#H7N9 Shanghai Onset Date Update

[This is an article that states the 86yo went to a city hospital on December 30, with a cough and fever.  We already know he was admited into ICU on the 3rd January. This article also states that it was 2 weeks ago that they had contact with the poultry farm.]
Translation
January 5, 2014

WASHINGTON (Reporter Gu Yong) City Health and Family Planning Commission notified the evening of 3: H7N9 confirmed cases of avian influenza reported one case of human infection with the city. 86-year-old patient Zhou Moumou, last December 30 due to cough, fever to a city hospital for treatment, after treatment ineffective, rapid progression of the disease, in the 3rd H7N9 bird flu confirmed cases of human infection. According to doctors for treatment, the patient had traveled two weeks ago to come into contact with poultry farms, their families are currently under medical observation period, the disease symptoms have not yet appeared. Because the eldest high specification Zhou Moumou symptomatic treatment, the situation is still not optimistic, now transferred from the Department of Infectious Diseases Respiratory treated. 　City Health and Family Planning Commission while briefing: According to state regulations, from November 1, 2013, the city has been included in people infected with H7N9 avian influenza B infectious management.   Lu, Shanghai Public Health Center Jieshao Respiratory director, the autumn season is a high incidence of respiratory disease season, the public should pay attention to improve their immune system, enhance personal hygiene. Now it seems that people infected with bird flu is still in sporadic signs appear between interpersonal communication nor the public need not worry too much. Author: Gu Yong  
http://roll.sohu.com/20140105/n392960578.shtml 

#H7N9 Hong Kong: 36(F) Indonesian Expected To Be Discharged Soon

Translation
1/5/14
Ming Pao News] Hong Kong Centre for Health Protection , said yesterday that the National Health and Family Planning Commission to obtain confirmation , Shanghai newly confirmed cases of avian influenza H7N9 on Friday ( 3 ) , the patient was a 86 -year-old man . Patient surnamed Zhou, being treated at a hospital in Shanghai . 3 Hong Kong from Shenzhen input cases of avian influenza H7N9 , one person died , two were hospitalized .
Hong Kong's three cases, a 80 -year-old man has died , a 86 -year-old man is still receiving treatment at Princess Margaret Hospital , a 36 year old Indian remaining commission reversed by Queen Mary Hospital, Tuen Mun Hospital general ward in hospital , two are in stable condition , and India is expected to be discharged soon commission .
Port commission infected printed material can be discharged from short-term.
-snip-
In addition , the Guangzhou Municipal Health Bureau yesterday informed the market last night found two loaded Zengcheng Hing Fat Goose cage , as well as a water sample tested positive for the H7N9 virus , because the birds may be infected birds have been destroyed Zengcheng city government within the market market closed Zuoqi 3, 2009, 17 poultry workers to accept a one-week checkup.

