#H7N9 Case List & Map

Updated.  This information will be located in the right side-bar under H7N9 Virus
link to map:  http://tinyurl.com/c4stjde

China:  Red Dot=Conf. Death; Red=Conf.; Blue=Uncon.

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H7N9 Human Cases 2013

Date of Report:  3/8/13

Name:  Li Family – Father & 2 Sons

Ages:  55 & 69 (below)

55(M)  Son of 87(M)

Adm:  yes between Feb 14-24 w/pneumonia

Confirmation:  no

DOD:  2/28

Note:  Cause of death under investigation.

69(M) Eldest son of 87(M)

Adm:  Between Feb 14-24 w/pneumonia

Confirmation:  no

Note:  Recovered and discharged.

Shanghai

Date of Report 3/31/13

Name:  Lee 87(M) Father of 2 above

From:  Minhang District, Shanghai

Adm:  2/24 (?)Shanghai No. 5 People’s Hospital

Onset:  2/19

Notes: No mutual infections among the 3 cases.  88 contacts are fine.  H7N9 has never been contracted to humans before.  Virus shows no signs of being highly contagious.  All sym’s were fever, cough developing into severe pneumonia & difficulty breathing in later stage.

Confirmation:  3/30/13

DOD:  3/4

Shanghai

Date of Report:  3/31/13

Name:  Wu 27(M) Pork Dealer in wet market

From:  Minhang District, Shanghai

Onset:  2/27

Adm:  Small clinic

Adm:  3/3  Shanghai No. 5 People’s Hospital, diag: pneumonia

3/6:  ICU, critical condition.

Notes: No mutual infections among the 3 cases.  88 contacts are fine.  H7N9 has never been contracted to humans before.  Virus shows no signs of being highly contagious.  All sym’s were fever, cough developing into severe pneumonia & difficulty breathing in later stage.

Confirmation:  3/30/13

DOD:  3/10

Anhui Province

Date of Report:  3/31/13

Name:  Mr. Han 35(F)

From:  Chuzhou City, Anhui Province

Onset:  3/9

3/14 fever 39.  3/15 Comm. Clinic.

Than another Clinic, fever 40.  No relief.

Adm:  3/19 – Chinese & Western Medicine, Chuzhou

Adm:  3/20 – First People’s Hospital, Chuzhou City

Adm:  3/20 – Afternoon - Nanjing Zhongshan Univ. Hospital, Jiangsu, ICU

Notes:  Critical Condition 3/31.  Contact with birds 5 days before onset, purchased live chickens.  Cut chicken up made soup.   No mutual infections among the 3 cases.  88 contacts are fine.  H7N9 has never been contracted to humans before.  Virus shows no signs of being highly contagious.  All sym’s were fever, cough developing into severe pneumonia & difficulty breathing in later stage.

Confirmation:  3/30/13

Jiangsu Province

Date of Report:  4/2/13

Name:  Xu - 45(F)

From:  Jiangning District, Jiangsu Province

Onset:  3/19, dizzy, fever, aches, fatigue

Adm:  3/27, ICU Nanjing Drum Tower Hospital

Confirmed:  3/30 – Prov. Ctr for Disease Detection

Confirmed:  4/2 – China CDC

Notes:  Critical Condition.  49 contacts being monitored.  Worked as poultry butcher at local market.

Jiangsu Province

Date of Report:  4/2/13

Name:  Female (48)

From:  Suqian Shuyang, Jiangsu Province

Onset:  3/19, fever, dizzy, cough

Adm:  3/30, Nanjing Hospital ICU

Confirmed:  3/30 Jiangsu Provinial Ctr for Dis. Detection

Confirmed:  4/2  China CDC

Notes:  Critical Condition.  60 contacts monitored.

Jiangsu Province

Date of Report:  4/2/13

Name:  Shen  83(M)

From:  Suzhou Wujiang District, Jiangsu Province

Onset:  3/20, fever, cough, sputum production

Adm:  3/29 Transferred Expert Group Wujiang

Confirmed:  4/1 Jiangsu Provincial Ctr for Disease Detection

Notes:  Critical Condition.  15 contacts monitored.

Jiangsu Province

Date of Report:  4/2/13

Name:  Zhang  32(F)

From:  Wuxi City, unemployed, Jiangsu Province

Onset:  3/21

Adm:  3/28 Wuxi ICU

Confirmed:  3/31 Jiangsu Prov. Ctr for Dis. Detection

Confirmed:  4/2 – China CDC

Notes:  Critical Condition.  43 contact monitored.  Lives alone, rural area.  No large-scale farms or famers’ markets, but habit of backyard poultry & livestock in rural areas.

Zhejiang Province

Date of Report:  4/3/13

Name:  Hung (38) – Cook, worked in Taicang City, Jiangsu Province

From:  Hangzhou Jiande, Zhejiang Province

Onset:  3/7

Adm:  3/18

DOD:  3/27

Confirmed:  4/1 Zhejiang Province CDC

Confirmed:  4/3 China CDC

Notes:  125 contacts monitored.

