China - 14 confirmed cases of human infection with H7N9 avian influenza - Five fatalities March 31 - April 4

[sharon sanders]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Also please see:

China - Emergency room seeing 20-30% more patients than normal due to pneumonia, fever in Suzhou, Jiangsu province - March 12

China - Hospitals crowded due to respiratory illnesses in Lu'an, Anhui province - seasonal period blamed - March 15

China - How to distinguish between the common cold and influenza epidemic by Shanghai gov March 14, 2013

China arrests & fines 4 internet users for spreading "epidemic" rumours in Hangzhou, Zhejiang province - March 23

China - Boy, 14, grave condition from viral encephalitis in Zhejiang province - March 23

[Diane Morin]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Machine translation

Extract:

Shanghai two male patients had died in the early March (edit - "May" is not translated properly s.), the two sons of the 87-year-old patients the last month serious pneumonia Yiyin the admission, of which one person died, the cause is still under investigation and detection.

http://hk.news.yahoo.com/%E5%85%A7%E5%9C%B0%E6%9C%89%E4%BA%BA%E6%9F%93h7n9%E5%85%A8%E7%90%83%E9%A6%96%E6%AC%A1-3%E6%82%A3%E8%80%852%E6%AD%BB-115000465.html

More:

http://www.epochtimes.com/b5/13/3/31/n3835736p.htm

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

The Chinese Center for Disease Control notified the WHO of the developments, specifying that the delay in announcing the result was caused by the amount of time it took to determine the source of the illness.http://rt.com/news/new-avian-flu-deaths-118/

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Taiwan-Mainland China, Shanghai, Anhui infected with the H7N9 avian flu, the CDC has been upgraded to the airport and port quarantine and bio-security measures, to remind the medical community to be vigilant, and called for overseas people to pay attention to prevent

According to the message of the March 31 release of the Chinese mainland health and birth control committee on March 30 to confirm the three people infected with the H7N9 avian influenza virus, in which two people died and one was dying, and in some cases had contact with poultry, and 3 of the world is not epidemiological association. Disease Control has stepped up to the Chinese mainland, Hong Kong and Macau, quarantine and monitoring as fever within 10 days of travel to the Chinese mainland, and history of exposure with the birds, will be sent to hospital for examination and inspection, to the exclusion of infected poultry flu so far.
The Centers for Disease Control and the circular issued by the medical community, to remind physicians for unexplained cases of severe pneumonia, pneumonia clustering, health care workers infected with unexplained pneumonia and other events, health authorities should be informed, and to strengthen the hospital infection control measures.
Council and remind people to mainland China, should avoid contact with birds, especially not to pick up the bird carcasses; consumption of chickens, ducks, geese (including eggs) need to pay attention to is completely cooked; hand-washing and other personal hygiene measures and should be implemented in order to to avoid infection. Provide appropriate return, such as fever or flu-like symptoms, you should inform the airline staff and airport and port quarantine officers; After returning to China, such as the above symptoms should wear a mask as soon as possible for medical treatment, and told the doctor that travel history, purpose in order to physician medical services. 　　The three infected with the H7N9 avian influenza virus, namely Shanghai, a 87-year-old and 27-year-old male patient, respectively, on February 19 and February 27, incidence, and died on March 4 and March 10; another Chuzhou City, Anhui Province, a man-made, 35-year-old female, March 15, the disease, is currently in critical condition.
Mainland China Disease Prevention and Control Center on March 29 from the H7N9 avian flu virus isolated specimen cases. The three cases were respiratory tract infection symptoms such as fever, cough, and then severe pneumonia and breathing difficulties. 3 of the world is not found epidemiological association. 　
　Based on agricultural authorities monitoring data, Taiwan poultry H7 avian influenza virus strains H7N3 and H7N7, has not been detected in the H7N9 influenza virus. CDC exercises had been testing in October 2012 starting and ending more than three thousand cases of influenza-like specimens, not yet detected the H7N9 influenza virus; another over the same period of the the 136 unexplained pneumonia specimens tested, three of them detected the H3N2 virus a detection of the H1N1 virus were not detected H7N9 influenza virus. 　　Area the international tourism information see the council website (http://www.cdc.gov.tw) information about the latest outbreak tourism infectious diseases, or call toll-free people Outbreak Communications and advice line 1922 to inquire If your phone can not dial a short code phone number, please dial 0800-001922 epidemic prevention hotline.http://www.doh.gov.tw/CHT2006/DM/DM2...1&doc_no=88070

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Nice find, IOH. That answers several important questions, but many things remain unanswered. Most importantly, it means that at least 2 of the 3 cases had direct animal contact, making it less likely that these are the most severe cases of a large, mild, human epidemic.

The other piece of information we might get soon that will help us explain this mystery is the sequence of the H7N9 virus itself. Is it a purely avian virus, or has it reassorted to pick up any human or swine genes? I cannot also help but notice Shanghai is the location of the pile of dead pigs in a river:

China - A report of 15,000 dead pigs found floating in Shanghai river


It would be interesting to see if they have been tested for this virus as well.

It is also unusual for an influenza virus (other than H5N1) to have such a high apparent fatality rate. If there are not large numbers of milder cases, this virus seems to have a fatality rate closer to that of H5N1 than that of other human infections with swine or avian flu viruses.

Hong Kong experts: mainland necessary acquisition Huangpu River the dead pigs sample investigation of avian flu

Hong Kong infectious disease expert said, the the Mainland first time h7n9 avian flu human cases of infection, a high probability of virus variants monitor cases of human infection may also occur in the future.

Shanghai and Anhui reported human infection h7n9 bird flu cases, two deaths in patients in critical condition, media reports said it was the first time human infection h7n9 virus. Big infection in Hong Kong and Hong Kong, and Director of the Centre for Infectious Diseases, Ho Pak-leung said, the past human infection with avian influenza type Mainland, mainly belonging to h5 category.


Ho Pak-leung: "So this is transmitted to humans are special varieties of avian flu virus is likely to show the place has begun to appear the epidemiological transition. Because human transmission of the virus causing death, so this kinds of viruses with low pathogenic h7n9 previously found in the gene level, what is the difference, it will not be involved in some completely different genes, which have led to infect humans, such information is quite critical. "

Ho Pak-leung also said that, the h7n9 virus may be lurking in some birds, but not enough to make these birds incidence or death, cases of human infection may also occur in the future.

Ho Pak-leung: "assumes that the birds, for example, duck and goose categories already Pu exists for it there and then transmitted to the human risk, if people in contact with birds, health is not good, the presence of the virus in birds have a chance to spread to humans, so it can not be ruled out that there will be sporadic cases of infection. "

As to whether a large number of dead pigs in Shanghai Huangpu River, Ho Pak-leung said there is not enough evidence base comment whether the two, but because of one of these cases, the pork traders, the relevant mainland authorities to collect dead pig samples, testing of avian influenza virus.http://www.kaixian.tv/R1/n1598418c11.shtml

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

The World Health Organization is "closely monitoring the situation" in China, regional agency spokesman Timothy O'Leary said in Manila.

"There is apparently no evidence of human-to-human transmission, and transmission of the virus appears to be inefficient, therefore the risk to public health would appear to be low," O'Leary said.http://www.cbsnews.com/8301-202_162-...ird-flu-fears/

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

... The early onset of both influenza-like symptoms, a week after symptoms develop into pneumonia and was progressively increased, two patients had chronic underlying disease history. Lee before the onset of his two sons are also due to similar symptoms to the hospital for treatment, the eldest son was diagnosed with a lung infection, pneumonia, has been cured; youngest son was diagnosed with severe pneumonia after she died. They were not detected in the H7N9 avian influenza...http://www.jfdaily.com/a/5647816.htm

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Taiwan on alert against H7N9 bird flu
2013/03/31 22:22:13
Taipei, March 31 (CNA) Taiwan heightened its vigilance at its entry ports and alerted the medical professionals to be on the look out for unknown pneumonia patients after China reported two deahttp://focustaiwan.tw/ShowNews/WebNe...D=201303310020

[Giuseppe]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

[Source: Centre for Health Protection, Hong Kong PRC SAR, full text: (LINK).]

Notification of three human cases of H7N9 in Shanghai and Anhui



(...)

A CHP spokesman said the two cases in Shanghai were two men aged 87 and 27, who passed away on March 4 and 10 respectively.

As regards the case in Anhui, the 35-year-old female patient is now in critical condition.

Laboratory tests on the three patients' specimens by the Mainland health authorities yielded a positive result for H7N9.

According to the Commission, the 27-year-old man was a butcher while the 35-year-old woman had exposure history to poultry before the onset of symptoms.

No epidemiological link between the three cases was identified.

So far, no abnormality was detected among the 88 close contacts of three cases.

(...)

This is the only piece of news that suggests a contact with poultry among the three patients infected with H7N9.

All other outlets, included authoritative sources, do not cite poultry or other animals as possible exposure of patients.

This point needs clarification.

[sharon sanders]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Apparently the WHO does know about this situation:

hat tip Mixin


A/Anhui/1/2013
EPI_ISL_138739
Submitted by WHO Chinese National Influenza Center

A/Shanghai/2/2013
EPI_ISL_138738
Submitted by WHO Chinese National Influenza Center

A/Shanghai/1/2013
EPI_ISL_138737
Submitted by WHO Chinese National Influenza Center


We would like to remind our posters that GISAID does not allow any public posting of any information about data from their database.

Our thread for sequence analysis is developing:

China - H7N9 Human Isolates on Deposit at GISAID

[Giuseppe]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Translation error? Do they mean to say that the H7N9 was found on the 22nd of March?