http://news.sina.com.hk/news/20140105/-2-3157793/1.html

China Guangzhou Zengcheng goose cage #H7N9 virus detected in 3 parts

January 5, 2013 Translation Since last winter, Shenzhen, Dongguan, Yangjiang and other surrounding cities, emerging human infection of bird flu H 7N 9, traced and found that many patients have had contact with poultry meat market. Last night, Zengcheng City, Guangzhou Hing Fat Meat Market detected three H 7N 9 positive specimens matter, the provincial CDC review yesterday, found after testing positive for the conclusion to determine the market found two geese cage. 　　Yesterday afternoon, the Guangzhou Municipal Health Bureau held a press briefing, the current employees in the poultry market 17 No suspicious symptoms, the market Zuoqi closed for three days. This is the second year in May in Zengcheng Licheng R & Meat Market found a case of the chicken samples tested positive H 7N 9 positive for avian flu virus, the Guangzhou City, the second H 7N 9 found traces of the virus. 　　Source: Source is tracking birds 　　According to the Guangzhou Municipal CDC deputy director Yang Zhicong introduced three positive samples from December 31 last year, Zengcheng Hing Fat Meat Market on daily monitoring sampling, detection from two goose cage. "External environment detection H 7N 9 virus, indicating that the environment herds infected birds may have." 　　CDC reported the day before yesterday in the evening will be concluded government, local government and the Guangzhou Zengcheng City of Industry, agriculture, health sector and make the appropriate action immediately. Yesterday afternoon, the Guangzhou municipal government held a human infection with avian influenza H 7N 9 meeting, Vice Mayor Jane tribute child prevention and control layout of the city. Yang Zhicong expressed by the city on the 3rd night, the market began a thorough cleaning, disinfection, and decided to rest for three days. While nine poultry stalls in the market, 17 birds inventoried all employees required to undergo medical observation for seven days. Currently they are in good health, yet suspicious symptoms. "Having been notified by the city, the population of the birds have already done a harmless treatment." 　　At present, the business sector is tracking market poultry sources. Once the source, the CDC will conduct appropriate testing with the agricultural sector. 　　Prevention: hospitals are paid in full "Tamiflu" 　　In April last year so far, a total of Guangzhou environmental samples collected nearly 7,000 copies, except by the city last May, in January this year found that positive environmental samples, the environmental monitoring of the remaining area of ​​Guangzhou, the city showed negative. "Similar environmental testing point in the city's 12 districts, county-level cities have set up, including wholesale meat market, bird habitat, the number of weekly monitoring is around 200." Yang Zhicong said, "At present, Guangzhou The Government has implemented strict management of the meat market, while clearly a cleanup day, a week, disinfect, January 1 closed system in December last year, has been the winter solstice, respectively, before and after New Year's Day has been closed. before the Spring Festival, Guangzhou will be a meat market closed. " 　　Before yesterday two days, CDC staff have begun to send reminders to Zengcheng local medical institutions, requiring the recent cases of pneumonia and influenza-like illness alert, immediately suspected cases to sample testing. Municipal Health Bureau, the CDC also specifically all medical institutions in the city for training, put plenty of "Tamiflu" sent to all designated hospital. "Each designated hospital drugs is very adequate reserves, in addition to Guangzhou, as well as backing store." 　　Yang Zhicong said that Guangzhou has been strengthening unexplained pneumonia, influenza-like illness H 7N 9 testing. Conclusions show that Guangzhou yet found cases of human infection with H 7N 9. But again after detection of positive environmental samples, suggesting that the risk of avian flu 7N 9 H-human infection has increased. 　　Site: Hing Fat live poultry market stalls closed 3 days 　　Hing Fat Market located in the city center of the city, seat of city government Licheng, near Summer Street, Avenue, is a medium-sized comprehensive Meat Market. 　　16:30 yesterday, the reporter saw, focusing on the market side of the nine gross chicken stalls are empty, the announcement posted on the wall display, chicken stalls will be closed for disinfection hair three days. Sales records from the market point of view, the market in addition to selling chickens, ducks, geese, but also the sale of pigeons, average daily sales of about 300 birds. 　　9 Mao chicken stalls specifications consistent visual area of ​​less than 10 square meters each, the wall has four layers cages emptied, washed, outside the basin, cabinets, wash clothes, etc., are still processing equipment, ceramic tile floor with flushing traces, sometimes not wash away the feathers. Went live poultry stalls can smell the odor and taste of disinfectant. Stalls exterior wall stickers "cleaning, disinfection, closed record" show yesterday, 10:00, 15:00, the market has been cleaned and disinfected twice, after a few days there decontamination, the fundamental frequency is once a day. 　　Mao chicken stalls surrounding walls close to the more than A 4 paper announcement, the words "in order to strengthen the prevention and control of avian influenza, chicken stalls in the market hair thoroughly cleaned and disinfected, scheduled for January 2014, three days 4,5,6 Collective closed disinfection. " 　　Other meat stalls in the market are in normal business. A stall confirmed to reporters the day before Mao chicken stalls there are people management, people did yesterday. 　　Several blocks away at Fu Peng Meat Market, the reporter saw the larger market of live poultry stalls, some stalls still normal business. Continued: http://news.sina.com.cn/c/2014-01-05/031929160363.shtml

China - CDC Information Page on Avian Influenza #H7N9: Travel Alert Definitions

Taiwan is currently upgraded to Level 2

Avian Flu (H7N9) in China

Warning - Level 3, Avoid Nonessential Travel Alert - Level 2, Practice Enhanced Precautions Watch - Level 1, Practice Usual Precautions http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china