Zhejiang Province

Date of Report:  4/3/13

Name:  Yang (67)M, Retired, unemployed

From:  Hangzhou, Zhejiang Prov.

Adm:  3/25 Hangzhou Hospital

Adm:  4/2 Zhejiang Univ. School of Med Hospital

Confirmed:  4/2 Zhejiang Province CDC

Confirmed:  4/3  China CDC

Notes:  Critical Condition.  58 contacts monitored

Zhejiang Province

Date of Report 4/4/13

Name:  Zhang 64(M) Farmer

From:  Wuxing district, Huzhou City

Onset:  3/29

Adm:  3/31 Huzhou

Confirmed:  4/3

Notes:  55 contacts monitored

DOD:  4/4/13

Shanghai

Date of Report:  4/4/13

Name:  Chu 48(M) Transported Chickens & Ducks

From:  Rugao (could be road?)

Onset:  3/28 cough, sputum, fever

Adm:  4/1 private clinic

Adm:  4/3 Tongji Hospital (deteriorated sharply)

Confirmed:  4/4 Shanghai CDC

Note:  Died 3 hours after admission.  8 contacts monitored.

DOD:  4/3/13

Shanghai

Date of Report:  4/4/13

Name:  52(F)

From:  Shanghai

Adm:  Huashan Hospital

DOD:  4/3/13

Confirmed:  4/4/13

Note:  Close contact developed fever and runny nose.

Shanghai

Date of Report:  4/4/13

Name:  4(M)

From:  Shanghai

Confirmed:  yes

Note:  Recovering from mild illness. Satisfactory.

Shanghai – 6^th case

Date of Report:  4/4/13

Name:  67(F)

From:  Shanghai

Confirmed:  Yes

Note: Critical Condition

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Shanghai – Close Contact to 52(F)

Name: 

From:  Shanghai

Adm:  Quarantine

Confirmed:  Tested Negative

Jiangsu Province

Date of Report:  4/5/13

Name:  Yin (61)F – Retirement Home

From:  Qinhuai District, Nanjing, Jiangsu Province

Onset:  3/20

Adm:  4/2 Nanjing Hospital

Confirmed:  4/3 Jiangsu Province CDC

Confirmed:  4/5 China CDC

Note:  12 contacts monitored.  Critical condition.

Jiangsu Province

Date of Report:  4/5/13

Name:  (79)M – Retirement Home

From:  Qinhuai District, Nanjing, Jiangsu Province

Onset:  3/21

Adm:  3/31

Confirmed:  4/2 Jiangsu Province CDC (Weak result, nucleic acid)

Confirmed:  4/5, Test Again – Weak Positive, nucleic acid

Confirmed:  4/5  China CDC  - lung aspirate

Note:  53 contacts monitored.

ECDC risk assessment on novel influenza A virus in China

03 Apr 2013

ECDC

On 31 March 2013, the Chinese authorities announced the identification of a novel influenza A virus, A(H7H9), in three seriously ill people from two provinces presenting with respiratory infections. So far, no epidemiological link has been identified between those three patients.
When testing for the influenza virus, the Chinese Center for Disease Control and Prevention identified genes from both A(H7N9) and A(H9N2) viruses, thus indicating a novel reassortant avian influenza A virus.
In its initial assessment of the situation, the ECDC rapid risk assessment concludes that the risk of the spread of the virus in Europe can be considered low at this stage. However, individual patients coming from China cannot be ruled out. It is thus important to further investigate the source of infection and the mode of transmission to develop ECDC’s assessment further.
This event stresses the importance of considering the possibility of zoonotic influenza due to novel influenza A viruses in persons presenting with severe acute respiratory disease. Especially when patients have recently been in countries where animal influenza A viruses circulate and these viruses have recently caused severe respiratory disease in humans. This includes China.
ECDC is working closely with WHO and the European Commission and will continue to monitor the situation.

http://ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8-e230-4424-a783-85742124029a&ID=876&RootFolder=%2Fen%2Fpress%2Fnews%2FLists%2FNews

#H7N9 "Gene Re-assortment" Allowing Virus to Lodge onto the Surface of Cells of Animals, Making Easier To Infect Humans

Excerpt:

Meanwhile, scientists said that based on information from genetic data and lab tests in China, the H7N9 virus appears to infect some birds without triggering noticeable symptoms, AP reported. 

“We speculate that when this virus is maintained in poultry the disease will not appear, and similar in pigs, if they are infected, so nobody recognizes the infection in animals around them, then the transmission from animal to human may occur,'' said Dr Masato Tashiro, director of the World Health Organization's influenza research center in Tokyo and one of the specialists who studied the genetic data. “In terms of this phenomenon, it's more problematic.’’
 
