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

[Today's report has some very young cases. Two in their 40's and one in the 30's]

January 28, informed the Ministry of Health and Family Planning Commission: H7N9 confirmed cases of avian flu in Shenzhen City, three cases of human infection with the new report. 
    Case 1 Zengmou, female, 43 years old, a native of Guangdong, Shenzhen, currently residing in Bao'an District of Shenzhen City streets. January 27 confirmed cases of human infection of H7N9 avian influenza, the patient's condition is currently stable in Shenzhen designated hospital admission. 
    Case 2 Cai, female, 41 years old, a native of Guangdong of the state, now living Longgang District streets. January 27 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in Shenzhen designated hospital admission. 
    Case 3 Lin, female, 31 years old, a native of Shantou, now live in the South Bay Street, Longgang District. January 27 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in Shenzhen designated hospital admission.

http://www.gdwst.gov.cn/a/zwxw/2014012811286.html

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update 1/27/14

27 January 2014 - WHO has been notified of two additional laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV).
Details of the cases are as follows:

• WHO was notified of one case by the Ministry of Health of Saudi Arabia. The case is a 54 year old man from Riyadh who developed respiratory illness symptoms on 29 December, 2013 and was hospitalized on 4 January, 2014. The patient received medical treatment in an intensive care unit. He died on 14 January 2014. Samples tested positive for MERS-CoV after his death. The patient was a health care worker. He had a history of chronic disease and had no history of contacts with animals or contact with known cases of MERS-CoV. In addition, he had no travel history. The investigation is ongoing.
• WHO was notified of one case by the Ministry of Health of Jordan on 23 January, 2014. The case is a 48 year old man who became ill on 31 December, 2013 and developed fever, dry cough, difficulty in breathing, abdominal pain and vomiting, and was admitted to a hospital on 9 January, 2014. While there, his condition worsened and on 16 January he was placed on mechanical ventilation. The patient died on 23 January. A sample taken from the patient on 21 January tested positive by PCR for MERS-CoV.
  The patient had underlying health conditions and he had travelled to the United Kingdom from 12 November to 25 December 2013 seeking treatment for his underlying conditions. The patient had no history of animal contact and is believed to have not attended any large social events in the last 30 days. It is reported that he had received 2 guests from Kuwait between 25 December and 31 December, 2013.
  National authorities in Jordan are following family contacts, medical staff and health workers, in addition to strictly applying infection control measures. Further investigations are ongoing in Jordan and UK.

Globally, from September 2012 to date, WHO has been informed of a total of 180 laboratory-confirmed cases of infection with MERS-CoV, including 77 deaths.

Continued:  http://www.who.int/csr/don/2014_01_27mers/en/index.html

Hong Kong to cull 20,000 chickens after #H7N9 found

1/27/14
Hong Kong will cull approximately 20,000 chickens after discovering the H7N9 avian influenza virus in a batch of poultry imported from mainland China, authorities said on Monday.

On Friday, the city introduced a serological test for H7 avian influenza in live poultry and soon discovered a batch that tested positive for the virus.
"A government department has confirmed that the sample chicken from the chicken imported from the mainland tested positive for H7N9 avian influenza virus," Hong Kong health minister Ko Wing-man told reporters late Monday.
"All the poultry in the wholesale market will be destroyed tomorrow morning... the total number of chickens concerned amounts to 20,000," Ko said, declaring the market to be an "infected place".
The government's decision comes less than a week before Lunar New Year, which starts on Friday, when live chicken is a popular dish at banquets and family gatherings.
"Because we have to close the wholesale poultry market... for the next 21 days, there will be no supply of live chicken," Ko said, suggesting that residents eat frozen chicken instead.
The market in the Cheung Sha Wan region of the city, which holds imported poultry into the city until cleared of infection, will be closed for disinfection.