Taiwan issues yellow travel alert for Shanghai after newest case of #H7N9

January 5, 2014
TAIPEI--Taiwan's Mainland Affairs Council (MAC) yesterday issued a yellow travel alert for Shanghai, a day after the Chinese city confirmed a new human H7N9 avian influenza case.
The MAC upgraded its epidemic travel advisory for Shanghai to a level-2 alert, the same level set last year for travel to Guangdong, Zhejiang and Jiangsu provinces after those areas reported confirmed cases of H7N9 avian influenza.
It also urged people to pay special attention to their health and safety if traveling to the city cannot be avoided.
The new H7N9 case in Shanghai involving an 86-year-old man brought the total number of confirmed H7N9 cases in China to 13 since October, including five cases in Zhejiang, five in Guangdong, two in Hong Kong and one in Shanghai, Taiwan's Centers for Disease Control (CDC) reported Saturday.
Since March 31, 2013, mainland China and Hong Kong have reported 147 confirmed human H7N9 cases, including 48 in which the patients eventually died, the CDC said.
Taiwan has confirmed two imported human cases of H7N9 avian influenza, with one involving a Taiwanese businessman who fell ill after returning from a trip to Jiangsu province in April 2013 and made a full recovery after a month of intensive treatment.
The second one involved an 86-year-old Chinese tourist who arrived in Taipei on Dec. 17, 2013, and was hospitalized on Dec. 24, according to the CDC.
The MAC asked Taiwanese citizens to pay special attention to travel safety if heading to China and reconsider their travel plans, warning that the H7N9 virus could spread to Southern China.
The MAC also urged people who have to travel to epidemic areas in China to avoid direct contact with birds or poultry, wash their hands frequently, wear a surgical mask, not feed wild birds including pigeons and not eat uncooked meat and eggs.
If travelers to epidemic areas develop a fever and cough, they should promptly see a doctor after returning to Taiwan, the council warned.

http://www.chinapost.com.tw/taiwan/national/national-news/2014/01/05/397602/Taiwan-issues.htm

#H7N9 Shanghai case in critical condition with ventilator

Translation
1/4/14

Are the recent frequent fog and haze spread of H7N9 avian influenza affected? Lu Hongzhou said, although not directly cause haze spread of avian flu H7N9, but easily lead to respiratory immunity, so that people infected with the H7N9 bird flu virus more easily onset and worse.

It is reported that Shanghai Health and Family Planning Commission date of disclosure, Shanghai confirmed one case of confirmed cases of human infection with H7N9 avian influenza. Patients Zhou Moumou, male, 86 years old, Shanghai household registration. He confirmed on January 3, has been hospitalized. Lu Hongzhou as authoritative experts participated in three of the afternoon's consultation. He revealed that the patient's condition is very bad, he has appeared in the H7N9 avian flu infection to severe pneumonia, the medical staff to give him taking Tamiflu and ventilator. The infection specialist, said patients are in critical condition.

According to reports, the 80-year-old man, along with his wife before the onset to the live bird markets, although not personally slaughter of live birds, but a closer look at the side of the chicken slaughter live poultry traders process. Lu Hongzhou said that at present, Shanghai is the families of the patients had disease control personnel to detect relevant live bird markets should also be closed.

How to prevent H7N9 virus? Lu Hongzhou said, do not live bird markets, do not touch live birds, they will not be infected. He believes that in order to live bird markets closed well to prevent infection of the disease. He said that for the H7N9 virus, the hospital should have a high degree of vigilance, as long as patients with flu-like symptoms such as fever, cough, pneumonia, regardless of whether the relevant checks should be performed as soon as possible H7N9 virus detection. He said many hospitals now have the ability to check this.

#H7N9 Shanghai Reports New Case

1/4/14

The Centre for Health Protection today verified with the National Health & Family Planning Commission an additional human case of avian influenza A(H7N9) in Shanghai affecting a 86-year-old man.

The case was confirmed yesterday, and the man is now being treated in a local hospital.

To date, 145 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (51 cases), Shanghai (34 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 centre will follow-up with Mainland health authorities on the case.

SHANGHAI, Jan. 4 -- A human case of H7N9 was reported in Shanghai on Saturday, the municipality's health and family planning commission said in a statement.

The patient is an 86-year-old local surnamed Zhou. He was confirmed to be infected with the bird flu virus on Friday.

The patient is receiving treatment at a local hospital, the statement said.

http://english.peopledaily.com.cn/90882/8503516.html

#MERS #Coronavirus United Arab Emirates (UAE) Reports 2nd Contact Case to 68(M)

The WHO has just reported a 2nd contact case, to the Index Case of the 68(M) in the UAE.  Below are my list notes.  Incubation period looks to be approx. 5-10 days.

