Announcement

**sharon sanders** · April 2, 2013, 04:02 AM

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Also please see:

China - Woman, 45, a suspected case of H7N9 avian influenza - in Nanjiang, Jiangsu province (BBC, April 2 2013, edited)

China - A report of 5 additional people tested positive for H7 - 3 possibly dead, 2 released from hospital - Shanghai

**Giuseppe** · April 2, 2013, 04:26 AM

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: China Radio International, full text: (LINK).]

Beijing Closely Monitoring Bird Flu Virus

2013-04-02 15:16:53 - Xinhua - Web Editor: Liu Ranran

Related: No Bird Flu Virus Found in Dead Pigs: Authorities

Public health authorities in Beijing said on Tuesday that they are keeping a close eye on the H7N9 bird flu virus that has killed two in east China.

Test reagents for the virus have reached the Chinese capital, where the the deadly SARS epidemic played havoc a decade ago, according to a statement from the Beijing Municipal Bureau of Public Health.

The city, with a population of around 20 million, has added avian influenza into its existing monitoring system for regular influenza and pneumonia without a clear cause.

The statement said all hospitals in Beijing have been asked to brace for emergencies and ensure enough medical supplies although no infection has been reported in the city as of Tuesday.

Three infection cases have been reported in east China's Shanghai City and Anhui Province. There are no vaccines against the virus worldwide.

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**Giuseppe** · April 2, 2013, 11:16 AM

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: RTHK, full text in Chinese: http://rthk.hk/rthk/news/expressnews...0402&55&912587 . WARNING. Automatic translation.]

Shanghai CDC: H7N9 whether human-to-human transmission not yet clear

2013-04-02 HKT 23:47

The Shanghai municipal government held a press conference in the evening, the City CDC Director Wu Fan said that the death of 87-year-old youngest son of H7N9 patients, severe pneumonia death, the eldest son, had been cured, they were not detected in the H7N9 virus.

In addition, the survey believe that the two H7N9 deaths does not belong to the same generation patients, not in the same infection period, have ruled out the possibility of nosocomial infection.

As for the human-to-human transmission of the viruses so still pending investigation.

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**Pathfinder** · April 2, 2013, 11:41 AM

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Translation Google

Two H7N9 patients not infect each other

2013 04 02, 23:26 Tuesday

Shanghai Municipal Center for Disease Control held a press conference, referring to the two infected with the H7N9 avian influenza cases of death, not infect each other in the hospital. The center also pointed out, temporarily unable to confirm the source of the virus from chickens or pigs. One of the deceased Wu Liang Liang, meat stall his lifetime work as usual open to do business failed sterilization and cleansing.

Shanghai Municipal Government Information Office held a press conference to explain the situation of epidemic prevention and control of avian influenza H7N9 evening. Shanghai Municipal Center for Disease Control refers to the two confirmed infection of the deceased, also have been admitted into the Fifth People's Hospital of Shanghai, but the time of admission has been suffering from severe pneumonia, I believe the two are not mutually contagious.

The authorities also pointed out that, due to the and diagnosed infections only two failed to determine the source of the virus is a chicken or a pig, unknown viruses so that human-to-human transmission, but denied that the delay in notification.

Shanghai has started three contingency plans will be cases sent to the designated medical institutions, will strictly implement the pre-screening, medical institutions will implement quarantine measures.

Which is an infection of the H7N9 avian flu death deceased Wu Liang Liang, alive pork file in Minhang District Jingchuang market. Wu Liang Liang's death, this the meat stalls did not particularly strengthen cleansing and disinfection.

The dead outside parent, meat stall main Wude Mao, Wu Liang Liang from early onset to death, the hospital also insisted that he was just acquired pneumonia. In the same market stall tenants also said they did not worry about infected, but said it would step up preventive measures.

兩名H7N9患者並非互相傳染

http://news.now.com/home/international/player?newsId=64071

上海巿疾控中心召開記者會，指兩名感染H7N9禽流感死亡的個案，並非在醫院內互相傳染。中心又指，暫時未能確認，病毒源頭是來自雞或是豬隻。而其中一名死者吳亮亮，他生前工作的肉檔，如常開門做生意，未有消毒清洗。

**Pathfinder** · April 2, 2013, 12:02 PM

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Translation Google

New North disinfection wild birds cluster point of anti-H7N9

United Daily News ╱ Reporters Wong Fook their / real-time reports]

2013.04.02 11:39 pm

Continent H7N9 avian flu killed two people, one person was dying. New Taipei City Government Bureau of Agriculture Zhongxiao pier into Lo Bridge and River Bridge under wild birds gather in public places clear of bird droppings, feathers and disinfection, and called on the people of the flock or flock "Lex" Do not go near feeding; if found that the abnormal birds died suddenly increase, immediately informed the city government to help master the possible outbreak.

http://udn.com/NEWS/BREAKINGNEWS/BREAKINGNEWS3/7806465.shtml#ixzz2PK6aEvPa

**Giuseppe** · April 2, 2013, 12:58 PM

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: Nature, full text: http://www.nature.com/news/novel-deadly-bird-flu-virus-kills-two-in-china-1.12722 . Excerpt.]

