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Influenza A(H7N9) - China - Monitoring human cases (ECDC/CDTR, February 14 2014, edited)

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  • Influenza A(H7N9) - China - Monitoring human cases (ECDC/CDTR, February 14 2014, edited)

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


    Week 7, 9-15 February 2014


    Influenza A(H7N9) - China - Monitoring human cases

    Opening date: 31 March 2013 Latest update: 13 February 2014

    Epidemiological summary

    In March 2013, a novel avian influenza A(H7N9) virus was detected in patients in China.

    Since then, human cases have continued to be reported, and as of 13 February 2014, there have been 338 laboratory-confirmed cases in China:
    1. Zhejiang (132),
    2. Guangdong (61),
    3. Shanghai (42),
    4. Jiangsu (39),
    5. Fujian (20),
    6. Hunan (11),
    7. Jiangxi (5),
    8. Henan (4),
    9. Anhui (6),
    10. Beijing (4),
    11. Shandong (2),
    12. Hebei (1),
    13. Guangxi (3),
    14. Guizhou (1),
    15. Hong Kong (4),
    16. Taiwan (2) and
    17. one case reported in Malaysia imported from China.

    In addition, the virus has been detected in one asymptomatic case in Beijing.

    Most cases have developed severe respiratory disease. Sixty-six patients have died (case-fatality ratio=19.5%).

    Since 15 October 2013, 204 cases have been reported, one case in Malaysia imported from China and 202 cases from China: Zhejiang (86), Guangdong (60), Fujian (15), Jiangsu (12), Shanghai (8), Hunan (8), Beijing (2), Guangxi (3), Guizhou (1), Anhui (2), Taiwan (1) and Hong Kong (5).


    ECDC assessment

    The continued and increasing transmission of a novel reassortant avian influenza virus, capable of causing severe disease in humans in one of the most densely populated areas in the world, is a cause for concern due to the pandemic potential. However, the most likely scenario for China is that this remains a local (but widespread) zoonotic outbreak, in which the virus is transmitted sporadically to humans in close contact with the animal reservoir, similar to the influenza A(H5N1) situation.

    The recent fatal case of influenza A(H5N1) imported to Canada and the recent imported case of influenza A(H7N9) in Malaysia provides support to the notion that imported cases of influenza A(H7N9) might also be seen in Europe. However, the risk of the disease spreading to Europe via humans in the near future is still considered low. People in the EU presenting with severe respiratory infection and a history of potential exposure in the outbreak area will require careful investigation in Europe.

    The risk of increased transmission of H7N9 viruses between humans is not negligible. European countries should continue to prepare for the eventuality of future pandemics, including one caused by A(H7N9).

    Preparedness activities should include the precautionary development of early human vaccine candidates and increased monitoring of animal influenzas at the animal��human interface.


    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 epidemiological update on 7 February 2014. ECDC published an updated Rapid Risk Assessment on 28 January 2014. ECDC published a guidance document for Supporting diagnostic preparedness for detection of avian influenza A(H7N9) viruses in Europe for laboratories on 24 April 2013.