Saturday, December 26, 2015

Hong Kong Notification: Fatal H7N9 Case In Guangdong Province


During the first two winters of H7N9 epidemics the Chinese offered daily detailed updates on new cases. Starting last season most Chinese provinces began to only submit brief monthly summaries, with little to no detail attached. Occasionally the media will report on a case, but when they do, we often go weeks before seeing any official confirmation.

Guangdong Provice - lying adjacent to (and trading daily with) Hong Kong - has been an exception, as they usually notify the Hong Kong's CHP relatively quickly.

Yesterday the Guangdong media picked up a report of a recent, fatal case of H7N9, which was collected, translated, and posted by FluTrackers (see  China - Man, 61, new H7N9 bird flu death Dougguan City, Guangdong - December 25, 2015).  

While the official provincial websites still have no mention of this case, they have notified the Hong Kong authorities, who posted the following statement this morning. 

CHP closely monitors a human fatal case of avian influenza A(H7N9) in Guangdong Province

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (December 26) closely monitoring a human fatal case of avian influenza A(H7N9) affecting a man aged 61 in Dongguan, Guangdong Province, 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 Guangdong Province, the man with underlying illnesses was admitted to a local hospital on December 22 and passed away the next day. The deceased had visited a local market and had contact with live poultry.

From 2013 to date, 664 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities.

"We will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," a spokesman for the DH said. 

The DH'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 broadcast 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 latest information.

Travellers, especially those returning from avian influenza-affected areas with fever or respiratory symptoms, should 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.

(Continue . . .)

In years past, while widely scattered and sporadic H7N9 cases were reported during the fall months, the yearly epidemic only really got underway in January. This year the pattern seems similar, although the lack of reporting out of China severely hampers our ability to accurately gauge the situation.

Like Egypt, the other recent hot spot for human avian flu infection, China is less than eager to publicly discuss their bird flu problem.

Yesterday Dr. Ian Mackay on his VDU Blog discussed this regrettable lack of data sharing in his blog:

Avian influenza A(H7N9) virus case data in humans: more chicken scratchings

The new 2005 IHR (International Health Regulations) - signed and approved by the World's nations - required – among other things – that countries develop mandated surveillance and testing systems, and that they report certain disease outbreaks and public health events to WHO in a timely manner.

Although the agreement went into force in 2007, member states had until mid- 2012 to meet core surveillance and response requirements.
Most, as of today, have not (see Adding Accountability To The IHR).

But even more egregious, many countries with the capability to gather and report this type of data continue to flaunt the spirit - if not the letter - of this global health agreement; either delaying, or limiting the amount of information they release. 

Although the WHO is usually reluctant to publicly name and shame non compliant member nations, we have seen signs that may be changing as in the WHO Statement On The 10th Meeting Of the IHR Emergency Committee On MERS.

MERS in the Middle East (and not necessarily just KSA), H5N1 in Egypt, and avian flu (H7N9/H5N1/H5N6) in China are just a few of the under reported and potentially serious zoonotic disease flash points around the world.  

There are others.  Some we know about, or at least suspect. And others not yet on our radar.

But until nations are willing to start responsibly, accurately, and immediately reporting on the outbreaks they already know about, there's little we can do about those hidden threats.