Continued:  http://www.channelnewsasia.com/news/asiapacific/hong-kong-to-cull-20-000/969900.html

China: High alert against #H7N9 flu after more infections, deaths

[I have 8 cases in Shanghai, but only 2 deaths, not 4; I have 49 cases in Zhejiang, with 1 death, not 12.  All editing below is mine]

For Xinua
1/27/14

BEIJING, Jan. 27 (Xinhua) -- China has banned live fowl trading in some areas, after more human H7N9 infection and deaths have been reported in several provinces.
Live poultry trading was halted in Hangzhou, Ningbo and Jinhua cities in eastern Zhejiang Province, which has reported 49 human H7N9 infections, including 12 deaths this year. The province has launched emergency surveillance of poultry farms, haunts of migrant birds and parks, in addition to halting the flying of domestic pigeons.
Shanghai, which neighbors Zhejiang, will halt live poultry trading from Jan. 31 to April 30 this year and strengthen surveillance of poultry and industry staff. The city has reported eight human H7N9 infections in January, four of whom died, including one doctor. The city's health authority will make use of media to publicize prevention information about H7N9.
Guangdong Province in the south reported 26 new H7N9 cases and four deaths so far in January.
Pang Xinghuo, deputy head of the Beijing Disease Prevention and Control Center, said Monday the capital had enough test reagents for suspected H7N9 infection cases. The center will strengthen training and check-ups on infection control work in medical institutions, according to Pang.
Other provinces, such as Jiangsu, Fujian and Hunan, also reported new H7N9 cases.
Improved surveillance methods and networks have increased the possibility of confirming new cases, but this does not mean a more rapid transmission of the virus, said Zhong Nanshan, director of the Guangzhou Institute of Respiratory Diseases in Guangdong Province.
"It deserves high attention when the infection cases increase by dozens or hundreds of times. Currently, public panic is unnecessary given the slow transmission speed," he added.
Zhong suggested adjustments to epidemic control tactics, including the early and longer use of antiflu drug Tamiflu for H7N9 patients.
The government should explore the poultry consumption model of mass slaughter and frozen products, suggested Zhang Yonghui, director of the Guangdong Center for Disease Prevention and Control.
Hangzhou is planning to close live poultry trading markets permanently and promote the supply chains of frozen poultry products instead, Zhang Hongming, acting mayor of the provincial capital of Zhejiang, told Xinhua.
China has also made progress in vaccine research for H7N9.
Hualan Biological Engineering Inc. said in early January that the H7N9 vaccine developed by its subsidiary Hualan Biological Bacterin Co. Ltd. had passed an initial examination and was being handled by the food and drug watchdog in central Henan Province, but it will be a long time before production of H7N9 vaccines.
With the epidemic developing in some areas, the Chinese government has been on high alert. The General Administration of Quality Supervision, Inspection and Quarantine intensified H7N9 bird flu virus monitoring at borders to prevent cross-border transmission.
Staff at customs will measure body temperature, conduct medical inspections and report on the health of passengers.
The National Health and Family Planning Commission said Monday that sporadic H7N9 cases will continue in some cities. The commission urged local health departments to strengthen prevention and control measures and ensure the implementation of them during the Spring Festival.
Chinese Vice Premier Liu Yandong on Sunday called for coordinated efforts to prevent and control H7N9 avian flu, urging local departments at all levels to keep on high alert and cooperate in prevention and control of the disease.
According to a plan for human H7N9 infection diagnosis and treatment issued on Sunday, the majority of human H7N9 infections are sporadic cases and there has been no evidence for consistent human-to-human infection, but limited, single human-to-human transmission cases cannot be be ruled out. 


http://news.xinhuanet.com/english/china/2014-01/27/c_126071190.htm

Beijing ‘downgrades’ #H7N9 bird flu description as new cases spike

From the South China Morning Post - editing is mine
1/27/14

China has reportedly downgraded H7N9 bird flu in humans, dropping its description as “infectious” in new guidelines on how to deal with the disease, even as new cases spike with the onset of winter.

The National Health and Family Planning Commission described it as a “communicable acute respiratory disease” in its 2014 diagnosis and treatment protocols.

In the 2013 version it was considered as an “infectious disease”.

The Beijing Times on Monday quoted an unnamed Beijing disease control centre official saying that health authorities decided to “make the downgrade” on the basis that nearly a year of analysis had shown H7N9 was “not strongly infectious”.