(...)

Scientists stress that it is far too early to make a full risk assessment of the potential pandemic threat. But the initial analysis of viral sequences is "worrisome? because they show several features suggestive of adaptation to humans, says Masato Tashiro, a virologist at the Influenza Virus Research Center in Tokyo, the World Health Organisation?s influenza reference centre in Japan.

(...)

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**Giuseppe** · April 2, 2013, 02:01 PM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: Ifeng, full text in Chinese: (LINK). Automatic translation.]

More on H7N9 avian influenza human cases in Nanjing

Apr. 03, 2013 02:17 Source: Beijing News

Original title: Nanjing of Chuzhou H7N9 patients had a history of contact with live chickens

The recent spate of human infection with the H7N9 avian influenza virus, 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 yesterday, the country has found seven cases of confirmed cases of H7N9 avian influenza this, many start to strengthen prevention and control deployment in response to the virus struck.

Have been confirmed cases What are the symptoms? Before the illness have come into contact with what the source of infection? In this regard, the reporter went to Nanjing, Anhui, of which two patients diagnosed with residence and work places to visit.

Beijing News News yesterday, a confirmed H7N9 patients in Chuzhou, Anhui Province Mr. Han still in Nanjing Zhongshan University Hospital ICU ward treatment , her husband said that his wife's condition is still very critical, and sent to experts in Beijing have provided treatment programs. It is understood that the five days prior to the onset of the patients went to the vegetable market to buy live chickens home cooking.

Chuzhou patients with anti-inflammatory therapy - Patients Mr. Han, female, 35 years old, living in Chuzhou City, Anhui Province, South Qiao Area Apartment 4 layers. Her husband Zhang said his wife suffered from depression, did not work, usually with a ten-year-old daughter to school.

March 14 this year, Mr. Han fever 39 ? C, the next day at community clinics for treatment, taking azithromycin and other anti-inflammatory, antiviral drugs, the symptoms are not relieved. Then she went to another clinic for treatment, but the symptoms are not relieved, and a high fever of 40 ? C.

On March 19, Mr. Han accompanied her husband to the Chinese and Western Medicine, Chuzhou, combined with the hospital due to serious condition, and the next day transferred to the First People's Hospital of Chuzhou City, was diagnosed with pneumonia. On the afternoon of the 20th, the patients go to the Nanjing Zhongshan University Hospital.

Nanjing Zhongda hospital admission diagnosis: severe pneumonia; septic shock; multiple organ dysfunction syndrome, viral myocarditis, liver dysfunction; depression.

Before the onset of the 5th purchase live chickens - It is understood that two weeks prior to the onset of Mr. Han have not been to the field. Sick two weeks before her daughter suffered from a cold fever for several days that healed, in addition, Mr. Han did not come into contact with other patients with fever.

Mr. Han lived in the area near a vegetable market, Han Mousheng disease before and after to the farms to buy food. March 9, Mr. Han and her husband went to the farms to buy a live chicken, let the chicken traders to slaughter, and then Mr. Han home the whole chicken chopped into pieces burn into chicken soup, so the whole family consumption.

Her husband, Zhang said, the family almost every day to the farms to buy food. After the onset of the wife, the family made a blood collection laboratory, were not detected in the virus.

National Center for Disease Control confirmed H7N9 - Yesterday, the the Chuzhou CDC staff said that they received a week ago, the Nanjing Center for Disease Control's notice before they informed the local emergence of H7N9 confirmed cases.

It is understood that the Nanjing Zhongshan University Hospital received Mr. Han, respiratory specimens sent to CDC of Jiangsu Province, and then sent to the Chinese Center for Disease Control detected. Eventually detected H7 subtypes of avian influenza virus nucleic acid positive.

According to staff, followed by the national CDC officially confirmed positive for H7N9 virus.

Chuzhou H7N9 cases, the city established the mayor as head of the emergency response team. Requested all medical units to focus on monitoring severe pneumonia, and calls for ...

The patient husband: hope all your savings countries reimbursement - Beijing News yesterday to Mr. Han living cell in Chuzhou, there is no exception, passers-by are basically not wear masks. 3 minutes walking on the west side of the district there is a farmer's market, this is Mr. Han often buy food. At noon, here is still full of people, business as usual.

Mr. Han's husband said that his wife is diagnosed, Nanjing CDC to him and his family to do the sampling, are not suspected symptoms.

