Guangdong Province Adds 5 H7N9 Cases, Jiangxi Adds 1

  

 

# 9738

 

The flow of H7N9 information out of Guangdong Province remains pretty steady, but sadly - the same cannot be said for the rest of Mainland China. Some provinces appear to have abandoned daily reporting, and instead release monthly figures in their epidemiological reports, others simply release batches of data at irregular intervals.

 

Most of the reports we do get are summations without the usual epidemiological details (age, gender, onset date, locations, exposures, etc.) that in the past have allowed us to chart, and cross-check, case reports.

 

As a result, we really can’t tell how this year’s H7N9 wave compares to last year’s.  It is possible that fewer infections are being recorded this winter, but the irregular reporting by individual provinces this year makes it impossible to tell.

 

We’ve reports of six cases this morning.  Five from Guangdong province, and 1 from Jiangxi.

 

Jiangxi new one cases of H7N9 confirmed cases

At 16:07 on February 22, 2015 Source: Xinhua

Health and Family Planning Commission of Jiangxi Province February 22 briefing, Jiangxi Province, the new one cases of H7N9 confirmed cases. This case is the first two cases in Jiangxi 2015 H7N9 cases. Currently, the patient's condition is relatively stable, Nanchang is a hospital.

The 74-year-old male patient, live Xihu District of Nanchang. February 21, Jiangxi Province, Nanchang, the Centers for Disease Control and Prevention on the patient specimens sent for review were identified as positive for H7N9 virus nucleic acid.

Health and Family Planning Commission of Jiangxi expert group based on clinical manifestations, laboratory test results, and epidemiology and other information, the diagnosis of this patient H7N9 cases. (Reporter Gao Hao Liang)

 

CHP notified of five 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 22) closely monitoring five additional human cases of avian influenza A(H7N9) 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, five male patients aged from 51 to 57 from Meizhou, Shantou, Jiangmen, Huizhou and Heyuan are hospitalised for treatment. Three of them are in critical condition, one in serious condition and one in stable condition.

To date, 582 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Guangdong (171 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (17 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).

(Continue . . . )

 

Despite the case tally provided at the end of these HK CHP reports, the actual number of H7N9 cases in mainland China is unknown, and believed to be far higher.

 

We know that H7N9 can produce a broad spectrum of illness, ranging from mild (or even asymptomatic), to severe and life threatening. Only those sick enough to be hospitalized, or monitored because they were a close contact of a hospitalized case, are likely to be tested for the virus.

 

We’ve seen estimates (see Lancet: Clinical Severity Of Human H7N9 Infection), that have suggested thousands (perhaps 10’s of thousands) of cases have gone undocumented, but the accuracy of these estimates is unknown.

 

Despite these gaps in our knowledge, thus far we seen no evidence to suggest the H7N9 virus is transmitting easily, or efficiently, between humans.  Contact with infected birds remains the biggest risk factor.

Referral: VDU Blog On Closure Of Guangdong’s Live Markets

Credit FAO

 

 

# 9725

 

Amid news of another H7N9 case reported from Guangdong Province (see CHP notified of additional human case of avian influenza A(H7N9) in Guangdong),  Dr. Ian Mackay weighs in with a blog on the importance of closing live bird markets (LBMs)  in China in order to reduce the spread of the virus.

 

Follow the link to read:

 

Guangdong sees sense among the feathers...

Guangdong province in southern China is suspending its poultry markets. All of them. From 15-Feb to 28-Feb.[1] While the closures are only for 2-weeks, this will be very important for stopping human cases of avian influenza, particularity of the H7N9 subtype, during the bustling spring period in China.

Live poultry market closures also remove a traditional dish of fresh cooked chicken. One can be certain that no-one will die because of the substitution of frozen or factory prepared chicken for a fresh chicken, even if chefs don't succumb to the tantrums of last year and refuse to prepare dishes made from anything but fresh market-selected poultry. One can be equally certain that if the markets remain operating during the peak season for influenza virus circulation as they have been, that human infections, and deaths, due to H7N9 infections, will also continue

(Continue . . . )

 

 

Last summer, in CDC: Risk Factors Involved With H7N9 Infection we looked at a case-control study conducted by an international group of scientists, including researchers from both the Chinese and the US CDC which concluded.

 

Exposures to poultry in markets were associated with A(H7N9) virus infection, even without poultry contact. China should consider permanently closing live poultry markets or aggressively pursuing control measures to prevent spread of this emerging pathogen. 

