Showing posts with label Jiangsu. Show all posts
Showing posts with label Jiangsu. Show all posts

Thursday, January 08, 2015

Jiangsu Province’s Uncertain H7N9 Count

image

Credit Wikipedia

 

 

# 9548


Since we were already aware of three H7N9 cases earlier in the fall (in October and November), it isn’t entirely clear how many of those cases are included in today’s report citing 8 cases, and 4 deaths over the past 2 months. 

 

Based on Jiangsu Province’s December Infectious disease report – which lists 4 H7N9 cases during that month – it seems likely that at least 4 or possibly 5 of these cases were previously unreported.

 

Without onset dates, ages, and genders it becomes increasingly difficult to keep any sort of reasonable count of cases.  Previously Hong Kong’s CHP has been notified of cases by the mainland, and has promptly published those announcements, but we’ve not seen any published accounts of these cases on their website either.

 

As I wrote earlier today, in Fujian Province Reports 6 H7N9 Cases In December, the lack of timely and robust reporting of cases would greatly diminish our ability to evaluate this year’s epidemic wave.  We obviously never know with precision how many infections occur – as  many will be too mild to seek medical care – but knowing the number of severe cases (and their outcomes) provides a pretty good snapshot of the epidemic.

 

About all we can say at this point is – with the addition of at least 10 more cases in the month of December – is that the H7N9 season is apparently off to a strong start.

 

 

Jiangsu H7N9 confirmed cases of influenza were reported over the past two months in 8 cases in 4 cases

January 08, 2015 20:10 source: China News Network to the engagement (0)

CNS, Nanjing, January 8 (reporter Zhu Xiaoying)-8th said health and family planning Committee, from Jiangsu Province, latest statistics showed that from November 2014, Jiangsu H7N9 confirmed cases of influenza were reported in 8 cases, 4 deaths. Cases before the attack, have come into contact with poultry farms, or to live poultry trading history.

As of now, all close contacts of the cases showed no abnormalities.

Jiangsu Province, according to the health and family planning Commission announced that at present, H7N9 flu cases are distributed State, have not yet found evidence of efficient person-to-person. China, meanwhile, such as Fujian, Zhejiang, Shanghai, Guangdong and Xinjiang also has H7N9 influenza cases have been reported.

The Commission experts believe, is the high incidence of influenza and other respiratory diseases in winter and spring season, Jiangsu Province in a local area of H7N9 the possibility of sporadic cases of influenza in humans.

In this regard, the Commission guidance relating to municipal health department in accordance with the relevant plans and regulations, implementation of case management, contact tracing and closely monitoring medical observation, emergency measures, such as.

The Commission experts believe H7N9 and H5N1 is considered to be an animal influenza virus, and occasionally infecting humans, and does not contact with poultry or live poultry trading floors H7N9 odds of infection, the public do not need to panic.

Yangtze River Delta as many government departments make tough rules on live poultry trade. Zhejiang from July 1 last year, districts and cities main city permanently closed live poultry markets. Huangpu district, Shanghai, Jing an district, and other live poultry trade point has been permanently closed. Poultry, Nanjing, Nanjing, Jiangsu set up the transaction management approach (draft) for public comment, which clearly, the main city intends to permanently halt sale of live poultry. (End)

Monday, November 03, 2014

Jiangsu Province Reports H7N9 Case

image

Two Waves of H7N9  - Credit Hong Kong’s CHP

 

# 9279

 

Although it  emerged less than two years ago (Feb 2013), the H7N9 avian influenza virus has already sparked two sizable human outbreaks in Eastern China – both peaking in late winter – and has shown that it is evolving in worrisome ways, prompting this warning last June from Eurosurveillance: Genetic Tuning Of Avian H7N9 During Interspecies Transmission.

 

Overall, due to the genetic tuning procedure, the potential pandemic risk posed by the novel avian influenza A(H7N9) viruses is greater than that of any other known avian influenza viruses.

 

While we can’t know what this winter holds in store for the H7N9 virus, studies released earlier this year (see EID Journal: H7N9 As A Work In Progress), show that the H7N9 avian virus continues to reassort with local H9N2 viruses, introducing new clades of the virus into China’s poultry population.

 

Admittedly, H5N1, H5N6, H10N8, H9N2, and H7N7 are not out of the running, but right now  H7N9 seems to be the rising star in the avian flu world.  Like its older cousin, H5N1, H7N9 shows distinct seasonality, with cases all but disappearing during the summer only to rise again during the winter.

 

After a slow summer, in mid-October we saw CHP: Mainland China Reports Two H7N9 Cases, and today we get this report from the Jiangsu MOH.

 

Province confirmed one case of human infection with H7N9 bird flu


Published: 2014-11-02 

Ministry of Health and Family Planning Commission informed the province confirmed one case of human infection with the H7N9 avian influenza.

Patients Tianmou, female, 58 years old. Nov. 1 pm Expert Group on human infection diagnosis was in Nanjing confirmed cases of H7N9 avian influenza. Two weeks to go before the onset grocer bought a chicken and live slaughter, currently in a hospital in Nanjing, where the condition is extremely critical.

 

Hong Kong’s CHP also takes note of this announcement:

 

3 November 2014

DH closely monitors additional human case of avian influenza A(H7N9) in Jiangsu 

The Department of Health (DH) is today (November 3) closely monitoring an additional human case of avian influenza A(H7N9) reported by the Jiangsu Provincial Commission of Health and Family Planning (the Commission), and hence called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.

According to the Commission, the patient is a woman aged 58 who visited a market and bought and slaughtered a chicken before onset. She is now hospitalised for treatment and is in critical condition.

To date, 441 human cases of avian influenza A(H7N9) have been confirmed on the Mainland in Zhejiang (139 cases), Guangdong (109 cases), Jiangsu (57 cases), Shanghai (41 cases), Hunan (24 cases), Fujian (22 cases), Anhui (17 cases), Jiangxi (eight cases), Beijing (five cases), Shandong (five cases), Henan (four cases), Guangxi (three cases), Xinjiang Uygur Autonomous Region (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).

