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H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013) - died

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

[Summary be the Mod.:

-- Hebei patient is hospitalized in critical condition at a Beijing hospital under strict isolation, treated with ECMO, antivirals and other supportive care;

-- The patient had not left her town before the disease onset;

-- The patient lives near a live poultry market and she used to go for shopping there;

-- Two of her close contacts possibly died for advanced stage cancer, before they could be tested for H7N9;

-- All other close contacts were tested and so far all remain healthy;

-- Environmental samples have been taken from live poultry market and at least one sample tested positive for H7N9;

-- Two Lanfang hospitals received the patient before she was finally transferred in Beijing, without testing her for H7N9.

-
-----

[Source: Ifeng, full page in Chinese: (LINK). Automatic translation.]

H7N9, Beijing: Hefei bird flu patient under strict isolation

At 02:25 on July 22, 2013 Source: Beijing News


Original title: H7N9 patients had undiagnosed removed Hebei two hospitals

-- Hebei to Beijing in patients diagnosed with H7N9 cases" Track

Beijing News News yesterday, Beijing newly confirmed human cases of avian influenza H7N9 infection in 61-year-old female patient Zhang, multiple organ failure has occurred. Previously, the patient had removed two Langfang hospital, but no diagnosis was later rushed to Beijing Chaoyang Hospital, local 120.

At present, Hebei, Beijing two CDCs have been discovered and monitored 30 close contacts, swabs were negative (including two close contacts due to advanced cancer deaths).


-- Patient was diagnosed as severe cases of H7N9

Yesterday, the Chaoyang Hospital, vice president, respiratory specialists Tong Zhaohui said that further aggravate the patient's condition before yesterday. It is understood that Zhang Beijing-level Expert Group has been diagnosed with severe cases of H7N9. In addition, viral pneumonia, acute respiratory distress syndrome, septic shock, acute renal failure, disseminated intravascular coagulation.

Tong Zhaohui said that after admission, the patient had the first time taking antiviral drugs. According to needs and conditions for tracheal intubation patients were given mechanical ventilation treatment; as the disease progresses, they used ECMO (extra corporeal membrane oxygenation technology), which is "artificial lung."


-- Langfang community hospitals and large hospitals were not detected H7N9

Beijing, Hebei and two health authorities have confirmed that Zhang July 10 already sick. July 13, 14, Zhang has received treatment in a community hospital, Langfang, Langfang, China Petroleum Pipeline Bureau General Hospital, two hospitals. July 18 afternoon by the local 120 referral to Beijing Chaoyang Hospital.

The next day, Chaoyang Hospital detected in patients positive for H7N9 avian influenza virus, after review by the Beijing Municipal Center for Disease Control, July 20 declaring the diagnosis. By this time, Zhang incidence from 10 days have passed from her first doctor also passed one week.

Why Zhang was removed Langfang two hospitals for treatment, from community hospitals to large hospitals were diagnosed with H7N9 bird flu? In this regard, Langfang Municipal Health Bureau official confirmed to reporters yesterday, the local two hospitals did not make H7N9 virus detection on patients sampled.

He said that the health sector has been a hospital patient visits to understand the situation, including asking doctors and retrieval of medical records. "From the medical situation, the patient was suffering from pneumonia in the left lung, the symptoms are not too severe, then the condition is chronic progressive." He said, this is also found in many national polio cases was the same as that in a week or so sudden illness worse.

The official said that after the local health department in accordance with the requirements of superiors will H7N9 bird flu prevention and control into the normal management, that is, "Not all patients are detected H7N9 virus." However, there have been asked local Large hospitals all severely ill patients for H7N9 virus detection, one by one investigation.


-- 28 close contacts asymptomatic so far

Zhang had close contact with the staff have found 30 people, including family members of patients, the same wards as well as in China Petroleum Pipeline Bureau, Langfang General Hospital medical staff in contact.

