# 9751
For reasons we can only speculate on - except for Guangdong Province – Mainland China has been very slow to report H7N9 cases this winter. We’ve seen some batch announcements - often buried in end-of-month provincial statistical reports - but daily reporting has been rare.
Of the 16 provinces that have reported cases during the first two waves, only about half of those have reported cases this winter.
While it is possible that H7N9 activity has diminished greatly across the region, when you figure in the irregular reporting, it does stretch credulity a bit. The point being that the numbers we are seeing posted by Hong Kong’s CHP may under-reflect the level of activity across the mainland during this third wave.
That said, we’ve two updates from the Centre For Health Protection, describing 5 new cases.
CHP closely monitors three additional human cases of avian influenza A(H7N9) in Mainland
The Centre for Health Protection (CHP) of the Department of Health (DH) is today (February 25) closely monitoring three additional human cases of avian influenza A(H7N9) in the Mainland, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.
According to the notification of the Health and Family Planning Commission (HFPC) of Guangdong Province, the male patient aged 59 in Zhaoqing was hospitalised for management in critical condition.
In addition, according to the HFPC of Anhui Province, the two male patients aged 48 and 75 with poultry exposure before onset were hospitalised for management. Both were in critical condition.
To date, 585 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities in Guangdong (172 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (19 cases), Xinjiang (10 cases), Jiangxi (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).
CHP notified of two additional human cases of avian influenza A(H7N9) in Guangdong
The Centre for Health Protection (CHP) of the Department of Health (DH) is today (February 25) closely monitoring two additional human cases of avian influenza A(H7N9) in Guangdong notified by the Health and Family Planning Commission of Guangdong Province (GDHFPC), and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.
According to the GDHFPC, a male patient aged 3 in Heyuan and a female patient aged 18 in Foshan were hospitalised for treatment, and are in a stable and critical condition respectively.
To date, 587 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities in Guangdong (174 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (19 cases), Xinjiang (10 cases), Jiangxi (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).
Even the best surveillance and reporting will fail to detect cases, and those who end up tested and counted are almost always the sickest of the sick – the ones who are sickened enough to go to the hospital.
Mild and moderate cases are very likely to go uncounted.
In Lancet: Clinical Severity Of Human H7N9 Infection we saw a study that proposed, after roughly 130 cases were confirmed in the spring of 2013, that:
Our estimate that between 1500 and 27 000 symptomatic infections with avian influenza A H7N9 virus might have occurred as of May 28, 2013, is much larger than the number of laboratory-confirmed cases.
How accurate these estimates are is unknown, but any official case count almost certainly under-represents the real burden of H7N9, perhaps by a sizable margin.