(Continue . . . )

 

For now the world remains focused on the enormous public health and humanitarian tragedy of Ebola in West Africa, and rightfully so. But at the same time there are a handful of other viruses – including H7N9 – that continue to circulate in the wild that are better suited to spark a pandemic (see It’s Not Just Ebola).

 

Over the past 12 months we’ve seen the importation of H5N1 into Canada, MERS-CoV cases into the United States (along with 20+ other countries), imported H7N9 to Taiwan, Hong Kong & Malaysia, imported CCHF in the UK, Lassa fever in a traveler in Minneapolis, and the recently arrived Chikungunya virus has probably infected a million plus people in the Americas.

 

Ample reminders that even while we fight one viral foe, there is always the chance that we could be blindsided by another coming out of left field.

Tuesday, January 28, 2014

Zhejiang, Guangdong & Jiangsu Provinces Add H7N9 Cases

image

Credit CDC

 

# 8232

 

 

After a one-day break in reporting, Zhejiang is back today with four new cases, along with three new cases in Shenzhen City (Guangdong Province), and one new case in Jiangsu Province.   We may see additional announcements later in the day, but for now we have 8 new cases.

 

Of note, two of the four cases announced today from Zhejiang are described as `mild’ – which, while good for the patient – can make it more difficult to identify and isolate those infected with this avian virus. It is axiomatic that we are more likely to test those experiencing serious illness, as they tend to go to hospitals more frequently.  

 

So, one of great the unknowns with this H7N9 virus  is how many `mild’ or asymptomatic infections go undetected.

 

Last summer, 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.

 

Zhejiang Province, four new cases of human infection of bird flu H7N9

Release date :2014 -01-28
Source: Ministry of Health and Family Planning Commission

 

Zhejian Provincial Health and Family Planning Commission January 28 briefing, the province today added four cases of human infection with H7N9 avian influenza.


1, the patient surname Wang, female, farmer, aged 43, Xiaoshan District, Hangzhou people. January 27 confirmed human cases of avian influenza H7N9 infection. Now the disease is mild, in Hangzhou, a hospital for treatment.


2, Shen certain patients, male, farmer, aged 81, Changxing County. January 27 confirmed human cases of avian influenza H7N9 infection. Is now in critical condition at a hospital in Huzhou treatment.


3, the patient Xia Moumou, female, farmer, aged 63, Huzhou, Deqing County. January 27 confirmed human cases of avian influenza H7N9 infection. Now the condition is severe, treatment in a hospital in Hangzhou.


4, the patient surname Wang, male, retired, 57 years old, Yinzhou District, Ningbo people. January 27 confirmed human cases of avian influenza H7N9 infection. Now the disease is mild, treatment in a hospital in Ningbo.

 

Shenzhen City, which is located just 20 miles north or Hong Kong, reports 3 new cases today.  Of note, Shenzhen’s cases today are running noticeably younger than most of those being reported the past few days.

 

 

Province added three cases of human infection with H7N9 bird flu

2014-01-28 15:26:06 Ministry of Health and Family Planning Commission |  color:

January 28, informed the Ministry of Health and Family Planning Commission: H7N9 confirmed cases of avian flu in Shenzhen City, three cases of human infection with the new report.


Case 1 Zengmou, female, 43 years old, a native of Guangdong, Shenzhen, currently residing in Bao'an District of Shenzhen City streets. January 27 confirmed cases of human infection of H7N9 avian influenza, the patient's condition is currently stable in Shenzhen designated hospital admission.


Case 2 Cai, female, 41 years old, a native of Guangdong of the state, now living Longgang District streets. January 27 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in Shenzhen designated hospital admission.


Case 3 Lin, female, 31 years old, a native of Shantou, now live in the South Bay Street, Longgang District. January 27 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in Shenzhen designated hospital admission.

 

Our last stop is Jiangsu Province, which reports their 7th H7N9 case of 2014.

 

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

Published :2014 -01-28 

Provincial Health Department, the province confirmed cases of new H7N9 bird flu case of human infection.

Patient named Ma, male, 53 years old. January 27 was the night of Huai'an City confirmed human cases of avian influenza H7N9 infection. Currently in Huai'an a hospital for treatment, serious condition.

 

Despite this daily parade of fresh cases , thus far we haven’t seen any epidemiological evidence to indicate the virus is transmitting between humans in an efficient or sustained manner.

Saturday, January 25, 2014

Zhejiang, Jiangsu & Guangdong Provinces Report H7N9 Cases

image

 


# 8220

 

 

While we continue to see a steady stream of H7N9 cases reported in Eastern China, thus far, we've not seen the kind of geometric increase in the numbers that would signify sustained human-to-human transmission.  Today, three provinces are reporting new cases, and as we've seen for more than the past two weeks, Zhejiang Province leads the way.

 

Zhejiang Province, three new cases of human infection of bird flu H7N9

Release date :2014 -01-25
Source: Ministry of Health and Family Planning Commission
January 25, 2014

Zhejiang Provincial Health and Family Planning Commission January 25 briefing, the province today added three cases of human infection with H7N9 avian influenza.

1, patients Moumou, male, worker, aged 49, Huzhou, Deqing County. January 24 confirmed human cases of avian influenza H7N9 infection. Now the condition is severe, treatment in a hospital in Hangzhou.

2, patients Luomou, female, farmer, aged 60, who Ningbo area. January 24 confirmed human cases of avian influenza H7N9 infection. Now the condition is severe, in Ningbo, a hospital for treatment.

3, the patient Yao Moumou, female, farmer, aged 48, Cixi, Ningbo people. January 24 confirmed human cases of avian influenza H7N9 infection. Now the condition is severe, in Ningbo, a hospital for treatment.

 

Guangdong Province also adds one case today.

