Lisa Schnirring | Staff Writer | CIDRAP News | Feb 03, 2014 Over the past 3 days, China reported 14 new H7N9 influenza infections, including 4 in children and 3 fatal cases.
Lunar New Year celebrations are winding down in China, and health officials are watching to see what impact that might have on the pace of human cases. Global health groups have warned that the surge of human cases could continue, fueled by increases in poultry trade and transport, as well as heavy volume of travel as families gather to observe the holiday season.
Southern provinces lead second-wave cases
Six of the latest cases are from Guangdong province, continuing a strong second-wave tilt toward the mainland’s southernmost areas. In the first wave, locations north of that area were driving most of the outbreak activity: Shanghai, Jiangsu province, and Zhejiang province. China’s steady stream of H7N9 cases has averaged about 5 to 7 a day over the past few weeks, and the latest reports puts the total close to the 300 case mark since the disease was first detected in people last spring. For comparison, it took H5N1 avian flu—another closely watched virus that can pass from poultry to people—4 years for the global total to reach 263 cases. China passed that mark for H7N9 last week after less than a year of outbreak activity.
Latest case announcements
News of the latest 14 cases appeared in provincial health ministry announcements translated and posted by Avian Flu Diary (AFD), an infectious disease blog, and five of the cases were also covered in the latest disease update today from the World Health Organization (WHO). Three more deaths were included in the reports: in a 63-year-old man and a 48-year-old man from Guangdong province, and in a 59-year-old man from Hunan province. The 48-year-old’s infection was first confirmed on Jan 15, according to the FluTrackers infectious disease news message board. Six of the latest case-patients are from Guangdong province, and three of them are children, a 2-year-old girl, a 5-year-old boy, and a 6-year old boy. Aside from the 63-year-old man who died from his infections, the other cases involve a 37-year-old man and a 76-year-old woman. The 6-year-old boy’s illness was detected on Jan 28 as he was traveling through a border point between Shenzhen and Hong Kong, according to the WHO report. He lives in Shenzhen and started having symptoms on Jan 27. His symptoms are described as mild, and he is in stable condition and is being treated and isolated at home. The investigation shows that he had been exposed to live poultry.
Meanwhile, the 5-year-old boy, from the city of Zhaoquing, got sick on Jan 29 and was hospitalized the same day. He is in stable condition. The WHO said he had been exposed to a live poultry market. The 2-year-old girl, whose illness was confirmed yesterday, is from Zhongshan City, where she is hospitalized in stable condition, according AFD’s translation of today’s health ministry report. The fourth child—an 8-year-old girl—is from Hunan province, which also reported two adult case-patients, a 38-year-old man and a 59-year-old man who died from his infection. Zhejiang province reported three new cases, all involving adult men, ages 80, 54, and 44. Fujian province also reported two more lab-confirmed cases, also in men, ages 27 and 35.
The 14 new cases boost the H7N9 outbreak’s total to 291, according to a running total compiled by FluTrackers. Of those, 155 have come in the second outbreak wave since October, compared with 136 in the first wave last spring. The three latest deaths lift the unofficial fatality total to 64.
WHO reports add to outbreak, case profiles
The WHO’s statement today also includes details on five case notifications it received from China on Jan 31. In addition, a separate statement from the agency on Feb 1 fleshes out new details on seven cases reported from China on Jan 30. Of the 16 patients reported in the two WHO statements, 11 had been exposed to live-poultry markets, three had been exposed to live poultry, and the source wasn’t known for two. Ages range from 5 years to 82 years. Twelve of the patients are male, and four are female. Eleven of the patients are in critical condition, one is serious, one is stable, and one has a mild infection. Two of the patients died from their illnesses. Illness-onset dates range from Jan 13 through Jan 29. The patients in the two WHO reports are from five different Chinese provinces, all in the southeastern part of the country. They include seven from Guangdong, 6 from Zhejiang, and 1 each from Guangxi, Hunan, and Jiangsu.
Feb 3 WHO statement
Feb 1 WHO statement
FluTrackers post on H7N9 death