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China - FAO H7N9 situation update: 1584 confirmed cumulative human cases, including 612 deaths - August 23, 2017

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  • China - FAO H7N9 situation update: 1584 confirmed cumulative human cases, including 612 deaths - August 23, 2017

    H7N9 situation update

    23 August 2017, 12:00 hours; Rome

    The next update will be issued on 20 September 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: 1584 confirmed; 612 deaths (since February 2013).

    Number of new findings in birds or the environment since last update (26 July 2017): 0
    Number of new human cases since last update (26 July 2017): 2

    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 in Xingtai City [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 in Hohhot and Baotou Cities [reference 1, reference 2] and Heilongjiang (a chicken layer farm in Shuangyashan City [reference]) Provinces.

    Out of the 1584 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

    • 10 July, the Ministry of Agriculture (MOA) circulated the Notice on Autumn National HPAI Immunization Campaign, including vaccination against H5 and H7. Earlier, MOA completed their H5-H7 bivalent vaccine evaluation and released technical standards [reference 1] [reference 2].
    • 22 August, Anhui, Henan, Zhejiang Provinces and Ningxia Hui Autonomous Region released 2017 Autumn immunization plans, including vaccination against H7N9 [reference 1] [reference 2] [reference 3] [reference 4].
    Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 23 August 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

    Click to enlarge

    Humans

    • Since the last update (26 July 2017), 2 new human cases have been reported in Fujian (1) and Hunan (1) [reference 1] [reference 2].
    • 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 23 August 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 23 August 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=189) reporting dates were used instead.

    Publications

    • Live bird markets (LBMs) play a significant role in the ecology and zoonotic transmission of avian influenzas (AIs) including H5N1 and H7N9. To mitigate risks for H7N9 and other zoonotic AIs, Viet Nam is considering temporary closures of LBMs as a policy. However, little is known about how poultry traders may react, and whether trading may emerge outside formal marketplaces. A Stakeholder Survey on Live Bird Market Closures Policy was conducted, the results showed that trading outside formal markets is very likely to occur in the event of a temporary LBM market closure; traders can trade poultry in many locations. The results indicate that simplifying of the poultry value chain along with strict enforcement, engagement of stakeholders, and adequate communication would be a necessary prerequisite before market closure could be an effective policy [reference].
    • A social-anthropological study presenting a systematic review of the scientific literature relating to practices exposing humans to AIVs in Asia and Egypt, to identify poultry exposure practices associated with human infection, describe their prevalence within human populations, and examine the rationales for persistence. It recognizes that the analytical category ?practice(s)? as deployed in the literature reviewed largely ignores the social, economic, and cultural context(s) and the subjective meanings of such ?practices? for the ?practitioners? [reference].
    • 2016/17 was the fifth winter season in the Northern Hemisphere with human cases caused by A(H7N9) infections. During this wave, the number of human cases has been higher than in previous waves and accounts for 48 percent of the human cases reported since 31 March 2013. The higher number of cases is most likely due to greater environmental contamination in LBMs and increased circulation of the virus among poultry. In contrast to the situation observed during the summer months in previous years, A(H7N9) viruses are continuously circulating in the poultry population, with transmission to humans causing a substantial number of cases [reference].
    • To understand the adoption of protective behaviour during an H7N9 emergency, the factors determining an individual's response to official recommended protective measures were analysed, based on the Health Belief Model and the Protective Action Decision Model. A public survey data involving 1,375 respondents conducted in Anhui Province during 2013 was used to test the research model and hypotheses. The results indicate that: protective, stakeholder, and risk perceptions influence positively an individual's willingness to take recommended actions; protective and stakeholder perceptions also have a positive bearing on lay people's risk perceptions; and a stakeholder perception is a vital determinant of a protective perception. More importantly, the effects of protective and stakeholder perceptions on behavioural responses to recommendations are mediated in part by risk perception [reference].

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  • #2
    We have the 2 additional cases above listed on our case list.

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