 

Province added one case of human infection of bird flu H7N9

2014-01-25 21:06:47 Ministry of Health and Family Planning Commission |  color:

 Health and Family Planning Commission of Guangdong Province on January 25 briefing, Shenzhen new confirmed cases of H7N9 avian influenza case of human infection.


Zhongmou patient, male, 82 years old, currently residing in Luohu District, Shenzhen, the evening of January 24 confirmed cases of human infection with H7N9 avian influenza is currently seriously ill patients, admitted in Shenzhen designated hospital.

 

As does Jiangsu Province.

 

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

Published :2014 -01-25 Provincial Health Department, the province confirmed cases of new H7N9 bird flu case of human infection.

Qianmou patient, male, 57 years old. The evening of January 24 was diagnosed Suzhou confirmed cases of human H7N9 avian influenza infection. Suzhou is currently in a hospital for treatment, serious condition.

 

The five H7N9 cases are in addition to the newly reported H10N8 case from Jiangxi province (see Jiangxi Province Reports Second H10N8 Infection) I blogged about earlier today.

Wednesday, January 22, 2014

Zhejiang, Jiangsu Provinces Report New H7N9 Cases

image

Dr. Ian Mackay’s most recent `SNAPDATE’ of H7N9 cases

 


# 8207

 

As the chart above, from Ian Mackay’s Virology Down Under blog clearly indicates, the number of H7N9 cases reported out of Zhejiang province is roughly double that of the second place finisher – Shanghai – and it continues to climb like a homesick angel.

 

For the 6th day running, Zhejiang Province is reporting another 3 H7N9 cases today, further extending their less-than-desirable lead.

 

Zhejiang Province, three new cases of human infection of bird flu H7N9

Release date :2014-01-22
Source: Ministry of Health and Family Planning Commission


Zhejiang Provincial Health and Family Planning Commission January 22 briefing, the province today added three cases of human infection with H7N9 avian influenza.


1, patients Lin Moumou, male, 53 years old, farmer, now living in Xiaoshan District. January 21 confirmed human infection of H7N9 avian influenza. Is now in critical condition, in Hangzhou, a hospital for treatment.


2, patients with Ruan Moumou, male, 71 years old, farmer, Taizhou Jiaojiang people. January 21 confirmed human infection of H7N9 avian influenza. Is now in critical condition, a hospital for treatment in Taizhou.


3, the patient Lin Moumou, female, 63 years old, farmer, Wenling, Taizhou City People, January 21 confirmed human cases of avian influenza H7N9 infection. Is now in critical condition, in Hangzhou, a hospital for treatment.

 

We also saw an announcement late yesterday from Jiangsu province of a single case.

 

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

Published :2014-01-21 

Provincial Health Department January 21 Bulletin, the province 1 new confirmed cases of human infection with H7N9 avian influenza.

A quarter of patients, male, 71 years old. January 21 pm Nanjing infected human H7N9 avian influenza cases diagnosed. Treatment in a hospital in Nanjing is currently in a critical condition.

 

Despite this daily parade of new cases, thus far we haven’t seen compelling evidence of sustained or efficient human-to-human transmission of this virus.

Friday, January 10, 2014

Jiangsu Province: Media Reports H7N9 Case

image

Credit Wikipedia


# 8156

 

The reports this morning continue to come in from Mainland China, with Chinese media reporting that Jiangsu Province has announced  their second H7N9 case of the New Year.   So far, I’ve not found any official statement on the Jiangsu Provincial Health Department website, but multiple media sources are reporting this latest case.

 

So far today – in addition to this latest one - we have 1 case reported from Fujian Province,  2 Cases from Guangdong Province, and 2 cases from Zhejiang Province.

 

Two media reports.  First from China News Network, followed by a report from Hong Kong’s Metroradio News summarizing all six cases reported today.

 

Jiangsu Province 1 new case of human infection of bird flu H7N9

At 19:47 on January 10 2014

Source: China News Network

BEIJING, Jan. 10 Nanjing Electric (Lu Hui) Jiangsu Provincial Health Department notified the afternoon of January 10, Jiangsu new confirmed cases of H7N9 avian influenza case of human infection. Up to now, a total of Jiangsu confirmed two cases of human infection with H7N9 avian influenza.

Jiangsu Province Health Department informed that the afternoon of the 10th, to declare a patient, male, 54 years old, 9 January afternoon in Nanjing confirmed infected human cases of avian influenza H7N9, now a hospital in Nanjing treatment, his condition is stable.


Another patient Qu a, female, 54 years old, now living in Nanjing. The evening of January 7, Jiangsu Province, the expert group for people infected with H7N9 bird flu diagnosis confirmed cases. Currently the treatment of patients in a hospital in Nanjing. (End)

 

 

Fujian, a man died after dyeing H7N9 bird flu


10/01/2014 9:01 PM

Mainland Six more confirmed H7N9 avian influenza infection, one of whom died.

Deaths from Fujian, the deceased was a 38-year-old man, who had tuberculosis, pneumoconiosis and other diseases, living in Hui'an, he developed symptoms on June 3, the day before due to exacerbations, Quanzhou stay hospital treatment, morning disease was diagnosed, but am dead.

Guangdong Nanhai District of Foshan two women are diagnosed with disease, two were 42 years old and 59 years old, one of whom engage in wholesale sales of live poultry, live birds of another person without obvious exposure history. Both currently hospitalized, authorities means that the two symptoms minor, is a sporadic cases, no epidemiological link.

Zhejiang province also added two infections. Patient was a 79-year-old woman and a 30-year-old man were in Jiaxing and Ningbo in hospital in a critical condition.

In addition, Jiangsu, a 54-year-old man also diagnosed disease, now in Nanjing hospital treatment, his condition is stable.

 

As we saw last spring, case reports often come out piecemeal, with each province reporting late in the evening (local time).  As the number increase, keeping track of these cases becomes increasingly difficult, and at some point, may become impractical.

 

While the pace continues to pick up, so far we’ve seen no indication that this virus is transmitting in a sustained or efficient manner among humans.

Wednesday, January 08, 2014

Jiangsu Province Reports H7N9 Case

 

image

Credit Wikipedia

 

 

# 8138

 

 

In what is getting to be a daily occurrence, mainland officials have notified Hong Kong of their 6th H7N9 case over the past 5 days, this time involving a 54-year old woman from Jiangsu Province.  This also marks the 4th province to report a human infection since the start of the New Year (others are Zhejiang, Guangdong and Shanghai), suggesting the virus remains widespread across much of Eastern China.

 

First the notification announcement from Hong Kong’s CHP, after which I’ll be back with a little more.

 

8 January 2014

NHFPC notifies additional human case of avian influenza A(H7N9) in Jiangsu 

The Centre for Health Protection (CHP) of the Department of Health (DH) received notification today (January 8) from the National Health and Family Planning Commission (NHFPC) of an additional human case of avian influenza A(H7N9) in Jiangsu affecting a woman aged 54.

The patient, who lives in Nanjing, was admitted to a local hospital for treatment. Her specimen tested positive for the avian influenza A(H7N9) virus by the relevant health authority of Jiangsu Province last night.

To date, a total of 151 human cases of avian influenza A(H7N9) have been confirmed on the Mainland. They are in Zhejiang (52 cases), Shanghai (34 cases), Jiangsu (29 cases), Guangdong (10 cases), Jiangxi (six cases), Fujian (five cases), Anhui (four cases), Henan (four cases), Beijing (two cases), Hunan (two cases), Shandong (two cases) and Hebei (one case).

The CHP will follow up with the Mainland health authorities for more case details.

"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.

(Continue . . .)

 

 

This increase in H7N9 cases in China was widely predicted once colder temperatures returned this winter (see last September’s Chinese CDC: Be Alert For H7N9), and the bigger surprise would have been its failure to return.  We should not be surprised to see a steady stream of such reports over the next couple of months.

 

Hong Kong, which was severely impacted by the SARS outbreak in 2003 (see SARS And Remembrance), has beefed up border checkpoints, increased testing and surveillance, and engaged in extensive public health messaging regarding the H7N9 virus threat, with reminders posted in shop windows, on billboards, and on the sides of buses across the city.

image


While there has been no indication of sustained human-to-human spread of this virus, and live healthy-looking market birds are considered the prime suspects in spreading the virus -  there are still many unanswered questions regarding how it is ultimately jumping  to humans.

 

Questions that include which animal reservoirs are spreading the virus, the incidence of mild or asymptomatic (hence, unidentified) infections in the human population, and  how much of a pandemic threat this virus really poses.

 

While this virus appears more easily transmitted to humans from its animal source than other avian flu viruses we’ve followed (H5N1, H7N9, H9N2), thus far it hasn’t adapted well enough to human physiology to spread efficiently once it makes that initial jump. 

 

And perhaps it never will.


But each new human infection gives the virus another opportunity to `figure us out’, and so we watch these sporadic cases carefully, looking for any signs that the behavior of this virus has changed.

Monday, April 15, 2013

H7N9: Jiangsu Province - 1 New Case, 1 Fatality, 1 Improves

 

image

Jiangsu Province - Credit Wikipedia

 

# 7139

 

 

This is about the time of day that we start seeing updates on the various provincial health department websites in China regarding the H7N9 virus. 


Jiangsu Province, which had already reported 16 cases (1 fatality), adds one more case, and reports the death of a case we already had logged.


This (machine translation) from the Jiangsu Health Department.

 

April 15 new confirmed cases of human infection of H7N9 avian influenza cases in Jiangsu


Published :2013 -4-15

Health Department of Jiangsu Province, April 15 Bulletin, Jiangsu newly confirmed cases of human infection of H7N9 avian influenza.

 

Patient Kongmou, male, 60 years old, now living in Kunshan City. On April 15, the provincial expert group diagnosed cases of human infection of H7N9 avian influenza confirmed cases. Where critical condition in a hospital in Suzhou. After investigation, close contacts of the cases a total of 3 people, far showed no abnormality.

 

In addition, the Nanjing case of human infection confirmed cases of the H7N9 avian flu Gumou female, 77 years old, and hypertension have done rectal surgery. By the provincial expert group consultations, rescue invalid death on the evening of 14 November.

 

A bit easier to decipher, the following short notice was posted on The Hong Kong Standard’s H7N9 Watch.

 

(H7N9 Watch) Fatality reported in Nanjing


A new case was reported in Jiangsu Province, where a 60-year-old man was infected of the H7N9 virus. He is being treated in a hospital now. It brings the total number of such cases in China to 61.

A 77-year-old woman who was infected by the virus died Sunday night, bringing the total deaths to 14.

 

Note: The case-count of 61 doesn’t apparently take into account the asymptomatic case reported yesterday in Beijing.

 

From the Jiangsu Health Department website we also learn of the improvement (and viral clearance) of a 79 year-old man who had been placed into intensive care 10 days ago.

 

Jiangsu, one case of H7N9 avian influenza in critically ill patients have been transferred to the general ward rehabilitation


Published :2013 -4-15

image

Patients 陆某, male, 79 years old. April 5 confirmed human infection of H7N9 avian influenza, and transferred to the intensive care unit treatment of Nanjing Second Hospital in critical condition, on April 6. Several consultation of provincial-level expert group organized by the Provincial Health Department, the rescue efforts, the patient's condition improved markedly, two H7N9 nucleic acid test results were negative. Consultation by the Expert Group, agreed to lift the quarantine, April 15 patients transferred from the intensive care unit to a general ward rehabilitation.

 

Patients admitted to hospital in critical condition, diagnosis lungs severe pneumonia, respiratory failure, heart failure, a large number of bloody pleural effusion, liver dysfunction after admission Tamiflu antiviral therapy, continuous mechanical ventilation, antibiotics and supportive care and other comprehensive treatment of inflammation of the lungs in patients gradually control, respiratory failure to correct, cardiac function returned to normal, bloody pleural effusion eliminate, the temperature dropped to normal respiratory function improved significantly.

 

Now successfully evacuated the ventilator, oxygen saturation in patients with low-flow nasal cannula oxygen maintained at more than 95% of peripheral blood leukocytes was back to normal, the reexamination chest CT lungs inflammation apparent absorption, pleural effusion elimination. Currently, patients with breathing steady, significant improvement in appetite and mental state, and has been able to get out of bed.

Saturday, April 13, 2013

Jiangsu Province Reports 2 New H7N9 Cases

 

image

Jiangsu Province - Credit Wikipedia

# 7125

 



With the announcement (see Beijing Confirms First H7N9 Case) that the emerging H7N9 virus has infected a child in China’s capital – some 800 miles away from Shanghai where the first cases appeared – this outbreak suddenly becomes both more widespread, and more difficult to contain.

 

This morning, a report out of Jiangsu Province announcing two more H7N9 infections, bringing the nation’s total to 46, with 11 fatalities. 

 

This rather barebones report from the Jiangsu Health Department.

 

Two cases of new confirmed cases of human infection with the H7N9 avian influenza in Jiangsu Province, April 13


Published :2013-4-13

Health Department of Jiangsu Province, April 13 Bulletin, Jiangsu Province, the new confirmed cases of human infection of H7N9 avian influenza.

Patient Gumou, female, 77 years old, live in Nanjing, the former Baixia. On April 13, the provincial expert group diagnosed cases of human infection of H7N9 avian influenza confirmed cases. Currently, where a critical condition in a hospital in Nanjing. After investigation, the close contacts of the cases of a total of seven people, far showed no abnormality.

 

The patients named Ma, male, 72 years old, live in Changshu. On April 13, the provincial expert group diagnosed cases of human infection of H7N9 avian influenza confirmed cases. Currently in a hospital in Suzhou City, where a critical condition. After investigation, close contacts of the cases of a total of nine people, far showed no abnormality.

 

 

Again we are seeing primarily older patients diagnosed with this virus, something we expect to see with seasonal flu, but not necessarily with a novel strain like H7N9  to which the entire community presumably has no prior exposure and therefore no immunity.

 

The age distribution of cases - with most being over the age of 50 - poses an interesting epidemiological riddle, with no solid answers at this time.

 

Now that testing reagents have been distributed to other provinces in China, and testing outside of China ramps us, we will hopefully start seeing some answers to the long list of questions we have on this emerging virus.

Thursday, April 11, 2013

H7N9: Jiangsu Province Adds Two Cases, China Total 35

 

image

Jiangsu Province – Credit Wikipedia

 

# 7111

 

 

 

It is early evening in China and local provinces are starting to post their new H7N9 updates on their Health Department websites.   First to report is Jiangsu Province, with the following announcement.

 

 

Jiangsu Province 2 new cases of human infection of H7N9 avian influenza confirmed cases


Published :2013-4-11

Health Department of Jiangsu Province, April 11 Bulletin, Jiangsu Province, the new confirmed cases of human infection of H7N9 avian influenza.

 

Patients surnamed Yin, male, 31 years old, now a hotel in Yangzhou City in chefs work. Disease, March 31 at noon on April 11, the provincial Expert Group on the diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. Currently, where a critical condition in a hospital in Nanjing. After investigation, the close contacts of the case has a total of 19 people, far showed no abnormality.

 

Patients Qianmou, male, 56 years old, now live in the Suzhou Industrial Park, teachers. Onset of April 3, April 11 at noon, the provincial expert group diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. Currently in a hospital in Suzhou City, where a critical condition. After investigation, the close contacts of the cases there were 33 people, far showed no abnormality.

 

 

Today’s announcement brings the total number of cases reported in Jiangsu Province to 12, exceeded only by Shanghai (with 15 cases)  in numbers.

 

While the case counts continue to increase, officials continue to report no signs of efficient, or ongoing, human-to-human transmission.  

 

This latest report brings China’s H7N9 outbreak up to 35 cases, with 9 fatalities.

Wednesday, April 10, 2013

China: Reports Of 3 New H7N9 Cases

 

image

Jiangsu and Zhejiang Provinces – Credit Wikipedia

 

 

# 7105

 

 

Information on China’s bird flu outbreak continues to arrive this morning in piecemeal fashion, as with these latest reports of 2 cases in Jiangsu province and 1 case in Zhejiang Province, but overall our understanding of the situation remains poor.

 

Although rising case counts are concerning, without knowing the identity of the reservoir host, how the virus is being spread to humans, and ultimately how many people have been infected, we are left with too little information to make any reasonable predictions about where this outbreak is headed.

 

For now, we remain very much in watchful waiting mode - but encouragingly - we have yet to see any signs of sustained human-to-human transmission of the virus.

 

The following statement comes from the Jiangsu Provincial Health Department.

 

Jiangsu Province 2 new cases of human infection of H7N9 avian influenza confirmed cases


Published :2013 -4-10

Health Department of Jiangsu Province, April 10 Bulletin, Jiangsu Province, the new confirmed cases of human infection of H7N9 avian influenza.

 

Patients Chen, male, 70 years old, and now live in Wuxi Huishan. Onset of March 29, April 10, the provincial expert group diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. Currently in critical condition. After investigation, the close contacts of the cases to a total of 18 people have a fever or respiratory symptoms were not found until now.

 

Patients Xu, male, 74 years old, Jiangyin City, Wuxi City. The onset of April 2, April 10, the provincial expert group diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. Current serious condition. After investigation, the close contacts of the cases there were 13 people, have a fever or respiratory symptoms were not found until now.

 

 

We’ve also a news report from the Zhejiang Daily indicating a new case in Zhejiang Province, although I can find no announcement on the Zhejiang Provincial Health Department website

 

This IFeng report h/t FluTrackers.

 

Zhejiang new cases of human infection with the H7N9 avian flu cases in the 10th

Apr. 10, 2013 13:48
 

News] Health Department of Zhejiang Province, April 10 briefing ended at 12:00 on April 10th, Zhejiang Province, new cases of human infection with H7N9 avian influenza. Patients Humou, male, 65 years old, farmers, Hangzhou , now a hospital for medical treatment. April 10, the provincial CDC report patient specimens for H7N9 avian influenza virus nucleic acid positive and confirmed by the Provincial Health Department organized experts. Currently, the patient's condition is still stable, the hospital is active treatment. Reporter Chen Ning

 

 

Assuming both reports are valid, this would bring the total number of cases to 31, with 9 fatalities. We may very well see additional reports later in the morning.

 

UPDATE:  Shortly after I posted this report, I found the following confirmatory update on Hong Kong’s CHP press release site.

 

Three more human cases of Influenza A (H7N9) verified by NHFPC 

The Centre for Health Protection (CHP) of the Department of Health (DH) verified with the National Health and Family Planning Commission (NHFPC) today (April 10) one human case of Influenza A (H7N9) in Zhejiang and two cases in Jiangsu.

 

According to the Department of Health of Zhejiang Province, the case involves a 65-year-old man who is currently receiving treatment in hospital and is in a stable condition. The patient's specimen yielded positive for H7N9 upon laboratory testing by the Mainland health authority.

 

In addition, the Jiangsu Health Department revealed that two male patients aged 70 and 74 are currently in a critical and serious condition respectively. The 31 close contacts of the duo are asymptomatic so far.

 

A spokesman for the DH stressed that the CHP is closely monitoring the situation and will continue to maintain close liaison with the Mainland health authorities for more case information as well as to keep a close eye on the latest advice from the World Health Organization.

 

The spokesman also reminded travellers, especially those returning from Shanghai, Anhui, Jiangsu and Zhejiang, with fever or respiratory symptoms, to wear facial masks immediately, seek medical attention, and reveal their travel history to doctors. Healthcare professionals should also pay special attention to those who might have had contact with birds, poultry or their droppings in the affected areas.

 

(Continue . . . )

Tuesday, April 09, 2013

China Reports 8th H7N9 Fatality

image 

 


# 7100

 

 

An 83 year-old patient that was described as being in critical condition with the H7N9 virus on April 2nd (see Statement From Jiangsu Province Health Department On H7N9) has died, according to an announcement this morning from the Jiangsu Health Department.


This makes the 8th known fatality (out of 24 cases identified to date) from this emerging virus. Many of the other surviving patients are describes as being in serious or critical condition.

 

This from Jiangsu Department of Health:

 

Jiangsu Province, one cases of human infection with the H7N9 avian influenza confirmed cases died after death


Published :2013 -4-9

Jiangsu Provincial Health Department Bulletin, April 9, Jiangsu Province, one cases of human infection with the H7N9 avian influenza confirmed cases died after death.

 

Patients Shen, male, 83 years old, Suzhou Wujiang District. Disease, on March 20 for medical treatment at a hospital in Suzhou. April 2 confirmed human infection of H7N9 avian influenza. Provincial expert group has organized a consultation, guiding clinical treatment. On the afternoon of April 9, died after rescue invalid.

 

 

The question of whether there are mild, and as yet undetected cases, from this virus remains unanswered.

 

Until we get a better idea of the total number of infections, it is impossible to accurately gauge the mortality rate from this virus.

Sunday, April 07, 2013

Jiangsu Health Dept Describes H7N9 Patient’s Critical Condition

image 

ECMO Machine – Credit Wikipedia

 

 

# 7088

 

This morning we have a detailed, and quite sobering account of one patient diagnosed with the H7N9 virus who remains in critical condition after being initially hospitalized on March 20th.

 

This patient, who is #3 on the ECDC case listing, is a 35 year-old man from Chuzhou, in Anhui province who reportedly had exposure to poultry. 

 

The Jiangsu report is a machine translation, and as such is a bit syntax-challenged, but it is worth wading through the narrative.  

 

In it we learn:

  • After initially being placed on a ventilator, the patient was then moved to an ECMO (Extracorporeal Membrane Oxygenation) machine, where the burden of pumping and oxygenating the blood is taken from the heart and lungs, to give them time to heal (see The ECMO Option).
  • The patient is described as suffering severe lung damage, septic shock, liver damage, and acute renal failure.
  • The patient has received - in addition to standard rehydration and nutritional IV support - anti-virals, expectorants, immune enhancement (unspecified), and vasopressors to maintain blood pressure and perfusion.
  • The patient is also undergoing hemofiltration (a form of dialysis) used for renal failure.
  • This narrative also highlights the isolation techniques in use in this patient’s care.
  • The patient remains in critical condition.

 

 

Up until a week ago, H7 influenza infections reported in humans have nearly always been characterized as mild, often presenting with little more than conjunctivitis.

 

This new H7N9 virus has now produced 20 known cases, six of which have proved fatal. Many more cases are reportedly in serious or critical condition.

 

A big unknown at this time is whether there are mild, undetected cases, not being captured by current surveillance efforts.


This from Jiangsu Health.

 

 

 

Anhui membership of human infection with H7N9 avian flu patients still rescue in

Published :2013 -4-7

March 20, Chuzhou go to Nanjing, where a 35-year-old man infected with the H7N9 avian flu patients Mr. Han, Zhongda Hospital, Southeast University, is still receiving treatment.

 

Patients admitted to hospital, his condition is very critical. Big hospitals for this purpose, the establishment of the treatment group, known in our intensive medical experts, under the leadership of Critical Care Medicine Branch of the Chinese Medical Association, chairman of the Hospital of Zhongshan University Professor Qiu Haibo, director of Critical Care Medicine, and actively carry out rescue work.

 

Early in the given conventional treatment of invasive mechanical ventilation, lung recruitment is still difficult to maintain oxygen saturation case, the treatment group adopts the international advanced technology of extracorporeal membrane oxygenation (referred to ECMO respiratory replacement therapy, commonly known as artificial lung) the patient's oxygen saturation and oxygen supply is maintained, and the rest of the damage lung and protection.

 

Actively given anti-viral, expectorant, immune enhancement, support and maintenance treatment of nutritional support and other organ function.

 

However, in patients with pulmonary infection due to go to Nanjing and extremely serious injury, and has appeared septic shock and liver injury, given rehydration supplement effective circulating blood volume and use of vasoactive drugs to maintain blood pressure and tissue perfusion in patients with lung injury and the shock does not get better, and the emergence of acute renal failure.

 

To patients with severe infection has led to multiple organ damage Zhongshan University hospital for treatment group to patients HEMOFILTRATION for the first time. The course of the disease, severe lung injury, and merge the high cardiac output, the treatment group also uses high-frequency oscillatory ventilation and prone position ventilation in the treatment, which is today one of the most effective treatment of severe acute respiratory distress syndrome.

 

The patients with confirmed human infection of H7N9 avian influenza, the National Health and Family Planning Commission, the Health Department of Jiangsu Province attaches great importance to the Expert Group of the National Health and Family Planning Commission Expert Group, Jiangsu Province came to the hospital several times to guide clinical treatment work.

 

Large hospitals not only for patients disbursements also specially arrange patient in independent isolation ward, multidisciplinary experts work together closely with meticulous care, and medical care. In the past few days, as the core of the health care team to Zhongshan University Hospital Critical Care Medicine bull by the horns, and not afraid of hard work to treat the Anhui patients. Because patients in critical condition who piping, the course of treatment and danger, doctors always monitor changes in condition, to constantly adjust treatment measures; care team in three shifts, 24-hour intensive care.

 

Medical personnel wearing Geli Fu, do not take into account any risk, stood at the patient's bedside, ready to respond to a variety of rescue and care, physical exertion out of the isolation ward, medical staff often drenched in sweat. Prone position ventilation in the treatment of patients with heavier wear Geli Fu into the negative pressure isolation rooms, need 4-6 medical staff to patients stand up to the prone position, 3-4 times a day this stand up to the medical staff take turns Go to the isolation ward for patients prone position ventilation therapy.

 

The hospital strictly do the various protective isolation and infection management in the prevention and control of early contact with 13 medical staff of the patient's medical observation, were not unusual.

 

At present, the patient's condition is still very critical, life is in danger at any time. The treatment group of experts is to rescue the patients.

Wednesday, April 03, 2013

Media Reporting Two New H7N9 Cases

 

image

Credit Wikipedia

 


# 7062

 

Although I’ve been unable to find the official statement from Jiangsu Province, it is being widely reported within the past hour that two more cases of H7N9 have been identified in that province.

 

FluTrackers has several of these reports collected on this growing thread.

 

The Hong Kong Standard has this brief report:

 

(H7N9 watch) One dies of new bird flu in Hangzhou:

Two persons in Hangzhou was found infected with H7N9 bird flu, where one of them was dead, China's state-run TV writes on its Sina microblog.

Two persons in the city were confirmed to be infected by the new bird flu, according to sources from Zhejiang provincial government. A 38-year-old man, who did not feel well since March 7, was dead.


A 67-year-old retired male is currently under treatment.

 

 

The most detailed report I’ve found so far comes from Zhejiang News, where we learn of a fatal case that fell ill on March 7th (died March 27th), and of a case that fell ill on March 25th.

Warning: Machine Translation ahead:

 

 

Zhejiang Province found two cases of human infection with the H7N9 avian influenza cases in which patients have died

April 3, 2013 18:16:25 The Zhejiang online news website

 

Lee Lee Wong Sau Ping, Hangzhou, Zhejiang Online News April 3 (Reporter) Zhejiang Provincial Health Department Bulletin, April 3, Zhejiang Province confirmed two cases of human infection with the H7N9 avian influenza, including the death of patients.

 

Patients, Mr. Hong, male, 38 years old, Hangzhou Jiande, cook, work in Jiangsu Taicang. March 7 about the disease, 18 Back Jiande a hospital; 20, 2009 transferred to Xiaoshan a hospital for treatment. Sicker patients on the 24th, after she died on the morning of the 27th. In the afternoon of April 1, Zhejiang Province CDC report test results of patient specimens positive for H7N9 avian influenza virus nucleic acid. April 3, China CDC influenza center laboratory for review of the H7N9 avian influenza virus nucleic acid positive. Provincial Health Department expert group based on the performance of the clinical, laboratory testing and epidemiological findings, the diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. The patients for the province's first cases of infection with the H7N9 avian flu. After investigation, the close contacts of the cases of 125 people. As of now, all close contacts of the cases were not found to have a fever or respiratory symptoms.

 

Patients Yang, male, 67 years old, Hangzhou people, retirement home. Check in Hangzhou hospital because of cough, fever and other symptoms on March 25; April 2 go to the Affiliated Hospital of Zhejiang University School of Medicine. In the afternoon of April 2, Zhejiang Province CDC report test results of patient specimens positive for H7N9 avian influenza virus nucleic acid. April 3, patient specimens for the H7N9 avian influenza virus nucleic acid positive review by China CDC influenza center laboratory. Provincial Health Department organized experts, according to the clinical manifestations, laboratory testing and epidemiological findings, diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. After investigation, the close contacts of the cases of a total of 58 people. As of now, all close contacts of the cases were not found to have a fever or respiratory symptoms.

(Continue . . .)

 

As soon as I can locate an official announcement, I’ll post it.

