H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

[sharon sanders]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

Hi Everyone!

We have expanded the forum to more clearly show the spread of H7N9 in China.

Please make double posts regarding confirmed and suspected cases - 1 post to the daily thread and a duplicate of the same post in the corresponding province.

Thanks!

[Giuseppe]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

[Source: Centre for Health Protection, Hong Kong PRC SAR, full text: (LINK).]

Six more human cases of Influenza A (H7N9) verified by NHFPC


The Centre for Health Protection (CHP) of the Department of Health (DH) verified with the National Health and Family Planning Commission (NHFPC) today (April 13) one human case of Influenza A (H7N9) in Beijing, two in Jiangsu, one in Shanghai and two in Zhejiang.

Among the cases, the one in Beijing involves a seven-year-old girl who is currently receiving treatment in hospital and is in stable condition. The patient's two close contacts are asymptomatic so far.

The two cases in Jiangsu involve a 72-year-old man and a 77-year-old woman. They are receiving treatment in hospital and currently in critical condition. The 16 close contacts of the duo are asymptomatic so far.

The one in Shanghai involves a 56-year-old man whose wife is an earlier confirmed case.

The two cases in Zhejiang involve two men aged 38 and 65. Both are in critical condition.

Specimens of the six cases tested positive for H7N9 upon laboratory testing by the Mainland health authority.

As of 9pm today, a total of 49 cases have been laboratory confirmed with Influenza A (H7N9) in Shanghai (21 cases), Jiangsu (14 cases), Zhejiang (11 cases), Anhui (two cases) and Beijing (one case).

A spokesman for the DH stressed that the CHP is closely monitoring the situation and will continue to maintain close liaison with the Mainland health authorities for more case information as well as to keep a close eye on the latest advice from the World Health Organization.

The spokesman also reminded travellers, especially those returning from Shanghai, Anhui, Jiangsu, Zhejiang and Beijing, with fever or respiratory symptoms, to wear facial masks immediately, seek medical attention, and reveal their travel history to doctors. Healthcare professionals should also pay special attention to those who might have had contact with birds, poultry or their droppings in the affected areas.

"No human case of Influenza A (H7N9) has been identified so far in Hong Kong," the spokesman reiterated.

"We would like to reassure the public that the Government will be as transparent as possible in the dissemination of information on human cases of Influenza A (H7N9). Whenever there is a suspected case, the CHP will release information to the public as soon as possible," the spokesman added.

Members of the public should remain vigilant and are reminded to take heed of the following preventive advice against avian influenza:

• Avoid direct contact with poultry and birds or their droppings. If contact has been made, they should immediately wash hands thoroughly with soap and water;
• 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 toilet, touching public installations or equipment such as escalator handrails, elevator control panels or 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 tissue and put it into covered dustbins;
• Avoid crowded places and contact with fever patients; and
• Wear a mask when respiratory symptoms develop or you need to take care of fever patients.

The public may visit the Avian Influenza page of the CHP (www.chp.gov.hk/en/view_content/24244.html) for further information.


Ends/Saturday, April 13, 2013
Issued at HKT 21:38
NNNN

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[C Smith]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