UAE

12/20/13

Name:  68(M) Husband

From:  Sharjah, UAE

Onset:  12/13

Adm:  12/14 for Joint replacement (syms cough)

Adm:  12/16 transferred to ICU

Note:  Co-morbidities.  No recent travel/or contact with animals.  No contact w/confirmed case.

DOD:  12/22/13

http://pandemicinformationnews.blogspot.com/2013/12/who-middle-east-respiratory-syndrome_31.html

UAE

12/31/13

Name:  59(F) Contact Case

From:  Sharjah, UAE

Adm:  Yes Isolation.

Note:  Wife of 68(M) [12/20] above.  Asymptomatic.  No contact w/animals or confirmed case.  No travel history.

UAE

1/3/14

Name:  33(M) Contact Case

From:  Dubai

Onset:  12/27

Adm:  12/28 ICU, stable

Sym’s on Adm:  bilateral pneumonia, acute renal failure and thrombocytopenia.  Co-morbidities.

Confirmed:  12/29/13

Notes:  Healthcare worker of 68(M) above.

2^nd contact case to index case.

Total Global Cases:  177  Deaths:  74

http://www.who.int/csr/don/2014_01_03/en/index.html

Middle East respiratory syndrome coronavirus (MERS-CoV) - update January 3, 2014

hat-tip @HelenBranswell

3 January 2014 - On 31 December 2013, WHO has been informed of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in United Arab Emirates.
The case is a 33 year-old male healthcare worker in Dubai who was in contact with the confirmed MERS-CoV case reported to WHO on 20 December. He developed symptoms on 27 December, and was hospitalized on 28 December with bilateral pneumonia, acute renal failure and thrombocytopenia. The patient has underlying history of bronchial asthma and chronic kidney disease. The case was laboratory confirmed for MERS-CoV on 29 December 2013. The patient is in critical but stable condition.
Globally, from September 2012 to date, WHO has been informed of a total of 177 laboratory-confirmed cases of infection with MERS-CoV, including 74 deaths.
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Continued:   http://www.who.int/csr/don/2014_01_03/en/index.html

Taiwan's R & D production of influenza vaccine for the first time in China sales

Translation
January 3, 2014

China Taiwan News Network January 3 Taiwan "Guoguang biotech", today announced the successful completion of the 1st influenza vaccine available drugs in clinical trials, vaccination certificates, Guangxi 1200 participants are expected mid-year, sales in the mainland before the end of , which will hit production of vaccines in Taiwan in the mainland's first sales records.

　　According to Taiwan's " Central News Agency "reports, with the H7N9 bird flu continent gradually expanded, confirmed cases start to appear, since October 2013, the mainland and Hong Kong reported 13 cases of H7N9 confirmed cases, five cases were in Guangdong, Zhejiang and 5 cases, Hong Kong, two cases, including one case in Hong Kong on December 26 last year, died; Taiwan also two cases of imported cases.

　　Increased interaction of the three places, especially after the New Year's holiday to return home immediately after the Spring Festival tide, more frequent personnel exchanges. Although there is no evidence of H7N9 avian influenza have sustained human to human phenomenon, but also can not rule out the limitations of human transmission events.

Continued:  http://news.xinhuanet.com/tw/2014-01/03/c_125954628.htm

#H7N9 Taiwan CDC: "Command Center reiterated" H7N9 flu briefing define " - May/may not have fever or cough

"Command Center reiterated" H7N9 flu briefing define "remind physicians found H7N9 flu suspected cases should be cautious response and immediately informed" (caused by the medical community for Disease Control Department Circular No. 227) (2014-01-03) 

Will the medical community friends, Hello:

H7N9 influenza Central Epidemic Command Center reiterated informed about the H7N9 influenza clinical condition is defined as the first "acute respiratory infection, clinical symptoms may include fever (≧ 38 ℃), cough" because clinical manifestations of acute respiratory infection varies,

Therefore, fever and cough which may or may not occur mention. Calls appear on the physician as clinical case of acute respiratory infections and pulmonary parenchymal disease has occurred, and the case with epidemiological conditions, which should be cautious response and immediately informed.

No. yesterday (1/2) published another date for Disease Control Department Circular No. 226 caused by the medical community "command center confirmed cases of influenza A H7N9 in mainland China imported the calls on physicians to ask patients to strengthen tourism / history of exposure, such as suspected cases, be sure to be vigilant and immediately notify health authorities and proper personal protective measures, "content" of patients without clinical manifestations of fever or cough, do not meet the definition of H7N9 influenza informed "and other text lines Mistransplant, is hereby corrected.

Thank you for contacting us to jointly safeguard the health and safety of all the people.

Disease Control Department

201 4 / 01/0 3

http://www.cdc.gov.tw/professional/info.aspx?treeid=cf7f90dcbcd5718d&nowtreeid=0441f6eeb625a9c1&tid=3E5E7D7CF2C6C370 

#H7N9 Is China Failing To Report Cases?

[posted earlier today, an article stating the 3 nurses tested negative]
January 2, 2014
Excerpt:

Taiwan imported Zaibao second case of confirmed cases of H7N9, now broke, three nurses suspected upper respiratory tract symptoms, this 86-year-old man from Jiangsu Province, to Taiwan travel everywhere, anywhere, including Taoyuan, Taipei New north, Taichung, Chiayi, Kaohsiung and Taitung and Hualien's famous attractions, all have been, according to statistics, the patient contacted 499 people, including 163 who are in close contact with the disease the Agency more urgent for 55 people prophylaxis.

But strange to say, from last October to now, the mainland five cases of notified cases in Guangdong, Zhejiang and Hong Kong as well as two cases of five cases, no new cases came out, but there will be patients from Taiwan Jiangsu how it? Afraid of China, failing to report.

The second confirmed cases, there is no precursor, a finding that pneumonia virus situation is probably worse than imagined, reminds people that want to prevent, can only try to avoid contact with birds.

http://www.epochtimes.com/b5/14/1/2/n4049410.htm 

China: Hunan #H9N2 case reported

January 2, 2014
 

Mainland authorities today notified the Centre for Health Protection of a case of avian influenza A (H9N2), affecting a seven-year-old boy in Hunan.

He fell ill on November 19 and has recovered after receiving treatment at a local hospital.

He had been in contact with poultry.

The Centre for Health Protection will liaise with Mainland health authorities on the case.

http://www.news.gov.hk/en/categories/health/html/2014/01/20140102_215944.shtml 

#H7N9 Taiwan Contacts Test Negative

[On January 1st, I posted an article on 3 medical staff with sym's and being tested for H7N9 in conjunction with the Taiwan case.]

Translation
January 2, 2014

The first two cases of H7N9 appears domestic imported cases, epidemiological investigation found responsible for the care of patients with three nurses also have symptoms of upper respiratory infection, but fortunately today released the results of specimen collection, were negative. Deputy Director of the Department of Disease Control, Zhou Zhihao said that to show caution, in addition to three symptomatic nurses, patients and health units have two daughters and tour guides collect specimens for examination, the results were negative.

http://www.chinatimes.com/realtimenews/20140102003815-260401

#MERS coronavirus claims another life in Oman

English -  Times of Oman
January 1, 2014

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) has claimed one more life in the Sultanate.

According to the Ministry of Health, the Sultanate's second MERS coronavirus patient died of lung failure in a hospital last Monday.

"A 59-year-old MERS coronavirus patient, who was under treatment, died on December 30. He had lung failure and pneumonia," the Ministry of Health said, while adding that the ministry is prepared to deal with these situations.

The Sultanate's first MERS coronavirus patient died in the hospital on November 10. The first MERS-CoV victim, who was admitted to the hospital in Nizwa in October, was suffering from diabetes and high blood pressure, among other complaints.

Last week, the Saudi health authorities announced a new casualty of MERS-CoV, bringing to 57 the number of people killed by the coronavirus in the country with the most fatalities.

The MERS-CoV, which can cause coughing, fever and pneumonia, emerged in Saudi Arabia last year and its occurance has been reported in Qatar, France, Germany, Italy, Tunisia and Britain.

MERS-CoV is considered a deadlier but less-transmissible cousin of the SARS virus that erupted in Asia in 2003 and infected 8,273 people, nine per cent of whom died.

 

http://www.timesofoman.com/News/Article-27637.aspx 

#MERS #Coronavirus Oman Confirmation and Death of 59 yo

[This article speaks of the "second"; the first being the 68(M) confirmed on 10/29/13]

January 1, 2014
Translation

Muscat - Qena

An official source at the Ministry of Health of Oman, on Wednesday, the second for the diagnosis of infection with HIV Coruna in the Sultanate.