 

In October of 2013 we saw another study (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission) which found:

 

Closure of LPMs reduced the mean daily number of infections by 99% (95% credibility interval 93—100%) in Shanghai, by 99% (92—100%) in Hangzhou, by 97% (68—100%) in Huzhou, and by 97% (81—100%) in Nanjing. Because LPMs were the predominant source of exposure to avian influenza A H7N9 virus for confirmed cases in these cities, we estimated that the mean incubation period was 3·3 days (1·4—5·7).

Despite the evidence that it would greatly reduce the transmission of the virus, closing LMBs is a hard sell to the Chinese public. Purchasing live market birds is deeply ingrained in the culture, as it reassures the buyer that the bird is both fresh and healthy. 

 

China, Indonesia, and other countries have attempted to close or strictly regulate live bird markets in the past – only to be met with tremendous public resistance (see 2009 blog China Announces Plan To Shut Down Live Poultry Markets In Many Cities). 

 

That ambitious plan, announced more than 5 years ago to `shut live poultry markets in all large and medium-sized cities throughout China’, obviously never happened.

 

While the temporary closure of markets Guangdong will hopefully reduce the impact of this year’s H7N9 outbreak, as Ian points out temporary closures are only expected to provide temporary relief.  

H7N9 In Guangdong, Seasonal Flu In Hong Kong

Credit HK CHP

 

 

# 9721

 

Hong Kong’s CHP has been notified of an additional H7N9 in Guangdong Province, bringing to 54 the number of cases reported from their neighboring province this winter.  Unfortunately, timely reports from the rest of mainland China are in short supply, making it difficult to characterize this year’s outbreak.

17 February 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 (February 17) closely monitoring an additional human case of avian influenza A(H7N9) 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 33 in Guangzhou was hospitalised for treatment in critical condition.

To date, 574 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Guangdong (163 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (17 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).

(Continue . . . )

 

Meanwhile, Hong Kong’s severe flu season continues unabated with daily reports painting a grim picture of both the number of ICU admissions and deaths, with the number of fatal flu cases this winter on track to more than double last year’s total.

 

 

Latest update of surveillance data in winter influenza season

The Centre for Health Protection (CHP) of the Department of Health today (February 17) reported the latest surveillance data of the winter influenza season, and again urged the public to heighten vigilance and get vaccinated early against seasonal influenza.

Regarding severe cases, from noon yesterday (February 16) to noon today, 22 additional cases of influenza-associated admission to intensive care units or death (including 18 deaths) among adults aged 18 or above have been recorded under the enhanced surveillance in collaboration with public and private hospitals reactivated since January 2, bringing the total to 322 (228 deaths) so far. Among them, 306 were A(H3N2), 10 were A pending subtype and six were B. In the last winter season in early 2014, 266 (133 deaths) were filed.

Meanwhile, no additional cases of severe paediatric influenza-associated complication or death among children aged under 18 have been reported since yesterday via the ongoing reporting system and the total this year hence remains at 14 (no deaths) and all were A(H3N2). In 2014, 27 (four deaths) were filed.

(Continue . . .)

This year’s flu season is so grim - that while located in the Northern Hemisphere - Hong Kong is making arrangements to purchase a quantity of the recently revised Southern Hemisphere vaccine, as announced earlier this month in New flu vaccine ready by April.

As we’ve seen this year in North America, Hong Kong’s flu season has been dominated by a drifted H3N2 virus which has greatly reduced this year’s vaccine effectiveness, and its greatest impact has been on the elderly.

 

Shanghai & Guangdong Province Report H7N9 Cases

 

# 9702

 

Guangdong Province reports 2 more cases to Hong Kong’s CHP, while Shanghai -   which appears to have been very proactive in their regulating and closing of live bird markets – reports only their 4th case of this third wave.

 

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 12) 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 of Guangdong Province, a male patient aged 61 (in Guangzhou) died while another male patient aged 60 (in Shantou) is in critical condition and was hospitalised for management.

According to the Shanghai Municipal Commission of Health and Family Planning, the patient in Shanghai is a man aged 53 who was under treatment in critical condition.

To date, 568 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Guangdong (157 cases), Zhejiang (156 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (45 cases), Hunan (24 cases), Anhui (17 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).

(Continue . . . )

 

Guangdong Province: 1 New H7N9 Case, Issues Seasonal Flu Warning

 

# 9694

 

Guangdong’s string of H7N9 announcements continues today with a brief report of a 33 year-old man from Shantou who was diagnosed on the 9th, and is in critical condition. 

 

Shantou reported one case of H7N9 cases

2015-02-10 16:36:35   Ministry of Health and Family Planning  | Views ( 34 ) | text background color:

Health and Family Planning Commission of Guangdong Province February 10 briefing, Shantou reported one case of H7N9 cases.

