China - Hong Kong CHP reports new imported H7N9 case hospitalized - traveled from Guangdong province - January 5, 2017

[sharon sanders]

CHP investigates imported human case of avian influenza A(H7N9)
**************************************************


The Centre for Health Protection (CHP) of the Department of Health is today (January 5) investigating an imported human case of avian influenza A(H7N9) in Hong Kong, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

The male patient, aged 62 with underlying illnesses, departed Hong Kong since December 15 last year and travelled to Zengcheng, Guangzhou. He has developed fever, cough and shortness of breath since January 1. He was admitted to a hospital for treatment in Dongguan during January 2 to 3. The patient discharged himself against medical advice on January 3 and returned to Hong Kong via Lo Wu on the same day. He attended the Accident and Emergency Department of Yan Chai Hospital yesterday (January 4) and was admitted for treatment on the same day. His condition deteriorated today and has been transferred to intensive care unit for further management. The patient is now in critical condition.

His endotracheal aspirate and nasopharyngeal aspirate specimen were confirmed to be positive for influenza A(H7N9) virus by the CHP's Public Health Laboratory Services Branch tonight.

The patient denied recent exposure to poultry or wet market.

His close contacts have remained asymptomatic so far and have been put under medical surveillance. Tracing of his other contacts in Hong Kong is underway.

"The case has been reported to Guangdong and Macau health authorities. We are communicating with the Mainland authority to follow up the patient's exposure and movements in the Mainland. Based on information available thus far, it is classified as an imported case. Epidemiological investigations are ongoing," a spokesman for the CHP said.

"Locally, three confirmed human cases of avian influenza A(H7N9) were recorded in the past three weeks. The activity of avian influenza is expected to increase in winter based on its seasonal pattern. Letters to doctors, hospitals, schools and institutions will be issued to alert them to the latest situation, " a spokesman for the CHP added.

more...


http://www.info.gov.hk/gia/general/2...7010501042.htm

 

[sharon sanders]

This is the 3rd imported H7N9 case into Hong Kong recently. The other 2 are:


#817 - Male, 75, onset December 8, hospitalized December 9 in Hong Kong, test positive December 19, travel history to Dongguan, Guangdong province Death WHO rpt 23/12/16

#827 - Male, 70, onset December 26, hospitalized December 27, serious condition, in Hong Kong, possible exposure in Zhongshan, Guangdong provinceWHO rpt 3/1/17

 

[sharon sanders]

Case #817 also did not report any contact with live poultry:


"In Zhongshan, he passed by mobile stalls selling live poultry on 14 December but reported no direct contact with the poultry. In Hong Kong SAR, he purchased a chilled chicken from a shop near a wet market on 22 December but no live poultry was sold in the shop, and he did not enter the wet market." link

 

[sharon sanders]

It appears from the dates that this patient traveled while very ill. Against medical advice he discharged himself in Guangdong. It is possible he traveled by rail through a popular border control point between the mainland and Hong Kong:

[h=2]Land boundary control point[edit][/h] Main article: Lo Wu Control Point
Lo Wu Immigration Control Point (羅湖入境管制站) is a passenger cross border point between Hong Kong and mainland China. It operates daily from 6:30 am to midnight. During peak hours, holidays and weekends, the waiting time for entries and exits through Lo Wu is shorter than the other 3 control points because it has the largest visitors' handling capacity. Of all passenger departures (including non-residents) from Hong Kong for mainland China, 90% go through the land border control points of Lo Wu, Lok Ma Chau, Man Kam To and Sha Tau Kok, with Lo Wu accounting for 85% of total departures.
Lo Wu is the most popular border crossing for people travelling to mainland China because most people take the East Rail Line, which is more convenient compared to other means of transport. By passing through Lo Wu, one can reach the busiest commercial zone of Shenzhen in the shortest period of time.

https://en.wikipedia.org/wiki/Lo_Wu

 

[sharon sanders]

There are many media articles tonight saying this patient has died. So far there is nothing posted about the death on the Hong Kong CHP site.

 

[sharon sanders]

Now posted:

Update on human cases of avian influenza A(H7N9)
***************************************


The Centre for Health Protection (CHP) of the Department of Health today (January 6) reported an update on the third human case of avian influenza A(H7N9) in Hong Kong this winter.

The male patient, aged 62, passed away in the small hours today in Yan Chai Hospital (YCH). Contact tracing has so far identified 33 close contacts and 90 other contacts.

Close contacts include the patient's family contacts as well as relevant in-patients and healthcare workers (HCWs) of YCH. An HCW with mild symptoms is pending testing and the others have remained asymptomatic. They will be given antiviral prophylaxis with oseltamivir (Tamiflu) for five days, advised to wear a mask and put under medical surveillance for 10 days following their last exposure to the patient.

Other contacts are the patient's other family members, other relevant in-patients, visitors and HCWs of YCH, personnel involved upon his arrival in Hong Kong and ambulance personnel involved in patient transfer. All remain asymptomatic. They will be advised to wear a mask and will be put under medical surveillance for 10 days following their last exposure to the patient. For those in-patients with underlying illnesses or higher risk of complications, they will also be given Tamiflu for five days as a precautionary measure.

Regarding the second human H7N9 case this winter reported on December 30, 2016, further epidemiological investigations revealed that the patient's residence in Zhongshan from December 14 to 16 last year was opposite a wet market with live poultry stalls and there were also mobile stalls selling live poultry outside the market. Based on information available thus far, it has been classified as an imported case. The patient was hospitalised in Princess Margaret Hospital in serious condition.

From 2013 to date, 19 imported human H7N9 cases have been confirmed in Hong Kong, with seven deaths (37 per cent).

In addition, the CHP is closely monitoring an additional human H7N9 case in Shandong. According to the Health and Family Planning Commission of Rizhao Municipality, the patient is a man aged 77.

"As H7N9 virus continues to be detected in animals and environments in the Mainland, additional human cases are expected in affected and possibly neighbouring areas. Epidemiological experience in the past few years shows that most imported human H7N9 cases were detected in Hong Kong in the first quarter. In view of the heavy trade and travel between the Mainland and Hong Kong, further sporadic human cases in Hong Kong every now and then are expected, especially in the coming few months," a spokesman for the CHP said.

"Therefore, we again urge the public to avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel, particularly in the upcoming Lunar New Year holidays. If feeling unwell, such as having a fever or cough, wear a mask and seek medical advice at once. Travellers returning from affected areas should consult doctors promptly if symptoms develop, and actively inform the doctors of their travel history for prompt diagnosis and treatment," the spokesman added.
Ends/Friday, January 6, 2017
Issued at HKT 18:13
http://www.info.gov.hk/gia/general/201701/06/P2017010600272.htm