South Korea: AI outbreak confirmed #H5N8

( SEJONG, Jan. 17 (Yonhap) -- The South Korean government on Friday announced an outbreak of avian influenza at a local farm, saying that a DNA test has confirmed ducks on the farm were infected with a highly pathogenic form of the virus.
"Poultry deaths at the farm were caused by a highly virulent strain of the H5N8 virus," the agriculture ministry said.
On Thursday, a suspected AI case was reported at the farm in Gochang, some 300 kilometers southwest of Seoul in North Jeolla Province.
Provincial quarantine authorities culled more than 20,000 ducks Friday after a preliminary test indicated a possible AI outbreak.
The latest discovery is the first case since May 2011, when more than 3 million poultry were slaughtered.
Earlier in the day, another suspected case was reported from a duck farm in Buan, a county adjacent to Gochang, the ministry said.
Quarantine officials confirmed the deaths of some 90 ducks in an on-site probe, and the remaining ducks are also showing AI symptoms, according to the ministry, adding that a DNA test is underway.
But the case turned out to have no connection with Gochang as no trade had been made between the farms, the ministry said.
Determining the exact strain of AI is often crucial as highly pathogenic strains may require more severe quarantine measures than low pathogenic strains.
Confirmation of an AI outbreak is followed by the immediate launch of intensive quarantine measures that include a lockdown of all poultry and personnel at farms in affected areas.
The ministry said it has also began taking initial quarantine measures at 24 poultry farms in four provinces that have recently purchased ducks from the affected farm in Gochang.

http://english.yonhapnews.co.kr/business/2014/01/17/53/0504000000AEN20140117008100315F.html

#H7N9 Guangdong Contact Case of Father and Daughter & Some Discharges

This post is going to be broken down, and taken apart, figured out....slowly.
Excerpts:

According to statistics, since August 2013 in Huizhou since the first reported cases, as of January 18, 2014, 23 cases were reported in Guangdong Province cases, 2 deaths. By patient place of residence, the distribution of cases in Guangzhou four cases, Shenzhen four cases (including 2 cases of discharge), 8 cases of Foshan, Huizhou and one case (already discharged), Dongguan, three cases (of which one case was discharged, 1 death), Yangjiang 3 cases (1 case of death).
-snip-

New Case: 62-year-old man after a number of hospital

Shenzhen, a retired 62-year-old man was diagnosed weekend H 7N 9 infected with avian influenza virus, has now been sent to the Shenzhen City hospital for treatment. This man lived in the Futian District, January 6 this year, fever, headache and other symptoms, have visited Peking University Shenzhen Hospital and many other hospitals for treatment.Review by the provincial CDC now, people diagnosed with H 7N 9 confirmed cases of avian influenza infection.

"At the time when he went to Peking University Shenzhen Hospital outpatient hospital treatment on their use of Tamiflu. Later deterioration, lack of hospital beds could he stay City Second People's Hospital Respiratory carried out anti-bacterial treatment, get some fever control. "Yesterday, the Third People's Hospital of Infectious Diseases district director Yuan Jing said, Zhou relatively mild, after two days of treatment has been improved significantly. Professionals now go to the patient's home and the hospital doctor had its epidemiological investigation and disposition, not currently found related abnormalities. The first case and the second case of human infection of bird flu H 7N 9 patients previously diagnosed are to be discharged today.

The first patient in Shenzen is the 31yo (reported on 1/7/14.  The second patient is the 65 yo, who is deceased.  The third is the 76 yo (reported on 1/11).  I would say they are both discharged.  Leaving the 62 yo reported on today. Hat-tip to ironorehopper of Flu Trackers for the information below. It appears the the 5yo is the son of a previous case: [Panmou 5yo is the daughter of Panmou 29yo reported on 1/11] 


Excerpts from the same article as above:

Reported that her daughter Panmou file management as the first cases of sand Guangzhou East markets tofu. She has introduced, according to the child's mother, "she also went along with their parents over the markets, currently everything is okay, nothing serious symptoms, just to be here for seven days in the hospital observation and treatment."

