China - FAO H7N9 situation update: 1552 confirmed cumulative human cases, including 596 deaths - June 14, 2017

[sharon sanders]

H7N9 situation update

14 June 2017, 12:00 hours; Rome

The next update will be issued on 28 June 2017

Disclaimer

Information provided herein is current as of the date of issue. Information added or changed since the last H7N9 situation update appears in red. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health, Provincial Government websites; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisation for Animal Health [OIE]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.


Overview

Situation: Influenza A(H7N9) virus with pandemic potential.
Country: China; three human cases originated in China and were reported in Malaysia (1) and Canada (2).
Number of human cases: 1552 confirmed; 596 deaths (since February 2013).
Number of new findings in birds or the environment since last update (7 June 2017): 3
Number of new human cases since last update (7 June 2017): 10
Provinces/municipalities: Beijing, Chongqing, Shanghai and Tianjin Municipalities; Anhui, Fujian, Gansu, Guangdong, Guizhou, Hebei, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning, Qinghai, Shaanxi, Shanxi, Shandong, Sichuan, Taiwan, Yunnan and Zhejiang Provinces; Hong Kong SAR; Macao SAR, Guangxi, Inner Mongolia, Ningxia Hui, Tibet and Xinjiang Uyghur Autonomous Regions; Sabah (Malaysia); British Columbia (Canada).
Animal/environmental findings: around 2,500 virological samples from the environment, chickens, pigeons, ducks and a tree sparrow tested positive; positives mainly from live bird markets, vendors and some commercial or breeding farms.
Highly pathogenic virus findings: The H7N9 highly pathogenic avian influenza virus was detected in a total of 45 poultry or environmental samples (34 chickens, 1 duck and 10 environmental samples) from 23 live bird markets (LBMs) in: Fujian (Longyan City), Guangdong (Dongguan, Guangzhou, Huizhou, Lufeng, Meijiang, Meizhou, Zhongshan Cities and Haifeng County), Hunan (Chenzhou City) and Guangxi (Guilin City) Provinces; and from 7 farms in: Guangxi (Guilin City), Hebei (a chicken layer farm [reference]), Henan (a chicken layer farm in Pingdingshan City [reference]), Hunan (backyard in Chenzhou City and a large chicken layer farm in Yongzhou City [reference]), Shaanxi (a chicken layer farm [reference]), and Tianjin (a chicken layer farm [reference]) Provinces.


Out of the 1552 confirmed human cases, H7N9 virus isolates from three human cases (two from Guangdong and one from Taiwan Provinces) were found to be highly pathogenic for chickens.


FAO actions: liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication. Map 1. Human cases and positive findings in birds or the environment

Click to enlarge - Note: Human cases are depicted in the geographic location where they were reported; for some cases, exposure may have occurred in a different geographic location. Precise location of 24 human cases in Anhui (2), Beijing (2), Guangdong (1), Guangxi (1), Hebei (3), Hunan (1), Hubei (2), Jiangsu (1), Jiangxi (6), Sichuan (2) and Zhejiang (3) Provinces are currently not known, these cases are therefore not shown on the map.



Situation update

Animals

• 12 June, Inner Mongolia: The outbreak observed in Jiuyuan District, Baotou City on 5 June in a chicken layer farm (3,850 sick birds and 2,056 deaths) was confirmed to be due to H7N9 virus. 52,967 poultry have been culled to limit the spread of the virus [reference].

• 8 June, Inner Mongolia: The outbreak observed on 31 May in a chicken layer farm of Saihan District, Hohhot City was confirmed to be due to H7N9 virus. During the outbreak 59,565 birds showed clinical signs of which 35,526 died. To prevent further spread of the disease 371,230 poultry have been culled [reference].

• 5 June: The Ministry of Agriculture of China released the H7 vaccination program that will start from early July in Guangdong and Guangxi Provinces, where both H7N9 LP and HP are co-circulating. A recombinant bivalent (H5 + H7) inactivated vaccine will be used. Breeding farms in other provinces may carry out H7 vaccination following approval by the local veterinary authorities; provincial veterinarians are authorized to conduct emergency H7 vaccination to facilitate outbreak control [reference].

• 2 June, Guangdong: An n expert discussion including both public and private business representatives was held to put forward opinions on: H7N9 prevention and control, improvement of market suspension system, live poultry operations and transformation of live poultry wholesale (farmers) markets [reference].

• 17 May: The Agriculture and Finance Ministries issued a joint policy notice regulating subsidies in relation to compulsory vaccination and forced culling due to key diseases (e.g. under forced culling for H7N9 an average of 15 Yuan will be paid per bird) [reference].

Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 14 June 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Click to enlarge

Humans

• Since the last update (7 June 2017), 10 new human cases have been reported in Beijing (3*), Anhui (2), Henan (2), Chongqing (1), Jiangsu (1), Shandong (1). * including patients from other provinces.

• For detailed information on human cases, please refer to WHO's Disease Outbreak News.

Figure 2. Number of officially reported human cases since February 2013 as of 14 June 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Click to enlarge

Figure 3. Incidence of officially reported human cases by month, based on onset date as of 14 June 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Click to enlarge - Note: For cases with unknown onset dates from wave 1 (n=7), wave 2 (n=2), wave 3 (n=146), wave 4 (n= 27) and wave 5 (n=209) reporting dates were used instead.

Publications

• In addition to the surveillance findings by MoA and MoH, 1,728 virologically positive samples have also been reported in 12 peer-reviewed articles (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12). A total of 71,920 samples have been collected in these studies since April 2013, of which 1,728 (2.4%) were positive for H7N9 (1,215 environmental samples, 501 chickens, 1 goose and 1 tree sparrow).
• A duplex real-time reverse transcription polymerase chain reaction (rRT-PCR) assay was developed to distinguish between highly and low pathogenic H7 virus. The data showed that the new method is sensitive, gave specific results in detecting novel highly pathogenic H7 virus and thus will play an important role in the rapid identification of novel highly pathogenic H7 virus [reference].

FAO?s support to countries

• FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion
• FAO is providing surveillance and sampling guidance for South and Southeast Asia
• Funding to date: US$ 8.1 million mobilized (US$ 6.7 million USAID, US$ 1.9 million TCPs)

http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/situation_update.html