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PostPosted: Mon Feb 10, 2014 8:01 am 
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The 8 H7N9 cases in Huaiji now appear to due to multiple familial clusters identified by family name (Oi, Li, and Liang).

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PostPosted: Mon Feb 10, 2014 8:24 am 
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The two cousins (5M & 4F) have the translation name of Oi (machine translation European). Another family named Li (machine translated Lee) has two cases (48M & 5F). A third family name Liang (machine translated Yijun) includes the critical case, 42M and 11M). A recent case in Baiyun is also named Liang (machine translated Yijun, 59F) who is followed by a very mild child (5F) who has already been discharged (with different name because name matches are when adult is a male).

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PostPosted: Mon Feb 10, 2014 8:57 am 
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10 February 2014 - The National Health and Family Planning Commission of China has notified WHO of 15 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus, including one death.


Details of height cases notified to WHO on 7 February 2014 are as follows:

Six of the eight cases are male, the age range is 5 to 73 years old. Cases were reported from Jiangsu (2) Zhejiang (2), Beijing (1), Guangdong (1) and Guangxi (1) and Hunan (1). Five cases are currently in critical condition, two cases in severe condition and one has a mild illness. Seven out of eight cases are reported to have had a history of exposure to poultry or a live poultry market. One of the eight is a close contact of a case from Heng County, Guangxi province, who had been notified to WHO on 5 February 2014.
A 64 year-old farmer from Huzhou City, Zhejiang Province, who became ill on 27 January and was admitted to hospital on 30 January and transferred to another hospital on 4 February. He is currently in a severe condition. The patient has a history of exposure to live poultry.
A 39 year-old man from Huzhou City, Zhejiang Province, who became ill on 26 January and was admitted to hospital on 28 January and transferred to another hospital on 31 January. He is currently in a severe condition The patient has a history of exposure to live poultry.
A 66 year-old man from Yancheng City, Jiangsu Province, who became ill on 22 January and was admitted to hospital on 4 February. He is in critical condition. The patient has a history of exposure to live poultry.
A 63 year-old man from Xuzhou City, Jiangsu Province, who became ill on 20 January and was admitted to hospital on 1 February. He is in critical condition. The patient has a history of exposure to live poultry.
A 61 year-old, woman from Yueyang City, Hunan Province, who became ill on 29 January and was admitted to hospital on 31 January and transferred to another hospital on 3 February. She is in critical condition. The patient has a history of exposure to live poultry.
A 36 year-old, woman from Foshan City, Guangdong Province, who became ill on 25 January and was admitted to hospital on 30 January and transferred to another hospital on 2 February. She is in critical condition. The patient has a history of exposure to live poultry.
A 5 year-old boy from Nanning City, Guangxi Province, who became ill on 3 February and was then transferred to a hospital. He has a mild illness. This patient is a close contact of a previously reported cases, a 41 year old woman from Nanning City who was notified to WHO on 5 February (see Disease Outbreak News dated 7 February). An epidemiological investigation is ongoing.
A 73 year-old man from Northern Beijing who became ill on 30 January and was admitted to hospital on 2 February and was transferred to another hospital on 5 February 2014. He is in critical condition . The patient has a history of exposure to live poultry.

Details of seven new cases, including one death, notified to WHO on 8 February 2014 are as follows:

Cases were reported from Guangdong (3), Zhejiang (2), Fujian (1) and Hunan (1). Four of the cases are male. The age range is between 21 and 81 years. Three cases are currently in critical condition and three cases are in severe condition. Six out of the seven cases are reported to have had a history of exposure to poultry or a live poultry market.
A 54 years old man, from Hangzhou City, Zhejiang Province, who became ill on 1 February and was admitted to hospital on 4 February. He is currently in a severe condition. The patient has a history of exposure to live poultry.
A 76 years old woman from Taizhou City, Zhejiang Province, who became ill on 24 January and was admitted to hospital on 31 January. She is currently in a critical condition.
A 81 years old man from Fuzhou City, Fujian Province, who became ill on 30 January and was admitted to hospital on 2 February and discharged from hospital on 6 February at the request of his family and died at home on the same day. The patient has a history of exposure to live poultry.
A 21 years old woman from Loudi City, Hunan Province, who became ill on 30 January and was admitted to hospital on 1 February and then transferred to another hospital on 2 February. She is currently in a critical condition. The patient has a history of exposure to live poultry.
A 48 years old man from Zhaoqing City, Guangdong Province, who became ill on 28 January. He was admitted to hospital on 30 January and then transferred to a hospital in Guangzhou City on 5 February 2014. He is currently in a severe condition. The patient has a history of exposure to live poultry.
A 62 years old man from Zhaoqing City, Guangdong Province, who became ill on 1 February and was admitted to hospital on 2 February. He is currently in a severe condition. The patient has a history of exposure to live poultry.
A 59 years old woman from Guangzhou City, Guangdong Province, who became ill on 27 January ad was admitted to hospital on 1 February. She is currently in a critical condition. The patient has history of exposure to live poultry.