This behavior is unlike the virulent H5N1 strain, which set off warnings when it began ravaging poultry across Asia in 2003. H5N1 has since killed 360 people worldwide. 

“In that sense, if this continues to spread throughout China and beyond China, it would be an even bigger problem than with H5N1 in some sense, because with H5N1 you can see evidence of poultry dying, but here you can see this would be more or less a silent virus in poultry species that will occasionally infect humans,'' said University of Hong Kong microbiologist Dr Malik Peiris, a Sri Lankan expert who also examined the information. Dr Peiris is chair professor of the Virology School of Public Health at HKU.

Dr Peiris praised Chinese health authorities for being forthcoming with data and information, but said animal health agencies needed to step up and act quickly. He urged China to widely test healthy birds in live animal markets in the parts of the country where the human infections have been reported to find out what bird species might be hosting the virus and stop the spread. 

“If you don't stamp it out earlier now, there won't be any chance of stamping it out in the future,'' Dr Peiris said. “It already may be too late, but this is the small window of opportunity that really one has to grasp, as quickly as possible.''
 
Other information gleaned from the genetic data was that the H7N9 virus was what scientists call a “gene re-assortant’’ _ in which three bird viruses swapped genes among themselves _ undergoing changes that allowed it to adapt more easily, though not fully, to human hosts, WHO's Tashiro said. One change has allowed it to lodge onto the surfaces of cells of mammals, making it easier to infect humans. 
 
“The tentative assessment of this virus is that it may cause human infection or epidemic. It is still not yet adapted to humans completely, but important factors have already changed,'' Tashiro said.

In the wake of the outbreak, the Chinese Center for Disease Control and Prevention shared the genetic sequence of the new virus with the global health community.



http://www.thestandard.com.hk/breaking_news_detail.asp?id=34300

China's deadly new #H7N9 bird flu virus may be harder to track than predecessors, scientists say

This article goes on to say that the virus could be harder to track than it's better known "cousin" which of course is the avian influenza H5N1 bird flu.  The poultry that are carrying it are not showing any symptoms....

Dr. Masato Tashiro, a WHO scientist, reports in this article that the virus appears to have mutated, and it has made it easier to infect animals (like pigs) making it alot easier to infect humans.

Not good news.

Article:  http://www.cbsnews.com/8301-204_162-57577666/chinas-deadly-new-h7n9-bird-flu-virus-may-be-harder-to-track-than-predecessors-scientists-say/

Cambodia reports 10th bird flu case this year #H5N1

[Hat-tip Flu Trackers:  http://flutrackers.com/forum/showthread.php?t=202797]

2013-04-03
PHNOM PENH, April 3 (Xinhua) -- A six-year-old boy from Southwestern Kampot province was confirmed to have contracted with Avian Influenza H5N1, bringing the number of the cases to 10 and the death toll remained at eight in 2013, a health expert said Wednesday. "The boy was admitted to the Kantha Bopha Hospital in Phnom Penh on March 31 for severe pneumonia, and he was tested positive for H5N1 at the Instituts Pasteur on Tuesday,"Dr. Denis Laurent, deputy director of the hospital, told Xinhua."The boy is still alive, but in severe conditions."
-snip-
Cambodian Prime Minister Hun Sen repeatedly appealed to television and radio stations to broadly educate people about the outbreaks of Avian Influenza H5N1 virus, which has killed eight people so far this year.

Full article:  http://news.xinhuanet.com/english/world/2013-04/03/c_132283023.htm  

#H7N9 2 More Cases, One Death in Zhejiang Province

[hat-tip Flu Trackers:  http://flutrackers.com/forum/showthread.php?t=202794]

LONDON, April 3: The Health Department of Zhejiang Province April 3 Bulletin, Zhejiang Province confirmed two cases of human infection with the H7N9 avian flu cases in which patients died.

　　Patients, Mr. Hong, male, 38 years old, Hangzhou Jiande, cook, work in Jiangsu Taicang. March 7 about the disease, 18 Back Jiande a hospital; 20, 2009 transferred to Xiaoshan a hospital for treatment. Sicker patients on the 24th, after she died on the morning of the 27th. In the afternoon of April 1, Zhejiang Province CDC report test results of patient specimens positive for H7N9 avian influenza virus nucleic acid . April 3, China CDC influenza center laboratory for review of the H7N9 avian influenza virus nucleic acid positive. Provincial Health Department expert group based on the performance of the clinical, laboratory testing and epidemiological findings, the diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. The patients for the province's first cases of infection with the H7N9 avian flu. After investigation, the close contacts of the cases of 125 people. As of now, all close contacts of the cases were not found to have a fever or respiratory symptoms.

