Hong Kong CHP Notified Of An H7N9 Case In Anhui Province

          

 

# 10,015

 

Occasional H7N9 case reports continue to filter in from Mainland China (Jiangxi Province reported a case on Saturday), but past 60 days has seen unexpectedly low numbers. Reporting from many provinces, however, has not as timely or a detailed as we’d like, leaving some doubt as to whether we are seeing the whole picture.

 

We may yet get another round of `bulk’ H7N9 announcements  from the EOM epidemiological reports filed by the individual provinces near the middle of this month, but this year’s epidemic seems to be winding down.

 

That said, we’ve another H7N9 report  - this time from Anhui Province – published by the Hong Kong Centre for Health Protection.

 

CHP closely monitors additional human case of avian influenza A(H7N9) in Anhui

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (May 6) closely monitoring an additional human case of avian influenza A(H7N9) in Anhui, 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 Anhui Province, the male patient aged three in Huaibei had mild symptoms and was in stable condition. He had poultry exposure before onset.

From 2013 to date, 636 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities. Regarding the third wave in the Mainland since November 2014, a total of 196 cases have been reported, including 72 in Guangdong (see attachment for geographical distribution), 39 in Fujian, 38 in Zhejiang, 17 in Jiangsu, eight in Anhui, seven in Xinjiang, six in Shanghai, three in Jiangxi, two in Hunan, two in Shandong, one in Guizhou and one in Hubei.

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The tally of  636 mainland cases provided by the CHP above represents only the `sickest of the sick’ – those ill enough to seek medical care and deemed ill enough to be tested for the virus.

 

Since H7N9 is capable of producing a broad range of symptoms in humans – ranging anywhere from asymptomatic or mild to severe pneumonia – the big unknown is how many cases go undetected in the community. 

 

As with any disease, conventional surveillance and reporting can only reveal the tip of the pyramid. 

Credit CDC

  

Despite their obvious limitations, passive surveillance systems can often tell us if an outbreak is trending up or down  - or spreading to new geographic areas - and it affords an opportunity for epidemiologists to test contacts of known cases to look for signs of human-to-human transmission.

Anhui Province Reports Another H7N9 Case

Credit Wikipedia

 

 

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After a slow start to this third winter’s wave of H7N9, Anhui Province has reported 7 cases in recent weeks, with the latest case announced today.

 

Anqing City, the new one cases of H7N9 cases

Published: 2015-03-06 Source: The Read 238 times

Anhui Provincial Health and Family Planning Commission briefing March 6, Anqing City, the new one cases of H7N9 cases.

Pingmou patient, male, 79 years old, Susong County, live poultry before the onset of exposure history. March 5 was diagnosed with H7N9 cases, patients are in critical condition, Hefei, now a hospital.

 

Hong Kong’s CHP has also published a notice:

CHP closely monitors additional human case of avian influenza A(H7N9) in Mainland 

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (March 6) closely monitoring an additional human case of avian influenza A(H7N9) on the Mainland, 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 Anhui Province, a male patient aged 79 with poultry exposure before onset was hospitalised for management in critical condition.

To date, 597 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities in Guangdong (179 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (24 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).

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As mentioned previously, H7N9 reporting from many of Mainland China’s provinces has been sporadic this winter, and so we are even less certain than usual over the size and scope of this year’s outbreak.  Hopefully some of the gaps in our data will be filled in as monthly epidemiological reports are filed by these provinces.

 

Surveillance and reporting – even at its best – can only be expected to measure the tip of the iceberg, as only the `sickest of the sick’ are apt to seek medical help, and are positioned to be tested and counted.

 

Despite these deficits in reporting, we’ve seen nothing to indicate any change in the way the virus is spreading, and the primary risk remains direct contact with infected birds. 

 

Meanwhile, the Anhui Provincial Health & Family Planning Department also reported the death today of a previously announced case (from February).

 

Anhui Province, one case of H7N9 death cases

Published: 2015-03-06 Source: 

February 23, Ma'anshan City, reported one case of H7N9 cases in patients with onset of February 10, February 22, Nanjing First Hospital diagnosed as H7N9 cases. The patients with the full treatment ineffective died on March 3.