Currently, there are two close contacts Langfang due to advanced cancer deaths, and the remaining 28 were required to be under medical observation for 7 days. Among them, Zhang's four family members in Beijing isolated for observation, others by the local disease control departments to arrange home quarantine observation. 28 close contacts no readme discomfort, throat swabs were negative and found no abnormal body temperature.

In addition, patients visiting hospital hygiene and disinfection has been carried out treatment.


-- H7N9 virus found in live bird markets in Langfang

Beijing News News yesterday, Langfang City, held a news briefing, said the live bird markets in the patient been found in sewage samples positive for H7N9 virus.

Beijing Municipal Health Bureau to identify patients at the June 30-July 9 daily home jolly 500 m near the vegetable market live poultry stalls.

Reporter yesterday from Langfang health department confirmed that the local epidemic prevention departments have been in the market in the patient samples collected dozens, which found an H7N9 virus-positive samples from poultry trading stalls in the sewage. Currently, Langfang City, has integrated market in the layout of the city's farmers live poultry trading disinfection, prevention and control measures such as closed.

Langfang public health emergencies has started four emergency response, requiring the implementation of zero reported outbreaks daily system. Hebei Province Health Department also issued an emergency "on further strengthening of human infection with H7N9 avian influenza epidemic prevention and control work notice", requiring the implementation of the first diagnosis responsibility system, pay attention to ask patients birds or live poultry market exposure history, to strengthen pre-triage and screening of cases, people infected with H7N9 bird flu found in suspected cases, confirmed cases reported in strict accordance with the prescribed time limit.


-- Patients with a single room without contact with other patients

Zhang lived in Building B is located in Chaoyang hospital ward building 13 floors respiratory critical care treatment ward. Yesterday, a security guard outside the ward. In the quarantine area, medical personnel wearing gowns, wearing masks.

"Suctioning for patients also need to wear goggles." According to Chaoyang Hospital infection and disease control experts Kun, currently Chaoyang Hospital, Health and Family Planning Commission in accordance with the prevention and control of the entire guide, take strict precautions. She says, is responsible for treatment, care Dr. Zhang Moude, nurses are "specialized health care professionals," that is specifically for her treatment, no contact with other patients.

Zhang Chaoyang Hospital for delivery when undiagnosed, will exist in contact with other patients, Kun explained, patients with severe illness, "come to the hospital after the first time was rushed single room negative pressure isolation ward treatment." Therefore, patients and Chaoyang hospital there is no contact with other patients.


-- Seasonality of H7N9 is not clear

Previously, a number of domestic and foreign experts and scholars put forward, with the arrival of summer, the temperature rises, H7N9 spread of the epidemic will be slowed down.

U.S. CDC had sent communique said, bird flu has seasonal characteristics. 10 years of the H5N1 avian influenza virus observations indicate that the virus in poultry in winter the level of activity increased, while weakening after the summer season. Correspondingly, the number of cases of human infection with avian influenza is increased in winter, summer, reduce, H7N9 virus may be true.

Why summer will appear H7N9 outbreak? Respiratory expert Tong Zhaohui said that this spring, experts on the causes and incidence of H7N9 infection have carried out a series of studies on the law, "that the disease may be more likely to occur in the spring season," but now, there have been cases in the summer.

Tong Zhaohui said that the lack of a sufficient amount of virus present epidemiological study sample size and therefore temporarily unable to clarify its peak incidence of the specific relationship with the seasons. As to whether the virus in about half the time variations appear, needs further study compared.

Edition have written / Beijing News reporter Wen Ru


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------
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

machine translation

Women diagnosed with H7N9 in Beijing, Hebei sicker patients using artificial lung
http://www.hdmnw.com 2013-07-21 21:44 Source: Beijing Evening News of0Comments Strait Metropolis Daily electronic version

  Langfang one patient at a local doctor will not go away, go to the Beijing Chaoyang Hospital, yesterday, the patient was diagnosed with human H7N9 avian influenza infection. Reporters learned this morning from the Chaoyang Hospital, the test results show that the patient's condition aggravated than yesterday, is still in the intensive care unit for respiratory rescue.