　　Patients Yang, male, 67 years old, Hangzhou people, retirement home. Check in Hangzhou hospital because of cough, fever and other symptoms on March 25; April 2 go to the Affiliated Hospital of Zhejiang University School of Medicine. In the afternoon of April 2, Zhejiang Province CDC report test results of patient specimens positive for H7N9 avian influenza virus nucleic acid. April 3, patient specimens for the H7N9 avian influenza virus nucleic acid positive review by China CDC influenza center laboratory. Provincial Health Department organized experts, according to the clinical manifestations, laboratory testing and epidemiological findings, diagnosis of the cases of human infection of H7N9 avian influenza confirmed cases. After investigation, the close contacts of the cases of a total of 58 people. Up to now, all close contacts of the cases were not found to have a fever or respiratory symptoms.

　　After the outbreak, the leadership of the provincial government attaches great importance to Xia Baolong secretary, Li Qiang, governor made ​​a written comment specifically requires close attention to the epidemic progress quickly to start the emergency response, seriously study the problems that may occur related plans, really good job in the prevention and control work . The provincial government held a special meeting this afternoon, emergency deployment do a good job of prevention and control work: First, with reference to the Ministry of Health, National Influenza pandemic contingency plans "to start Ⅳ grade emergency response.Second, health departments should earnestly implement the national norms on the prevention and control and clinics to treat the patient, do a good job the active surveillance and prevention and control work. Third, agriculture, education, industry and commerce departments should strengthen communication and coordination in accordance with the contingency requirements, and jointly improve the prevention and control work. The fourth is to strengthen the public health-oriented education, combined with the Patriotic Health Month activities, active preventive care.

　　Currently, no epidemiological association exists between the above two cases. Experts remind that this is the season of high incidence of influenza and other respiratory diseases, for the prevention of influenza, should wash their hands, indoor handling ventilation, attention to nutrition, to maintain a good physique; sneezing, coughing and other symptoms of respiratory tract infection, use paper towels , handkerchiefs Cover your mouth and nose to prevent infection of others; once the symptoms of fever, cough and acute respiratory infections, especially high fever, breathing difficulties, you should seek immediate medical attention; avoid contact and edible disease (dead) poultry, livestock.

http://news.eastday.com/c/20130403/u1a7301868.html 

Hong Kong: Experts are Developing Means to Test Poultry for #H7N9

4/3/13

Secretary for Food & Health Dr Ko Wing-man said experts are now trying to develop a means of testing poultry for the deadly H7 avian influenza virus after four more human cases of Influenza A (H7N9) were confirmed on the Mainland yesterday, bringing the total number to seven.

The Government is stepping up surveillance measures, Dr Ko said on a radio show this morning. He added there is no need to raise the Alert Response Level now, but the Government will closely monitor the situation.

He said the situation is worrying as all four newly confirmed human cases in Jiangsu are in critical condition. Two men earlier died of the disease, and another infected woman is also in critical condition.

“This reflects that either the virus is very serious, or the minor cases cannot be recognised by the frontline healthcare staff,” he said.

He said the chance of importing infected chickens is low as all the Mainland poultry farms supplying chickens to Hong Kong are registered. The Government will bolster surveillance measures on imported poultry, local chicken farms, and wholesale and retail markets.

After the radio show, in response to reporters' queries, Dr Ko admitted that the current infrared body-temperature screening at border checkpoints is not 100% correct, but people suspected to have a fever will have their temperature taken by other means.

Dr Ko added that the World Health Organisation has not issued a travel alert, but he reminded people to avoid direct contact with animals, birds or poultry when travelling.

Hong Kong: SFH on human cases of Influenza A (H7N9) in the Mainland #H7N9

4/3/13
Hong Kong (HKSAR) - Following is the transcript of remarks made by the Secretary for Food and Health, Dr Ko Wing-man, before attending a media programme this morning (April 3):

Reporter: Do you see there is a need right now to step up the infection control measures at the border? Do you want to introduce the health declaration requirement?

Secretary for Food and Health: I visited the Lo Wu border this morning to get to understand the operation of the body temperature checking mechanism at the immigration control point. We noticed that there are comments about the accuracy of the infrared whole-body temperature scanning devices, saying that people with a lower degree of fever might not be detected by this device. However, this is a more efficient method when facing a high flow of travellers.

Hence, we would (maintain the existing arrangement) and also carry out (random) temperature check (with handheld devices) on some passengers.

Reporter: Are you concerned that there is a high risk that the actual number of cases in the Mainland is actually more than what are reported? How can you ensure that chickens imported to Hong Kong are all safe?

Secretary for Food and Health: We are very concerned about the situation of human cases of Influenza A (H7N9) in the eastern part of the Mainland, mainly because of the high mortality and the seriousness of the disease. Secondly, the seven patients concerned do not have any epidemiological linkage, meaning that they might have contracted the illness separately in the community. This also means that the virus might be actually circulating widely among wild animals or poultry.