Good to see that the child victims are being given antivirals - no mention of this treatment is made in the cases of the older victims even though the course of the illness is slow - two weeks ending in pneumonia/MOF
Reports are coming in that Tamiflu is not effective http://www.ecdc.europa.eu/en/press/n...2FLists%2FNews
so one wonders why every WHO Bulletin ends with a statement that 'there are as yet no indication that they are not effective'? Are these drugs only being tested in the laboratory rather than on the patients? Are the Pharmaceutical companies wary of their drugs being declared ineffective?
At last reports are coming out that the danger is that this variant H7N9 influenza A being a reassortment between two avian viruses is not contagious BUT now that it is in so many people there is a danger of it meeting up with an H1N1 or H2N3 human influenza virus and reassorting to make a new contagious and possibly deadly virus? (The vaccine race will be on if that happens otherwise it is only a vaccine for poultry which is not tempting to Big Pharma!)
Now the median age of victims is 65 - hence no evidence of a Cytokine storm but also low risk of reassortment because older people will have good immunity to existing 'flu viruses - with me so far?
So the biggest risk is someone contracting both types of influenza virus who is not immune and especially if that person travels on public transport eg works in an office rather than setting off in the early hours to market.
The young victims must be isolated and monitored therefore.
It we duck this bullet perhaps the new Chinese leadership will reform the way that poultry interface with humans throughout their society - oh and educate children about the nature of viruses so that they really understand what to do to interrupt the cycle and scorn the rumour-mongers - and can organise their parents...

http://www.ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8-e230-4424-a783-85742124029a&ID=892&RootFolder=%2Fen%2Fpress%2Fnews%2FLists%2FNews

I found this 2008 report that highlights some of the difficulties H7 influenza viruses pose when producing a vaccine

http://iipdigital.usembassy.gov/st/english/article/2008/06/20080618172808lcnirellep0.5212824.html#axzz2QKqHBB5M

[Giuseppe]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

One among four deposited GISAID sequences of H7N9 genes demonstrated a neuraminidase inhibitors resistance mutation (R292K), while the other three was susceptible.

Further phenotipical test in China WHO Collaborating Centre demonstrated H7N9 susceptible to NAIs.

For more details see the WHO paper: http://www.euro.who.int/__data/asset...res_update.pdf

Genotypic analysis is important to detect early possible mutation in the NA segment that may signals resistance to NAIs.

However, clinical importance of such virologic findings are not clear at the moment, as well as the effectiveness of antiviral treatment with approved drugs at the dosage estimated useful for uncomplicated seasonal influenza or human cases of avian influenza H5N1 virus infection.

We will await a more complete clinical course description published in review eagerly.

[Catbird]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

Some details on the Beijing case.

Machine translation:


"Beijing's first H7N9 parents of children no longer sell live poultry after April 6

2013-04-13

Summary: Beijing found the first case of confirmed cases of human infection with the H7N9 avian influenza. The first confirmed case is a 7-year-old little girl, she lived in Shunyi District houshayu, parents of Zhangjiakou in Hebei Province, are now staying in Shunyi District, is principally engaged in the live poultry business. Children's body temperature has dropped from a high of 40.2 degrees Celsius to 36.8 degrees Celsius, two close contacts her parents so far found no abnormalities.


Beijing has found the first case of confirmed cases of human infection with the H7N9 avian influenza. The first confirmed case is a 7-year-old little girl, she lived in Shunyi District houshayu, parents of Zhangjiakou in Hebei Province, are now staying in Shunyi District, is principally engaged in the live poultry business. Children's body temperature has dropped from a high of 40.2 degrees Celsius to 36.8 degrees Celsius, two close contacts her parents so far found no abnormalities. Morning, the Municipal Government Information Office informed the city's first case of human infection with the H7N9 avian flu cases. Municipal Bureau of Agriculture Deputy Secretary Liu Yaqing said, due to the H7N9 virus has yet to be detected in poultry, the city will not culling of poultry, but live poultry trading and on-site slaughter have stopped.

Diagnose

Visits to the diagnosis: in just a day and a half

Deputy Secretary of the Municipal Health Bureau Zhongdong Bo said, this morning, by the Chinese Center for Disease Control to review the city comprehensive judgment first case of human infection of H7N9 avian influenza confirmed cases. Children Yaomou this year, 7-year-old, living in the old village center of town Houshayu Street Shunyi District. Her parents live in live poultry trafficking work.

The morning of April 11

Children with symptoms such as fever, sore throat, cough, headache, 11:00 to Ditan Hospital emergency treatment.

1:00 pm

To lung infection admitted to hospital.