Experts Again: Currently there is evidence to suggest that exposure of human infection with live bird markets H7N9 avian influenza morbidity risk factors, carrying the virus in poultry and their droppings, secretions may be infected with H7N9 avian influenza viruses were the main source of infection. Residents in their daily lives should avoid direct contact with live poultry, birds or their droppings, especially disease (dead) birds. In food processing, food process, to achieve raw and cooked separately to avoid cross contamination; if it has contact Wash hands with soap or hand sanitizer as soon as possible; children should avoid direct contact with poultry and wild birds; if found disease (dead) birds, animals Do not deal with on their own, should report the authorities. Do not buy live poultry slaughtered on their own, do not touch, do not eat sick (dead) poultry, meat, do not buy without quarantine certificates fresh, live, frozen poultry and their products; raw poultry, meat and eggs must be cooked cooking . "A healthy lifestyle is very important for the prevention of the disease, usually physical exercise should be strengthened to ensure adequate sleep, balanced diet. Wash your hands, pay attention to personal hygiene."

H7N9 in Guangdong, Anhui Provinces – Prevention Push & Drills

Anhui & Guangdong Province

 

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After a quiet start to this third winter wave, Anhui Province has reported its fifth H7N9 case in just under 10 days. The following statement comes from the Anhui Provincial Health and Family Planning Commission.

 

Hefei new H7N9 cases, 1 case

Published: 2015-03-03 

Anhui Provincial Health and Family Planning Commission March 3 briefing, the city added one case of H7N9 cases.

Tangmou patient, male, 50 years old, currently residing in Chaohu City, live poultry before the onset of exposure history. March 2 was diagnosed with H7N9 cases, patients are sicker, Hefei, now a hospital for treatment.

 

Hong Kong’s CHP also announces another case from neighboring Guangdong Province, which this year has reported (by far) more cases than any other province. 

 

3 March 2015

CHP notified of additional human case of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (March 3) closely monitoring an additional human case 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, the female patient aged 36 in Chaozhou was hospitalised for management in critical condition.

To date, 594 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities in Guangdong (179 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (21 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).

"Locally, we will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," the spokesman said.

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Outside of Guangdong province, the number of cases being reported this year is lower than last year, although it there are signs that some provinces may not be announcing cases in a timely manner.  Last month some provinces buried their counts in their monthly epidemiological reports, while others were simply silent on the matter.

 

Elsewhere in the Chinese press this morning we’re seeing a number of articles and reports on H7N9 prevention, and specialized training for medical personnel to handle cases.

 

A couple of (machine translated)  examples follow - first from Anhui Province, then from Guangdong:

 

Focus on the prevention of H7N9 flu this month

At 09:13 on March 3, 2015
Source: Anhui Daily

 WASHINGTON (correspondent reporter Wang Huihui Li Nixdorf) March spring, but also a high incidence of many infectious diseases. Hefei CDC released the 2nd disease prediction, reminding residents of this month to focus on the prevention of H7N9 influenza, measles, scarlet fever, chicken pox and other infectious diseases.

Recent domestic and province have reported new cases of H7N9 influenza confirmed, "early discovery, early reporting, early diagnosis and early treatment" is the key to diagnosis and treatment of disease. Experts remind residents of everyday life, such as heavy cold symptoms appear, must not be ignored. H7N9 influenza and influenza symptoms similar to other illnesses, such as fever, headache, cough and sore throat, etc. Therefore, if fever, stuffy nose, cough, muscle aches and other symptoms should wear a mask, as soon as possible to the hospital, and be sure to tell the doctor whether to cross himself before the onset of the avian flu epidemic, whether in contact with sick poultry, etc., and under the guidance of doctors and medication therapy. Prevention measures should minimize unnecessary contact with poultry, especially in contact with sick or dead poultry; wash their hands, stay away from poultry secretions; if contact with birds or their droppings, be sure to use disinfectant and water thoroughly Clean your hands. 

 

Xiangqiao more than 500 medical personnel to participate in prevention and control of H7N9 medical training

2015-03-03 10:24:14  

March 1, Xiangqiao hold H7N9 prevention and medical treatment courses, the region's more than 500 medical staff training.

Training from Guangdong bird flu prevention and control situation, analyzes the characteristics of H7N9 viruses, clinical manifestations, interpret national health planning commission "human H7N9 avian influenza infection treatment program", requiring medical personnel found that admissions of patients with influenza-like symptoms should consult their use Oswald oseltamivir (Tamiflu) drugs, and quickly identify the cause of the disease.

Vice president of Chinese medicine Xiangqiao, doctor Xing Hongji advise that if people develop fever, chills, headache, muscle pain and other symptoms should seek immediate medical attention and inform the doctor if there is contact with live birds or recently visited live animal markets .