The H7N9 human outbreak began in China in February last year and reignited fears that a bird flu virus could mutate to become easily transmissible between people, potentially triggering a pandemic.
The guidelines come as human cases undergo a seasonal spike, with 95 cases confirmed in mainland China so far this month according to an AFP tally of reports by local authorities.
More than half have been in the eastern province of Zhejiang, with 24 in Guangdong in the south.
So far seven patients have died in mainland China this year.
That compares with 144 confirmed cases, including 46 deaths, in the whole of last year according to official statistics.
It was not clear whether the rise in cases and decrease in fatality rate so far are due to the virus becoming more widespread and possibly less severe, or detection and treatment improving.
Cases and deaths dropped significantly after the end of June, but have begun to pick up with the onset of winter.
“So far, most cases have been sporadic and there were some cluster outbreaks among family members,” the commission said in the guidelines.
“But there is no evidence of sustained human-to-human transmission yet,” it said, although it added that “limited” and “unsustained” infections could not be ruled out.
The guidelines shortened the disease’s incubation period from seven days to three to four days, and the Beijing Times said hospitals would reduce the quarantine time for suspected exposures accordingly.
The health commission also inserted the phrase “particularly the elderly” in its description of those vulnerable to the virus, who it specifies are those who have had contact with poultry or been to a live poultry market in the week ahead of showing symptoms.
The World Health Organisation did not immediately respond to a request for comment.

http://www.scmp.com/news/china/article/1414939/beijing-downgrades-h7n9-bird-flu-description-new-cases-spike

#MERS #Coronavirus Jordan Reports 1 Case, Death

[done tongue in cheek.]  Updates if/when they are reported with be forthcoming.

Jordan

Date of Article:  None.  WHO Tweet

Name:  It’s A Mystery...IAM

From:  Jordan

Adm:  Your Guess Is As Good As Mine

Notes:  Underlying conditions

DOD:  1/23

WHO Human infection with avian influenza A(H7N9) virus – update 1/27/14

27 January 2014 - The National Health and Family Planning Commission of China has notified WHO of nine additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus.
Details of the cases notified on 26 January 2014 are as follows:

• A 49 year old man from Huzhou City, Zhejiang Province, who became ill on 16 January. He was admitted to hospital on 20 January and transferred to other hospital on 23 January. He is currently in a serious condition. The patient has a history of exposure to poultry.
• A 60 year old woman farmer from Ningbo City, Zhejiang Province, who became ill on 19 January. She was admitted to hospital on 23 January. She is currently in a serious condition.
• A 48 year old woman farmer from Ningbo City, Zhejiang Province, who became ill on 20 January. She was admitted to hospital on 23 January and is currently in a serious condition. The patient has a history of exposure to poultry.
• A 57 year old farmer from Suzhou City, Jiangsu Province, who became ill on 16 January. He was admitted to hospital on 19 January and transferred to other hospital on 22 January. He is currently in a serious condition. The patient has a history of exposure to live poultry market.
• A 46 year old woman farmer from Quanzhou City, Fujian Province, who became ill on 18 January. She was admitted to hospital on 22 January and is currently in a critical condition. The patient has a history of exposure to poultry.
• A 82 year old man from Shenzhen City, Guangdong Province, who became ill on 11 January. He was admitted to hospital on 21 January and is currently in a critical condition. The patient has a history of exposure to live poultry market.

Details of the cases notified on 27 January 2014 are as follows:

• A 76 year-old farmer from Wuxi City, Jiangsu Province, who became ill on 18 January. He was admitted to hospital on 21 January and is currently in a serious condition.
• A 40 year-old man from Hangzhou City, Zhejiang Province, who became ill on 19 January. He was admitted to hospital on 23 January and was transferred to another hospital on 25 January. He is currently in a critical condition. The patient has a history of exposure to poultry.
• A 65 year-old, man from Huzhou City, Zhejiang Province, who became ill on 16 January. He was admitted to hospital on 22 January and was transferred to another hospital on 23 January. He is currently in a serious condition. The patient has a history of exposure to a live poultry market.

The source of infection is still under investigation. So far, there is no evidence of sustained human-to-human transmission.
The Chinese government continues to take the following measures:

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

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

http://www.who.int/csr/don/2014_01_27/en/index.html 

Jiangsu Province 1 new confirmed cases of human infection with #H7N9 avian influenza

1/27/14
Translation

　Provincial Health Department, the province confirmed cases of new H7N9 bird flu case of human infection.

　　Patients Zhou, female, 74 years old. January 27 morning man was diagnosed Suzhou H7N9 avian influenza infection. Currently in Suzhou, a hospital, in critical condition.

http://www.jswst.gov.cn/fbts/yqgb/2014/01/27150740031.html 

Hunan confirmed one case of human infection with the H7N9 avian flu

1/27/14
Translation

Recently, Changsha, Hunan, monitoring found one cases of severe acute respiratory infections, 2014 in 1 month 27 days, specimens Results Changsha Municipal Center for Disease Control and Prevention and the Hunan Provincial Disease Prevention and Control Center are testing and reviewing H7N9 nucleic acid positive. According to epidemiological history, clinical manifestations and laboratory test results, the determination of a case of human infection of H7N9 avian influenza.

