HK CHP Notified Of An Additional Mainland H7N9 Case

Location of Jiangxi Province – Wikipedia

 

# 10,001

 

Despite the abrupt slowdown in H7N9 reporting out of China beginning the first week of March (see H7N9: No News Is . . . . Curious), the Mainland has still managed to post nearly 200 cases since November of 2014.  Based on limited, and often delayed reporting to date, this third wave appears to have been less active than the 2nd wave.

 

Note: Many provinces have elected tor release bulk information in EOM epidemiological reports, and it is possible we’ll see additional `April’ cases announced over the next couple of weeks.

 

In the meantime, we’ve got this announcement from Hong Kong’s CHP of their notification of a single H7N9 case in Jiangxi province. 

 

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

May 2, 2015 Issued at HKT 18:09

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (May 2) closely monitoring an additional human case 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 Health and Family Planning Commission of Jiangxi Province, the patient is a 39-year-old woman who is hospitalised for treatment in critical condition.

From 2013 to date, 635 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities. Regarding the third wave in the Mainland since November 2014, a total of 195 cases have been reported, including 72 in Guangdong , 39 in Fujian, 38 in Zhejiang, 17 in Jiangsu, seven in Anhui, seven in Xinjiang, six in Shanghai, three in Jiangxi, two in Hunan, two in Shandong, one in Guizhou and one in Hubei.

"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.

The DH's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up.

The display of posters and broadcast of health messages in departure and arrival halls as health education for travellers is underway. The travel industry and other stakeholders are regularly updated of latest information.

Travellers, especially those returning from avian influenza-affected areas with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Healthcare professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas.

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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.

Jiangxi Reports 1 H7N9 Case

Jiangxi Province – Credit Wikipedia

 

# 9585

 

As noted previously, we don’t seem to be getting the kind of proactive reporting on H7N9 cases out of China this year that we saw during the first two epidemic waves.  Some cases are not announced until days or even weeks after the fact (see Jiangsu Province’s Uncertain H7N9 Count), and often without the kind of detail we’ve seen in the past.

While some reports filter through the Chinese media, without identifying information (age, gender, onset date, etc.), it becomes increasingly difficult to keep track and to weed out duplicate reports. 

 

While we know that even the best surveillance and reporting systems won’t catch all of the cases, if the current reporting situation remains unchanged, this year’s picture of China’s H7N9 wave may be `fuzzier’ than usual. 

 

That said, Jiangxi is reporting a new case today. 

 

Jiangxi confirmed one case of H7N9 cases

Health and Family Planning Commission of Jiangxi www.jxwst.gov.cn 2015 年 1 月 16 MVP: Commission Emergency Management Office    

Health and Family Planning Commission of Jiangxi Province January 16 briefing, Jiangxi diagnosed one case of H7N9 cases. Currently, patients in critical condition, was Ganzhou a hospital.

Blue patients, male, 34 years old, live in Ganzhou Anyuan County. January 15, Jiangxi Province Center for Disease Control and Prevention Ganzhou patient specimens are sent for review were identified as positive for H7N9 virus nucleic acid. Provincial Health and Family Planning Commission expert group on the basis of clinical manifestations, laboratory and epidemiological findings, such as the diagnosis of the patient for H7N9 cases.

 

There media reports suggest there are others, including a recent case in Fujian Province, so far I’ve found no official statements.   Hopefully Hong Kong’s CHP, or the World Health Organization will produce some detailed listings.

Jiangxi Province Reports 3rd H10N8 Case

 

Jiangxi Province – Credit Wikipedia – Site of 3 H10N8 Cases

# 8295

 

Over the past couple of months a new avian flu virus – H10N8 – has emerged in mainland China, infecting and killing two people since last December.  A little over a week ago, in Lancet: Clinical & Epidemiological Characteristics Of A Fatal H10N8 Case, we saw an analysis of this virus that warned `The pandemic potential of this novel virus should not be underestimated.’

 

Over the past hour news of a third H10N8 infection has filtered through the Chinese media, and very recently the Jiangsu Provincial MOH has posted the following statement (h/t Sharon Sanders on FluTrackers).

 

Jiangxi 1 new confirmed cases of human infection with avian influenza H10N8

Jiangxi Provincial Health and Family Planning Commission www.jxwst.gov.cn 2014 年 2 月 13, 2008 Source: Office of Emergency Committee

Recently, Nanchang, Jiangxi Province monitoring found one case of severe pneumonia cases. February 13, 2014, the provincial health planning committee then China Disease Prevention and Control Center laboratory test reports, the case for the specimens showed H10N8 avian influenza virus nucleic acid positive. Ministry of Health and Family Planning Organization expert consultation, based on the cases of clinical manifestations, laboratory and epidemiological findings, such as the diagnosis of the human cases of avian influenza infection H10N8 confirmed cases.

Hu patient, male, 75 years old, who lives in Nanchang. The patients with fever, fatigue and other symptoms on February 4 hospitalized, February 5 aggravate lung infection, Feb. 8 died.

 

While three cases does not a public health emergency make, this reaffirms that this virus continues to circulate in Jiangxi province – probably in poultry – and that it occasionally jumps to humans.

While we watch H7N9 and H5N1 with the most concern, as we recently discussed in The Expanding Array Of Novel Flu Strains, we could just as easily be blindsided by a novel virus coming out of left field.

 

All of which highlights the need for continual and enhanced surveillance of humans, livestock, and wild birds for emerging viral threats.

Jiangxi Province Reports Second H10N8 Infection

Jiangxi Province – Credit Wikipedia

 

# 8219

 

Our winter of oddball or unusual avian influenza virus infections (and outbreaks)  continues today with word from Jiangxi Province, China that – for the second time in just 5 weeks – they’ve detected a human infection with the H10N8 virus. While I was away from my desk this morning, Crof published a report via the China Times (see China: A second case of H10N8 reported).