(Please also refer to the Chinese portion of the transcript.)
Source: HKSAR Government

#H7N9: Shanghai News Conference details

[a bit on the news conference.  It speaks of the 2 sons that were not confirmed, one died, one recovered].

The Shanghai held a news conference has been over 20 days since the death of two infected with the H7N9 virus patients, friends and members of the public had long been questioned whether there is concealed, the delay of the suspects, Wu Fan, director of the Shanghai Disease Prevention and Control Center, responded by saying: Unknown pathogen detection is very difficult, and will take some time. She said, H7N9 is a new virus, detect cases in outpatient and admitted the process, to rule out SARS known viruses, and again the unknown virus judgment and clinics, gene sequencing and comparison, and sent to the National Center for Disease Control virus isolation confirmed its infected with the H7N9 virus was confirmed.

It is understood that the 43 influenza monitoring sites in Shanghai and 130 the unknown medical institutions set up fever clinics the reason the pneumonia active search frequency from a weekly report system to "daily report" system. "As of now, we do not have access to the unexplained pneumonia cases in the new report. Wu Fan said, many pathogens causing pneumonia, this season infirm elderly, children are likely infected with various pneumonia pathogens, clinical relatively common, two cases of H7N9 deaths all close contacts, including family members, medical staff, have been medical observation at home for two weeks, have been lifted under medical observation, were not found similar symptoms and morbidity. The online rumors 1 case of 87-year-old H7N9 deaths two sons are infection and death, the reality is that his son suffers from other serious lung disease due to long-term smoking and other bad habits, died of severe pneumonia, the eldest son has recovered, they were not detected in the H7N9 virus.

Covering Yunnan province's 17 laboratories have ability to detect the H7N9 virus, and the test results obtained in half a day

2013-04-03

Excerpt:  Translation out of China 

Xuwen introduced, the province's prevention and control measures mainly carried out by the province-wide 19 influenza sentinel hospital surveillance, where there are cases of fever, leukopenia, abnormal symptoms of the disease were to be reported. The clinicians found unexplained pneumonia, it is necessary to report and sampling detection. Currently covered by the province's 17 laboratories have the ability to detect the virus, half a day results.

Xuwen, Shanghai and Anhui have been found in cases of dissemination of the source is unclear, but with geographical, not yet confirmed that the virus has the ability of human-to-human transmission.

http://society.yunnan.cn/html/2013-04/03/content_2678645.htm 

#H7N9: Shanghai Influenza Contingency Plan Level III: Yellow Warning - Definition

Start influenza pandemic three contingency plans

　　2, 2009, Shanghai started the influenza pandemic three contingency plans, a yellow warning sounding the avian flu. Relevant departments, health care institutions fully operational detection and prevention and control of influenza outbreaks, to respond to the H7N9 avian influenza virus. This also means that the H7N9 avian influenza was officially rated a greater level of public health events.

　　Shanghai Health and Family Planning Commission Xu Jianguang, Shanghai Public Health Clinical Center security preparations for the implementation of the personnel required medical treatment, medicines, equipment and other municipal designated medical institutions, have been identified. 43 influenza monitoring sites of the city and 130 medical institutions set up fever clinics unexplained pneumonia active search for rapid increases frequency changed by weekly report daily report.

　　Shanghai primary schools and nurseries illness absences absences and reporting system is also highly concerned about the schools, hospitals, nursing homes and other collective units 5 cases in 1 week and above ILI epidemiological association, the parties concerned will take immediate measures.Shanghai at the same time still the seven districts poultry farms set up monitoring points, monitoring the health status of waders staff.

　　Link

　　According to China's relevant regulations, the outbreak of the new influenza virus subtype is divided into general (Ⅳ) larger (Ⅲ), major (Ⅱ) and especially significant (Ⅰ), followed by blue, yellow, orange and red early warning, emergency response to the implementation of grade Ⅳ, Ⅲ, Ⅱ grade and grade Ⅰ respectively.

　　Ⅳ level blue alert, a new subtype of influenza A virus isolated in human specimens, but did not produce specific antibody response, or produce specific antibody response failed to show clinical signs.

 Ⅲ grade yellow warning, and incidence of human infection with the new influenza virus subtype, but no human-to-human transmission occurred. Ⅱ level orange alert, new subtype of influenza A virus in human-to-human transmission, but the transmission range is relatively limited. Ⅰ level red alert, said the pandemic phase.

CDC: Avian Influenza A (H749) + Sequences

On April 1, 2013, the World Health Organization reported three human infections with avian influenza A (H7N9) viruses in China. This is the first time avian influenza A (H7N9) viruses have been detected in humans. Each of the three confirmed cases had severe respiratory illness; two of them died. According to WHO, no human-to-human transmission has been identified at this time, and the cases do not have a known epidemiological link to one another. An investigation by Chinese health authorities is ongoing to determine the source of infection and detect any additional cases. The sequences of these viruses are posted and publicly available in GISAID.