  This patient is 61 years old, female, living in Langfang City, the District. July 10 she appeared cough, fever and other symptoms, self-test temperature 38 ℃. July 13, she went to Langfang City, a community hospital, and outpatient infusion therapy. July 14, patients still have symptoms of fever, the highest temperature reached 40 ℃, and accompanied by cough, sputum, she went to China Petroleum Pipeline Bureau, Langfang General Hospital for treatment after being diagnosed with severe pneumonia in the outpatient infusion therapy. July 15, patients in the China Petroleum Pipeline Bureau, Langfang General Hospital inpatient treatment, chest radiograph showed left lung pneumonia. Has given a variety of antibiotics anti-infection treatment, symptoms do not improve, there coughing, pink frothy sputum, dyspnea, chest X-ray shows lung inflammation shooting again, sicker. At 14:38 on July 18, 120 patients referred to by the local Beijing Chaoyang hospital. At 18:30 on July 18, further aggravate symptoms, difficulty breathing, transferred to the intensive care unit, giving mechanical ventilation therapy. July 19, Chaoyang Hospital for patients with H7N9 avian influenza virus detection, the result is positive, then sending the specimen to CDC, Beijing Review, 20 am Beijing CDC review of the patient H7N9 avian influenza virus nucleic acid positive. July 20 morning, the Beijing Municipal Health Bureau organized expert consultation, combined with the results of the review City CDC, diagnosed the patient with severe human infection of H7N9 avian influenza cases. Merge diagnosis: viral pneumonia, acute respiratory distress syndrome, severe sepsis, acute kidney injury, disseminated intravascular coagulation.

  Beijing Chaoyang Hospital respiratory specialist Tong Zhaohui said that at present the patient in critical condition, hospital for patients to develop the next treatment, while in the city of Chaoyang District, disease control and disease control, including support for the assistance of family members of patients and health care workers, including many close contacts to give the necessary testing, preventive medication and isolation. Has not yet found an abnormal temperature or symptomatic contacts.

  In terms of treatment, the hospital took a doctor specialized tertiary care, that is, the patient's doctors and nurses are devoted to her treatment, no contact with other patients. In the prevention of nosocomial infections, hospitals have taken the necessary precautions: Patients living in single room negative pressure rooms, the medical staff wards need to follow required to wear gowns, masks, suction for patients to wear goggles when medical personnel. Tong Zhaohui said that the name of the patient to the hospital, has been taking antiviral drugs for the first time, according to the needs and conditions, as patients were intubated with a ventilator therapy; as the disease progresses, they used ECMO (in vitro oxygenation technology), which is "artificial lung."

  According to preliminary epidemiological investigation, patients in the June 30-July 9, between home every day about 500 meters near the jolly, the live poultry markets stalls. Patients in the June 30 to July 18 in Beijing between not before never left Langfang City. Currently nine family members of patients with close contacts no abnormal symptoms.

http://www.hdmnw.com/news/china/638880.html
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Translation google

China reproduction of human infection with avian influenza transmission remains poultry experts say to people

2013-07-22 10:00:19 | Source: International Online Zhuangao

?International online news (reporter Pan Ying): first time in nearly two months, the Chinese mainland again reported case of human infection of H7N9 avian influenza: a patient in Beijing, Hebei, was diagnosed with H7N9 avian influenza virus infection.

?20, an Hebei to Beijing to visit patients in the Beijing Chaoyang Hospital, was diagnosed with human H7N9 avian influenza infection. Chaoyang Hospital, vice president, Respiratory director Tong Zhaohui 21, 2011, said the patient was a farmer, female, 61 years old, living in Langfang, Hebei Province. The patient in critical condition, are respiratory intensive care unit for treatment. Tong Zhaohui said: "Today (21 May) 9:00 organize expert consultation, patients were analyzed. According to test results, that further aggravate the patient's condition."