Patients Moumou, male, 33 years old, currently living Shantou area. February 9 diagnosed with H7N9 cases, the patient is currently in critical condition. In Shantou admitted to inpatient hospital.

 

Guangdong province has a population of 105 million people – three times more than the state of California – and with seasonal flu and other winter respiratory viruses common this time of year, it is likely that a good many H7N9 cases go undetected.

 

Those who are diagnosed are those who are sick enough to be hospitalized, which probably explains the high mortality rate among known cases.

 

Today Guangdong’s Ministry of Health and Family Planning also issued a seasonal influenza warning, reporting that flu cases are – as we’ve seen this past month in Hong Kong – ramping up.  Based on the tone of this letter, it appears that Guangdong province is running few weeks behind Hong Kong in flu activity. 

 

 

Provincial Health Commission releases seasonal flu early warning information

2015-02-10 15:33:02 Ministry of health family planning |  :

As of February 9, 2015 2342 influenza cases were reported in the province, reported flu-like cases clusters of outbreaks, 14, of which 10 were H3N2 influenza a viruses, 2 were influenza b viruses, 1 for multiple influenza a viruses, 1 for non-influenza caused by influenza a virus.

Experts assessed that the two periods of high seasonal influenza than in our province, March-July and September-November, respectively. Our province has entered the active period of onset of seasonal influenza and gradually into the first peak, population mobility increased along with the holiday, community disease will gradually increase, influenza patients still be up. After the end of winter and the Spring Festival holiday, school collectives such as aggregation of outbreak events will increase.

Recently, the Hong Kong flu pandemic aroused social concern. According to the Department of Health's Center for health protection of Hong Kong announced on February 8, and continued to increase in the number of deaths due to influenza in Hong Kong so far this year, a total of 142 cases of death. In this regard, provincial health contact the Planning Commission has strengthened its communication with the Hong Kong authorities, joint control and outbreak response. Due to the influenza epidemic season of our province and the virus type changes and Hong Kong differ so far this year the province has not received any report of death due to the flu, the public need not panic.

(Continue . . . )

As seasonal influenza tends to strike anywhere from 5% to 10% of the population each year, the next few weeks could see several million new flu cases emerge in Guangdong province. Most will undoubtedly be seasonal H3N2 or H1N1 (still active in Asia this year), but since most will be mild or moderate and not require hospitalization, relatively few will be tested for novel influenza.

 

Today Hong Kong’s CHP released their latest Avian Influenza Report (Volume 11, Number 6 (Week 6), and in it they provide a partial line-listing of recent H7N9 cases (n=54). 

 

As we’ve seen previously, cases tend to skew heavily towards older males, with just 14 females (26%) in this list. 

 

More striking yet is how few young children (< 10 years of age) have been reported infected with this virus, and those that are diagnosed tend to experience less severe disease.   

There were only 4 (7%) reported in this latest list, none listed as critically ill. This under 10 age group represents roughly 11% of China’s total population.  In comparison, 34 of the 54 cases listed (63%) were 55 or older, an age group that only comprises about  20% of China’s population.

Credit PRB.org

 

Admittedly, since exposure to birds (usually at live markets) has been cited as the primary source of infection, it seems likely that adults have more opportunities to be exposed than do young children.  And co-morbidities (including smoking) in older patients could account for some of the disparity in outcomes. 

 

But the demographics remain heavily skewed.

 

And it is curious that, unlike the H5N1 avian flu virus - which has shown a decided predilection for the young over the years – H7N9 continues to show a strong preference for predominantly older, male victims.

HK CHP Notified Of 2 More H7N9 Cases In Guangdong

Credit HK CHP

 

 

# 9685

 

Although it hasn’t been posted yet on the Guangdong MOH website, Hong Kong’s Centre for Health Protection has announced 2 more H7N9 cases in the neighboring province, bringing to 10 the number reported there in February.

In yesterday’s post we looked at some of the reasons why the case counts provided by Hong Kong almost certainly under represent the size of this outbreak.

Here is today’s notification.

 

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 8) 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, the male patient aged 52 in Shenzhen and the other male patient aged 73 in Zhongshan were hospitalised for treatment in stable and critical condition respectively.

To date, 564 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (156 cases), Guangdong (154 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (44 cases), Hunan (24 cases), Anhui (17 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).

(Continue . . . )

HK CHP Notified Of 1 Additional H7N9 In Guangdong Province

 

# 9682

 

After reporting 5 cases yesterday, Guangdong province has notified Hong Kong’s CHP of one additional H7N9 case this morning.

 

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

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (February 7) closely monitoring an additional human case of avian influenza A(H7N9) in Jiangmen, 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 patient is a 56-year-old man with underlying illness. He is currently hospitalised for treatment in critical condition.