She has told reporters, "The child is the 13th initial symptoms began to appear, the 15th began to monitor the child has more than 38 ℃ fever, cough, and I followed up immediately communicated to the CDC staff, then was sent to Guangzhou 8th the People's Hospital for treatment. "the discovery, treatment time, the child's situation has been significantly improved, seven close contacts yet found an exception. "On the 17th in the evening after the review sample materials, today (the 18th) laboratory testing has turned negative, I believe you can discharged as soon as possible", the Guangzhou relevant agency heads told reporters.

 

Guangzhou 4 Case case

● Panmou male, aged 29, is living with and street Baiyun District, Guangzhou City, Tianhe District, Longgang Road, Sha East market operators tofu file.January 11 diagnosed, currently in critical condition.

● Fumou male, aged 59, retired, currently residing in Haizhu District of Guangzhou. January 16 diagnosed, currently in a stable condition.

● Panmou female, 5 years old, currently residing in Baiyun District of Guangzhou City. January 18 confirmed that the current mild, Guangzhou first cases daughter.

● Yang female, aged 83, retired personnel, currently residing in Liwan District of Guangzhou City. January 18 diagnosed, currently in critical condition.

  The whole article can be found here:  http://news.ifeng.com/gundong/detail_2014_01/19/33141646_0.shtml 
 

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

Translation

2014 On January 18, the date

　　Zhejiang Provincial Health and Family Planning Commission Jan. 18 date of notification, the province today added three cases of human infection with H7N9 avian influenza.

　　1 , the patient Xiao Moumou, male, 35 years old, farmer, Cixi, Ningbo people. 1 month 16 days confirmed human infection of H7N9 avian influenza. Is now in critical condition, a hospital for treatment in Ningbo.

　　2 , patients Moumou, female, 72 years old, retired, Binjiang District, Hangzhou people. 1 month 17days confirmed human infection of H7N9 avian influenza. Is now in critical condition, in Hangzhou, a hospital for treatment.

　　3 , patients with Bell XX , male, 69 years old, farmer, Shaoxing Paojiang people. 17 days diagnosedpeople infected with H7N9 avian influenza. Existing condition critical, in Shaoxing a hospital for treatment.

http://wst.zj.gov.cn/art/2014/1/18/art_362_406733.html 

Guangdong Province added three cases of human infection with #H7N9 bird flu

January 18, 2014
  Health and Family Planning Commission of Guangdong Province on January 18 briefing, the province confirmed three cases of human infection with the H7N9 avian influenza cases were reported two cases in Guangzhou, Shenzhen, reported one case. 
    Case 1 Panmou, female, 5 years old, currently residing in Baiyun District of Guangzhou City.January 14 onset, January 18 confirmed cases of human infection of H7N9 avian influenza, patients with mild symptoms currently in Guangzhou designated hospital admission. 
    Case 2 Yang, female, 83 years old, retired people, now living in Liwan District of Guangzhou City. January 2 disease, January 18 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in the Guangzhou designated hospital admission. 
    Case 3 Zhou, male, 62 years old, retired people, now living in Futian District, Shenzhen.January 6th disease, the patient's condition is currently stable in Shenzhen designated hospital admission.
http://www.gdwst.gov.cn/a/zwxw/2014011811256.html 

New cases put H7N9 pace near last year's peak

January 16, 2014

The pace of new H7N9 avian flu cases in China over the past week is rivaling the daily crush of infections that occurred during the first peak of activity last spring after the virus first emerged, with reports today of seven new illnesses, one of them fatal.
What began as a trickle of reports in October that signaled H7N9's resurgence in humans, primarily from poultry exposure, has expanded over the past few weeks to several cases reported each day. Thirty-one have been confirmed from Jan 10 through today, a number below but approaching the 38 cases reported during the peak week of disease activity, which began on Apr 8, 2013.
Experts contacted by CIDRAP News say the situation bears close monitoring but differed in their level of expressed concern over the situation.
The spike in activity comes as China enters a heavy travel and shopping period for its Spring Festival season, marked by the Lunar New Year celebration on Jan 31. China estimates that its citizens will make about 3.62 billion trips during the 40-day holiday travel rush, according to a report today from Xinhua, China's state news agency.
Against the backdrop in H7N9 activity, Chinese health officials have aired concerns about crowded travel conditions and the chance that people visiting urban areas could carry the virus back to their rural homes.