?According to reports, this patient there are multiple organ failure condition, the hospital has developed a targeted treatment programs.

Both health and disease control departments, including family members of patients and health care workers, including several close contacts with the necessary testing, preventive medication and isolation. Has not yet found an abnormal temperature or symptomatic contacts.

?This name is also the case since May 29, the Chinese mainland for the first time reports of human infection with H7N9 avian influenza. Previously there have been experts believe, H7N9 avian influenza virus may gradually disappear as the temperature rises. This name cases appear somewhat unexpected. In this regard, Tong Zhaohui said that the current H7N9 avian influenza virus on the epidemiological characteristics, there is a need to continue to explore. Tong Zhaohui said: "Our traditional flu, may often during the winter and spring, etc. colder season, but Beijing in the summer appears this case, for the propagation characteristics need further exploration, because, after all, not many cases of the sample, whether mutation also need Further laboratory tests, such as the patient's DNA sequence comparison Southern case. "

?This patient is diagnosed, the H7N9 avian influenza virus has risen to 133 people, including rehabilitation of 79 people, 15 people in hospital, 39 people died. Chinese Academy of Engineering, the famous respiratory medicine expert Zhong Nanshan said that, H7N9 avian influenza reproduction is not surprising, is still in the dissemination of state, has not disappeared. He said: "I do not find it strange, or sporadic cases, maybe all year round summer temperatures is not suitable for transmission of the virus, but there has been sporadic cases."
?
Chinese National Influenza Center director Shu Yuelong In an interview this station reporters, also said that the current cases of presumed route of transmission from birds to humans is still, showing a distributed state, does not appear effective interpersonal communication. He said: "The same as before are distributed, the virus is still prevalent in animals, human exposure will be infected due to some factors. Now and April of transmission is the same, should be due to exposure to animal and human infections."
?
Not long ago, a Chinese scientist pointed out that H7N9 avian influenza virus through a comprehensive and systematic study, we found that it is possible through droplets "efficient dissemination." This also led to H7N9 avian influenza virus will emerge interpersonal communication concerns.

Shu Yuelong said about interpersonal communication, there is no epidemiological evidence and laboratory evidence to prove. He said: "droplet spread from animal models made out of the result is a prompt effect may occur, but not really happen, but also epidemiological evidence. Limited interpersonal communication or interpersonal communication has occurred, need our case reports and epidemiological investigation. "

?Experts believe that the next period of time, people infected with H7N9 avian influenza occurred virus still exists the possibility of sporadic cases, people should be vigilant against this virus, can not be taken lightly.

Chinese director Feng Zijian national CDC Emergency Office said that in the past few months, you can clearly see the role of prevention and control measures in controlling the epidemic significantly in the future prevention and control measures need to be further implemented. Feng Zijian, said: "To strengthen the monitoring, detecting infected birds to take measures, including the closure of live bird markets, poultry cross-regional flow limitation, these measures still to be done."

http://gb.cri.cn/42071/2013/07/22/6351s4189832.htm
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Hebei Province

http://en.wikipedia.org/wiki/Hebei

Translation Google

Hebei is now the first case of human infection with H7N9 avian influenza

At 09:30 on July 22, 2013 Source: China Network Television

Hebei is now the first case of human infection with H7N9 avian influenza

Hebei H7N9 patients with multiple organ failure expert: Not determined whether the virus mutation

Hong Beijing July 22 news (Reporter Du Zhen Feng Huiling), according to Voice of China "News" reported the first case of Beijing, Hebei emergency treatment in patients with severe H7N9 avian influenza, Summer, why the virus to reproduce?

Recently, an Hebei to Beijing for treatment of patients infected in Beijing was diagnosed human cases of H7N9 avian influenza. Patients Zhang is a 61 year-old farmer living in Langfang, Hebei Province. 13th of this month there have been signs of fever, body temperature up to 40 ℃. In the local treatment, the disease has been seen better. At 15:00 on the 18th, the patient came to the Beijing Chaoyang Hospital, fever clinic, because in critical condition, on the same day 18:00 into the respiratory intensive care unit. The day before yesterday morning, was diagnosed with severe human infection with the H7N9 avian influenza.

