Tweet
H7N9 situation update
02 October 2019, 17:00 hours; Rome
The next update will be issued on 06 November 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 (04 September 2019): 21
New human cases since last update (04 September 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. During period 7 (October 2018-September 2019), 8 positive samples were detected in the exact same location in Liaoning Province (see map). For 14 samples from Inner Mongolia Autonomous Region the precise geographic location is currently unknown; these findings 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 66 poultry or environmental samples (46 chickens, 8 peacocks, 2 duck and 10 environmental samples); H7N9 virus isolates from 32 human cases were found to be HPAI virus.
Table 1. Number of locations testing positive for H7N9 HPAI virus (n=44) in birds and/or the environment, by province and sampling site as of 02 October 2019.
*LBM: live bird market; **Others include one airport and one zoo.
Situation update
Animals
11 September: MARA published the results of monthly post vaccination surveillance for the period January-June 2019. During this period, 22 virological samples tested positive for H7N9 virus: 8 samples collected from peacocks during the H7N9 HPAI outbreak in Liaoning Province in March (reported earlier) and 14 chicken samples collected in Inner Mongolia Autonomous Region in April. Samples were taken in 28 administrative regions during the period January-June 2019. However, the selection of administrative regions for sampling slightly varied from one month to another. The table below summarizes the post-vaccination surveillance results by month. [reference 1, reference 2, reference 3, reference 4, reference 5, reference 6].
Table 2. Post vaccination monitoring results in China during the period January to June 2019, by month.
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 02 October 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 02 October 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=281; nHPAI=50) collected from birds or the environment, by sample origin between October 2016 and 02 October 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
Figure 4. Number of officially reported human cases since February 2013, as of 02 October 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 02 October 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
02 October 2019, 17:00 hours; Rome
The next update will be issued on 06 November 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 (04 September 2019): 21
New human cases since last update (04 September 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. During period 7 (October 2018-September 2019), 8 positive samples were detected in the exact same location in Liaoning Province (see map). For 14 samples from Inner Mongolia Autonomous Region the precise geographic location is currently unknown; these findings 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 66 poultry or environmental samples (46 chickens, 8 peacocks, 2 duck and 10 environmental samples); H7N9 virus isolates from 32 human cases were found to be HPAI virus.
Table 1. Number of locations testing positive for H7N9 HPAI virus (n=44) in birds and/or the environment, by province and sampling site as of 02 October 2019.
| Province | LBM* | Farm | Backyard | Others** | Total |
| Anhui | 0 | 1 | 0 | 0 | 1 |
| Fujian | 1 | 0 | 0 | 0 | 1 |
| Guangdong | 22 | 0 | 0 | 0 | 22 |
| Guangxi | 0 | 1 | 0 | 0 | 1 |
| Hebei | 0 | 1 | 0 | 0 | 1 |
| Heilongjiang | 0 | 1 | 0 | 0 | 1 |
| Henan | 0 | 1 | 0 | 0 | 1 |
| Hunan | 3 | 1 | 1 | 0 | 5 |
| Liaoning | 0 | 1 | 0 | 1 | 2 |
| Inner Mongolia | 0 | 2 | 0 | 0 | 2 |
| Ningxia Hui | 0 | 2 | 0 | 0 | 2 |
| Shaanxi | 0 | 2 | 0 | 0 | 2 |
| Shanxi | 0 | 1 | 0 | 0 | 1 |
| Tianjin | 0 | 1 | 0 | 0 | 1 |
| Unknown | 0 | 0 | 0 | 1 | 1 |
| TOTAL | 26 | 15 | 1 | 2 | 44 |
Situation update
Animals
11 September: MARA published the results of monthly post vaccination surveillance for the period January-June 2019. During this period, 22 virological samples tested positive for H7N9 virus: 8 samples collected from peacocks during the H7N9 HPAI outbreak in Liaoning Province in March (reported earlier) and 14 chicken samples collected in Inner Mongolia Autonomous Region in April. Samples were taken in 28 administrative regions during the period January-June 2019. However, the selection of administrative regions for sampling slightly varied from one month to another. The table below summarizes the post-vaccination surveillance results by month. [reference 1, reference 2, reference 3, reference 4, reference 5, reference 6].
Table 2. Post vaccination monitoring results in China during the period January to June 2019, by month.
| Reporting period (2019) | #serum samples collected | Average post-vaccination monitoring immunization rate (target 70%) | #virological samples collected | #H7N9 positive virological samples |
| January | 126 998 | 92.36 | 34 815 | 0 |
| February | 66 572 | 94.84 | 17 042 | 0 |
| March | 85 973 | 94.19 | 21 975 | 8 |
| April | 87 940 | 93.03 | 16 980 | 14 |
| May | 96 152 | 95.39 | 13 029 | 0 |
| June | 189 453 | 95.34 | 26 767 | 0 |
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 02 October 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 02 October 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=281; nHPAI=50) collected from birds or the environment, by sample origin between October 2016 and 02 October 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 (04 September 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 02 October 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 02 October 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
- Ma, J., Yang, N., Gu, H., Bai, L., Sun, J., Gu, S., & Gu, J. Effect of closure of live poultry markets in China on prevention and control of human infection with H7N9 avian influenza: a case study of four cities in Jiangsu Province. Journal of Public Health Policy, 2019 September 16. [reference]. The objective of this study was to assess the impact of live poultry markets (LPMs) closure on reducing zoonotic transmission of H7N9 avian influenza (AI) virus in four cities of Jiangsu Province and to make specific recommendations on the duration of closure. Results show that the closure of LPMs can effectively control the spread of H7N9 AI and reduce the incidence of human infection. If cases of H7N9 avian influenza continue to occur, LPMs should close for at least 3-4 weeks in susceptible areas to control the spread of infection.
- Inui, K., Nguyen, T., Tseng, H.J., Tsai, C.M., Tsai, Y.L., Chung, S., […], & Claes, F. A field-deployable insulated isothermal RT-PCR assay for identification of influenza A (H7N9) shows good performance in the laboratory. Influenza and other respiratory viruses, 2019 September 5. [reference]. The study assessed the analytical and diagnostic sensitivity and specificity of the portable iiRT‐PCR for H7N9 virus detection. The H7 and N9 iiRT‐PCR reagents yielded comparable levels of analytical sensitivity and specificity with real‐time RT‐PCR for the detection of H7N9 virus.
- Li, J., Chen, C., Wei, J., Huang, H., Peng, Y., Bi, Y., Liu, Y., Yang, Y. Delayed peak of human infections and ongoing reassortment of H7N9 avian influenza virus in the newly affected western Chineses provinces during Wave Five. International Journal of Infectious Diseases, 2019 September 6. pii: S1201-9712(19)30363-7. [reference]. This study aimed at analyzing the epidemiological and virological characteristics of the outbreaks that occurred in western provinces of China during the fifth wave. A delayed peak of human infections was observed in the newly affected western Chinese provinces, and reassortment has been ongoing since the introduction of H7N9 viruses. Almost all of these viruses originated from eastern and southern China, and were most possibly imported from neighboring provinces.
- 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 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)
- Comments: EMPRES-Animal Health
- ? FAO, 2019
- Updated on: 2 October 2019