To date, 562 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (156 cases), Guangdong (152 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (44 cases), Hunan (24 cases), Anhui (17 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).

(Continue . . . )

 

Despite the always helpful tally provided at the end of these HK CHP reports, the actual number of H7N9 cases in mainland China is unknown, and believed to be far higher. 

 

We know that H7N9 can produce a broad spectrum of illness, ranging from mild (or even asymptomatic), to severe and life threatening. The result is, only those sick enough to be hospitalized, or monitored because they were a close contact of a hospitalized case, are likely to be tested for the virus.

 

We’ve seen estimates (see Lancet: Clinical Severity Of Human H7N9 Infection), that have suggested thousands (perhaps 10’s of thousands) of cases have gone undocumented, but the accuracy of these estimates is unknown.

 

There are also questions regarding this year’s reporting of cases. Since July of 2014, the Hong Kong’s Centre for Health Protection has incremented their totals by just 126 cases, with neighboring Guangdong Province responsible for more than 1/3rd of those cases (n=43). 

 

Seven provinces (Hunan, Anhui, Henan, Guangxi, Jilin, Guizhou & Hebei) that reported cases during the first two H7N9 waves have yet to report a single case during this third wave, while several more (Shanghai, Zhejiang, Jiangsu, Fujian & Jiangxi) have so far reported substantially lower numbers this season.

Although closing of some live markets, and better disinfection protocols could account for this reporting decline, we’ve also seen evidence that some provinces simply aren’t reporting cases in `real time’, and instead are releasing `bulk’ announcements at irregular intervals (see HK CHP Notified Of 49 Recent H7N9 Cases In Mainland China).

Regrettably that, and the lack of patient details (age, gender, onset dates, etc.) have made it increasingly difficult to keep any reasonable track of this year’s epidemic.  

Hopefully, between upcoming journal publications by Chinese scientists, and periodic updates from the World Health Organization, we’ll be able to make better sense of this third epidemic wave in the coming months.  

Until then, we’ll simply have to accept that we may be seeing even less of the iceberg than usual.

Guangdong Province Reports 5 New H7N9 Cases

 

# 9679

Guangdong province is back today with news of an additional 5 H7N9 cases.   First the report from the Guangdong Ministry of Health and Family Planning website, then Hong Kong’s CHP notification.

 

Report of five cases of H7N9 cases in our province

2015-02-06 16:38:10   Ministry of Health and Family Planning  | Views ( 106 ) | text background color:

Case 1 Binghui Wu, male, 48 years old, history of hypertension and chronic kidney disease, now living in Tianhe District, Guangzhou City. February 5 diagnosed with H7N9 cases, the patient is currently in critical condition in hospitals in Guangzhou admitted to hospital.

Case 2 yellow Zen living, male, 76 years old, currently residing in Zhuhai City, the Bay Area. February 5 diagnosed with H7N9 cases, the patient is currently in critical condition, in Zhuhai City, admitted to inpatient hospitals.

Case 3 Huang Yuanfen, female, 62 years old, now living Huizhou City. February 5 diagnosed cases of H7N9 deaths, the day after she died.

Case 4 Wang Yanzhao, male, 55 years old, currently residing in Chaozhou Chao. February 5 diagnosed with H7N9 cases. Currently in critical condition, in Chaozhou City hospitals admitted in hospital.

Case 5 Wen Kai Ying, female, 2 years old, now living Guzhen Town, Zhongshan City. February 6 patients diagnosed with H7N9, is currently in a stable condition in Zhongshan City, admitted to inpatient hospitals.

CHP notified of five human cases of avian influenza A(H7N9) in Guangdong 

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (February 6) closely monitoring five additional human cases of avian influenza A(H7N9) 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 five patients involve three males and two females aged between 2 and 76. Among them, a woman aged 62 has passed away while the others are currently hospitalised for treatment.

To date, 561 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (156 cases), Guangdong (151 cases), Jiangsu (70 cases), Fujian (58 cases), Shanghai (44 cases), Hunan (24 cases), Anhui (17 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," a spokesman for the DH said.

(Continue . . .)

 

 

Outside of Guangdong Province, we continue to see only intermittent and often delayed announcements from the other provinces (HK CHP Notified Of 49 Recent H7N9 Cases In Mainland China). 

Guangdong Province Reports 2 Additional H7N9 Cases

Credit Wikipedia

# 9666

 

Although China’s other provinces have been strangely quiet regarding their H7N9 cases, Guangdong Province continues to report cases on their MOH website and to neighboring Hong Kong’s CHP.   Today we are informed of two more.