He and his family now move freely, not isolation. Their year-old daughter is still in school. Wife during the illness, the family still go to the farms to buy food, "every day is always cooking.

Mr. Han's husband said, he was working in a factory, although he and his wife are city accounts, but the wife does not work, do not have any savings at home, now a doctor does not take money out, this is sick because of avian flu, he wants the state to reimburse medical expenses.

The slaughtered work is confirmed for the first patient in Nanjing - Home address information is posted on the microblogging in Jiangning District, East New farmers market in live poultry slaughter

The Beijing News confirmation hearing Nanjing, the first patient was a 45-year-old female Xu. She lives in Jiangning District, a district in a place not far from her home, a farmers market, the sale of poultry, eight years ago, Xu rent a stall in the market, and began to engage in live poultry slaughtered.

Ten days before the cold symptoms - Xu husband said, as early as March 19, Xu has been aware of the discomfort, her son the industry sea (a pseudonym) said, feeling sore, uncomfortable.

March 20, industry sea came home from work and found the mother appeared cold symptoms, some coughing, fever, he and his mother, after discussions, decided the next day to take her home to a nearby hospital for treatment.

On the 21st, after the diagnosis, the local hospital told Xu, she got pneumonia. At noon the same day, "X-ray examination report card" displayed a shooting permit any markings increased sheet height dense shadow in the lower right lung, including diagnosis and advice column reads: consider the right middle lobe inflammation, if necessary review or further examination.

Industry, Hai said the hospital was "no beds" to Community Hospital infusion treatment recommendations Xu. He did not expect the mother in the last two days after the infusion, the situation has not improved.

Critical condition, still in the rescue - March 23, 2011 20:00 more, industry sea again with his mother to the diagnosis and treatment of hospital transfusion process, Xu suddenly said chest tightness, and then the temperature rose to 41 ? C and immediately transferred to the ICU (intensive care unit) treatment .

22:00 the next day, the industry sea connected to the hospital phone, said the mother in serious condition, is trying to rescue. March 27, Xu sicker, industry sea mother go to Nanjing, a hospital ICU treatment. On April 2, the hospital informed that, Xu critical condition, is rescue.

This one afternoon, Jiangsu Province, organized by the Office of Health expert, according to Xu clinical manifestations, laboratory testing and epidemiological findings, diagnosis permit any confirmed cases of the H7N9 avian flu infection, she is the first case of human infection of H7N9 avian influenza in Jiangsu Province cases.

For Sellers cure is published address - The Beijing News XunYe family said that the, although engaged in live poultry slaughter but Xu Mouping days of, good condition, never thought Xu infected with avian influenza.

A relative of the industry home, Xu and her husband previously are the Jiangning District silk factory workers laid off after the two engaged in live poultry slaughtered in different markets.

Industrialists said Xu treated in the ICU cost nearly a million a day, they have gradually spent 10 million, part of which borrow or with relatives and friends.

Second-hand housing was originally intended to sell the home to pay medical expenses, workers and entrepreneurs, suddenly found yesterday, home address was posted on the microblogging. "Who to buy now? Certainly not sell." The industry sea some anger. He said should be investigated for the responsibility of users to publish these information.

The home industry is still worried about medical expenses, they hope someone help also hope that the hospital will do their best treatment.
Permit any of the work of the farmers market administrator Characteristic study of brown, relevant departments have been on the market disinfection permit any contact with people who are blood tests, the test results are good. "

Edition have written / Beijing News reporter coated heavy Airlines Zhu Liu Di Lie

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**JimO** · April 2, 2013, 03:57 PM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Fears as more H7N9 cases in China

http://www.thehindu.com/news/fears-as-more-h7n9-cases-in-china/article4573676.ece

H7N9 bird flu,China avian flu,World Health Organisation

Fears as more H7N9 cases in China
Ananth Krishnan

snip

The four new cases were reported on Tuesday in Jiangsu province, which borders Anhui to the east and lies north of Shanghai. The Jiangsu health bureau said three women, aged 45, 48 and 32, and a man (83) had been infected. Worryingly, the four cases were in four different cities, and all patients were in “critical condition” and “under emergency treatment”, Xinhua reported.

**Catbird** · April 2, 2013, 08:36 PM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

A little bit of info I haven't seen in other media reports yet.

Machine translation from original article:

"2013 4 3

Jiangsu 1 day 4 confirmed H7N9

The National to 7 Yuen Kwok-yung: From wild bird genes

...Yuan: viruses multiply faster at 37 ℃

Achieved Mainland H7N9 avian influenza virus gene map HKU Department of Microbiology, Professor Yuen Kwok-yung said the preliminary analysis of the extracts, found that the genes of wild birds from three regions of Zhejiang, South Korea, and north of the Yangtze River, instead of human beings or animals, but do not rule out the future of wild birds gene mutation of the virus through the pig again shuffle order. Part of the gene in a 37 ° C environment will begin to adapt to human or animal virus propagation more efficient. Hong Kong Centre for Health Protection is very concerned about the incident, and learned from the WHO data, the pathogenicity of the virus in birds, but human lethal, means that the H5N1 avian influenza, there may not be a large number of birds died (see figure).