12 am 1:50

According to the results of further examination after admission and progression of the disease situation, the hospital reported cases of influenza surveillance in at 1:50 on the 12th, Chaoyang District CDC specimens sent to Chaoyang District CDC 3:00.

At 10:00 on the 12th

Chaoyang District CDC confirmed influenza A universal primer nucleic acid testing positive, and at 11:00 the specimens were sent to the Beijing CDC review of detection.

At 15:30 on the 12th

The Beijing CDC detected the H7N9 avian influenza virus nucleic acid positive, in accordance with the provisions of the National Health and Family Planning Commission, and suspected cases of the samples sent to China CDC review of detection.

13 am

The China CDC feedback review results. Clinical expert in Beijing, according to the Chinese Center for Disease Control and the Beijing CDC pathogen detection and review results, combined with the patient's clinical manifestations, epidemiological investigation, in accordance with the National Health and Family Planning Commission to develop the people infected with the H7N9 avian flu clinics program (2013, second edition) ", the overall judgment of the cases of human infection of H7N9 avian influenza confirmed cases.

Where

15 hours to spend Tamiflu, is currently in stable condition

Children admitted to hospital, the Beijing Ditan Hospital to be anti-infection and symptomatic treatment. Confirmed cases of influenza surveillance, the hospital at 23:50 on the 11th, that is, 15 hours after the time of onset distance give children Tamiflu antiviral rehydration supportive care. Later, the children whose condition heavier Go to the intensive care unit, give oxygen treatment on ECG. After active treatment, children with significant improvement in symptoms of cough hold your breath, yesterday afternoon, the temperature dropped from its peak of 40.2 ℃ to 37.3 ? C in the case of no use of antipyretics, morning body temperature and decreased to 36.8 ? C. Now, the children of the lung wet rales disappeared, stable condition.

Director of the Center of Beijing Ditan Hospital Infection Li Xingwang said, children with only 50 hours from the onset of the current carried the disease is relatively fast. However, due to the children in the 15 hours after the onset of the use of antiviral drugs, the condition has been under control. Experience from field cases, most of the 3-5 days after the onset of the disease is relatively heavy. The children with the disease will be repeated, Li Xingwang is not quite sure, he said, "the moment, early treatment may inhibit the progression of the disease, and the hope that the condition will not deteriorate."

Prevention

Two close contacts found no abnormalities

Recognized as suspected cases, the Beijing Municipal Center for Disease Control, Shunyi District and Chaoyang District CDC disposal to investigate the scene, confirmed that two close contacts and medical observation measures. As of now, the two close contacts found no abnormalities. This reporter has learned, the children with a primary school student, before the onset of health, but has two weeks did not go to school.

Zhongdong Bo, Deputy Secretary of the Municipal Health Bureau, said the first case of human infection with the H7N9 avian influenza diagnosis and treatment process, with only a day and a half's time, children with the disease will soon be effectively controlled, it shows that the effectiveness of the prevention and control of the city pre . Children according to the publicity obtained the information directly to the designated hospitals Ditan Hospital for treatment, improve clinic efficiency, reduce close contacts. The clinic behavior Beijing Ditan Hospital in strict accordance with the provisions of the protective measures to ensure the safety of medical staff, attention to the popular history of interrogation and influenza universal primers monitoring and timely reporting of outbreaks, created the conditions as soon as possible diagnosis, early use of Tamiflu antiviral treatment, and the use of Chinese medicine treatment methods (Yinqiaosan White Tiger Decoction), children with the disease will soon be controlled relief. Three regions, municipalities, national CDC rapid response, seamless connectivity, day and night, working overtime to 24 hours to complete the testing, review and again review process.