 

Guangzhou, Zhongshan, respectively, reported one case of H7N9 cases

2015-02-03 17:24:12   Ministry of Health and Family Planning 

Health and Family Planning Commission of Guangdong Province February 3 briefing, Guangzhou, Zhongshan, respectively, reported one case of H7N9 cases.

Case 1 Stuart, male, 56 years old, now living in Haizhu District of Guangzhou City. February 2 diagnosed with H7N9 cases, the patient is currently in critical condition in hospitals in Guangzhou admitted to hospital.

Case 2 text of a female, 9 months old, now living Zhongshan. February 2 diagnosed with H7N9 cases, the patient's condition is currently stable, in Jiangmen City, admitted to inpatient hospitals.

 

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (February 3) closely monitoring two additional human cases of avian influenza A(H7N9) 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 male patient aged 56 in Guangzhou and the 9-month-old female patient in Zhongshan were hospitalised for management in critical and stable condition respectively.

To date, 506 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (144 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

 

Given the recent lack of reports from the rest of Mainland China, the totals listed in the CHP notification must admittedly be taken with a grain of salt. 

 

We also know that – based on the number of mild or moderate cases detected – there are likely hundreds, if not thousands, of cases that go undetected (see Lancet: Clinical Severity Of Human H7N9 Infection).

 

But it is interesting to note – based on HK’s numbers – that Guangdong province, after not even registering a human case during the 1st wave in the spring of 2013, is now within striking distance of taking the lead from front runner Zhejiang Province.

Of course, that could quickly change with the next monthly epidemiological report from Zhejiang province.

HK CHP Notified Of 2 H7N9 Cases In Guangdong Province

Credit Wikipedia

 

# 9653

Guangdong Province’s streak of H7N9 reports continues with two more cases reported to Hong Kong’s CHP today.

 

 

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 31) closely monitoring two additional human cases of avian influenza A(H7N9) 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 48 (in Jieyang) died while a female patient aged nine (in Shanwei) is in stable condition and was hospitalised for management.

To date, 504 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (142 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . . )

 

The number of case reports in Guangdong are about on par with what we saw this time last year, unfortunately we’ve heard relatively little news from the other provinces.  Hopefully we’ll get a better idea of China’s overall situation from their respective monthly provincial epidemiological reports and from China’s notifications to the World Health Organization.

H7N9: HK’s CHP Notified Of 3 More Cases In Guangdong Province

Credit Wikipedia

 

# 9643

 

Guangdong province continues to find, and report, new H7N9 cases with three more added today. We are also seeing a fair amount  of `noise’ in the Chinese press about the severity of this year’s epidemic, but you couldn’t prove it by the official reports we’ve seen released this month by China’s other provinces.

Of course, an absence of data doesn’t necessarily mean an absence of cases.  Hopefully some of these cases will end up reported in their monthly epidemiological summaries.

Meanwhile, Hong Kong’s CHP has published the following notification, which makes this Guangdong’s 7th day in a row reporting 2 or more cases.

 

CHP notified of three human cases of avian influenza A(H7N9) in Guangdong

 

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 29) closely monitoring three additional human cases of avian influenza A(H7N9) 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, two male patients aged 21 (in Shenzhen) and 59 (in Meizhou) and a female patient aged 42 (in Foshan) were hospitalised for management. The male patients are in a stable condition while the female patient is in a critical condition.

To date, 502 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (140 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . .)

 

Guangdong Province: Two More H7N9 Cases

Credit Wikipedia

 

# 9636

Guangdong Province’s two-a-day streak continues with their announcement (for the 6th day in a row) of two more H7N9 cases.  First the announcement from the Guangdong Ministry of Health and Family Planning, followed by Hong Kong’s CHP summary.

 

Meizhou, Heyuan City, one case of H7N9 cases were reported

2015-01-28 16:28:38   Ministry of Health and Family Planning  |

Health and Family Planning Commission of Guangdong Province January 28 briefing, Meizhou, Heyuan City, one case of H7N9 cases were reported.

Case 1 Xiemou, male, 83 years old, now living Meizhou Dabu. January 28 diagnosed cases of H7N9, the current patient in critical condition, in Meizhou City, admitted to inpatient hospitals.

Case 2 Liaomou, male, 4 years old, now living in Heyuan City. January 27 H7N9 cases diagnosed, the patient is currently stable condition, no fever, in Heyuan City hospitals admitted to hospital.

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong (2)

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 28) closely monitoring two additional human cases of avian influenza A(H7N9) 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 two male patients aged 83 and 4 respectively in Meizhou and Heyuan were hospitalised for management in critical and stable condition.

