notification of four additional human cases of avian influenza A(H7N9) in Jiangsu (two cases) and Shandong (two cases) from the National Health and Family Planning Commission.
The two patients in Jiangsu are a man and a woman, both aged 51, who are now hospitalised for treatment. The two cases in Shandong involve a man aged 61 who had poultry exposure and died and a man aged 33 who is hospitalised for management.
A total of 433 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (138 cases), Guangdong (108 cases), Jiangsu (56 cases), Shanghai (41 cases), Hunan (23 cases), Fujian (22 cases), Anhui (17 cases), Jiangxi (eight cases), Shandong (five cases), Beijing (four cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one imported case from Zhejiang) and Hebei (one case).
"Locally, enhanced disease surveillance, port health measures and health education against avian influenza are ongoing. We will remain vigilant and maintain liaison with the World Health Organization (WHO) and relevant health authorities. Local surveillance activities will be modified upon the WHO's recommendations," a spokesman for the DH said.
"In view of human cases of avian influenza A(H7N9) confirmed locally and in the Mainland, further sporadic cases are expected in affected and possibly neighbouring areas. Those planning to travel outside Hong Kong should maintain good personal, environmental and food hygiene at all times," the spokesman urged."All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Random temperature checks by handheld devices have also been arranged. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.
Regarding health education for travellers, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are proceeding.
The spokesman advised travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, to immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces.
- Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:
- Do not visit live poultry markets and farms. Avoid contact with poultry, birds and their droppings;
- If contact has been made, thoroughly wash hands with soap;
- Avoid entering areas where poultry may be slaughtered and contact with surfaces which might be contaminated by droppings of poultry or other animals;
- Poultry and eggs should be thoroughly cooked before eating;
- Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
- Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
- Avoid crowded places and contact with fever patients; and
- Wear masks when respiratory symptoms develop or when taking care of fever patients.
The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf) for more information on avian influenza-affected areas and provinces.
Ends/Wednesday, June 4, 2014
Issued at HKT 12:12
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While it is always worrisome whenever a novel flu jumps to humans, the good news is that H7N9 remains primarily an avian-adapted virus. The vast majority of cases appear to have contracted the virus from direct exposure to infected poultry, and only a handful of cases are even suspected as due to human-to-human transmission.
The concern, of course, is that these viruses are constantly changing (see EID Journal: H7N9 As A Work In Progress) and that what we say about their behavior today may not hold true tomorrow.