Survey

Parents of children no longer sell live poultry after April 6

Municipal Bureau of Agriculture Deputy Secretary Liu Yaqing said the parents of the children in Zhangjiakou in Hebei Province, are now staying in Shunyi District, mainly engaged in the live poultry operations. April 2, parents of children with from Shunyi District Gaoliying moved houshayu was carrying live chickens 15, and later bought 60 chickens. A total of 75 chickens were sold to the Shunyi District, Chaoyang District 29, the remaining 46, sold to the village, the villagers kill 44, the two left their own homes to eat. Relevant departments to carry out the extensive publicity, the parents of the children in the 6 April has stopped the live poultry from operating activities, and their home has no live poultry. After investigation, found that a total of 51 in this village poultry farming, rearing chickens, ducks and a total of 503, pigeon 2700. Agricultural sector quickly launched emergency measures, poultry serum samples collected from the village, and detection does not detect the virus. Village 503 chickens, ducks and have all been culled, and harmless treatment; the 2700 homing pigeon prohibit all voyage. Meanwhile, relevant departments of the village and children shelter disinfection the village surrounding environment disinfection.

Also conducted a survey of the relevant departments of live chickens for sale to the Shunyi and Chaoyang. Chaoyang District, has been traced to products for archiving and processing; Shunyi District, is traced to poultry products sold in the village. Liu Yaqing from monitoring, Beijing did not find brutish infected with the H7N9 bird flu virus, and therefore will not be large-scale culling of poultry...".


xhttp://ndnews.oeeee.com/html/201304/13/47429.html

[Shiloh]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

Some details on case #48, the 65 yr. old man from Zhejiang Province:

Source: http://hznews.hangzhou.com.cn/chengs...nt_4691827.htm

65-year-old Guo Dabo confirmed to have been infected with the H7N9 avian flu
2013-04-14 07:25:13 Hangzhou Network



Yesterday afternoon, a hospital in Zhejiang University of Infectious Diseases, on the fourth floor, the medical staff of the armed disease area busy, Guo Dabo being treated inside. Reporter Chen Zhongqiu photo

Source Mau near a supermarket, the live poultry District has closed. March 23, Guo Dabo here bought a live chicken slaughtered on the spot. Reporter Chen Zhongqiu photo

The the home balcony Guo Dabo, neighbors birdcage often hanging in the racks. Reporter Chen Zhongqiu photo

Guo Dabo, who lives on the city Yuanmao Lane

Family yesterday detailed incidence after

The uncle the recent three possible contact with live poultry

Confirmed yesterday H7N
9 avian sense of Guotai Bo, who lives on the city Yuanmao away from Hangzhou, discovered the first case of bird flu after streets not far from Binsheng farmers market is also very close, less than 10 minutes walk.

The live in Yuanmao a woman more than 10:00 last night, before going to bed she went out the garbage, saw a lot of people are standing outside the door, a car parked in a doorway, the body of the vehicle says, "CDC "down in the car were wearing white protective clothing. Many residents feel curious, families want to be approached to look at, but was blocked out, "said the people inside, now in disinfection, we should not close."

A detailed account of the family told reporters

Guo Dabo After the incidence

Kuo little house, 60 square meters, home to four generations of six people: Guotai Bo, his wife Luo aunt, son, daughter-in-law, a 5-year-old grandson, also Guo Dabo fast 90-year-old mother-in-law.

Aunt Luo Guo Dabo before retirement factory kotelshchik, two years increasingly bad body, heart disease, diabetes, cholecystitis, frequent illness.

At 13:30 on April 9, Guo Dabo home sudden onset of high fever, body temperature 39.4 ? C, slept, fever or refunded, home, think about it this time around avian influenza traumatic powerful, do not worry, his wife and son. Guo Dabo sent to a municipal hospital.

The doctor asked him how he felt? Guo Dabo said spit twice, stomach hurt. Film examination lot of found that Guo Dabo lung bubbles went fever and surgical examination, diagnosis is a disease caused by intestinal infarction, hospitalization is recommended.