To date, 499 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (137 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

 

While it is highly unlikely that Guangdong Province is the only hot spot for H7N9 infections in China, over the past couple of weeks we’ve seen very little information being released by the other provinces.  We may get a better idea when they release their January epidemiological reports next month.

Guangdong Province Reports 2 More H7N9 Cases

Credit Wikipedia

 

# 9634

 

Although we aren’t hearing much of anything out of China’s other provinces  Guangdong Province – perhaps because of it’s proximity and close relationship with Hong Kong – continues to update their Ministry of Health website almost daily with new H7N9 cases. 

Today, for the fifth day in a row, Guangdong is reporting two new cases (hat tip Sharon Sanders on FluTrackers).

 

Shenzhen, Meizhou City were reported one case of H7N9 cases

2015-01-27 16:56:26   Ministry of Health and Family Planning  

Health and Family Planning Commission of Guangdong Province January 27 briefing, Shenzhen, Meizhou City were reported one case of H7N9 cases.

Case 1 Lumou, female, 75 years old, have a history of hypertension, currently residing in Longhua District. January 26 diagnosed cases of H7N9, the current patient in critical condition, in Shenzhen hospitals admitted to hospital.

Case 2 Liu, female, 62 years old, have a history of hypertension, now living Meijiang District, January 26 diagnosed cases of H7N9, the current patient in critical condition, in Meizhou City, admitted to inpatient hospitals.

 

For a discussion of the likelihood that there are mild, or asymptomatic cases going undetected, you may wish to revisit Sunday’s blog :HK CHP Notified Of 2 More H7N9 Cases In Guangdong Province.

Guangdong Province Reports Two More H7N9 Cases

Credit Wikipedia

 

# 9630

A hat tip to Sharon Sanders of FluTrackers for the link to this Guangdong Emergency Management Office report on two more cases of H7N9 in Guangdong Province.  

 

Added two cases of H7N9 cases in our province

2015-01-26 19:36:00 Ben

According to the Ministry of Health and Family Planning Commission report, January 26, 2015, the province Shanwei, Jieyang City, one case of H7N9 cases were new. Shen patients (female, 20 years old), living in Shanwei City Haifeng, January 25 diagnosed cases of H7N9, now designated admitted to hospital in Shanwei City, sicker; patients Hwang (male, 52 years old), living Jieyang Rongcheng District, January 25 diagnosed cases of H7N9, now Jieyang designated hospital hospitalized in critical condition.

 

Hong Kong’s CHP has just posted a confirmation as well.

 

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 26) closely monitoring two additional human cases of avian influenza A(H7N9) 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 male patient aged 52 in Jieyang and the female patient aged 20 in Shanwei were hospitalised for management. The male patient is in critical condition while the female patient in serious condition.

To date, 495 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (133 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . . )

 

Unfortunately, we don’t appear to be getting the same kind of timely reporting out of many of the other provinces as we have seen from Guangdong Province.

HK CHP Notified Of 2 More H7N9 Cases In Guangdong Province

# 9625

 

While this winter’s reporting of H7N9 cases out of many of China’s provinces seems suspiciously slow (see Jiangsu Province’s Uncertain H7N9 Count), Guangdong Province has provided almost daily reports of new cases over the past week.

 

Today Hong Kong’s CHP has been notified of 2 more confirmed infections, making 9 (actually 10, if you count HK’s imported case) from Guangdong Province over the past 7 days.

 

First today’s update from Hong Kong’s Centre For Health Protection, then I’ll be back with a little more.

 

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 25) closely monitoring two additional human cases of avian influenza A(H7N9) 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 male patient aged 62 in Dongguan and the female patient aged 78 in Shanwei were hospitalised for management. The male patient is in critical condition while the female patient in serious condition.

To date, 493 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (131 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . . )

 

 

Since H7N9 is capable of producing a broad range of symptoms in humans – ranging anywhere from asymptomatic or mild (see Concerns Over Asymptomatic H7N9 Case In Beijing)  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

 

Simply put, those who are the most severely affected are the ones most likely to seek medical care, and are therefore more likely (but not guaranteed) to be tested for H7N9.  Being sicker, they are also more likely to succumb to the disease.

 

Inevitably, passive surveillance systems pick up `the sickest of the sick’, while mild or moderate infections in the community go untallied, skewing our perception of the mortality rate of the virus.

 

Attempts have been made to estimate the total size of the H7N9 pyramid (see Lancet: Clinical Severity Of Human H7N9 Infection), but the accuracy of these estimates is unknown.  

 

Despite their obvious limitations, the passive surveillance systems being used can often tell us if the 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.

 

Useful information, as long as you take it with a large grain of salt.