Today's report: 7 new cases, 1 fatal

Hong Kong's Centre for Health Protection (CHP), citing official mainland sources, said that Guangdong, Fujian, and Zhejian provinces have two new H7N9 cases each, and Guizhou province has one. The patients are all adults, ages 20 to 76, and five are men. The six survivors are hospitalized, four of them in critical condition.
All of the provinces have reported several other cases recently, except for Guizhou, which is reporting its first H7N9 case, in a 38-year-old man got sick while working in Zhejiang province. News of his illness first appeared in media reports on Jan 13 that said he had a suspected infection, but his H7N9 illness has now been confirmed.
Guangdong province's cases involve a 59-year-old man from Guanzhou and a 76-year-old woman from Foshan, according to the CHP. Fujian province's new case-patients are both from the city of Quanzhou, a 30-year-old man, plus a 60-year-old man who had a history of poultry contact.
Meanwhile, Zhejiang province's patients are a 20-year-old woman from Hangzhou and a 58-year-old man from Taizhou, located about 171 miles southeast of the provincial capital.
The new cases push the H7N9 outbreak total to 188 cases and the number of deaths to 53.

Latest WHO confirmations

In related developments, the World Health Organization (WHO) today acknowledged three H7N9 cases initially reported by China on Jan 14, filling in several more clinical details about each of the cases.
Two of the patients have a history of exposure to poultry, including a 58-year-old man from the Zhejiang province city of Hanzghou and a 50-year-old man from the Fujian province's Jinjiang City. Both men are hospitalized in critical condition.
The third patient is a 29-year-old man who is also from Hangzhou who is hospitalized in serious condition.

Experts weigh in on H7N9 momentum

Joseph Bresee, MD, chief of the Epidemiology and Prevention Branch in the US Center for Disease Control and Prevention Influenza Division, said the increasing number of confirmed cases reported from China during the past few weeks bears watching closely.
"Fortunately, despite additional cases, Chinese health officials haven't reported changes in the epidemiology of the virus that would indicate an increased capacity for spread between humans," he said.
Gregory Hartl, a spokesman for the WHO, said the surge in new cases hasn't changed the agency's risk assessment. He said H7N9 is still a virus that causes sporadic human infections and doesn't appear to transmit well from human to human. "We have only seen a handful of human clusters and only very limited human-to-human spread," he said.
Research studies published over the last few months, designed to help gauge pandemic risk the new virus poses, have found H7N9 currently has limited ability for airborne spread.
Hartl said health officials haven't seen H7N9 before in January and February, so they aren't sure what to expect. However, he added that since the months are the peak of flu season and H7N9 is a flu virus, "it would not be surprising—in fact it would be expected—that we see an upsurge in cases."
University of Minnesota infectious disease expert Michael T. Osterholm, PhD, MPH, said the world has almost a year's worth of experience with H7N9 in humans and poultry under its belt, and there is not the same level of "unknowns" as a year ago.
"But I worry that most of the world seems asleep at the switch, " he said, adding that activity over the past 10 days has been as robust of a case onset period as health officials have seen so far. "We're right there. What's different?"
The steady stream of new cases could mean that Chinese health officials are better at detecting cases, but he added that it doesn't look like they missed many cases last year in the early months of the outbreak. "There must be a similar widespread circulation in poultry," said Osterholm, who is the director of the Center for Infectious Disease Research and Policy, publisher of CIDRAP News,
Recent H7N9 developments raise questions about what's being done to minimize the risks to humans and should be setting off bells, whistles, and sirens warning about the threat, he said. "Each one [case] is another throw at the genetic roulette table."
See also:
Jan 16 Xinhua report
Jan 16 CHP statement
Jan 16 WHO statement
CIDRAP/MCEIRS chart of H7N9 cases by week of onset (through November 2013)

http://www.cidrap.umn.edu/news-perspective/2014/01/new-cases-put-h7n9-pace-near-last-years-peak 

Look for weird flu symptoms, CDC reminds doctors

By Maggie Fox
The case of a Canadian woman who died of H5N1 bird flu earlier this month has mystified flu experts, who say they are both puzzled by how she got the virus, and more than a little surprised that it was H5N1 and not a newer virus, called H7N9, that infected her.
The woman’s unusual symptoms – she didn’t have some of the more obvious signs of flu – prompted a health alert from the U.S. Centers for Disease Control and Prevention this week reminding doctors to be on the lookout for odd symptoms.
“It caught us a little unawares because we were expecting this to happen with H7N9,” CDC flu expert Marc-Alain Widdowson told NBC News. “It came a little out of the blue.”
The victim, a 22-year-old nurse from the central Canadian province of Alberta, had encephalitis – a swelling of the tissue surrounding the brain. She also had pneumonia, but her flu infection wasn’t diagnosed right away and she apparently wasn’t coughing hard.
By the time she came back to the hospital a few days later, she was already dying. Severe and unusual symptoms are a hallmark of avian influenzas, doctors say.
The CDC says people coming back from countries affected by any kind of avian flu should be on the lookout. “Clinicians should consider the possibility of avian influenza A (H5N1) virus infection in persons exhibiting symptoms of severe respiratory illness who have appropriate travel or exposure history,” the Health Alert reads.
And travelers to affected regions should stay away from live or freshly killed birds and only eat meat or eggs that have been thoroughly cooked.
Since 2003, H5N1 has infected around 650 people in 16 countries – counting the latest case in Canada – and killed around 350 of them, according to the World Health Organization. In most cases, it causes severe pneumonia, acute respiratory distress syndrome, and, eventually, multiple organ failure. But experts say it sometimes causes encephalitis and septic shock.
The Canadian victim had been in China since early December and didn’t get really ill until she was headed home at the end of the month, so she almost certainly became infected while in Beijing. H5N1 does not spread easily from person to person, so experts are not alarmed and not worried that the traveler infected anyone else. But the CDC says the case is a reminder that infections other than seasonal flu might show up and doctors need to be alert.
“Clinicians and state health departments should also be aware that human infection with avian influenza A (H7N9) viruses have been reported among persons in China and Taiwan since April 2013, and may exhibit similar symptoms to those of influenza A (H5N1), including pneumonia, respiratory failure, and acute respiratory distress syndrome,” the CDC says.
Of course, this is extra tricky when seasonal influenza is also circulating and causes the same symptoms.
H7N9 has infected around 180 people in the past year – 18 in China in just the past week – and killed around a third of them. “There is a clear second wave that is ongoing now,” Widdowson said. “We expected this. This is the season for avian flu in that region of the world. We expected this winter to be busy.”
That’s also why health officials were on the lookout for bird flu in travelers. “We have been preparing for a traveler coming with H5 disease for many years now,” said Dr. Joe Bresee, another CDC flu expert.
But what everyone had really been looking for was either someone coming from China with H7N9, or if it was H5N1, for the traveler to have been in a region where H5N1 was circulating. Currently, it’s not being seen among people in China, although reports to the OIE, the world health organization for animals, show ongoing outbreaks among birds in several parts of China.
Initial interviews suggest the young Canadian nurse spent her whole time in Beijing, where there are strict rules about keeping, selling and slaughtering poultry. Kevin Fonseca, a clinical virologist for Alberta Health Services, filed a report with the International Society for Infectious Diseases saying the woman, who’s not being named, had no known contact with poultry.
That’s not entirely mysterious, Widdowson says. In the decade that H5N1 has been circulating, there have been a few cases where the patient had no apparent contact with poultry. It doesn’t pass easily from person to person but people might catch it from indirect contact with birds. And Widdowson says people do occasionally smuggle birds into Beijing from other parts of China.
“There are other routes other than actually physical touching a chicken that may cause H5 infection,” Widdowson said. “One is wild birds.” Wild waterfowl can carry H5N1. They can deposit the virus into ponds, too, and people have been infected by bathing in water that infected birds were in.
“You can be exposed to chickens without even knowing it,” Widdowson added. For instance, a vegetable vendor might be set up right next to a chicken seller. “You don’t need to be close,” Widdowson added.
The appearance of infection in a traveler to a region where H5N1 wasn’t seen to have been infecting people shows just how tricky influenza can be. “It’s a capricious virus. It always surprises us,” Widdowson said.
“I am mystified as anybody. It really is a strange event,” agreed Dr. Arnold Monto, a flu expert at the University of Michigan. “I don’t know if we will ever understand it.”