 

Last December, as you may recall, we saw the HK CHP Notified Of Fatal H10N8 Infection In Jiangxi, which was the first time that virus had been isolated in a human host.

Two weeks later we saw the report Hong Kong: Isolation & Treatment Of An H9N2 Patient, which while considerably more common than H10N8, is still rarely seen in humans.  Add to that the upstart outbreak of a highly pathogenic H5N8 avian virus in Korean ducks last week, and the alphabet soup of unusual virus designations continues to simmer.

 

First the announcement from the Jiangxi Provincial Ministry of Health, then I’ll return with a bit more.

 

Jiangxi confirmed cases of avian influenza H10N8 found one case of human infection

Jiangxi Provincial Health and Family Planning Commission www.jxwst.gov.cn 2014 年 1 月 25, 2008 Source: Office of Emergency Management Office

Recently, Nanchang, Jiangxi Province monitoring found one case of severe pneumonia, January 25, 2014, by the National Family Planning Health Organization expert consultation, diagnosis H10N8 avian flu case confirmed cases of the human infection.

Patients Zhang, female, 55 years old, who lives in Nanchang Hi-tech Development Zone. The patient appeared in the January 8, sore throat, dizziness, fatigue and other symptoms, January 15 hospitalized patients currently in critical condition. The epidemiological investigation, the patient had a history of exposure bazaars. All close contacts through medical observation does not appear abnormal.

Expert Tip: prevention of respiratory diseases in winter and spring, pay attention to the ground ventilation to reduce stay in crowded, poor air circulation spaces; wash their hands and avoid touching your eyes, nose and mouth; direct contact with live poultry, birds or After the stool, must wash their hands; buy fresh, live, pay attention to prove that view when frozen poultry quarantine. If fever and respiratory symptoms should wear a mask, a doctor as soon as possible.

 

Since testing for non-seasonal influenza viruses is rarely done, we honestly don’t know how often these rare influenza strains actually infect humans.  But it is probably more common than surveillance numbers suggest.

 

With the ongoing H7N9 virus threat in China, the screening of severe pneumonia cases for non-seasonal influenza A viruses is in overdrive, and so cases like today’s – that might well have slipped by unnoticed in  the past – are coming to our attention.

 

As to whether H10N8 is a transient blip on the surveillance radar, or an emerging human health threat, we’ll have to wait for more data.  

 

The upside to  the  the enhanced surveillance for novel flu viruses in China, and around the world is - that the better the surveillance - the sooner we’ll know when a new threat does appear.

Xinhua News : Jiangxi H7N9 Case Confirmed

 

Location of Jiangxi Province – Wikipedia

# 7193

 

The report earlier today (see H7N9: Watching Jiangxi Province) of a suspected infection appear now  to be confirmed by Xinhua News, expanding the range of the virus further south into  Jiangxi Province.

 

This from Xinhua News.

 

First H7N9 bird flu case confirmed in Jiangxi

English.news.cn   2013-04-26 00:20:43
 

NANCHANG, April 25 (Xinhua) -- Health authorities in east China's Jiangxi Province late on Thursday confirmed the province's first human case of H7N9 avian influenza.

 

A 69-year-old man surnamed Xiong, a local retiree in the provincial capital of Nanchang, showed symptoms of high fever, tight chest and diarrhea, and was admitted to the No. 3 Hospital in Nanchang, according to a statement issued by the provincial health department.

 

Xiong is in critical condition, said the statement.

 

He had not left the city recently, nor had any contact with dead birds, but lives near a live poultry market, the statement said.

 

The city's disease control authority has quarantined 14 people who have had close contact with the patient. None of them have exhibited any abnormal symptoms.

 

Three more new cases of H7N9 bird flu were reported on Thursday, two in Zhejiang Province and one in Henan Province.

 

The National Health and Family Planning Commission said in its Wednesday update that the total number of H7N9 cases reported in the mainland stood at 108, including 23 cases that have ended in death.

 

Most of the cases were reported in east China's Shanghai Municipality and the provinces of Zhejiang, Jiangsu and Anhui.

 

Although we’ve seen several cases announced in Zhejiang and Henan Provinces in the past 24 hours (see H7N9: Zhejiang & Henan Add Cases), the official tally as reported by Chinese state media hasn’t been updated to reflect them. 

H7N9: Watching Jiangxi Province

Location of Jiangxi Province – Wikipedia

 

# 7189

 

Right now it’s just a `suspect’ case, and still awaiting confirmation from China’s CDC, but state media is reporting on a 69 year-old man who is in isolation at a Nanchang hospital.

If confirmed, this would signal the expansion of H7N9’s geographic range to yet another province.

 

Jiangxi's first suspected H7N9 case detected

 

English.news.cn   2013-04-25 10:28:04

NANCHANG, April 25 (Xinhua) -- The health department of east China's Jiangxi Province on Thursday reported the province's first suspected human case of H7N9 avian influenza.

 

In line with established protocol, the provincial center of disease control and prevention has sent the patient's samples to the national lab to confirm the diagnosis.

 

The patient, a 69-year-old man, has been admitted to the No. 3 Hospital in Nanchang, the provincial capital.

 

The health department has not disclosed his condition.

 

The city's disease control authority has quarantined 14 people who have had close contact with the patient. None of them have exhibited any abnormal symptoms.

 

The National Health and Family Planning Commission said in its Wednesday update that the total number of H7N9 cases reported in the mainland stood at 108, including 23 cases that have ended in death.

 

Most of the cases were reported in east China's Shanghai Municipality and the provinces of Zhejiang, Jiangsu and Anhui.