CDC is following this situation closely and coordinating with domestic and international partners in a number of areas, including gathering more information to make a knowledgeable public health risk assessment and developing a candidate vaccine virus. CDC also is reviewing posted genetic sequencing of the new H7N9 viruses and assessing possible implications in terms of the viruses’ transmissibility and severity and whether existing influenza diagnostic tests need to be enhanced or new ones developed. All of these actions are routine preparedness measures taken whenever a new novel influenza virus is detected in humans.
This is an evolving situation and there is still much to learn. It is too soon to speculate regarding the significance of these cases/viruses, however, CDC will provide updated information as it becomes available.

http://www.cdc.gov/flu/avianflu/h7n9-virus.htm
hat-tip Flu Trackers

New bird flu strain creates fear and surveillance

By Peter Christian Hall

April 2, 2013

 

An emerging bird flu that is mysterious and deadly is haunting China. With four fresh H7N9 cases reported in Jiangsu Province and no indication as to how three Chinese adults caught the little-noted avian flu virus that killed two of them in March, the global medical community is hoping the new flu will calm down until China’s health system can determine how it spread. “I can tell you this thing is real and definitely has the markings of being a killer,” says Jason Tetro, coordinator of the Emerging Pathogens Research Centre in Ottawa, which on Monday examined gene sequences from three of China’s H7N9 cases.
“I don’t wish to cause panic,” Tetro said in an interview, noting that if the subtype were proven to have emerged from a small farm, he wouldn’t be much alarmed. Infecting a big poultry reservoir, on the other hand, might well enable H7N9 to access Asia’s wild bird population. The upstart subtype could then become as menacing as H5N1, which since 2005 has officially taken 371 lives in 622 cases, mostly in China, Southeast Asia and Egypt, according to the World Health Organization. The additional Chinese cases have convinced Tetro that “close contact with birds” has been involved. “And I think the CAFOs [industrial chicken farms] have definitely contributed to the evolution of this virus,” he says.

Continued:  http://blogs.reuters.com/great-debate/2013/04/02/new-bird-flu-strain-creates-fear-and-surveillance/
 

#H7N9 Beijing, Shanghai Guangdong Response Level 3 Emergency Response

H7N9 bird flu strikes, the Beijing-Shanghai Guangdong emergency response to H7N9, the start of an influenza pandemic contingency plans for response level III in Shanghai today, In addition, the Guangdong Provincial Department of Agriculture today announced that, as of now, not received the highly pathogenic avian influenza outbreaks have been reported in Guangdong , but has been made ​​across the province issued an emergency notice, further deployment of avian flu and other major animal disease prevention and control. 
-snip-
According to the news that the Information Office of the Shanghai Municipal Government, 5:15 tonight, will hold a press conference, the person in charge of the municipal guard Planning Commission, the City CDC, Agriculture Commission and other departments to introduce H7N9 avian flu prevention and control work, and answered questions from reporters.
http://hk.finance.yahoo.com/news/%E4%BA%AC%E6%BB%AC%E7%B2%B5%E7%B7%8A%E6%80%A5%E6%87%89%E5%B0%8D-h7n9-%E4%B8%8A%E6%B5%B7%E4%BB%8A%E6%97%A5%E8%B5%B7%E5%95%9F%E5%8B%95%E6%B5%81%E6%84%9F%E6%B5%81%E8%A1%8C%E6%87%89%E6%80%A5%E9%A0%90%E6%A1%88-%E7%B4%9A%E9%9F%BF%E6%87%89-094508910.html 

#H7N9: China: Beijing & Shanghai Contingency Plans - Level-3 (2nd lowest in a four-stage scale)

4/2/13
Excerpt:

Eastern seaboard cities boost health measures in light of new H7N9 virus

Under the contingency plan, schools, hospitals and retirement facilities are to be on the alert for fevers, and administrators are to report to health authorities if there are more than five cases of flu in a week.

Cases of severe pneumonia with unclear causes are to be reported daily by hospitals to health bureaus, up from the weekly norm. The plan also called for stronger monitoring of people who work at poultry farms or are exposed to birds.

The Level-3 response plan, the second lowest in a four-stage scale, reflects higher concern after the H7N9 bird flu virus led to the deaths in Shanghai and seriously sickened a woman in the city of Chuzhou 360 kilometres west.