So far, there is no evidence of sustained human-to-human transmission.

The Chinese Government continues to take the following surveillance and control measures:
strengthen surveillance and situation analysis;
reinforce case management and treatment;
conduct risk communication with the public and release information;
strengthen international collaboration and communication; and
conduct scientific studies.

Sporadic human cases

While the recent report of avian influenza A(H7N9) virus being detected in live poultry imported from the mainland to Hong Kong SAR, shows the potential for the virus to spread through live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred through humans or animals.

Further sporadic human cases of A(H7N9) infection are expected in affected and possibly neighbouring areas, especially given expected increases in the trade and transport of poultry associated with the Lunar New Year.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travellers should follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.

As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

http://www.who.int/csr/don/2014_02_10/en/index.html

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PostPosted: Mon Feb 10, 2014 10:52 pm 
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H7N9 illness total grows by 13, with 2 more deaths

Lisa Schnirring | Staff Writer | CIDRAP News | Feb 10, 2014

Over the past 3 days, China reported 13 new H7N9 influenza infections, 2 of them fatal, from a broad swath of provinces in the eastern part of the country, including the first 2 cases of the second wave from Anhui province.

Most of the new cases involve adults, but two are in children, a 5-year-old girl and an 11-year-old boy, both from Guangdong province.

Eight of the 13 cases are from Zhejiang (5) and Guangdong province (3), which have reported by far the most cases in the second wave of infections that began in October. Other provinces reporting fresh cases include Anhui (2), Hunan (2) and Jiangsu (1).

The steady pace of reported infections has propelled the number of cases in the second wave of disease activity to 201, well above the 136 people who were sickened in the first wave after H7N9 first emerged last spring.

Also, there so far appears to be no letup in case reporting from China or its individual provinces, despite media reports from a few days ago that said the country's poultry industry groups have asked health officials to tone down their reports, due to the impact negative publicity is having on poultry sales.

Details of new cases

The patients from Zhejiang province include four men, ages 61, 62, 67, and 68, and one woman, age 47, according to provincial health reports translated and posted by FluTrackers, an infectious disease news message board, and Avian Flu Diary (AFD), an infectious disease news blog.

The three patients from Guangdong province include an 81-year-old woman who died from her infection and the two children, according to FluTrackers and AFD.

Anhui province's two patients are a 66-year-old man and a 56-year old man who died from his infection on February 7. The two case-patients from Hunan province are a 38-year-old man and a 23-year-old woman.

The new case reported from Jiangsu province is in a 53-year-old man.

The new cases boost the outbreak total to 337, according to a running tally of H7N9 cases kept by FluTrackers. The two fatalities lift the unofficial death count to 71.

WHO gives details on 15 other cases

In related developments, the World Health Organization (WHO) today reported more details about 15 case reports it received from China on Feb 7 and Feb 8.

The report confirmed a family connection with two H7N9 infections reported from Guangxi province, which borders northern Vietnam. It said the 5-year-old boy got sick on Feb 3 and is hospitalized with a mild infection and that he is a close contact of a 41-year-old woman whose infection was reported by the WHO on Feb 7. Media reports have said the woman is the boy's mother.

Thirteen of the patients had been exposed to live poultry before they got sick. Of the 14 people who have survived their infections so far, eight are hospitalized in critical condition, five are in severe condition, and one—the 5-year-old boy—has a mild illness, according to the WHO.

Patient ages in today's WHO report range from 5 to 81, and they hail from Beijing and six different provinces, though eight are from Zhejiang and Guangdong, the top two hotspots. Illness onsets range from Jan 20 to Feb 1. One death was reported among the patients, in an 81-year-old man from Fujian province.

Poultry control actions

Meanwhile, a weekly update on H7N9 activity and control measures from the WHO's Western Pacific Region office (WPRO) said the city of Shenzhen in Guangdong province has announced a market rest period for 2 weeks, from Jan 31 through Feb 13. It said all live-bird markets, including wholesale and retail, are temporarily closed, and poultry are barred from the market.

It added that Shanghai's live-bird trade suspension took effect on Jan 31 and extends until April 30, and Zhejiang province has temporarily shuttered live-bird markets until Feb 15 in areas in which several human cases have been reported. WPRO said Zhejiang plans to close live-poultry markets in its cities' main districts permanently as of Jul 1.

During the first wave of infections, live-bird market closures were shown to tamp down the pace of human cases in areas such as Shanghai.

See also:

Feb 10 FluTrackers thread

Feb 10 AFD post

FluTrackers human H7N9 case list

Feb 10 WHO statement

Feb 7 WHO WPRO update

http://www.cidrap.umn.edu/news-perspect ... ore-deaths

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PostPosted: Mon Feb 10, 2014 11:36 pm 
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Commentary

http://www.recombinomics.com/News/02101 ... _CofC.html

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PostPosted: Tue Feb 11, 2014 9:13 am 
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11 FEBRUARY 2014 - The National Health and Family Planning Commission of China has notified WHO of seven additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus, including one death.