The source explained that the Omani citizen at the age of 59 years, has passed away yesterday, the first Monday; due to deficiencies in lung function caused by severe pneumonia, and the results of laboratory confirmed the virus infected Corona.

The Ministry of Health is fully prepared to deal with these cases, and immediate action by the response team and to take the actions required for each case.

http://www.al-sharq.com/news/details/191134 

#H7N9 Taiwan 3 Med Staff Contacts of Confirmed on Tamiflu

January 1, 2014

Mainland tourists travel to Taiwan island, has been found infected with H7N9 virus.  Because multiple patients visited the well-known tourist attractions, Disease Control Department today (1), said that after a full day of track, the current master nine contacts with respiratory symptoms, three of whom are in close contact, and therefore has prophylactic dosing; lower risk another six people still listed track list.

Chinese mainland tourists travel to Taiwan, but diagnosed cases of H7N9 infection.Disease tracking the Agency found that the passenger since December 17 last year after the entry of Taiwan, the Taiwan tourism during the eight days, visited Taipei, Taichung, Kaohsiung, and Hualien seven counties famous tourist attractions, fears spread of the disease, the Agency launched an emergency disease outbreak investigation.

After tracing the 1st of illness the Agency this evening said that the current master 149 close contacts, including with the group tour guides, drivers and visits hospital staff, including three medical staff because of upper respiratory tract symptoms, has taken delivery inspection experience and give Tamiflu prophylaxis, requiring independent health management 14 days; another master 499 general contact, six of whom have appeared on respiratory symptoms, because the risk of infection is very low, and therefore not given administration, but still included track list.

Deputy Director of the Agency Zhou Zhihao illness, said: "(acoustic) regarding H7N9 bird flu confirmed cases of contact for Disease Control Department and Health Department after a day of track, a total of 648 contacts, of which there are three, after evaluation, We give Tamiflu drug, there is no need to give another six dosing, as long as the disease can be tracked. "

Zhou Zhihao said the Lunar New Year approaching, many Taiwanese businessmen will return to Taiwan to Chinese New Year, the disease also requires the Agency to Taiwan MAC advocacy, access to the mainland to avoid live bird markets; such as fever or flu-like when you return to Taiwan symptoms, seek medical advice as soon as possible to wear a mask, and inform airline personnel and airport quarantine known port personnel.

http://tw.news.yahoo.com/%E8%BF%BDh7n9%E6%8E%A5%E8%A7%B8%E8%80%85-3%E9%86%AB%E8%AD%B7%E6%8E%A5%E5%8F%97%E9%A0%90%E9%98%B2%E6%8A%95%E8%97%A5-092200591.html 

86-year-old Jiangsu tourists in Taiwan infected with #H7N9 bird flu confirmed

translation:

Taipei, Dec. 31 Xinhua Taiwan's disease control department electric evening of 31 confirmed one case of human infection with the H7N9 bird flu, the patient is 86 years old male tourists from Jiangsu Province, the incidence of traveling to Taiwan is still in ICU treatment.

Taiwan epidemic command center responsible person pointed out that the tourists on December 17 entry, the 19th loss of appetite, chest tightness on the 23rd, when the 24th emergency medical treatment for pneumonia ventilator and ICU stay so far.

It is reported that 25 people with this same tour group tourists, there were 22 people on Dec. 24 return to the mainland. Only patients with two daughters to stay in Taiwan to take care of his father, the two no symptoms.

This is Taiwan's first two cases of human infection with H7N9 imported confirmed cases of bird flu, the first imported case was discovered in April of this year.

http://news.163.com/14/0101/07/9HG4PB6U00014JB5.html 

Taiwan reports 2nd case of imported #H7N9 in 2013 (update)

2013/12/31 22:06:54

Taipei, Dec. 31 (CNA) Health authorities confirmed Tuesday that a Chinese tourist in Taiwan has been infected with the H7N9 strain of bird flu, marking the second imported H7N9 infection this year.

The infected, an 86-year-old man from Jiangsu Province, is still in Taiwan receiving treatment, though most of his 25-person tour group has already returned to China, according to the Centers for Disease Control (CDC).

Two of his daughters have stayed with him but have thus far shown no symptoms associated with the virus. The man entered Taiwan Dec. 17 and began showing symptoms two days later, starting with a loss of appetite. On Dec. 23, he reported tightness of the chest before being rushed to an emergency room the next day, where he was put on a ventilator to treat pneumonia.