Patients Yang Moumou, female, 58 years old, who lives in Yueyang City, Hunan Miluo. Currently, the treatment of patients in a hospital in Changsha. The epidemiological investigation of live poultry before the onset of patient exposure history. Close contacts of the cases have been timely measures taken under medical observation and found no abnormalities.

Expert Tip: daily life should avoid contact with live poultry, birds live bird droppings, especially disease (dead) birds, if they have contact with, shall wash their hands with soap and water as soon as possible; raw poultry, meat and eggs must be cooked Cook; attention to food hygiene, food processing and food in the process, there must be separate raw and cooked, to avoid cross-infection; buy fresh, live, pay attention to see when frozen poultry quarantine certificate. During the spring should be prohibited on vehicles carrying live birds to avoid outbreaks. If fever and respiratory symptoms should wear a mask, a doctor as soon as possible.

http://www.21hospital.com/zwxx/wsyw2/201401/t20140127_23404.html 

Fujian Province 2 new cases of human infection of bird flu H7N9

 Translation

1/27/14 

 Health and Family Planning Commission of Fujian Province 27 days notification , the province 27 Nisshin confirmed two cases of human infection with the H7N9 avian influenza.

    Patients Lai Moumou, male, 69 years old, currently residing in Xiamen Haicang District. Currently patients in critical condition, a hospital in Xiamen, isolation and treatment.

    Patients Huang Moumou, female, 72 years old, currently residing in Sanming ShaXian. Currently patients in critical condition in a hospital isolation ShaXian treatment. (Emergency Management Office)

http://www.fjphb.gov.cn/show.aspx?ctlgid=246246&Id=90124 

12 #H7N9 deaths in Chinese Zhejiang province in 2014

[Wow.  I must be doing an extremely bad job of tracking.  I have one death in Zhejiang this year.  12 makes much more sense though.  Wonder where I should go to get the true figures?]

1/27/14
English

HANGZHOU, Jan. 27 (Xinhua) -- H7N9 bird flu has caused 12 deaths in east China's Zhejiang Province alone this year, local health authorities said on Monday.

From Jan. 9 to 26, Zhejiang had seen new human H7N9 cases for 18 consecutive days. The total number of infections in the province reached 49 as of Monday noon, said the provincial health and family planning commission.

Of the 49 cases, 12 people died, one person has recovered fully, and the rest remain hospitalized, according to the commission.

http://news.xinhuanet.com/english/health/2014-01/27/c_133078729.htm

Guangdong Province #H7N9 - 2 New Cases, 1 Cured

1/27/14
Translation
[The case that has been discharged is:

Date of Report:  12/16/13

Name:  Zhang 65(F), retiree

From:  Yangjiang City, Guangdong

Onset:  12/11

Adm:  12/15

Status:  12/17:  Critical Condition

Confirmed:  12/16/13

Notes:  Exposed to live poultry

WHO Update: http://www.who.int/csr/don/2013_12_17influenza/en/index.html

Discharged:  1/25/13

January 27 Provincial Health and Family Planning Commission communications: Shenzhen, Jiangmen City, the new confirmed cases of H7N9 avian influenza case of human infection. 
    Some cases a practice, female, 77 years old, Cantonese, now living in Longgang District, South Bay streets. January 26 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in Shenzhen designated hospital admission. 
    Case 2 Zhu, male, 68 years old, farmer, now living Jiangmen ritual streets. January 25 after she died. January 26, confirmed human cases of avian influenza H7N9 infection. 
    Also, Yangjiang City, December 16 confirmed cases of Zhang has been cured and discharged on January 25; Shenzhen City, January 11 confirmed cases of Zhao, January 18 confirmed cases have been cured Zhou, January 26th discharged.
http://www.gdwst.gov.cn/a/zwxw/2014012711281.html 

People infected with #H7N9 incubation period of four days to

[The changes from last year - to this year, are bolded in red which is my editing. ]
Translation
1/27