...5 patients full in critical condition and 167 had been exposed to isolation

TIANJIN TRADE UNION ADMINISTRATORS clear and poultry history of exposure, the authorities did not inform the other three patients had contact with poultry. A female patient surnamed Sang, aged 48, Suqian Shuyang people engaged in wood processing, the onset of March 19, 30 deteriorated go to Nanjing therapy...167 people in close contact with the patients have been isolated for observation, currently the nobody with fever or respiratory illness...".

ETA: I am going to go ahead and post the graphic that accompanied the article in the hopes that someone can get a decent translation of it.

From: http://news.mingpao.com/20130403/gaa1.htm

明報新聞網

http://news.mingpao.com/20130403/ga__03ga301.jpg

ETA 2: My apologies. The image is too big and is causing the side scrolling problem. So in the interests of keeping this a "fast read" thread, I'm going to delete the pic and just post the link. Hopefully, someone can follow the link and get us a translation of the infographic.

**Laidback Al** · April 2, 2013, 11:20 PM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Here is the image that Catbird posted a link to--

The colored text boxes on the left are remarks about biosecurity measures in surrounding provinces. The list on the right side is an individual case listing of the seven cases with name, age, sex, occupation, dates of onset, etc. The center graphic is an enlarged local map showing the relative geographic location of the cases.
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**Giuseppe** · April 3, 2013, 01:33 AM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: RTHK, full page in Chinese: (LINK). Automatic translation.]

Dr Zhong Nanshan: H7N9 outbreak in the Mainland seems unlikely so far

2013-04-03 HKT 14:19

Chinese Academy of engineering, and Director of the Institute for respiratory disease in Guangzhou, Dr Zhong Nanshan said that mainland H7N9 outbreak not appear, at present, only sporadic cases.

Dr Zhong Nanshan the interviews explained that outbreak to meet the three conditions, including person-to-person, large clusters of cases, numbers of seizures and , But that is not the case.

Dr Zhong Nanshan said, as authorities against H7N9 and unexplained pneumonia cases enhanced monitoring, number of confirmed cases "in all likelihood" increase.

He said that, although the Administration did not identify the source, but has H7N9 gene sequencing and illness profile, most provinces control difficulty is unlikely, even if the outbreak , Are also believed to manufacture vaccines soon to cope with.

He appealed to the people on the Mainland as far as possible avoid contact with live poultry, must be cooked before eating.

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**Giuseppe** · April 3, 2013, 01:41 AM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: The Standard, full text: (LINK).]

(H7N9 watch) Anhui woman remains critically ill

(04-03 11:24)

An Anhui woman infected with the killer H7N9 strain of bird flu, is still critically ill in a hospital in Nanjing, in east China's Jiangsu province, media reports said. She had been in intensive care for more than a week., She became infected in Chuzou, in eastern Anhui province, china.org.cn reports. The 35-year-old woman was admitted to a hospital on March 20th.

(?)

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**Giuseppe** · April 3, 2013, 01:43 AM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: The Standard, full text: (LINK).]

(H7N9 watch) Flu expert suspects killer virus has already adapted to mammals

(04-03 11:39)

The new bird flu virus that has so far killed two in China has shown signs that it is adapting to mammals, suggesting what was once a bird virus is now probably spreading in a mammalian host, an influenza expert said. Seven people in China are now infected.

And while it's not clear what that mammalian host is, the two most obvious choices are pigs or humans, said Dr Richard Webby, head of the World Health Organization's influenza collaborating center at St Jude Children's Research Hospital in Memphis, Tennessee, The Canadian Press reported. Webby, a swine flu expert, said the virus ? doesn't any longer look like a poultry virus.?? He added: ?It really looks to me like it's adapted in a mammalian host somewhere.??

(?)

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**gsgs** · April 3, 2013, 02:01 AM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Webby ignores the subsequent reassortments with poultry segments.
He would need multiple independent adaptions in mammalean hosts
which is just unlikely.

**Giuseppe** · April 3, 2013, 03:21 AM

Re: China - Seven confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: Government of Hong Kong PRC SAR, full text: (LINK).]

SFH on human cases of Influenza A (H7N9) in the Mainland

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.)

Ends/Wednesday, April 3, 2013
Issued at HKT 15:45
NNNN

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Announcement

China - 14 confirmed cases of human infection with H7N9 avian influenza - Five fatalities March 31 - April 4

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