http://www.nbcnews.com/health/look-weird-flu-symptoms-cdc-reminds-doctors-2D11945123
 

Avian Influenza A(H7N9) Virus Infection in Pregnant Woman, China, 2013

From CDC Emerging Infectious Diseases

Volume 20, Number 2—February 2014

Letter

http://wwwnc.cdc.gov/eid/article/20/2/13-1109_article.htm 

HK CHP: Case of severe paediatric influenza A infection under CHP investigation

The Centre for Health Protection (CHP) of the Department of Health is today (January 17) investigating a case of severe paediatric influenza A infection affecting a 17-year-old boy.

     The patient, with underlying medical condition, presented with fever, shortness of breath, cough and sore throat since January 16. He was admitted to Yan Chai Hospital on the same day. He was transferred to the Paediatric Intensive Care Unit of Princess Margaret Hospital for further management today. His clinical diagnosis was pneumonia and asthmatic attack.
     His nasopharyngeal aspirate tested positive for influenza A(H3). He is currently in a serious condition.

     The patient has no recent travel history. His home contact is asymptomatic.

     To prevent respiratory tract infections, a spokesman for the CHP urged members of the public to take heed of the following advice:

* Build up good body immunity by having a proper diet, regular exercise and adequate rest, reducing stress and avoiding smoking;
* Maintain good personal hygiene, wash hands after sneezing or coughing and cleaning the nose, and wear a mask when symptoms of respiratory tract infection develop;
* Maintain good ventilation;
* Avoid visiting crowded places with poor ventilation; and
* Receive seasonal influenza vaccination. For details, please visit the Influenza Page of the CHP's website (www.chp.gov.hk/en/view_content/14843.html).

Ends/Friday, January 17, 2014
Issued at HKT 19:23

http://www.info.gov.hk/gia/general/201401/17/P201401170689.htm 

#H5N1 HK CHP: HK bans import of poultry products from North Jeolla, Korea

The Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department announced today (January 17) that in view of confirmation from the Korean authorities about an outbreak of H5N1 avian influenza on a duck farm in North Jeolla Province of Korea, it has banned the import of poultry meat and products (including poultry eggs) from the province with immediate effect for the protection of Hong Kong's public and animal health.

     A CFS spokesman said about 5 000 tonnes of frozen and chilled poultry meat, as well as about 4.9 million poultry eggs, were imported into Hong Kong from Korea between January and November last year.

     "We will be in close liaison with the Korean authorities over the issue and will closely monitor information issued by the World Organisation for Animal Health on the avian influenza outbreaks in the country. Appropriate action will be taken in response to the development of the situation," the spokesman said.

Ends/Friday, January 17, 2014
Issued at HKT 20:47

http://www.info.gov.hk/gia/general/201401/17/P201401170704.htm 

#H7N9 HK CHP: NHFPC notifies CHP of four additional human cases of avian influenza A(H7N9) in Shanghai and Zhejiang

 The Centre for Health Protection (CHP) of the Department of Health (DH) received notification today (January 17) from the National Health and Family Planning Commission (NHFPC) of four additional human cases of avian influenza A(H7N9) in Shanghai (one case) and Zhejiang (three cases).

     The patient of Shanghai is a 54-year-old man. He is currently under treatment in a local hospital.

     In Zhejiang, three cases involve three men aged 54, 62 and 66. They are still hospitalised for treatment.

     As of 9pm today, a total of 187 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (68 cases), Shanghai (38 cases), Jiangsu (30 cases), Guangdong (20 cases), Fujian (nine cases), Jiangxi (six cases), Anhui (four cases), Henan (four cases), Beijing (two cases), Hunan (two cases), Shandong (two cases), Hebei (one case) and Guizhou (one case, imported from Zhejiang).

     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.

     "All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Random temperature checks by handheld devices will also be arranged. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.

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

     "Travellers, especially those returning from avian influenza-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 had contact with poultry, birds or their droppings in affected areas and provinces," the spokesman said.

     Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:

* Do not visit live poultry markets. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear masks when respiratory symptoms develop or when taking care of fever patients.

     The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf) for more information on avian influenza-affected areas and provinces.

