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Influenza A(H7N9) - China - Monitoring human cases (ECDC/CDTR, January 13 2014): New Outbreak Wave underway

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  • Influenza A(H7N9) - China - Monitoring human cases (ECDC/CDTR, January 13 2014): New Outbreak Wave underway

    [Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]


    COMMUNICABLE DISEASE THREATS REPORT

    Week 2, 5-11 January 2014

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    Influenza A(H7N9) - China - Monitoring human cases

    Opening date: 31 March 2013 Latest update: 9 January 2014


    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, 156 cases of human infection with influenza A(H7N9) have been reported from: Zhejiang (52 cases), Shanghai (35), Jiangsu (28), Henan (4), Anhui (4), Beijing (2), Shandong (2), Fujian (5), Hunan (3), Jiangxi (5), Hebei (1), Guangdong (10), Hong Kong (3) and Taiwan (2).

    In addition, the virus has been detected in one asymptomatic case in Beijing. Most cases have developed severe respiratory disease.

    Forty-nine patients have died (case-fatality ratio=31%).

    Twenty-one cases have been reported since October 2013. Seventeen of these cases have occurred in previously affected provinces (Zhejiang, Shanghai, Jiangsu and Guangdong).

    Three of the cases have been reported in Hong Kong and one case in Taiwan. Both the 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.

    There is an increasing number of cases reported from China since October signalling perhaps a new wave of the outbreak. However, this is not unexpected and the majority of patients live in areas where the virus has previously been detected and have had contact with poultry. There is no sign of sustained human-to-human transmission.

    EU citizens travelling to and living in China are strongly advised to avoid live bird markets. The risk of the disease spreading to Europe via humans is considered to be 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 and a guidance for Supporting diagnostic preparedness for detection of avian influenza A(H7N9) viruses in Europe for laboratories on 24 April 2013.

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