"The health bureau will take effective and powerful measures to prevent and control the disease, to make sure the flu epidemic is effectively guarded against and to safeguard the health of the city's residents," said Xu Jianguang, head of the Shanghai Health Bureau.

http://www.cbc.ca/m/touch/news/story/2013/04/02/bird-flu-china-new-virus-cases.html

China: A Pig Story

Translation out of China
April 2, 2013

About six or seven o'clock in the morning before the morning thin mist hanging over the fields of early rice. Lu Gensong riding his motorcycle around a horizontal circle, to see the dead pig on impossible to stop the thieves a ride on the Harbor Village open. The village on the road from time to time someone passing, few people are willing to say hello and Lugen Song.
This day is March 18. Since the Shanghai media reported the Huangpu River rafting dead pig from Jiaxing, the pressure of public opinion a little bit transmitted to the outside 70 km cross Harbour Village, roadside dead pig than too few, the farmers began to put the pig while back gathered a set point, no longer scattered thrown on the roadside.
Cross pig corpses "into the winter after the local scene, Lu Gensong daily receive 40-50 dead pigs, which is more to piglets.
Is similar to Lugen Song received dead pig on land, in the water on the road, half a month to a group of people from dawn to dusk fishing dead pig, they come from the government. The sanitation department of Shanghai daily from 17:00 pm will be announced the day of the salvage digital microblogging. Since March 13, the data dissemination has become routine. Rather delicate the data never involves the "sum", only the specific figures of the day.
As of March 20, from the Huangpu River and recovered from the 231 dead pigs, totaled 10,395. March 7, microblogging users to publish photos of dead pigs in the Huangpu River, the number of salvage to now over a million less than two weeks before and after, and this time, Jiaxing, Huangpu River, dead pig keywords, rafting, formed a quite dramatic mystery.
A foreign media in the headlines for position to ask the question: "Please guess a mystery: 2,813 dead pigs found in the water of a major city, under what circumstances this is not a public health problem? Answer: When this happened in China. "under the pressure of public opinion, the spearhead of accountability first point in Jiaxing, and other local governments. But the the Reporter field survey a few days, tens of thousands of dead pigs can along the river rafting the story of a few days is like a Chinese version of "Rashomon", the answer is as complicated beyond imagination.

Continued:  http://gongyi.people.com.cn/n/2013/0402/c152509-20992392.html

China has found seven cases of H7N9 avian flu cases around the strengthening of prevention and control measures

04 - 02 22:31
China news agency, Beijing, April 2 (Reporters Ou Yang and Kai Yu) - The mainland of China has found seven cases of confirmed cases of the H7N9 avian flu, aroused great concern. In this regard, China has been much strengthened start the prevention and control of deployment in response to the virus struck.

People infected with the H7N9 avian influenza virus in China is the world's first discovery of new influenza virus subtype. Shanghai has two deaths, Anhui, patients in critical condition, still under treatment in All four cases the latest notification from Jiangsu. As of the reporters press time on the evening of 2, Beijing, Guangdong, Hunan, Chongqing, Hainan, announced the news that has not yet found of human infection with the H7N9 avian influenza.

Jiangsu aspects of the establishment of new found four cases of human infection with the H7N9 avian flu prevention and control leading group people infected with the H7N9 bird flu prevention and control of the Group of Experts, medical treatment expert group to strengthen epidemic prevention and control. Meanwhile, Jiangsu has also specified 16 tertiary hospitals as admitted to the hospital in Jiangsu Province.

Shanghai launched in the 2nd level III response of an influenza pandemic contingency plans, and said it would establish influenza joint prevention and control mechanism, the relevant departments of the city's comprehensive investment in monitoring and prevention and control of influenza outbreaks. For public concerns about some time ago "floating dead pig" to say about the avian flu, the the Shanghai Animal CDC said, Huangpu River floating dead pig avian influenza virus is not found.

Anhui patients in Nanjing for treatment, not yet out of danger. Nanjing positive organizational strength to treat the cases of human infection with avian influenza cases Anhui transferred. The province has started contingency plans, continue to organize experts to rescue patients.Beijing has started the deployment of the prevention and control of the city's medical institutions, the H7N9 virus in the flu and pneumonia of unknown causes two main monitoring system, once suspicious cases, you need the first time reported to the county disease control departments.

In addition, Hebei, Sichuan, Guangdong, Hunan, Hubei, Chongqing and other places, the CDC has commenced virus monitoring, personal protective items ready to work.
 For the public on how to prevent this type of influenza virus, medical experts extensive knowledge outreach through the media, reminding people should try to avoid direct contact with sick or dead poultry and livestock. , Use a paper towel, handkerchief Cover your mouth and nose when sneezing, coughing and other symptoms of respiratory tract infection. Remember not to eat raw or half-cooked chicken, goose, duck, etc..

Although no conclusive evidence of the H7N9 human infection of human experts still remind close contact with patients, medical staff have more opportunities than the general public should take standard precautions plus droplets admissions with suspected or confirmed H7N9 avian influenza dissemination of prevention and the contact prevention of measures.

Jiangsu Provincial Health Department: At home and abroad there is no vaccine against the H7N9 avian influenza virus.