At the same time, the medical staff at the reception to be in strict compliance with operating procedures, do their own health protection work. After fever, headache, muscle aches, runny nose, sneezing and other patients admitted to relieve or aggravate the symptoms yet, should be transferred to the city designated hospital, the Central Hospital and the City People's Hospital.

Xiangqiao region requires all medical units to strengthen publicity and improve prevention and treatment plan, reserve-related treatment medicines, disinfectants and personal protective equipment; to be vigilant and strictly implement the fever patient's pre-triage and medical personnel self-protection, etc., suspected cases should be referred promptly to the designated hospitals, good medical treatment.

(Source: Chaozhou broadcast networks)

Anhui Province: 3 New H7N9 Cases

Map showing the location of Anhui Province – Credit Wikipedia

 

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Although well down the list of Chinese provinces reporting H7N9 cases, Anhui contributed one of the first three human cases to this 15 month-long outbreak.  Since then (as of CHP’s most recent report) there have been 14 cases reported in that province – until this week, as three more have been reported over the past three days.

Although a bit of a late-season surge, all three are described as coming from different parts of the province, and no epidemiological links are suggested from either the official statements or the Xinhua report below:

 

H7N9, like its H5N1 cousin, continues to circulate in avian species and occasionally jumps to humans – usually from direct contact with infected birds.  The H7N9 virus appears to be more readily transmittable from birds to humans than does H5N1, but neither at this time show an ability to spread efficiently from one human to another.

 

Both, however, are capable of causing severe – even fatal – illness.

 

For now, the risks from H7N9 are geographically localized to  Eastern China, and are mainly to those who are in direct contact with infected birds. The concern is, that given enough time and opportunities, one of these viruses could better adapt to human physiology and spark a larger public health crisis. 

 

So we watch these sporadic human infections carefully, looking for any signs that the virus has changed.

 

 

China Reports 3 New Human H7N9 Cases

2014-05-22 17:41:37    Xinhua      Web Editor: Mao

Health authorities in east China's Anhui Province on Thursday reported three more human cases of H7N9 bird flu.

 

A 40-year-old man surnamed Yang, a native of Taihu County, was confirmed to have been infected with the H7N9 virus on Monday and is in a critical condition, the provincial health and family planning commission announced on Tuesday.

 

Two other cases were reported on Thursday. One patient, 69, surnamed Cao, is from Tunxi District of Huangshan City. Cao was confirmed to have contracted the virus on Wednesday. The third patient, a 58-year-old native of Maanshan City surnamed Han, was confirmed to be infected on Thursday.

 

Cao and Han are both in critical condition. They are being treated in local hospitals.

 

H7N9 bird flu was first reported in China in March 2013. The virus causes severe diseases in humans, including acute and often lethal respiratory failure. The country has reported more than 200 human H7N9 cases.

 

Anhui Province Reports 2nd H7N9 Case Of 2014

Map showing the location of Anhui Province – Credit Wikipedia

 

# 8281

 

Yesterday, in Zhejiang, Jiangsu, Guangdong, Hunan & Anhui Report Weekend H7N9 Cases, I noted that Anhui Province had reported its first H7N9 case of this second wave; that of a 66 year old man from Susong County.   Today, we’ve word of another case from Anhui – this time fatal – of a 57 year old male from Linquan County, who died on the 7th.

 

While both patients hail from the same province, Anhui is a large place (53,900 sq mi, pop 59.9 million), and based on the MOH reports, geographically they were separated by several hundred kilometers.

 

In this instance, H7N9 was diagnosed two days after the patient died.   First the announcement from the Anhui MOH, followed by a pair of Xinhua News accounts.

 

Province 1 new confirmed cases of human infection with H7N9 avian influenza

Published :2014-02-10 

Anhui Provincial Health Department on February 10 briefing, the province new confirmed cases of H7N9 avian influenza case of human infection.

Patients Chen, male, 56 years old, Linquan people, February 9 confirmed cases of human infection of H7N9 avian influenza, February 7 died. Local prevention and control work is actively carried out by the relevant plans.

 

The Xinhua News report on this death:

 

H7N9 bird flu kills another in China

  2014-02-10 12:12:45
 

HEFEI, Feb. 10 (Xinhua) -- Health authorities in east China's Anhui Province on Monday reported the death of a man who had contracted H7N9 bird flu.

Surnamed Chen, aged 56, the man was a native of Linquan County.

He died on Friday before it was confirmed that he had the virus on Sunday, said a statement issued by the provincial health department.