CHP Notified Of Two Additional H7N9 Cases In Guangdong

Credit Wikipedia

 

# 9622

 

Hong Kong’s CHP has announced that they’ve been notified of an additional 2 H7N9 cases in neighboring Guangdong Province, although the Guangdong Ministry of Health and Family Planning website has yet to post a statement. This bring to 20 the number of cases reported in this third wave by Guangdong Province.

 

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 24) closely monitoring two additional human cases of avian influenza A(H7N9) 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 male patient aged 46 in Meizhou and another male patient aged 77 in Chaozhou were hospitalised for management and are in critical condition.

To date, 491 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (129 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . .)

Guangdong, Zhejiang & Shanghai Report H7N9 Cases

 

# 9617

We continue to see sporadic reports of H7N9 coming out of the Chinese Mainland, with four cases reported today from three separate provinces.  

 

First stop, a notice from  Guangdong province – which has now reported 18 cases during this third H7N9 season – that informs us of two new cases.

 

Shantou, Zhaoqing City, one case of H7N9 cases were reported

2015-01-23 16:59:29   Ministry of Health and Family Planning  |      Health and Family Planning Commission of Guangdong Province January 23 briefing, Shantou, Zhaoqing were reported one case of H7N9 cases. 

Case 1 Humou, male, 68 years old, currently living Shantou area. January 23 diagnosed cases of H7N9, sicker patients currently in Shantou City, admitted to inpatient hospitals.

Case 2 Leimou, male, 4 years old, now living in Zhaoqing Sihui City, January 22 H7N9 cases diagnosed, the patient's condition is currently stable, in Zhaoqing City hospitals admitted to hospital.

 

For the second time this week Shanghai is reporting a new case as well.

 

Shanghai reported one new confirmed cases of human infection with H7N9 virus

Published: 2015-1-22

Shanghai Health and Family Planning Commission on January 22 briefing, Shanghai reported confirmed cases of the new H7N9 virus one case of human infection.

Patients, Chen, female, 75 years old, the city residence. Confirmed on January 22, patients in critical condition, is now in active treatment.

 

And lastly, Hong Kong’s CHP reports a `new’ case from Zhejiang Province.   Whether this case belongs to the group reported earlier this week by Xinhua News (see Zhejiang province has seen 14 cases this winter) or is a fresh case, is impossible to tell from the information provided.   Despite the Xinhua report, Hong Kong is only showing 8 new cases this winter in Zhejiang. 

 

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

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 23) closely monitoring four 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 of Guangdong Province, the two cases involved a 68-year-old man in Shantou who was hospitalised for treatment in serious condition, and a 4-year-old boy in Zhaoqing who is in stable condition.

According to the Shanghai Municipal Commission of Health and Family Planning, the patient in Shanghai is a woman aged 75 who was under treatment in critical condition. In addition, according to the Health and Family Planning Commission of Yiwu Municipality, the patient in Yiwu, Zhejiang, is a man aged 45 who was under isolation and treatment.

To date, 489 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (146 cases), Guangdong (127 cases), Jiangsu (63 cases), Shanghai (44 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . .)

  

The above listing showing 489 human cases represents only those cases hospitalized, tested, and diagnosed with the H7N9 virus and likely represents only a portion of the total number of cases. There are likely a number of mild, or even asymptomatic infections that go unnoticed, as well as serious or even fatal cases that are simply never diagnosed.

 

In 2013, a study appearing in  The Lancet (see Lancet: Clinical Severity Of Human H7N9 Infection) attempted to quantify that number - at a time when the `official count’ hovered around 130 cases -estimating `that between 1500 and 27 000 symptomatic infections with avian influenza A H7N9 virus might have occurred as of May 28, 2013’.

 

The accuracy of these estimates is unknown, but it is very likely that the official case counts under-represent the real burden of H7N9, perhaps by a sizable margin.

And this winter, the reporting of cases out of China seems more inconsistent than during previous H7N9 epidemic waves, with less detailed information provided, all of which adds a bit more `fog’ to obscure our view of this year’s outbreak.

Hong Kong CHP Notified Of 1 H7N9 Case In Shenzhen

 

 

# 9615

 

We’re having a much tougher time figuring out what’s going on with the H7N9 virus in China this winter, as reporting of cases has become increasingly haphazard, and those reports we do get have very little information in them. 

 

It is possible that closure of some live poultry markets has reduced the number of human infections this year, but the inconsistent reporting of cases and conspicuous lack of detail are less than reassuring. 

 

This from Hong Kong’s CHP.

 

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

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 22) closely monitoring an additional human case of avian influenza A(H7N9) in Shenzhen 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 male patient aged 58 with underlying illnesses was hospitalised for treatment in serious condition.

