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China - FAO H7N9 situation update: 1580 confirmed cumulative human cases, including 608 deaths - July 12, 2017

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  • China - FAO H7N9 situation update: 1580 confirmed cumulative human cases, including 608 deaths - July 12, 2017

    12 July 2017, 12:00 hours; Rome

    The next update will be issued on 26 July 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: 1580 confirmed; 609 deaths (since February 2013).

    Number of new findings in birds or the environment since last update (28 June 2017): 0
    Number of new human cases since last update (28 June 2017): 12

    Provinces/municipalities: Beijing, Chongqing, Shanghai and Tianjin Municipalities; Anhui, Fujian, Gansu, Guangdong, Guizhou, Hebei, Heilongjiang, 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 48 poultry or environmental samples (37 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 8 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]), Tianjin (a chicken layer farm [reference]), Inner Mongolia (two chicken layer farms [reference 1, reference 2] and Heilongjiang (a chicken layer farm [reference]) Provinces.
    Out of the 1580 confirmed human cases, H7N9 virus isolates from 25 human cases (including one from Taiwan Province) 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 30 human cases in Anhui (2), Beijing (2), Guangdong (1), Guangxi (1), Hebei (3), Hunan (1), Hubei (2), Jiangsu (2), Jiangxi (6), Sichuan (2), Zhejiang (3) and unknown (5) Provinces are currently not known, these cases are therefore not shown on the map.



    Situation update

    Animals

    • 5 July, Guangdong: Guangzhou City Food and Drug Administration in conjunction with the Municipal Bureau of Agriculture, Municipal Health Commission, the Municipal Trade and Industry Bureau and the Municipal Commission of Commerce, Municipal Management Committee and other relevant departments announced the expansion of the live poultry restricted area from 1 August 2017 for a period of 5 years. [reference 1]. [reference 2].
    • 10 July: The Chinese Ministry of Agriculture (MoA) has decided to implement nation-wide H7N9 poultry vaccination beginning in September 2017. All chickens, ducks, geese, and domestic quail, pigeons, and rare birds will be affected. Those poultry found in AI free zones or to be used for export purpose can apply for exemption of vaccination from the corresponding provincial veterinary authority. [reference 1].
    Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 12 July 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

    Click to enlarge

    Humans

    • Since the last update (28 June 2017), 12 new human cases have been reported in Yunnan (4), Guizhou (1), Shanxi (1), and Xinjiang (1). For 5 cases the location is currently unknown.

    Figure 2. Number of officially reported human cases since February 2013 as of 12 July 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 12 July 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=188) reporting dates were used instead.

    Publications

    • A rapid communication from Eurosurveillance compares the demographical, epidemiological, and clinical characteristics between the HPAI and LPAI A(H7N9) human cases in Guangdong from 2016 to 2017. Case fatality and severity were similar. Touching sick or dead poultry was the most important risk factor for HPAI A(H7N9) infections and should be highlighted for the control of future influenza A(H7N9) epidemics. [reference].
    • A cross sectional study was conducted using all 40 live bird markets within the Chittagong Metropolitan Area of Bangladesh, targeting demographic information and hygienic status of LBMs in concurrence with avian influenza virus (AIV) prevalence and its subtype distribution, as well as the associated risk factors for avian influenza virus. The results suggest that housing chickens and ducks together in the stalls, birds kept on floors, and lack of adequate hygienic measures of the stall were the crucial factors for spreading AIV. This research outcome could be used to develop a proof-based program concerning environmental sanitation along with development of an effective surveillance system to reduce the AIV transmission through LBMs in Bangladesh. [reference].

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