China has reported more than 120 human H7N9 cases this year, including at least 27 deaths, with provinces of Zhejiang and Guangdong worst affected.

 

As well as this cautionary report:

 

China predicts more H7N9 infections

2014-02-10 15:59:53
 

BEIJING, Feb. 10 (Xinhua) -- Health experts predicted more H7N9 cases in the near future after east China's Anhui Province reported a new death from the virus on Monday, according to health authorities.

Speaking at a press conference on Monday, Yao Hongwen, spokesman for the National Health and Family Planning Commission, said that there will continue to be sporadic reports of H7N9 infections.

"No mutation of the virus has been identified so far that could affect public health, and transmission from animals remains the only way in which humans have picked up the virus," the spokesman said.

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While the bulk of cases reported during this second wave have come from coastal and southern provinces, these two Anhui cases – along with the case announced from Beijing last week – reinforce the idea that the virus remains endemic across much of Eastern China.

H7N9: Anhui Reports 1 New Case – Totals Cases 64, 14 Fatalities

 

Anhui Province – Credit Wikipedia

 

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Case reports continue to trickle in this morning, with Anhui Province now reporting a single case as well.

 

Xinhua News is reporting 63 cases,`A total of 63 H7N9 cases have been reported across China, with 24 in Shanghai, 17 in Jiangsu, 16 in Zhejiang, three in Anhui, two in Henan and one in Beijing.’

 

But if you include the asymptomatic 4 year-old who tested positive in Beijing yesterday, this should bring the total to 64 confirmed cases and 14 deaths.

 

From the Anhui Provincial Health Department.

 

Anhui Province new case of human infection with H7N9 avian influenza

Published :2013-04-15 Source: Read 433 times

Anhui Provincial Health Department Bulletin, April 15 in Anhui Province confirmed case of human infection of H7N9 avian influenza. So far, Anhui Province reported a total of three cases of human infection with the H7N9 avian flu, and 1 died.

Patients Chen, male, 60 years old, Tianchang people, retirees, a company in the local guard. Patients with disease, Tianchang a hospital on April 11 to April 10. April 14, Chuzhou CDC influenza the network laboratory detection of influenza virus in patients with Universal nucleic acid positive, H7 subtypes positive; April 15, the provincial CDC detects review man infected with the H7N9 avian influenza virus nucleic acid positive. The same day, the provincial expert group based on national human infection with the H7N9 avian flu clinic program (2013 Edition) ", and the diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. Patients in critical condition, has been transferred to a hospital in Chuzhou isolation treatment. Close contact with a total of 25 people, until now, were not unusual.

(The Information Office of the Provincial Health Department)

Anhui Health Department On 21st H7N9 Case

 

Credit NIAID

# 7090

 

Chinese media (and now AP) has been reporting on a 3rd confirmed H7N9 case this morning, bringing China’s total to 21 cases.

 

I found the following statement posted on the Anhui Provincial Health Department’s website.

 

 

Anhui Provincial Health Department Bulletin, April 7

Anhui newly confirmed cases of human infection of H7N9 avian influenza.

Patients Lee, male, 55 years old, Bozhou Qiaocheng engaged in live poultry sales and slaughter. March 28 onset. April 1 to Bozhou City, a hospital for treatment due to exacerbations. Currently, the patient is stable. April 6, Anhui Province CDC laboratory test results for the H7N9 avian influenza virus nucleic acid positive.

April 7, Chinese Center for Disease Control laboratory for review results for the H7N9 avian influenza virus nucleic acid positive. April 7, issued by the Province, according to the state Health and Family Planning Commission, the Group "treatment program, 1 (2013), the diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases of human infection with the H7N9 avian influenza. After investigation, the close contacts of the cases of a total of 12 people, until now, were not found to have abnormalities.

(The Information Office of the Provincial Health Department)

 

 

Xinhua News is reporting this case now, as well.

 

Another H7N9 Case Reported in East China

2013-04-07 23:09:53    Xinhua     

Web Editor: Liu Yuanhui

Another H7N9 infection has been confirmed in east China's Anhui Province, local authorities said Sunday night, bringing the total number of confirmed cases in China to 21.

The patient, a 55-year-old male working in the live poultry trade, began exhibiting flu symptoms on March 28 and was taken to a hospital in Bozhou City on April 1 after his condition worsened, according to a statement from the Anhui Provincial Health Department.

The Chinese Center for Disease Control and Prevention diagnosed the patient, surnamed Li, positive of the H7N9 avian influenza virus on Sunday.

Li is currently in stable condition, according to the statement.

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