To date, 485 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (145 cases), Guangdong (125 cases), Jiangsu (63 cases), Shanghai (43 cases), Fujian (28 cases), Hunan (24 cases), Anhui (17 cases), Jiangxi (nine cases), Xinjiang (nine cases), Shandong (six cases), Beijing (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . .)

 

Curiously, we’ve seen cases reported from some of China’s provinces that have yet to be added to Hong Kong’s list, such as the announcement by Xinhua News yesterday that Zhejiang province has seen 14 cases this winter.

 

The list above only reflects 7 cases this year in Zhejiang.

 

So, while we continue to get scattered reports of H7N9 out of China, how well that represents the level of activity in this year’s wave remains to be seen.

Guangdong & Shanghai Report New H7N9 Cases

 

# 9594

 

The flow of H7N9 information out of China has been - to put it kindly - `variable’  this winter, with some provinces releasing information as they get it, and others waiting to release case reports in weekly or monthly summaries.  

 

We are also not seeing the kind of detail (onset dates, possible exposures, etc.) this year that we often saw released during the first two H7N9 waves, complicating the creation of reliable line-list reports.

 

Although I haven’t found anything on the Guangdong Health Department website, we have this first report on two new Guangdong cases reported by Xinhua News.

 

Guangdong soared two H7N9 cases

CNA -January 18, 2015 19:55 pm

(CNA Taipei 18 (Xinhua)) today informed the Guangdong Provincial Health and Family Planning Commission, Shenzhen, Shanwei were a new confirmed cases of avian influenza virus H7N9. In which a man in critical condition, another girl of clinical symptoms disappeared already.

Xinhua News Agency reported, H7N9 cases confirmed in Shenzhen for 66-year-old man surnamed Chen patients, now living Longhua District, renal insufficiency, diabetes and other diverse history, the 17th confirmed, is currently in critical condition at a hospital in Shenzhen, treatment .

Shanwei confirmed H7N9 cases was a year and a half of Huang girl now living Shanwei City, on the 13th specimen was collected specimens, 16 were confirmed as H7N9 positive.

But reported that, after treatment, clinical symptoms Huang girls have disappeared, and then after 17 specimen samples collected and tested, has been restored to a negative reaction.

 

 

Along with this brief report from the Shanghai Department of Health & Family Planning.

 

Shanghai reported one case of H7N9 virus infection confirmed cases

January 17, 2015

Shanghai Health and Family Planning Commission on January 17 briefing, Shanghai reported one case of H7N9 virus infection confirmed cases.

Patients Zhang, male, 69 years old, the city residence. Confirmed on January 17, is now in active treatment.

 

Although there is a high degree of uncertainty over just how many cases China is seeing right now, so far there are no indications that the H7N9 virus is spreading any more efficiently this year than we’ve seen in previous years.

Guangdong Reports 2 New H7N9 Cases

Credit Wikipedia

 

# 9563

 

Although we’ve seen some recent evidence suggesting that some of China’s provinces are a bit slow in announcing H7N9 cases (see Jiangsu Province’s Uncertain H7N9 Count), the good news is that Hong Kong’s immediate neighbor – Guangdong Province – still appears to be publishing notices when cases are detected.

 

This morning word of two more cases of H7N9 infection.  First the announcement from the Guangdong Province Ministry of Health, followed by the notification of Hong Kong’s CHP.

 

Health and Family Planning Commission of Guangdong Province January 12 briefing,

Shenzhen, Dongguan City, were reported one case of H7N9 confirmed cases.

Patients with a Yang, male, 42 years old, currently living Luohu District, Shenzhen, January 11 diagnosed cases of H7N9, the current patient in critical condition, in Shenzhen hospitals admitted to hospital.

Patient 2 Zhu, female, 52 years old, now living in Dongguan City, Huang, January 11 diagnosed cases of H7N9, the current patient in critical condition, in Dongguan City, admitted to inpatient hospitals.

 

 

CHP notified of two human cases of avian influenza A(H7N9) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 12) closely monitoring two additional human cases of avian influenza A(H7N9) 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 male patient (aged 42) in Shenzhen and the female patient (aged 52) in Dongguan were hospitalised for management and are in a critical condition.

To date, 460 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities, respectively in Zhejiang (141 cases), Guangdong (117 cases), Jiangsu (59 cases), Shanghai (42 cases), Hunan (24 cases), Fujian (23 cases), Anhui (17 cases), Jiangxi (eight cases), Xinjiang Uyghur Autonomous Region (eight cases), Beijing (five cases), Shandong (five cases), Henan (four cases), Guangxi (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . . )