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FAO H7N9 situation update January 09, 2019

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  • FAO H7N9 situation update January 09, 2019

    H7N9 situation update

    09 January 2019, 17:00 hours; Rome

    The next update will be issued on 06 February 2019

    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

    Hazard: Influenza A(H7N9) virus with pandemic potential.
    Country: China; imported cases in Malaysia (1) and Canada (2).
    Number of human cases: 1,567 confirmed; 615 deaths (since February 2013).
    New findings in birds / environment since last update (05 September 2018): 0

    New human cases since last update (05 September 2018): 0
    Note: H7N9 LPAI viruses have recently been reported in Japan as follows: Chiba Prefecture (October 2018; reference); Aichi Prefecture (December 2018; reference); and Izumi city, Kagoshima Prefecture [10 December 2018; reference1, reference2]. Preliminary analysis indicates that these H7N9 LPAI viruses are genetically different from the ones circulating in China (personal communication). The detection in Izumi, Kagoshima was confirmed in a water sample collected at a large crane wintering area; no evidence of infection in wild birds, such as cranes, or domestic poultry.

    Map. 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. Regarding the fifth wave (October 2016-September 2017), precise location of 20 human cases in Guangdong (1), Guangxi (1), Hebei (3), Hunan (1), Hubei (1), Jiangsu (1), Jiangxi (5), Zhejiang (2) and unknown (5) Provinces are currently not known, these cases are therefore not shown on the map.


    Provinces/municipalities affected: Beijing, Chongqing, Shanghai and TianjinMunicipalities; 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 (China); Sabah (Malaysia); British Columbia (Canada).

    Highly pathogenic virus findings: Since 10 January 2017, highly pathogenic avian influenza (HPAI) type H7N9 virus was detected in a total of 58 poultry or environmental samples (46 chickens, 2 duck and 10 environmental samples); H7N9 virus isolates from 32 human cases were found to be HPAI virus.


    Table. Number of locations testing positive for H7N9 HPAI virus (n=43) in birds and/or the environment, by province and sampling site as of 09 January 2019.
    Province
    LBM*
    Farm
    Backyard
    Airport
    Total
    Anhui
    1
    1
    Fujian
    1
    1
    Guangdong
    22
    22
    Guangxi
    1
    1
    Hebei
    1
    1
    Heilongjiang
    1
    1
    Henan
    1
    1
    Hunan
    3
    1
    1
    5
    Liaoning 0 1 0 0 1
    Inner Mongolia
    2
    2
    Ningxia Hui
    2
    2
    Shaanxi
    2
    2
    Shanxi
    1
    1
    Tianjin
    1
    1
    Unknown
    1
    1
    TOTAL
    26
    15
    1
    1
    43
    *LBM: live bird market

    Situation update

    Animals

    9 December 2018, Ministry of Agriculture and Rural Affairs (MARA), China issued an announcement listing six newly registered inactivated avian influenza recombinant (H5+H7) vaccines. These new vaccines are available since 9 December 2018 [reference]. The registered names, labels and inserts of the vaccines are available on the MARA website [reference].

    Since the beginning of wave 7 (1 October 2018), no H7N9 outbreak or H7N9 positive animal or environment findings were reported.

    Animal/environmental findings: Since 4 April 2013 around 2500 virological samples from the environment, chickens, pigeons, ducks, turkeys, a tree sparrow and a magpie robin tested positive; positives mainly from live bird markets, vendors and some commercial or breeding farms.
    Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 09 January 2019. Data include both high and low pathogenic H7N9 viruses.

    Click to enlarge

    Figure 2. Distributions of low* and highly pathogenic H7N9 virologically positive samples (nLPAI=246; nHPAI=43) collected from birds or the environment, by sampling location, between October 2016 and 09 January 2019. Samples from the same location and time are grouped.

    Click to enlarge - *may contain unconfirmed HPAI at the time of publishing

    Figure 3. Distributions of low* and highly pathogenic H7N9 virologically positive samples (nLPAI=280; nHPAI=49) collected from birds or the environment, by sample origin between October 2016 and 09 January 2019. Samples from the same origin, location and time are grouped.
    Click to enlarge - *may contain unconfirmed HPAI at the time of publishing


    Humans

    • Since the last update (07 November 2018), no human cases were reported.
    • For detailed informationon human cases, please refer to WHO report.
    Figure 4. Number of officially reported human cases since February 2013 as of 09 January 2019. Data include both high and low pathogenic H7N9 viruses

    Click to enlarge

    Figure 5. Incidence of officially reported human cases by month, based on onset date from October 2013 (Beginning of wave 2) to 09 January 2019. Both high and low pathogenic H7N9 viruses are included.