This is the first case of human infection of Hebei Province found confirmed cases of H7N9 avian influenza. Yesterday, the patient's condition continues to grow, even in the case of multiple organ failure. Hospital has developed a targeted emergency rescue plan. Current treatment is still in progress.

Yesterday evening, the reporter went to Beijing Chaoyang Hospital intensive care unit, where the atmosphere was significantly different from the past, not only added a security door, the reporter's visit, medical staff are quite cautious.

Reporter: Langfang to that now how?

Staff: heavy, not improved. And she has more than one organ has a problem, and now renal function does not work. We also gave her a blood filter, and now is not optimistic. Anyway, we are also able to use, and have lost a lot of blood ah.

Beijing Chaoyang Hospital infection control management office director Liu Kun told reporters that the hospital has included family members of patients and health care workers, including several close contacts given the necessary testing, preventive medication and isolation.

Kun: The first time the patient has placed in our single room negative pressure rooms, isolation and treatment. Specialized doctors and nurses have come to manage this patient. Then out of the ward, in strict accordance with the requirements of the Ministry of Health guidelines say wear protective masks to wear gowns and so on. Then engaged in a number of suction ah, etc. operations, we have to take the goggles so a series of protective measures.

Reporters learned that, in addition to the patient was diagnosed with severe H7N9 avian influenza, the merged diagnosis are: viral pneumonia, acute respiratory distress syndrome, septic shock, acute renal failure, disseminated intravascular coagulation. Hospital first time given antiviral treatment, and the condition of patients were intubated, extracorporeal membrane oxygenation and other supportive care. However, the patient's condition is still worse. To this end, Beijing Chaoyang Hospital emergency patients again yesterday conducted a hospital-wide expert consultation, the development of the latest treatment programs.

Beijing Chaoyang Hospital, vice president, deputy director of Beijing Institute of Respiratory Diseases Tong Zhaohui: According to the current situation as well as in patients with radiographic report, which further aggravate the patient's condition now. There is the case of multi-organ failure, so we are just discussed a long time, has also developed a number of targeted treatment options.

Reporters learned yesterday from Langfang City, Hebei Province, patients on June 30 to July 9 daily home about 500 meters near the jolly, the market live poultry stalls. CDC staff is here found H7N9 virus positive samples, it comes from poultry trading market stalls in the sewage.

Yesterday afternoon, Langfang City for the live poultry market within the city started off.

In patients every day to go before the onset of Langfang City Maiwa markets, the reporter saw the door locked trading of live poultry and live chickens and ducks have been locked in a cage, epidemic prevention staff are on the whole area disinfected. A stall at the door around.
..
According to the preliminary epidemiological investigation, June 30 to July 18 in Beijing before the patient never left Langfang City. Currently Hebei has close contact with the patient's medical quarantine implementation.

Langfang Municipal Health Bureau Chengyu Qiu: A total of 30 identified close contacts, present, except in close contact Langfang two deaths due to advanced cancer, the remaining 28 were all in close contact with the required medical observation seven days, at present no exception.

Chengyu Qiu also told reporters that the three live bird markets Maiwa booth staff have done a blood test, the city's H7N9 bird flu prevention and control warfare has begun.

Chengyu Qiu: further strengthening of close contacts under medical observation, abnormal immediately dispose of; right now all hospitalized cases of severe pneumonia, unexplained pneumonia cases for all sampling and testing; strengthen training of clinical staff, good knowledge of prevention and control of publicity, so that people know human infection with H7N9 avian influenza can be prevented, controlled and governance.

Although H7N9 preventable and controllable and curable This concept has gained, but yesterday, a report has once again let the public's nerves up. Chinese scientists in the U.S. "Science" magazine online edition of a report, after their H7N9 avian influenza virus carried by far the most comprehensive and systematic study found that the virus may be spread by droplet "efficient dissemination."