New Year, Zhejiang, Guangdong, Beijing and other places after another reported case of human infection with H7N9 virus in dozens of cases. Through in-depth investigation of reported cases, yesterday, the State Planning Commission released 2014 edition Guardian "people infected with H7N9 avian flu" that the avian influenza virus, or through contact with virus-contaminated environments spread to humans, do not rule out limited non-sustained person to person. Virus incubation period has been shortened by a week last year to define 3-4 days, according to the new country program will shorten the H7N9 bird flu quarantine close contacts of the observation period to four days. Change one of Identification is not highly contagious infectious diseases dropped　　last year's treatment program was called "human infection with H7N9 avian influenza is an acute respiratory infection by the H7N9 subtype of avian influenza caused by a virus." New version of "human H7N9 avian flu infection" (hereinafter referred to as the "program") noted that people infected with H7N9 avian influenza is caused by the H7N9 avian influenza virus, acute respiratory infections, which often can be combined cases of severe pneumonia with acute respiratory distress syndrome , septic shock, multiple organ failure and even. 　　Treatment programs to the H7N9 bird flu a new "identity recognized." And acute respiratory infections in acute respiratory disease What is the difference? Beijing CDC relevant person in charge explained that this is because the past year by the health department of the meta-analysis of H7N9 avian influenza cases summed up, H7N9 virus is not contagious too, only limited human-to-human transmission, it will reduced to its "infectious disease" is more accurate. 　　Program clearer H7N9 gene sources, can infect human avian influenza virus subtypes H5N1, H9N2, H7N7, H7N2, H7N3, etc., this is H7N9 avian influenza virus. The virus is a novel reassortant virus, a gene encoding HA from H7N3, NA is derived from the gene encoding H7N9, the 6 internal genes from H9N2 avian influenza virus. "This shows that with the increase in cases, we know it is more in-depth, scientific defined by isolated virus, which will help guide and adjust the existing levels of prevention and control strategies", industry experts said. Changes in two pathways through virus-contaminated environment is poisonous　　to public concern H7N9 virus transmission, the program clearly states that the specific ways can spread through the respiratory tract or close contact with infected poultry infected secretions or excretions obtained; or by contact with virus-contaminated environments spread to humans; does not exclude limited non-sustained person to person. 　　Contrast the previous version referred to treatment programs "through the respiratory tract, can also be infected through close contact with poultry secretions or excretions, or direct contact with the virus," CDC relevant person in charge explained that the new version will be "birds secretions or excretions, "summed up as" viral contamination of the environment "is more accurate because the H7N9 cases have indeed touched equipped to carry the virus in poultry cages or containers, and even soil, air and other large environment then infected cases , just its secretions or excretions, this definition will raise awareness and self-protection awareness at the same time, the late-site cleanup and disinfection of the disease control department of health instructive, more comprehensive and specific. 　　What is "does not exclude limited non-sustained person to person"? The official explained that due to the current understanding of the case from the point of view, H7N9 virus spread from person to person really is limited, not mass spread, with "non-persistent" is to better explain the spread of limited characteristics, which is China's medical scientists for nearly a year by the virus observed summed up, "the present situation, reported cases are cases sporadic and relatively independent, did not see signs of continued infection." 　　Meanwhile, the program that is now in its secretions or excretions of poultry and live bird markets in environmental samples to detect and separate the H7N9 avian influenza virus, and people infected with H7N9 avian influenza virus is highly homologous. Source of infection may carry H7N9 avian influenza virus in poultry. Currently, the majority of sporadic cases, the incidence of individual family aggregation phenomenon, but there is no evidence of sustained human-to-human transmission between the.3 Changes incubation period incubation period is shortened to 3-4 days　　scenario that according to the incubation period of influenza and human infection with H7N9 avian influenza existing case findings, the incubation period is usually 3-4 days. With the previous "one week incubation period" compared to significantly shortened. 　　