An infectious diseases experts familiar with the case said he was not surprised by the second case of H7N9 coming from China following the first back in April. Even so, this patient's symptoms were slightly different from previously reported infections, indicating that doctors still face some difficulty in diagnosing the virus, he added.

The man's infection could mean that H7N9 has become prevalent across all of southern China even though, puzzlingly, major duck and chicken farms in the region have been found disease-free."Beware of the virus if you see any ducks in the Jiangnan (south of the Yangtze River) area," he cautioned.


http://focustaiwan.tw/news/asoc/201312310045.aspx

Genetic marker indicates severity of #H7N9 infection

Wang Z. Proc Natl Acad Sci. 2013;doi:10.1073/pnas.1321748111.

• December 31, 2013

A group of researchers have identified a genetic marker that can predict which patients infected with the new influenza A(H7N9) strain will experience more severe disease, according to data published in Proceedings of the National Academy of Sciences.

Influenza A(H7N9) has infected 134 people in nine provinces in China and caused 44 deaths, according to the paper, which was published online Dec. 23. According to WHO, there is no evidence of sustained human-to-human transmission.

“By using genetic markers in blood and lung samples, we have discovered that there are certain indicators that signal increased susceptibility to this influenza,” Katherine Kedzierska, PhD, associate professor in the department of microbiology and immunology at the University of Melbourne in Australia, said in a press release. “Higher than normal levels of cytokines, driven by a genetic variant of a protein called IFITM3, tells us that the severe disease is likely.”

Lower levels of plasma inflammatory cytokines at hospital admission were associated with faster recovery among 18 patients admitted to the hospital with H7N9, but high concentrations of interleukin-6, IL-8 and macrophage inflammatory protein-1 beta were associated with less favorable or fatal outcomes, the researchers wrote.

When they analyzed bronchoalveolar lavage samples, they found up to 1,000-fold greater cytokine and chemokine levels relative to plasma samples. They also found that patients with the rs12252-C/C genotype of IFITM3 had more rapid disease progression and were more likely to die than patients with the rs12252-T/T or rs12252-T/C genotypes.

“We call this a Cytokine Storm and people with the genetic variant of the protein IFITM3 are more likely to succumb to severe influenza infection,” Kedzierska said. “Being able to predict which patients will be more susceptible to the emerging influenza strain will allow clinicians to better manage an early intervention strategy.”

Disclosure: Kedzierska and colleagues report no relevant disclosures.

http://www.healio.com/infectious-disease/influenza/news/online/%7Bd3163a6f-6bd3-4de5-bce9-cede487e67c7%7D/genetic-marker-indicates-severity-of-h7n9-infection

 

#H7N9 Chinese Tourist from Jiangsu Province to Taiwan Confirmed

The last day of 2013, the country imported cases appear second case of H7N9. Case of 85-year-old mainland Chinese man recently went to visit Taiwan, loss of appetite, chest symptoms seek medical treatment, check for pneumonia, ventilator, Central Epidemic Command Center last night was diagnosed with H7N9.
Epidemic center, said the mainland tourists are "atypical symptoms", no fever, cough;, and the same group of passengers and daughter are asymptomatic, infectious judged not high, people need not panic. Department of Disease Control, Area Control Center keeps track of the situation with the relevant contact man with round-person group.
Following the first since April last year, the country imported H7N9 appears Taiwanese cases; these mainland tourists from Jiangsu Province, is the second from the case.
Currently epidemic center in Jiangsu Province has increased tourism activity levels for the second level "warning", including Zhejiang and Guangdong provinces also have confirmed cases of H7N9, appealed to the local people do not live bird markets, poultry or eating raw meat category.
World Health Organization, H7N9 is currently limited to "the limitations of human transmission stage." Epidemic center, said commander Zhang Fengyi, H7N9 flu outbreak so far, only five cases of human to human transmission limitations cases.
Although imported from mainland tourists in this country went to Taipei, Taoyuan, Nantou Tou, eluanbi Pingtung, Hualien Taroko so many tourist attractions, is still in a hospital in the northern part of the treatment in the intensive care unit, but was its first test weakly positive, low viral load.
Due to the frequent cross-strait exchanges, enhance Taiwan's epidemic level is? Zhang Fengyi said that if the virus mutated to human transmission stage, quarantine and epidemic prevention policy will be updated.
Director of Children's Infectious Diseases Hospital, National Taiwan University, said Li-Min Huang, mainland epidemic widespread than imagined, he judged the entire south of the Yangtze River has a virus exists, calling the people must be vigilant.