Ends/Friday, January 17, 2014

http://www.info.gov.hk/gia/general/201401/17/P201401170693.htm
Issued at HKT 21:04

#H7N9 HK CHP: Hong Kong & Mainland to launch H7 avian influenza serological test next Friday

[all editing below is mine]

January 17, 2014

 

Starting from January 24, Hong Kong and the Mainland will conduct serological test for H7 avian influenza (AI) on live poultry at Mainland registered farms and the Man Kam To Animal Inspection Station.  Serological test will also be introduced to local poultry farms in Hong Kong on the same day. 

     The Hong Kong Special Administrative Region Government (HKSARG), the General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) and the relevant Mainland entry-exit inspection and quarantine authorities (CIQs) reached consensus on this decision after discussions. 

     The Secretary for Food and Health, Dr Ko Wing-man, today (January 17) announced the above decision and the relevant arrangements at a meeting of the Legislative Council Panel on Food Safety and Environmental Hygiene. 

     "At present, stringent biosecurity measures, traceability arrangements, vaccination programme for poultry against H5 AI and import protocol are imposed on all Mainland registered farms that export poultry to Hong Kong.  All live poultry bound for Hong Kong must be accompanied by an official animal health certificate and delivered to Man Kam To directly from the registered farms. These farms are subject to regular inspections by the relevant CIQs and the Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department (FEHD) to ensure compliance with the prescribed AI control requirements.

     "The existing AI preventive and control measures have been effective in preventing AI.  Building on such a foundation, we have decided to introduce the serological test, which serves as an additional surveillance measure on poultry or farms to determine if they have been infected with H7 AI in the past. This can further strengthen the capability in background monitoring and in providing alerts at the farm level.

     "While a positive result in serological test reflects the fact that the live poultry have been infected in the past, it does not mean the concerned chickens are carrying AI virus at the time when being tested. To ascertain if individual birds are carrying AI virus, we rely on genetic testing for H7 AI which is currently in use," Dr Ko said.

     In accordance with scientific and risk management principles, the HKSARG has reached a consensus with the AQSIQ on the notification mechanism and contingency measures in dealing with H7N9 AI cases on the Mainland.  The details are as follows:

- If live poultry from the Mainland are tested positive in the H7 serological test at Man Kam To, the CFS will immediately take 120 additional samples from the same consignment of live poultry for H7 Polymerase Chain Reaction (PCR) test (genetic testing) for the purpose of verification.  The consignment of poultry will be released to the local market when there is a negative result certifying that the consignment of live poultry is not carrying AI virus. Separately, the HKSARG will notify the relevant Mainland authorities so that action is taken to step up surveillance and conduct investigation on the registered farm concerned.  The supply of live poultry to Hong Kong from that farm would continue after both sides have agreed on the investigation result.
    
- If live poultry from the Mainland are tested positive in the H7 genetic testing, it means that the consignment of live poultry carries H7 AI virus and should be destroyed immediately.  The live poultry co-stored with that consignment of poultry in the wholesale market will also be destroyed.  With reference to the advice of the World Organisation for Animal Health (OIE), we will close the wholesale market for 21 days for thorough cleansing and disinfection.  The Mainland will suspend the supply of live poultry to Hong Kong from the registered farm found to be the source of the outbreak, for 21 days. The Mainland authority will conduct investigation and ensure that the farm complies with all the biosecurity management requirements.  The supply of live poultry from the relevant farm to Hong Kong will resume after both sides have agreed on the investigation result.
   
- Where live poultry samples or environmental samples from the Mainland with positive genetic testing results, or confirmed cases of human infection on the Mainland come to light, it is not necessary to suspend the supply of Mainland live poultry to Hong Kong since Mainland poultry exported to Hong Kong must come from registered farms and through an independent supply chain without contact with the Mainland’s poultry markets. However, as a precautionary measure, we will step up surveillance on imported live poultry from registered farms within a radius of 13 km from the source of the samples with positive testing results or the possible source of human infection cases. 
    
     The HKSARG will continue to enhance liaison and exchange with the relevant Mainland authorities.  As and when the situation so warrants, exchanges including site visits will be organised to fortify the AI prevention and control efforts.

     The supply of live poultry to Hong Kong from the registered poultry farms in Shenzhen may resume on January 24 as well.