Beijing CDC relevant person in charge explained that this is the year to accumulate through the conclusion of the case, just go to the beginning of the H7N9 virus in the country appeared to be in accordance with the estimated incubation period of a stream to determine the incubation period, "one week", but the combination of epidemiological situation and the investigation of cases can be found, usually in contact with the 3-4 days after the onset of H7N9 that will be infected with the avian influenza virus environment, "meaning it has two aspects, the one we can from their own note, if suspected exposure After about four days of poultry self-observation, if there are no symptoms of fever, cough or "pass"; the other hand, in close contact with H7N9 bird flu patients observation period will be shortened, "the official pointed out that the country will be in accordance with the new version treatment programs to be adjusted to shorten Beijing on H7N9 bird flu quarantine close contacts of the observation period will be increased from one week to four days. 　　Meanwhile, in order to facilitate the public "condemnation", the program clearly the symptoms, signs and clinical characteristics of H7N9 cases. Patients generally showed flu-like symptoms such as fever, cough, sputum less, may be associated with headache, muscle aches, diarrhea and other symptoms. Rapid development in patients with severe disease, occur more in 3-7 days of onset of severe pneumonia, mostly sustained temperature above 39 ℃, difficulty in breathing, may be associated with hemoptysis sputum. Often rapidly progress to acute respiratory distress syndrome, sepsis, septic shock, multiple organ dysfunction and even, in some patients, there may be other symptoms of pleural effusion. Change 4 high-risk groups have a history of exposure in poultry elderly are "high risk"　　in the definition of H7N9 infection in high-risk groups, the old and the new version is also a clear distinction between the two, legacy as "a week before the onset of those who come into contact with poultry, such as engaging in poultry farming, trafficking, sale, slaughter, processing industry and other personnel, "the new version was" a week before the onset of contact with birds or those who have been to live poultry markets, especially the elderly, "In this regard, industry experts point out that the current national report Over 200 cases of confirmed cases of bird flu, more than half are older, and therefore have had contact with poultry elderly should pay special attention to prevent, but as for the elderly because of its heat resistance intention is not as good as other young people, or aggravation of chronic viral power and so further study. 　　Programs that people infected with H7N9 avian influenza in critically ill patients with poor prognosis. Prognostic factors may include patient age, underlying diseases and complications. Drug treatment remains oseltamivir, peramivir, zanamivir and Chinese medicine dialectical theory of governance methods, antiviral drugs should be used within 48 hours of onset. Related to various hospitals to prevent nosocomial infections　　program pointed out the strict norms of human infection admitted to hospital H7N9 bird flu infection prevention and control measures in health care institutions. Follow the standard precautionary principle, according to the spread of disease prevention and control measures taken way.January 20, according to the Shanghai Wei Planning Commission informed the first 20 days, the Shanghai 7 new cases of human infection of H7N9 avian influenza in January, including two deaths. Emergency department physicians Shanghai Pudong New Area People's Hospital, 31-year-old Zhang Xiaodong is one of the two deceased. 　　Beijing CDC relevant responsible person said, early detection, early reporting, early diagnosis, early treatment, strengthening the treatment of severe cases, pay attention to both Chinese and Western medicine is an effective prevention and control, improve the cure rate, the key to reducing mortality. Currently, the city has asked the two hospitals found H7N9 confirmed cases, all within the jurisdiction of two or more hospitals will conduct two weeks of flu-like illness, severe acute respiratory infections in hospital intensive surveillance. Meanwhile heat treatment of patients, medical staff must be asked in detail about whether the exposure history or history of exposure to poultry H7N9 cases, if the suspected H7N9 virus infection should be carried out immediately H7N9 pathogen detection at the same time, CDC reporting system. Link easily into severe risk factors　　. 1 Age> 　　60 years; 　　2 patients with severe underlying diseases or special clinical situations, such as heart or lung disease foundation, hypertension, diabetes, obesity, cancer, immunosuppression, pregnant women; 　　3. after the onset of sustained fever (T> 　　39 ℃) over three days and three days; 　　4 lymphocyte counts continue to decrease; 　　5.CRP, LDH and CK continued to increase; 　　6 Tips chest radiographic pneumonia. 　　Beijing Times reporter Li Qiumeng

