Thursday, December 19, 2013

Shenzhen Reports H7N9 Case

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# 8089

 

As predicted last September (see Chinese CDC: Be Alert For H7N9)  - with the onset of colder weather,  Mainland China finds itself dealing with yet another H7N9 case – this time in Shenzhen – uncomfortably close to Hong Kong.  This marks that city’s first `official’ case, although Hong Kong has seen two cases in the past month which they strongly link to visiting Shenzhen. 

 

This marks the 6th known case from  Guangdong province, the fifth in recent weeks, and comes with a warning from their own CDC that there is a `high risk’ of seeing additional sporadic cases.

 

Sporadic cases, however, are not a sign of efficient or sustained human-to-human transmission.  An ability this virus has yet to demonstrate.   But, with each human infection, the virus is given another opportunity to `figure us out’, and so public health officials in Asia, and around the world, remain vigilant  for that possibility.

 

First stop, the Shenzhen CDC news release, followed by the announcement from Hong Kong’s CHP.

 

Shenzhen confirmed the first case of human infection with the H7N9 avian flu
Source: Shenzhen CDC update: December 19, 2013

 The city confirmed the first case of human infection with H7N9 bird flu

December 19, 2013, by the provinces and expert consultation, the city confirmed the first case of human infection with the H7N9 avian influenza. European patients, male, 38 years old, workers, living in Longgang District, South Bay Street. December 9, patients with cough, fever clinics near their homes to a treatment, no significant improvement; 12, 2009, to South Bay Hospital for treatment and hospitalization; the 13th Municipal People with severe pneumonia transferred to hospital for treatment; 17 evening, Shenzhen Centers for Disease Control and Prevention for the next patient infected with human respiratory specimens positive for H7N9 avian influenza nucleic acid; 18, 2009, by the Guangdong Provincial Disease Prevention and Control Center to review consistent results. 18 pm, the patient was transferred to the Third People's Hospital for further treatment, is currently in critical condition. After receiving the report, the Center for Disease Control and Prevention urban tissue immediately carry out epidemiological investigations, 135 patients were implemented in close contact with medical observation, yet unusual circumstances.

High risk of occurrence of sporadic human infection with the H7N9 city bird flu cases

After the winter weather is getting cold, virus outer environment more active, longer survival time, CDC experts believe that the high risk of occurrence of sporadic human infection with the H7N9 city bird flu cases, there may be new cases occur at any time. Main reasons: First, Shenzhen's first human cases have occurred, the surrounding cities of Shenzhen, Dongguan (two cases), Huizhou (one case) and Hong Kong (2 cases) cases have been reported five cases, and Dongguan and Hong Kong cases may be related Shenzhen an association. Second, December 10 parts of the city detection of nucleic acid samples positive for H7N9 in poultry in markets outside the gathering environmental samples. Third, Shenzhen population, frequent movement of goods, the larger the amount of sales and transportation of poultry, to a certain extent, increased risk of infection. Fourth, Shenzhen is located in the main migratory route, with the potential risk of spread of the epidemic. Therefore, the city improved disease control experts reminded the public awareness, actively carry out prevention.

However, since the transmission of the virus from the birds to humans is still, yet found has the ability to spread between people going, so people infected with H7N9 bird flu continued to show sporadic, low-risk community outbreak occurs, people do not need to panic .

Prevention of this disease should be "three to" and "Three Do"

People infected with H7N9 avian influenza is an acute respiratory disease, mainly due to contact with objects contaminated with the virus in poultry or spread, clinical fever, upper respiratory tract infection symptoms can quickly progress to severe pneumonia, severe cases can be fatal. Prevention of this disease should be "three to" and "Three Do"

(1) "three to" want to wash their hands: after contact with poultry, wash hands before meals and after; to cook: meat, eggs and poultry should be cooked before eating classes; to early treatment: If fever occurs, cough , headache, general malaise and other respiratory symptoms, should go to regular medical institutions for treatment, and the initiative to inform the doctor of poultry in contact information.

(2) "three not to" try not to direct contact with live poultry and processed, especially poultry practitioners should pay more attention to occupational protection, including wearing masks, gloves, etc.; do not eat sick (dead) birds; Do not buy class birds of unknown origin products.

Meanwhile, disease control experts called the live bird market operators should actively assist the authorities implement the "Three Ones" system, or "cleaning day a week, a disinfectant, closed in January," and do joint prevention and control of avian influenza .

Shenzhen Disease Prevention and Control Center

December 19, 2013

Here are excerpts from Hong Kong’s Notification.

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

19 December 2013

The Centre for Health Protection (CHP) of the Department of Health (DH) was notified by the Health and Family Planning Commission (HFPC) of Guangdong Province today (December 19) of a human case of avian influenza A(H7N9) affecting a man aged 38 in Shenzhen.

The patient developed fever and cough on December 9 and sought medical attention from local clinic and hospital. His specimen tested positive for the avian influenza A(H7N9) virus upon testing by the Shenzhen Center for Disease Control and Prevention (CDC) on December 17 and was confirmed by the Guangdong CDC on December 18. He is currently admitted to a local hospital for treatment in critical condition.

To date, a total of 144 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (51 cases), Shanghai (33 cases), Jiangsu (28 cases), Guangdong (six 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 remarked.

All border control points (BCPs) have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation.

 

Regarding health education for travellers at BCPs, distribution of pamphlets, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are all proceeding.

 

"Travellers, especially those returning from avian influenza A(H7N9)-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.

(Continue . . .)

 


With months of cold weather ahead, and the Chinese Lunar New Years celebration and travel season scheduled for late January, we probably ought to get used to the idea of seeing reports like this one over the short term.

 

And as an added bonus, the extra testing and surveillance going on in China may provide some surprise findings – such as we saw this week with a report of a a Fatal H10N8 Infection In Jiangxi.

 

Where all of this will lead is anybody’s guess.  But it does seem likely that we’re not going to lack for things to  talk about in the coming months. 


Stay tuned.