     "Since the outbreak of H7N9 AI in the Mainland, the Administration has been maintaining close liaison with the relevant Mainland authorities to assess the development of the outbreak and discuss the required measures to ensure the safety of live poultry and poultry products supplied to Hong Kong.  With the support of the AQSIQ, the relevant CIQs have enhanced H7 AI surveillance on live poultry and poultry products bound for Hong Kong by increasing the sampling size and the frequency of farm inspections. All testing results are negative so far," Dr Ko said.

     In Hong Kong, starting from April 2013, the CFS has conducted H7 genetic tests on imported live poultry at the boundary control point.  More than 14 000 samples have been tested so far and all were negative for H5 and H7 viruses. The Agriculture, Fisheries and Conservation Department, the FEHD and the CFS have also strengthened the preventive and control measures against H7N9 at various levels of the local live poultry supply chain.

     "The Government will continue to closely monitor the development of the H7N9 outbreak and update the risk assessment.  However, preventive measures can only be effective with the support of the public.  I appeal to the public again to join us in our preventive efforts and maintain good personal and environmental hygiene, including washing hands frequently, wearing masks when feeling unwell, avoiding contact with live poultry or visiting live poultry markets in the affected districts, revealing their travel history to doctors and not bringing poultry to Hong Kong illegally.  These are important and effective measures for preventing diseases," Dr Ko added.

Ends/Friday, January 17, 2014

http://www.info.gov.hk/gia/general/201401/17/P201401170794.htm
Issued at HKT 22:31

#H7N9 Fujian Announces 2 New Cases

Translation
1/17/14

   Health and Family Planning Commission of Fujian Province 17 days notification , the province 17 Nisshin confirmed two cases of human infection with the H7N9 avian influenza.

    Patients Wu Moumou, female, 38 years old, self-employed businessmen, currently residing in Quanzhou, Jinjiang City. Currently in critical condition in a hospital isolation Jinjiang treatment.

    Patients Moumou, male, 54 years old, cadres, now living Ningde Gutian County. Is currently in critical condition at a hospital in Fuzhou, isolation and treatment. (Emergency Management Office)

http://www.fjphb.gov.cn/show.aspx?ctlgid=246246&Id=90026 

Xinhua: #H7N9 Citing Experts: Epidemic Unlikely -- 28 Cases This Year -- No Mutation Found

BEIJING, Jan. 17 (Xinhua) -- China's National Health and Family Planning Commission said on Friday that a large-scale H7N9 epidemic is unlikely, following 28 cases reported nationwide this year.

"Current cases are scattered, and no mutation of the virus has been idntified so far that could affect public health," said a Friday statement from the commission.

The 28 cases of human infection of H7N9 so far were reported in east China's coastal regions of Shanghai, Zhejiang and Jiangsu as well as south China's Guizhou and Guangdong provinces.

Guangdong reported on Thursday two new cases of human H7N9, and another avian flu patient that died on Wednesday after treatment failed.

"The virus is still spreading from birds to human, and the chances of large-scale human H7N9 infection are slim," the statement said, citing experts.

However, the commission noted that cases will keep rising as the country's urban and rural fowl markets are scattered while the transporation and trade of poultry will become more frequent to meet the demand around the upcoming Spring Festival.

The commission urged local health departments to strengthen monitoring and step up treatment of patients while carrying out detailed prevention and control measures and timely risk evaluations.

Editor: Fu Peng

http://news.xinhuanet.com/english/china/2014-01/17/c_133054111.htm

WHO Human infection with avian influenza A(H7N9) virus – update January 17, 2014

17 January 2014 - On 15 January 2014, the National Health and Family Planning Commission of China notified WHO of four additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus.
Details of the cases are as follows:

• A 35 year old man from Shanghai who became ill on 1 January and was admitted to hospital on 12 January. He is currently in a critical condition. The patient has a history of exposure to poultry.
• A 41 year old man from Hangzhou City, Zhejiang Province, who became ill on 5 January and was admitted to hospital on 9 January and then transferred to another hospital on 12 January. He is currently in a critical condition.
• A 48 year old man from Foshan City, Guandong Province, who became ill on 2 January and was admitted to hospital on 12 January. He is currently in a critical condition.
• A 55 year old man from Dongguan City, Guandong Province, who became ill on 1 January and was admitted to hospital on 9 January. He is currently in a critical condition. The patient has a history of exposure to poultry.

