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FAO - H7N9 situation update September 2019 - no new cases

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  • FAO - H7N9 situation update September 2019 - no new cases

    H7N9 situation update

    04 September 2019, 17:00 hours; Rome
    The next update will be issued on 02 October 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: 1,568 confirmed; 616 deaths (since February 2013).
    New findings in birds / environment since last update (07 August 2019): 0

    New human cases since last update (07 August 2019): 0
    Map. Human cases and positive findings in birds or the environment in China

    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 period (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=44) in birds and/or the environment, by province and sampling site as of 04 September 2019.
    Province
    LBM*
    Farm
    Backyard
    Others**
    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 1 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
    2 44
    *LBM: live bird market; **Others include one airport and one zoo.

    Situation update

    Animals

    Since the last update (07 August 2019), 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, peacocks, 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 04 September 2019

    Click to enlarge - Data include both high and low pathogenic H7N9 viruses.


    Figure 2. Distributions of low* and highly pathogenic H7N9 virologically positive samples (nLPAI=246; nHPAI=44) collected from birds or the environment, by sampling location, between October 2016 and 04 September 2019. Samples from the same location and time are grouped.

    Click to enlarge - Note: * May contain unconfirmed HPAI at the time of publishing.


    Figure 3. Distributions of low* and highly pathogenic H7N9 virologically positive samples (nLPAI=280; nHPAI=50) collected from birds or the environment, by sample origin between October 2016 and 04 September 2019. Samples from the same origin, location and time are grouped.

    Click to enlarge - Note: * May contain unconfirmed HPAI at the time of publishing.



    Humans
    • Since the last update (07 August 2019), no human cases were reported.
    • For detailed information on human cases, please refer to WHO report.
    Figure 4. Number of officially reported human cases since February 2013, as of 04 September 2019

    Click to enlarge - Data include both high and low pathogenic H7N9 viruses.


    Figure 5. Incidence of officially reported human cases by month, based on onset date from October 2014 (beginning of period 3) to 04 September 2019

    Click to enlarge - Note: For cases with unknown onset dates from period 2 (n=2), period 3 (n=146), period 4 (n=27) and period 5 (n=55), reporting dates were used instead. Both high and low pathogenic H7N9 viruses are included.



    Publications
    • Qiu Y, Sun R, Hou G, Yu X, Li Y, Li J, Zhang Q, Zou F, Liu H, Jiang W. Novel reassortant H7N2 originating from the H7N9 highly pathogenic avian influenza viruses in China, 2019. J Infect. 2019 Aug 29. pii: S0163-4453(19)30256-7. doi:10.1016/j.jinf.2019.08.016. [reference] This study reports the emergence of a new reassortment of H7N2 AIV with novel viral characteristics and warns of the challenge still faced to control zoonotic H7N9 AIVs and their reassortants.
    • Cui B, Wang LD, Ke J, Tian Y. Chinese poultry farmers' decision-making for avian influenza prevention: a qualitative analysis. Zoonoses Public Health. 2019 Sep;66(6):647-654. doi: 10.1111/zph.12617. Epub 2019 Jun 18.[reference] In this study, authors elicited insight into the underlying factors influencing Chinese poultry farmers' protective behaviours in response to the risk of A/H5N1 and A/H7N9. The findings suggest Chinese poultry farmers weighted more attention on the risk of poultry infection which was highly associated with economic losses. The government should build and improve an early AI warning and information transmission network to poultry farmers. Further reinforcement of related self-protective and preventive knowledge training towards poultry farmers is necessary.
    • Lee DH, Killian ML, Torchetti MK, Brown I, Lewis N, Berhane Y, Swayne DE. Intercontinental spread of Asian-origin H7 avian influenza viruses by captive bird trade in 1990's. Infect Genet Evol. 2019 Sep;73:146-150. doi: 10.1016/j.meegid.2019.04.028. [reference] In this study, authors sequenced H7 viruses isolated from quarantine facilities and aviaries using next-generation sequencing and conducted a comparative phylogenetic analysis of complete genome sequences to elucidate spread patterns. The sequencing and analysis suggested that H7 viruses originated from a common source, even though they were obtained from birds in distant geographical regions. All H7N1 and H7N8 viruses were LPAIV, except a H7N1 highly pathogenic AIV (HPAIV), A/Pekin robin/California/30412/1994(H7N1) virus. The results support the continued need for regulation of the captive wild bird trade to reduce the risk of introduction and dissemination of both LPAIV and HPAIV throughout the world.
    • Xiong J, Zhao P, Yang P, Yan Q, Jiang L. Evolutionary dynamics of the H7N9 avian influenza virus based on large-scale sequence analysis. PLoS One. 2019 Aug 12;14(8):e0220249. doi: 10.1371/journal.pone.0220249. eCollection 2019. [reference] This study investigated the evolution of H7N9 avian influenza A viruses (AIVs) at the population level. Compared to H7 and N9 before 2013, there were 18 and 24 substitutions in the majority of novel H7N9 AIVs, respectively. On an overall scale, the evolution of H7 and N9, both in terms of time distribution and host species, is under negative selection. However, both in HA and NA, several sites were under positive selection. It is necessary to strengthen the surveillance of novel H7N9 AIVs, both in human and bird population to determine whether a new virus has emerged through selection pressure and to prevent future epidemics from occurring.
    FAO actions
    • Report of the WHO Vaccine Composition Meeting – February 2019 [link]
    • FAO published a risk assessment update entitled, “Chinese-origin H7N9 avian influenza: spread in poultry and human exposure” [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 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

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