http://roll.sohu.com/20140127/n394253415.shtml 

No proof of constant #H7N9 human-to-human transmission: health authority

2014-01-27 03:12:48

BEIJING, Jan. 26 (Xinhua) -- Current H7N9 cases are scattered and there is no evidence of constant inter-human transmission, according to a paper on H7N9 diagnosis and treatment issued by the National Health and Family Planning Commission on Sunday.

The paper said that the infection source might be the poultry that carry the H7N9 bird flu virus. The H7N9 bird flu could be infected via respiratory spread, close touch with poultry excretion or contact with contaminated environment.

H7N9 patients who have contact with poultry or been to live poultry markets one week before morbidity, especially the seniors, are high risk groups, the paper said.
According to a survey on H7N9 cases, the incubation period for H7N9 human cases is three to four days, and patients will develop to severe pneumonia three to seven days after morbidity (onset?), with body temperature above 39 degrees centigrade.
The paper said that early report, diagnosis and treatment are the best ways to prevent and control the virus.

http://news.xinhuanet.com/english/china/2014-01/27/c_126066004.htm

China NHFPC #H7N9 Update & Guidance

1/26/14
From Avian Flu Diary:
We’ve a long and informative document, released today by China’s NHFPC, providing the latest update and guidance on the H7N9 virus.  This is essentially the `playbook’, issued by the Chinese government, to local health departments, doctors, and hospitals giving them instructions on how to identify, isolate, and treat H7N9 cases.

Continued:  http://afludiary.blogspot.com/2014/01/nhfpc-h7n9-avian-flu-update.html

CDC: Possible Role of Songbirds and Parakeets in Transmission of Influenza A(H7N9) Virus to Humans

Volume 20, Number 3—March 2014

Research

 

Jeremy C. Jones, Stephanie Sonnberg, Zeynep A. Koçer, Karthik Shanmuganatham, Patrick Seiler, Yuelong Shu, Huachen Zhu, Yi Guan, Malik Peiris, Richard J. Webby, and Robert G. Webster 

Author affiliations: St. Jude Children’s Research Hospital, Memphis, Tennessee, USA (J.C. Jones, S. Sonnberg, Z.A. Kocer, K. Shanmuganatham, P. Seiler, R.J. Webby, R.G. Webster); Chinese Center for Disease Control and Prevention, Beijing, China (Y. Shu); Shantou University Medical College, Shantou, China (H. Zhu, Y. Guan); State Key Laboratory of Emerging Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China (H. Zhu, Y. Guan, M. Peiris); The University of Hong Kong, Hong Kong, China (H. Zhu, Y. Guan, M. Peiris)

 

Abstract

Avian-origin influenza A(H7N9) recently emerged in China, causing severe human disease. Several subtype H7N9 isolates contain influenza genes previously identified in viruses from finch-like birds. Because wild and domestic songbirds interact with humans and poultry, we investigated the susceptibility and transmissibility of subtype H7N9 in these species. Finches, sparrows, and parakeets supported replication of a human subtype H7N9 isolate, shed high titers through the oropharyngeal route, and showed few disease signs. Virus was shed into water troughs, and several contact animals seroconverted, although they shed little virus. Our study demonstrates that a human isolate can replicate in and be shed by such songbirds and parakeets into their environment. This finding has implications for these birds’ potential as intermediate hosts with the ability to facilitate transmission and dissemination of A(H7N9) virus.

http://wwwnc.cdc.gov/eid/article/20/3/13-1271_article.htm

 

Beijing #H7N9 tests find no positive samples

BEIJING, Jan. 26 (Xinhua) -- A round of tests for H7N9 bird flu on samples taken from Beijing's poultry markets have so far not found any positive samples, local authorities said on Sunday.

The tests have been carried out since December 23 on 22,595 samples from 12,000 poultry farms and households in the city. A total of 6.05 million poultry from 27,000 farms and households have received compulsory immunizations since December 22.

Bird flu, or avian influenza, is a contagious disease of animal origin caused by viruses that normally only infect birds and, less commonly, pigs. It can be fatal to humans.

Several regions, including Shanghai, Beijing, Zhejiang, Jiangsu,Guangdong, Fujian, have reported H7N9 human infections so far this year.

Beijing reported its first human infection case of this year on January 23.

With the forthcoming Chinese Lunar New Year, health experts have called on the public to stay away from live poultry and to maintain good hygiene habits as there is typically a boom in poultry consumption during the festivities. Birds carrying H7N9 are the sources of sporadic infections.

http://news.xinhuanet.com/english/china/2014-01/26/c_133075092.htm 

Zhejiang Province, two cases of human infection with the #H7N9 new bird flu cases

1/26/14
Transltion

January 26, 2014

      Zhejiang Provincial Health and Family Planning Commission January 26 briefing, the province today added two cases of human infection with H7N9 avian influenza. 
      1, patients Moumou, male, individuals, aged 40, who now lives in Yuhang District of Hangzhou.January 25 confirmed human cases of avian influenza H7N9 infection. Is now in critical condition at a hospital in Hangzhou treatment. 
      2, patients Jin Moumou, male workers, aged 65, Huzhou, Deqing County. January 25 confirmed human cases of avian influenza H7N9 infection. Now the condition is severe, treatment in a hospital in Hangzhou.

http://wst.zj.gov.cn/art/2014/1/26/art_362_407208.html