Details of the three cases notified to WHO on 9 February 2014 are as follows:
All three cases are male. The age range is 38 to 61 years. Cases were reported from Hunan (1), Jiangsu (1) and Zhejiang (1). Two of the cases are currently in a critical condition, and the third case is in a severe condition. One of the three cases has been reported to have had a history of exposure to poultry or a live poultry market.

A 53 year-old man from Taizhou City, Jiangsu Province, who became ill on 1 February and was admitted to hospital on 8 February. He is currently in a severe condition.
A 61 year-old, man from Hangzhou City, Zhejiang Province, who became ill on 29 January and was admitted to hospital on 2 February. He is currently in a critical condition.
A 38 year-old man from Shaoyang City, Hunan Province , who became ill on 27 January and was admitted to hospital on 2 February. He is currently in a critical condition. The patient has a history of exposure to live poultry.
Details of the cases including one death, notified to WHO on 10 February 2014 are as follows:
Three of the four cases are male. The age range is 11 to 81 years. Cases were reported from Guangdong (2), Anhui (1) and Zhejiang (1). Currently, one is in a critical condition, one is in a severe condition, and one is in a stable condition with mild disease. All four cases are reported to have had a history of exposure to poultry or a live poultry market

An 81 year-old woman from Shenzhen City, Guangdong Province, who became ill on 31 January and was admitted to a hospital on 7 February. She died on the same day. The patient had a history of exposure to live poultry.
An 11 year-old boy from Zhaoqing City, Guangdong Province, who became ill on 5 February and went to hospital on the same day. He is currently in a stable condition. The patient has a history of exposure to live poultry.
A 68 year-old farmer from Shaoxing City, Zhejiang Province, who became ill on 5 February and was admitted to hospital on 7 February. He is currently in a severe condition. The patient has a history of exposure to live poultry.
A 66 year-old man from Anqing Prefecture, Anhui Province, who became ill on 1 February and was admitted to hospital on 7 February. He is currently in a critical condition. The patient has a history of exposure to live poultry.
So far, there is no evidence of sustained human-to-human transmission.

The Chinese Government continues to take the following surveillance and control measures:

strengthen surveillance and situation analysis;
reinforce case management and treatment;
conduct risk communication with the public and release information;
strengthen international collaboration and communication; and
conduct scientific studies.
Sporadic human cases

While the recent report of avian influenza A(H7N9) virus being detected in live poultry imported from the mainland to Hong Kong SAR, shows the potential for the virus to spread through live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred through humans or animals.

Further sporadic human cases of A(H7N9) infection are expected in affected and possibly neighbouring areas, especially given expected increases in the trade and transport of poultry associated with the Lunar New Year.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travellers should follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.

As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

http://www.who.int/csr/don/2014_02_11/en/index.html

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PostPosted: Tue Feb 11, 2014 10:55 am 
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Commentary

http://www.recombinomics.com/News/02111 ... C_WHO.html

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PostPosted: Tue Jul 29, 2014 7:20 pm 
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Flu Scan for Jul 29, 2014
Mild H7N9 cases in kids; H10N8 in China; Global flu update
Filed Under:
H7N9 Avian Influenza; Avian Influenza (Bird Flu); Influenza, General


Study: Children could be 'silent' H7N9 spreaders

An analysis of seven children infected with H7N9 avian influenza during the outbreak's second wave in China found that the illnesses were mild, a phenomenon that could contribute to spread of the virus. Researchers from China's Guangdong province published their findings today in an early online edition of the Pediatric Infectious Disease Journal.

They looked at seven children whose illnesses were identified in Guangdong province as of Feb 10, 2014. Ages ranged from 2 to 17, and four of the patients were boys. Three illnesses were detected during sentinel surveillance, three during contact tracing, and one during border-crossing screening. The patients were from five cities in Guangdong province, with illness onsets that ranged from Oct 29, 2013, to Jan 31.

All of the children had mild fever, with other symptoms varying, the most common ones being throat congestion and rhinorrhea. Three had upper respiratory infections but none had pneumonia. Six were hospitalized, and none of the children required intensive care. One child never visited a clinic or hospital.

Six of the kids had a history of poultry exposure, four of them at their homes. Environmental testing in the wake of the infection detections yielded positive samples in three cases.

Family links were found for four of the children, two of whom had parents with H7N9 infections. Two of the children were cousins, but their parents tested negative for the virus.

Mild infections occurring in highly contaminated environments may contribute to underestimation of H7N9 infections in children, posing challenges for surveillance, because they may continue to spread the disease, making the epidemic more difficult to control, the authors wrote. They added that more vigilance for H7N9 in youngsters and their close contacts is needed, along with more thorough disinfection of poultry markets to curb the source of infection.
Jul 29 Pediatr Infect Dis J abstract

http://www.cidrap.umn.edu/news-perspect ... ul-29-2014

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