The source of infection is still under investigation. So far, there is no evidence of sustained human-to-human transmission.

http://www.who.int/csr/don/2014_01_17/en/index.html 

#H7N9 Zhejiang To Close Markets? Jinhua City & Shanghai has.

Translation
1/17/14
Excerpt:

Close to the supermarket area of ​​live poultry

    From the 14th start trading live poultry in Jinhua City, the major supermarkets have closed, no longer live poultry trade. Previously, Shanghai also issued a message, close the live animal markets during the Spring Festival.

    So Zhejiang other avian influenza H7N9 has appeared in the city, will close the live bird markets?

    Yesterday, the reporter contacted the provincial agriculture department, the staff told reporters, live bird markets are closed, a decision by the municipal government departments around the permissions are not in the Agriculture Department.

    In the first half of last year, Zhejiang closure of some live animal markets, the government introduced a series of subsidy policies, present, Zhejiang not restart this policy.

    It is understood that poultry Zhejiang market, part of the local farming industry, "local birds", in part, from the provinces to the "floating birds," Currently, the Agriculture Department of the relevant departments to strengthen the correlation detection, and has been part of the market environment and who live birds detected H7N9 avian influenza virus.

http://www.zj.xinhuanet.com/newscenter/focus/2014-01/17/c_119005737.htm 

#H7N9 Zhejiang: 3 Cases in Xiaoshan District

The cases, their specifics are located below

Zhejiang

Date of Report:  1/14/14

Name:  58(M)

From:  Xiaoshan District, Hangzhou

Onset:  1/6

Adm:  1/12 ICU Hangzhou hospital

Confirmed:  1/13

Note:  Exposure to poultry.

Zhejiang

Date of Report:  1/16/14

Name:  20(F)

From:  Xiaoshan District, Hangzhou

Adm:  ICU Hangzhou

Confirmed:  1/15

Note:  Farmer, poultry exposure.

Zhejiang

Date of Report:  1/17/14

Nme:  62(M), Farmer

From:  Xiaoshan District, Hangzhou

Adm:  ICU, Hangzhou

Confirmed:  1/16

#H7N9 Zhejiang 3 New Cases, all Farmers, all Critical Condition

Translation
1/17/14

2014 On January 17, the date

　　Zhejiang Provincial Health and Family Planning Commission Jan. 17 date of notification, the province 16 Nisshin confirmed three cases of human infection with H7N9 avian influenza.

　　1 , Shen certain patients, male, 66 years old, retired, Huzhou Wuxing people. 1 month 16 days confirmed human infection of H7N9 avian influenza. Now is critical, in Hangzhou, a hospital for treatment.

　　2 , patients Zhu Moumou, male, 54 years old, farmer, Huzhou Wuxing people. 1 month 16 days confirmed human infection of H7N9 avian influenza. Now is critically ill in a hospital in Huzhou treatment.

　　3 , patients with the surname Wang, male, 62 years old, farmer, Xiaoshan District, Hangzhou people. 1 month 16 days confirmed human infection of H7N9 avian influenza. Now is critical, in Hangzhou, a hospital for treatment.

http://wst.zj.gov.cn/art/2014/1/17/art_362_406687.html

CDC Taiwan: Second imported human case of H7N9 avian influenza confirmed in Taiwan

• Release date of 2014-01-16
• Last modified at 2014-01-16

The second imported human infection with avian influenza A (H7N9) has been confirmed in Taiwan.

   

Since “H7N9 influenza” was listed as a Category V Notifiable Infectious Disease on April 3, 2013, as of January 13, 2014, a cumulative total of 487 suspected H7N9 cases have been reported to Taiwan CDC. Infection with avian influenza A (H7N9) has been confirmed in two imported cases. The possibility of H7N9 infection has been ruled out in 485 cases. (updated every Tuesday)

http://www.cdc.gov.tw/english/info.aspx?treeid=e79c7a9e1e9b1cdf&nowtreeid=9a24eaf046a7abf8&tid=E5FAD41AE02672CD