"On the evening of the same day, he **** 67 bottles of saline, felt a lot better the next day began a high fever, approaching 40 ℃ run out of medicine to burn on the back around 19:00 body temperature at around 37 ℃, blood pressure also dropped to 70/120, almost normal. "

But soon, Guotai Bo fever has made up repeatedly, and increasingly difficult breathing, coughing very serious. At noon that day, the doctor advised transferred to the intensive care unit, said that if it continues, the situation is bad enough. "Guotai Bo's son said.

The doctor suspected The Guotai Bo infected with the H7N9 avian influenza, immediate sampling laboratory.

At 9:00 p.m. on the 12th over, Luo Aunt hospital received the phone, said a weak positive test results, but also further confirmation, just in case, preferably immediately transferred to a Zheda hospitals for comprehensive treatment.

Luo aunt, at 21:30 on the 12th, she suddenly made a lot of people, said the CDC's, but also with a lot of drugs, and added that one person was all blood tests.

"I ask how your wife test results, they said, weakly positive, the situation is not very good ..."

Guo Dabo transferred to Zhejiang University to a hospital that night, Luo aunt how to sleep. "The whole night I head is full of H7N9 is avian flu, the more they want more chaotic heart ......"

Noon yesterday, the doctor told Luo aunt, Guo Dabo situation "very optimistic" in vitro detoxification, need ventilator with treatment, may at any time of danger, hospital full treatment, but the families still have to be psychologically prepared ... ...

Luo aunt said, his wife was admitted to the Zhejiang University was hospitalized that day, the last sentence she said, "your body should be properly ..."

According to family memories, Guo Dabo recent three chance of contact with live poultry.


March 23

Bought a hen live poultry stalls in the supermarket

Luo remember Aunt, March 23, Guotai Bo bought a hen.

Place to buy chicken from Guotai Bo home far Huimin Road ? ? ? ? supermarkets selling live poultry stalls in the supermarket, to provide on-site slaughter.

Luo aunt the day, Guo Dabo buy hens, slaughtered the scene in the supermarket on the live poultry stalls.

Take home, he wash well, cut a half a chicken stew at night the whole family to eat another half a chicken in the fridge, April 3, the other half eaten.

Yesterday afternoon, ? ? ? ? supermarkets live poultry stalls has stopped the industry.

Wangjiang outside Zhijie buy food every day to

Aunt Luo Guo Dabo almost every morning, should go to the farmers market to buy food Wangjiang outside Zhijie, than, after the streets Binsheng farmers market from his home, but Guo Dabo go very little. Luo aunt said, because look Jiangmen side farms of vegetables a little cheaper.

"Our family meals are in his possession before admission, in fact, that when the avian flu is very powerful, he was every day to go to that food market, food market stalls selling live chickens, like a few days later no business."

Neighbor's bird cage on the balcony

Every day while he water the flowers while cleaning up bird droppings

Luo aunt said, in addition to farms to buy food every day, his wife will basically stay at home, go to the second floor balcony every morning pouring water the flowers on the balcony, in addition to Guotai Bo Yang flower pots, as well as the next door neighbor to raise a bird , birdcage hanging in flowerpots above.

Every morning, Guo Dabo while gardening, while cleaning up the bird droppings. Aunt Luo Guo Dabo clean up bird droppings, sometimes wiping with a cloth, may sometimes directly by hand.

Yesterday morning, Luo aunt home to several animal epidemic prevention station staff, medication water to every corner of the balcony are disinfected, and later taken away by a bird and birdcage and bird droppings take home tests.

Yesterday afternoon, on the balcony remained some guano has been sterilized, Luo aunt said.

When her 5-year-old grandson is trying to reach out and grab Luo aunt suddenly snatched away.
Source: City Express Author: reporter Dong Lu Ping Editor: high Tingting

[sharon sanders]

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 13 2013): 6 cases / 0 deaths (Total 49 / 11)

Please see the next day's thread here.