Shanghai found the world's first two cases of human infection with the H7N9 avian flu death
Updated March 31, 2013, Greenwich Mean Time 06:54

http://www.bbc.co.uk/zhongwen/trad/china/2013/03/130331_china_new_bird_flu.shtml

[snip]

Announced after weeks of delay in these cases, the Ministry of Health announced the interpretation of the Shanghai municipal authorities in the detection process has excluded the seasonal influenza H1N1 and H3N2, commonly known as swine flu (H1N1) influenza, H5N1 highly pathogenic avian influenza, SARS and the possibility of the new type of coronavirus, was found in 22 patients may be infected with the H7 influenza.

The virus samples transferred to the China Disease Prevention and Control Center, the center isolated H7N9 virus, and the final diagnosis.

The Chinese Ministry of Health stressed that did not have a strong human-to-human transmission, H7N9 virus, according to who is in close contact with medical observation. The Ministry of Health called on the public to maintain personal hygiene habits, and to avoid contact and edible disease, dead livestock.

The Ministry of Health said that the authority has informed the World Health Organization the three cases.

---

Word-by-word translation:

at day 22 current patients could be infected by...

English version of BBC story does not mention ''22'' cases or date: http://www.bbc.co.uk/news/world-asia-china-21988423

[Treyfish]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Published Date: 2013-03-31 12:12:36
Subject: PRO/AH/EDR> Avian influenza, human (14): China (Shanghai, Anhui) H7N9, fatal
Archive Number: 20130331.1612370
AVIAN INFLUENZA , HUMAN (14): CHINA (SHANGHAI, ANHUI) H7N9, FATAL


..Communicated by:
Gert van der Hoek
<gertvanderhoek@gmail.com>

[Two of the first three known human case of the relatively rare avian H7H9 serotype avian influenza A virus have died. The condition of the third patient has not been disclosed. The three cases are unrelated, of different ages, and not known to have any predisposing medical conditions. The two fatal cases were resident in Shanghai and the surviving case is resident in Chuzhou City, Anhui Province. None of the immediate contacts of theses patients have contracted the infection. The extent of the three victims contact with diseased or normal poultry is not revealed, nor any contact with wild birds.

While these facts do not indicate any imminent threat of a human epidemic, the situation is novel and alarming, particularly as the human population has not been exposed to influenza viruses of H7 or N9 antigenicity in the past, and can bassumed to have no innate immunity. Further information is awaited.

A map of China showing the locations of Shanghai and Anhui province ca be accessed at:
http://www.sacu.org/provmap.html. - Mod.CP]..




http://www.promedmail.org/direct.php...130331.1612370

[sharon sanders]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Some are speculating that this event is connected to the Hogs and Pigs found this month in some rivers in China.

We have no idea if these events are connected, or not.

Here is our ongoing thread:

China - A report of 15,000 dead pigs found floating in Shanghai river

The last information we have posted on this event is that the FAO has become involved to help ascertain what killed the animals.

http://www.flutrackers.com/forum/showthread.php?p=489757#post489757

[sharon sanders]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

Translation error? Do they mean to say that the H7N9 was found on the 22nd of March?

Shanghai found the world's first two cases of human infection with the H7N9 avian flu death
Updated March 31, 2013, Greenwich Mean Time 06:54

http://www.bbc.co.uk/zhongwen/trad/china/2013/03/130331_china_new_bird_flu.shtml

[snip]

Announced after weeks of delay in these cases, the Ministry of Health announced the interpretation of the Shanghai municipal authorities in the detection process has excluded the seasonal influenza H1N1 and H3N2, commonly known as swine flu (H1N1) influenza, H5N1 highly pathogenic avian influenza, SARS and the possibility of the new type of coronavirus, was found in 22 patients may be infected with the H7 influenza.

The virus samples transferred to the China Disease Prevention and Control Center, the center isolated H7N9 virus, and the final diagnosis.

The Chinese Ministry of Health stressed that did not have a strong human-to-human transmission, H7N9 virus, according to who is in close contact with medical observation. The Ministry of Health called on the public to maintain personal hygiene habits, and to avoid contact and edible disease, dead livestock.

The Ministry of Health said that the authority has informed the World Health Organization the three cases.

---

Word-by-word translation:

at day 22 current patients could be infected by...

Yes, it is a date.

Jennifer Yang @jyangstar 15m
@HelenBranswell Yup, translation glitch. Have only limited Chinese skills, but "22" refers to the date on which they confirmed H7N9

[AlaskaDenise]

Re: China - Three confirmed cases of human infection with H7N9 avian influenza - Two fatalities

A few years ago, I read a paper which said that only H5 and H7 have the physical space beside their cleavage sites that would allow for a polybasic cleavage site. So this increase in infectivity of an H7 really worries me.

Here they discuss HP H7:

http://www.ncbi.nlm.nih.gov/pubmed/8790895

http://www.ncbi.nlm.nih.gov/pubmed/8503786

.