BEIJING, April 2 Jiangsu Provincial Health Department has posted on its official website the question-and-answer human infection with the H7N9 avian flu.  
Question-and-answer pointed out, at home and abroad there is no vaccine against the H7N9 avian influenza virus. The following is the transcript:
One patients from the means by which the people infected with the H7N9 avian influenza infection? Whether the close contacts of morbidity or mortality? Close contacts whether they are under medical observation?
Answer: the people infected with the H7N9 influenza virus from the virus biology belonging to the avian influenza virus, previously found in the international human infection H7 subtypes of influenza virus are mostly from birds, but so far, three cases of diagnosed patients The specific source of infection is not clear.
According to the relevant provisions of unexplained pneumonia Management, Shanghai, Anhui and Jiangsu, the health sector (1 patient in Anhui where Nanjing) all close contacts of patients implemented under medical observation. The Shanghai patients diagnosed patients prior to the onset, the two family members with severe pneumonia, the cause is still under investigation and detection. 3 patients the incidence of the family association, pending further investigation. In addition, Shanghai, Anhui diagnosed patients of all close contacts were not found in similar cases.
Second, the National Health and Family Planning Commission, as well as local health departments to take measures? Which investigations were carried out?
The cases of the disease, local health departments attach great importance to take timely clinical treatment, epidemiological investigation, specimen collection and submission, medical observation of close contacts, and to strengthen the monitoring of unexplained pneumonia cases.
National Health and Family Planning Commission attaches great importance to this epidemic, received severe unexplained pneumonia outbreaks have been reported, immediately sent a working group of experts to Shanghai, Anhui and Jiangsu, there to supervise the patient's treatment and investigation, to convene a multisectoral Chamber of Commerce will the epidemic nature of the analysis and judgment, and arrangements for the investigation, prevention and control and preparedness work. China CDC received case reports and submission of specimens in a timely manner to carry out the epidemic risk judgments and laboratory testing research, clear etiological diagnosis.
Third, the two cases diagnosed patients died in early March, why the state Health and Family Planning Commission, released March 31, the epidemic?
A: The people infected with the H7N9 avian influenza virus, is the world's first discovery of a new subtype of influenza virus, has not been included in our statutory report infectious disease monitoring and reporting system.
Medical and health institutions in Shanghai found that the above-mentioned cases, in a timely manner to carry out the relevant laboratory screening, has ruled out the infected with seasonal H1N1 and H3N2 influenza, H1N1 flu, people infected with the highly pathogenic avian influenza (H5N1) and SARS, new Coronavirus possible. In further testing, the Shanghai Public Health Clinical Center on March 22 found that patients may be infected with the H7 influenza, after specimens were sent to the China Disease Prevention and Control Center. On the afternoon of March 29, the Chinese Center for Disease Control three H7N9 avian influenza virus isolated from the submission of cases specimens. National Health and Family Planning Organization experts further verification, according to laboratory test results, combined with the clinical manifestations, epidemiological data to conduct a comprehensive analysis to determine the patients with human cases of infection with the H7N9 avian flu virus. National Health and Family Planning Commission, in accordance with the law to the public on March 31.

Fourth, after media reports that a family of three infection unexplained pneumonia, two of whom died, whether related to the reported cases?
February 20-25, in a hospital in Shanghai has treated three people suffering from severe pneumonia, surnamed Li and his son, two people died. Mr Lee, his father was diagnosed with the H7N9 avian influenza virus infection, the diagnosis of two patients in progress.
H7N9 virus with previous H1N1, H5N1 and other seasonal influenza cases compared to its virulence and infectious?
Currently only found three cases of human infection with the H7N9 avian flu virus confirmed cases of the virus and its diseases caused by very limited research data, expert judgment is that the virulence of the virus and the human ability to spread further.
Sixth, if the infection early symptoms seek immediate medical attention if you can get effective treatment?
The gene sequence analysis showed that the drug-sensitive virus neuraminidase inhibitor class of anti-influenza virus. Experience other type influenza antiviral treatment after the onset of the early use of the neuraminidase inhibitor class of anti-influenza virus drugs may be effective remains to be seen, but the means of specific treatment of newly discovered human H7N9 avian influenza virus infection research.

How to prevent the H7N9 avian flu? Are there any other special precautions?
Influenza is an acute respiratory tract infection. Wash their hands, indoor Qin ventilation, attention to nutrition, to maintain a good physique is conducive to the prevention of influenza and other respiratory diseases. Respiratory tract infection symptoms such as sneezing, coughing, use a tissue, handkerchief Cover your mouth and nose to prevent infection of others. In addition, special attention to avoid direct contact with sick or dead poultry and livestock.
More contact with patients suffering from infectious diseases than the general public due to the medical staff, it is recommended that the medical staff to take the necessary protective measures in the process of the treatment of the patients. Admissions with suspected or confirmed H7N9 avian influenza, effective protective measures should be taken, that the standard prevention, prevention of airborne droplets and contact transmission precautions.