[2014/01/01 United Daily News]

http://udn.com/NEWS/HEALTH/HEA1/8396665.shtml

#H7N9 first two cases the onset of mainland tourists to Taiwan tourism

January 1, 2013
Translation

Disease Control Department on December 31 evening confirmed the first two cases of 2013 H7N9 influenza imported confirmed cases , the patient is 86 years old male membership Jiangsu mainland , Taiwan travel time of onset , is still in the intensive care unit for treatment. Experts say H7N9 comeback "no accident ."
Central Epidemic Command Center pointed out that the Changzhou City, Jiangsu Province, 86 -year-old man mainland tourists in Taiwan on December 17 inbound tourism , the 19th began loss of appetite, chest tightness phenomenon 23, 2009 , 24 am emergency medical treatment, the use of the day due to bilateral pneumonia respirator ICU stay far, the 26th vote to Tamiflu .
Among 25 patients with the same group of 22 people was December 24 return to the mainland , the patient's two daughters continued to stay in Taiwan to take care of patients , 2 per capita symptoms did not appear.
No symptoms in patients with two daughters
Command Center said the patient during the journey to Taiwan, visited Taoyuan County, Taipei City , New Taipei City , Taichung City , Chiayi City, Kaohsiung , Taitung , Hualien County and other counties famous attractions, there is no fever or journey cough , detailed travel history is being confirmed and accommodation information . Command Center has informed WHO and synchronization between the mainland and Hong Kong and Macao contact notification window .
http://www.chinatimes.com/newspapers/20140101001067-260309

#MERS #Coronavirus UAE Wife of recent 68yo confirmed case/fatality -- is also confirmed

Hat-tip @ironorehopper

On December 20th, I posted a story of a confirmed case out of Dubai, United Arab Emirates (UAD). 

A new case of the Sars-like virus, that originated in the Middle East and has killed 75 people worldwide, has been confirmed by the Dubai Health Authority (DHA).

The DHA said a 68-year-old Emirati patient was admitted to an unnamed hospital after showing symptoms of the new Corona virus Mers and was receiving treatment in the intensive care unit, state news agency Wam reported.  It said the man was also suffering from diabetes and chronic kidney failure.

In a report today out of the World Health Organzation (WHO), the wife of the above confirmed case has also contracted MERS.

On December 26, WHO has been informed of one new confirmed case of MERS CoV from the United Arab Emirates (UAE).  In addition, UAE announced the death of the 68 year old male reported on 22 December 2013. 



The new case is a 59 year-old female from Sharjah, and is the wife of the 68 year old male reported on 22 December, 2013. She is reported to have no symptoms, no history of contact with animals and no travel history. She is currently in hospital under isolation. Other contacts have been screened and are negative for MERS-CoV.

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update December 31, 2013

Disease outbreak news



31 December 2013 – On 25 December 2013, WHO has been informed of five additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Saudi Arabia.



One of the cases is a 57 year-old male from Riyadh who was hospitalized on 17 December,  2013 and is currently in an Intensive Care Unit (ICU). He was laboratory confirmed on 19 December,  2013. He has underlying chronic diseases. There are no known exposures to animals or a laboratory-confirmed case, and the case has no history of traveling outside Riyadh region.



Second case is a 73 year-old male national, from Riyadh who developed respiratory symptoms and was transferred to an intensive care unit on 25 November 2013, and died on 17 December 2013. On 19 December 2013, he was laboratory confirmed for MERS-CoV. There are no known exposures to animals or a laboratory-confirmed case. In addition, he has no history of travel outside of Riyadh



Three additional cases (two males and one female) are health care workers who have not reported any symptoms.



On December 26, WHO has been informed of one new confirmed case of MERS CoV from the United Arab Emirates (UAE).  In addition, UAE announced the death of the 68 year old male reported on 22 December 2013. 



The new case is a 59 year-old female from Sharjah, and is the wife of the 68 year old male reported on 22 December, 2013. She is reported to have no symptoms, no history of contact with animals and no travel history. She is currently in hospital under isolation. Other contacts have been screened and are negative for MERS-CoV.



Globally, from September 2012 to date, WHO has been informed of a total of 176 laboratory-confirmed cases of infection with MERS-CoV, including 74 deaths.

Continued:  http://www.who.int/csr/don/don_updates/en/index.html