Tuesday, April 02, 2013

Statement From Jiangsu Province Health Department On H7N9

image

Credit Wikipedia


# 7052

 


I’ve located the official statement from Jiangsu Province Health Department regarding the four new cases of H7N9.

 

Jiangsu Province, found four cases of human infection with the H7N9 avian flu cases in the provincial health department to implement five measures to make every effort to epidemic prevention work


Published :2013-4-2

Jiangsu Province, found four cases of human infection with the H7N9 avian influenza
Provincial Health Department to make every effort to implement five measures epidemic prevention work

Jiangsu Provincial Health Department Bulletin, April 2, Jiangsu Province, diagnosed four cases of human infection with the H7N9 avian influenza.

 

Patients Xu, female, 45 years old, Jiangning District, engaged in live poultry slaughter. March 19, fever, dizziness, body aches, fatigue and other symptoms. In the morning of March 27, go to Nanjing sicker ICU treatment in a hospital. Currently, patients in critical condition, is to rescue. On the afternoon of March 30, the Jiangsu Provincial Center for Disease testing positive for H7N9 avian influenza virus nucleic acid. In the afternoon of April 2, review by China CDC influenza center laboratory for the H7N9 avian influenza virus nucleic acid positive. In accordance with the relevant requirements, the afternoon of April 2, the provincial Health Department organized experts, according to the clinical manifestations, laboratory testing and epidemiological findings, the diagnosis of the cases human infection confirmed cases of the H7N9 avian flu. The patients for the province's first cases of infection with the H7N9 avian flu. After investigation, the close contacts of the cases of 49 people. Medical observation, so far, all close contacts of the cases were not found to have a fever or respiratory symptoms.

 

Patients with a mulberry, female, 48 years old, Suqian Shuyang engaged in sheet metal processing. March 19, fever, dizziness, coughing and other symptoms. March 30, sicker patients transferred to a Nanjing hospital ICU treatment. Currently, patients in critical condition, is to rescue. On March 30, the Jiangsu Provincial Center for Disease Detection H7N9 avian influenza virus nucleic acid weakly positive. In the afternoon of April 2, review by China CDC influenza center laboratory for the H7N9 avian influenza virus nucleic acid positive. In accordance with the relevant requirements, the afternoon of April 2, the provincial Health Department organized experts, according to the clinical manifestations, laboratory testing and epidemiological findings, the diagnosis of the cases human infection confirmed cases of the H7N9 avian flu. After investigation, the close contacts of the cases of a total of 60 people. Medical observation, until now, were not found to have a fever or respiratory symptoms.

Patients Shen, male, 83 years old, Suzhou Wujiang District. March 20 fever, cough, sputum production, accompanied by symptoms such as chest tightness, shortness of breath and chest pain. On March 29, the sicker patients to Wujiang Area hospital treatment. Currently, patients in critical condition, is to rescue. On April 1, the Jiangsu Provincial Center for Disease Detection identified as the H7N9 avian influenza virus nucleic acid positive. In accordance with the relevant requirements, the afternoon of April 2, the provincial Health Department organized experts, according to the clinical manifestations, laboratory testing and epidemiological findings, the diagnosis of the cases human infection confirmed cases of the H7N9 avian flu. After investigation, the close contacts of the cases of a total of 15 people. Medical observation, until now, were not found to have a fever or respiratory symptoms.

 

Patients Zhang, female, 32 years old, Changzhou, now lives in Wuxi city, unemployed. March 21, fever, cough, and other symptoms. On March 28, the sicker patients transferred to a hospital in Wuxi ICU treatment. Currently, patients in critical condition, is to rescue. March 31, identified as the H7N9 avian influenza virus nucleic acid positive by the Jiangsu Provincial Center for Disease Detection. In accordance with the relevant requirements, the afternoon of April 2, the provincial Health Department organized experts, according to the clinical manifestations, laboratory testing and epidemiological findings, the diagnosis of the cases human infection confirmed cases of the H7N9 avian flu. After investigation, the close contacts of the cases of a total of 43 people. Medical observation, until now, were not found to have a fever or respiratory symptoms.

 

After the outbreak, the provincial government attaches great importance to the health sector in accordance with the relevant plans and programs to rapidly launch epidemic prevention and control work. First, the Provincial Health Department established human infection with the H7N9 avian flu prevention and control work leading group, and people infected with the H7N9 bird flu prevention and control of the Group of Experts, medical treatment expert group issued "effectively strengthen human infection with the H7N9 avian flu prevention and control work urgent notice "to strengthen epidemic prevention and control, and to treat the patient. The specified 16 tertiary hospitals as a province first admitted to the hospital to make every effort, in accordance with the principle of "concentrated heavy suffering, a pool of experts, pooling of resources, centralized treatment, medical treatment, efforts to reduce the mortality. Third, the development of Jiangsu Province, people infected with H7N9 avian influenza monitoring the investigation and management solutions, organization of medical and health institutions at all levels to strengthen the monitoring of the unexplained cases of pneumonia and influenza-like illness, active search, and strive to early discovery, early reporting, early diagnosis, early isolation and early treatment. The fourth is to strengthen the hospital infection control hospital infection prevention and control, strict implementation of disinfection and isolation system and norms, strict precautions against the spread of the epidemic hospital. The fifth is to strengthen the communication links with the departments of agriculture, industry and commerce, business and work together to epidemic prevention and control work.

 

Currently, no epidemiological association exists between the above four cases. The experts have warned that the face of human infection with the H7N9 avian flu, Mo panic, to be alert to. First, to maintain good personal hygiene, such as washing hands frequently, indoor Qin ventilation. The second is to pay attention to improve nutrition, enhance personal physical. The third is to avoid contact and edible disease (dead), poultry, livestock. The event of fever, cough and other symptoms of acute respiratory infections, especially high fever, breathing difficulties, you should seek immediate medical attention.

 

Provincial Health Department will continue to make every effort to epidemic prevention and control work, and take effective measures to effectively protect public health