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Influenza A(H7N9) - China - Monitoring human cases (ECDC/CDTR, January 3 2014, extract)
[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK). Extract.]
COMMUNICABLE DISEASE THREATS REPORT
Week 1, 29 December-4 January 2014
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Influenza A(H7N9) - China - Monitoring human cases
Opening date: 31 March 2013 Latest update: 19 December 2013
Epidemiological summary
In March 2013, Chinese authorities announced the identification of a novel reassortant A(H7N9) influenza virus in patients in eastern China.
Since then, 148 cases of human infection with influenza A(H7N9) have been reported from:
In addition, the virus has been detected in one asymptomatic case in Beijing.
Most cases have developed severe respiratory disease. Forty-seven patients have died (case-fatality ratio=32%). The median age is 61 years, ranging from three to 91 years; 42 of 148 patients are female, with gender being unknown in five cases.
Thirteen cases have been reported in China since October 2013. Ten of these cases have occurred in previously affected provinces (Zhejiang and Guangdong), two cases have been reported in Hong Kong and one case in Taiwan. Both cases in Hong Kong and the case in Taiwan have visited mainland China prior to falling ill.
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ECDC assessment
Influenza A(H7N9) is a zoonotic disease that has spread in poultry in parts of eastern China, causing severe disease in humans. There is no evidence of sustained person-to-person transmission. Close to 3 000 contacts have been followed-up, and only a few are reported to have developed symptoms, as part of three small family clusters. Many unanswered questions remain regarding this disease, e.g. the reservoir, the route of transmission, the spectrum of disease and the reason for an unusual age��gender imbalance.
Authorities in China have employed strict control measures including closing live poultry markets and culling poultry in affected areas. Following these measures, the number of reported cases has dropped. It is not possible to determine at this point whether these new cases, reported since October, mark the resurgence of the outbreak. ECDC��s earlier risk assessment remains valid.
EU citizens travelling and living in China are strongly advised to avoid live bird markets. The risk of the disease spreading to Europe via humans is considered low. However, it is not unlikely that people presenting with severe respiratory infection in the EU and a history of potential exposure in the outbreak area will require investigation in Europe.
Actions
The Chinese health authorities continue to respond to this public health event with enhanced surveillance, epidemiological and laboratory investigation including scientific research. ECDC is closely monitoring developments. ECDC published an updated Rapid Risk Assessment on 8 May 2013. ECDC guidance for Supporting diagnostic preparedness for detection of avian influenza A(H7N9) viruses in Europe for laboratories was published on 24 April 2013.
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COMMUNICABLE DISEASE THREATS REPORT
Week 1, 29 December-4 January 2014
(...)
Influenza A(H7N9) - China - Monitoring human cases
Opening date: 31 March 2013 Latest update: 19 December 2013
Epidemiological summary
In March 2013, Chinese authorities announced the identification of a novel reassortant A(H7N9) influenza virus in patients in eastern China.
Since then, 148 cases of human infection with influenza A(H7N9) have been reported from:
- Zhejiang (51 cases),
- Shanghai (34),
- Jiangsu (27),
- Henan (4),
- Anhui (4),
- Beijing (2),
- Shandong (2),
- Fujian (5),
- Hunan (3),
- Jiangxi (5),
- Hebei (1),
- Guangdong (6),
- Hong Kong (2) and
- Taiwan (2).
In addition, the virus has been detected in one asymptomatic case in Beijing.
Most cases have developed severe respiratory disease. Forty-seven patients have died (case-fatality ratio=32%). The median age is 61 years, ranging from three to 91 years; 42 of 148 patients are female, with gender being unknown in five cases.
Thirteen cases have been reported in China since October 2013. Ten of these cases have occurred in previously affected provinces (Zhejiang and Guangdong), two cases have been reported in Hong Kong and one case in Taiwan. Both cases in Hong Kong and the case in Taiwan have visited mainland China prior to falling ill.
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ECDC assessment
Influenza A(H7N9) is a zoonotic disease that has spread in poultry in parts of eastern China, causing severe disease in humans. There is no evidence of sustained person-to-person transmission. Close to 3 000 contacts have been followed-up, and only a few are reported to have developed symptoms, as part of three small family clusters. Many unanswered questions remain regarding this disease, e.g. the reservoir, the route of transmission, the spectrum of disease and the reason for an unusual age��gender imbalance.
Authorities in China have employed strict control measures including closing live poultry markets and culling poultry in affected areas. Following these measures, the number of reported cases has dropped. It is not possible to determine at this point whether these new cases, reported since October, mark the resurgence of the outbreak. ECDC��s earlier risk assessment remains valid.
EU citizens travelling and living in China are strongly advised to avoid live bird markets. The risk of the disease spreading to Europe via humans is considered low. However, it is not unlikely that people presenting with severe respiratory infection in the EU and a history of potential exposure in the outbreak area will require investigation in Europe.
Actions
The Chinese health authorities continue to respond to this public health event with enhanced surveillance, epidemiological and laboratory investigation including scientific research. ECDC is closely monitoring developments. ECDC published an updated Rapid Risk Assessment on 8 May 2013. ECDC guidance for Supporting diagnostic preparedness for detection of avian influenza A(H7N9) viruses in Europe for laboratories was published on 24 April 2013.
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