    Click to enlarge - Note: For cases with unknown onset dates from wave 2 (n=2), wave 3 (n=146), wave 4 (n=27) and wave 5 (n=55), reporting dates were used instead.


    Publications
    • Tanikawa, T., Uchida, Y., Takemae, N., Tsunekuni, R., Mine, J., Liu, M., […], & Saito, T. Pathogenicity of two novel human-origin H7N9 highly pathogenic avian influenza viruses in chickens and ducks. Archives of Virology, pp:1-11. [reference]. The relative infectivity of two H7N9 highly pathogenic avian influenza (HPAI) viruses, namely A/Guangdong/17SF003/2016 and A/Taiwan/1/2017, were experimentally evaluated in poultry, chickens and ducks. All chickens died within 2-5 days after inoculation, and the viruses replicated in most of the internal organs examined. Conversely, none of the ducks inoculated with either virus displayed any clinical signs, and less-efficient virus replication and less shedding were observed in ducks compared to chickens.
    • Huang, K.A., Rijal, P., Jiang, H., Wang, B., Schimanski, L., Dong, T., […], & Townsend, A.R. Structure-function analysis of neutralizing antibodies to H7N9 influenza from naturally infected humans. Nature Microbiology. 2018 November 26. [reference]. In this study, 73 H7-reactive monoclonal antibodies from four donors infected in 2013 and 2014 were isolated and characterized. Neutralization capacity of these antibodies against different H7N9 isolates from 2013 and 2017 was analysed. Findings indicate that few monoclonal antibodies from the four donors retained activity for the Yangtze River Delta lineage viruses isolated in 2016-2017 that have undergone antigenic change.
    • Ma, M.J., Yang, Y., & Fang, L.Q. Highly Pathogenic Avian H7N9 Influenza Viruses: Recent Challenges. Trends in Microbiology. 2018 December 12. pii: S0966-842X(18)30258-0. [reference]. This review addresses novel H7N9 highly pathogenic avian influenza (HPAI) viruses of the fifth epidemic wave that infect humans and poultry. Recently, H7N9 HPAI viruses have evolved into different genotypes, exhibited heightened virulence in mammals, and extended their host range.
    • Li, Y., Wang, Y., Shen, C., Huang, J., Kang, J., Huang, B., Guo, F., & Edwards, J. Closure of live bird markets leads to the spread of H7N9 influenza in China. PloS one, 13(12), 2018 December, e0208884. [reference]. The role of live bird market (LBM) closure on the spread of N7N9 influenza following the closure of LBMs during March to May 2013 (the first wave) and October 2013 to March 2014 (the second wave) is described in this paper. Findings presented provide evidence that the closure of LBMs in early waves of H7N9 influenza had resulted in expansion of H7N9 infection to uninfected areas.
    • Pu, Z., Xiang, D., Li, X., Luo, T., Shen, X., Murphy, R. W., Liao, M., & Shen, Y. Potential Pandemic of H7N9 Avian Influenza A Virus in Human. Frontiers in cellular and infection microbiology, 8, 414. [reference]. The authors compiled amino acid changes required for avian influenza viruses to infect humans: 58 were listed, that can be found in very high proportions in H7N9 viruses isolated from both humans and poultry. Most of the amino acid changes in H7N9 appear to originate from H9N2.
    FAO actions
    • Report of the WHO Vaccine Composition Meeting September [link] and February 2018 [link]
    • A webinar entitled “Pros and cons of avian influenza vaccination” was presented by Leslie Sims on 14 May 2018 with technical support from FAO HQ. A recording of the webinar is available [link].
    • FAO published a risk assessment update entitled, “Chinese-origin H7N9 avian influenza: spread in poultry and human exposure” [reference]
    • FAO guidance and risk assessments are available on a dedicated website [link]
    • Liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.
    FAO’s support to countries

    http://www.fao.org/ag/againfo/progra...on_update.html
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela
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