Prior H7N9 virus from person to person would have no clear, this report will break this statement? The so-called "efficient communication" Does that mean that there is a large area of the outbreak may be? In addition, influenza viruses do not generally popular in the summer, Hebei cases mean that the virus mutated?

Chinese Feng Zijian, director of the CDC, said health emergency, if there is a mutation, patients also need to be determined after the virus isolation.

Feng Zijian: the case of this variant is not found, because the virus is not isolated, we have to do the analysis of the sequence of the virus, so as to know whether it is what happens.

Chinese scientists published in the U.S. "Science" magazine online edition reported that, H7N9 virus may spread by droplet "efficient dissemination."

Refers to the so-called droplet spread of pathogens from the source of infection through coughing, sneezing, talking to discharge properly and droplets, so that the suction susceptible to infection. Droplets of "person to person" in an important way, in 2003 the "SARS" virus is the droplets. Such reports can not help but make people scared: Does this mean that H7N9 will be a wide range of infections?

Chinese Academy of Engineering academician Zhong Nanshan: In general, laboratory studies not mean the epidemic can not be equated to infect human epidemiological data must be able to prove. Epidemiological this situation, such as the emergence epidemic, there concreteness occurred near a person's home, person to person considered. The report published in the journal Science, is to have this possibility. In addition, there are several variations of amino acids that may be converted to human avian flu, so we propose to pay attention. However, from February to now, there is not a very clear evidence of human to human transmission, so I want to laboratory work presents us with a note that filing an alarm, but to get the evidence, I am afraid or through epidemiological evidence. Feng Zijian also said that the current H7N9 mainly from birds to humans through the spread. Ordinary people should reduce contact with live birds, areas of high incidence of the virus, the temporary closure of live bird markets in alleviating, blocking transmission of the virus still has a good effect.

Feng Zijian: droplets is a result of animal experiments, it can not be directly extrapolated to humans.

Until now, we have a way to infect humans is not particularly clear, clear that direct contact with birds carrying the virus, especially chicken, or been to a live poultry market, exposure to such an environment prone to infection. But how specific infection, is not particularly clear.

Communication between people is not particularly easy, mainly spread from birds to humans. Or to strengthen the monitoring of birds, found a new place to be infected with a virus outbreaks continue to take relevant measures, including temporary closure of live bird markets, poultry cross-regional flow limitation, these measures are still to be done.

http://cen.ce.cn/more/201307/22/t20130722_24593722.shtml
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Translation Google

Hebei to Beijing H7N9 patients had removed two local hospitals undiagnosed

At 07:23 on July 22, 2013 Beijing News..

Beijing News News yesterday, Beijing newly confirmed human cases of avian influenza H7N9 infection in 61-year-old female patient Zhang, multiple organ failure has occurred. Previously, the patient had removed two Langfang hospital, but no diagnosis was later rushed to Beijing Chaoyang Hospital, local 120.

At present, Hebei, Beijing two CDCs have been discovered and monitored 30 close contacts, swabs were negative (including two close contacts due to advanced cancer deaths).

Patients were diagnosed with severe cases of H7N9

Yesterday, the Chaoyang Hospital, vice president, respiratory specialists Tong Zhaohui said that further aggravate the patient's condition before yesterday. It is understood that Zhang Beijing-level Expert Group has been diagnosed with severe cases of H7N9. In addition, viral pneumonia, acute respiratory distress syndrome, septic shock, acute renal failure, disseminated intravascular coagulation.

Tong Zhaohui said that after admission, the patient had the first time taking antiviral drugs. According to needs and conditions for tracheal intubation patients were given mechanical ventilation treatment; as the disease progresses, they used ECMO (in vitro oxygenation technology), which is "artificial lung."

Langfang community hospitals and large hospitals were not detected H7N9

Beijing, Hebei and two health authorities have confirmed that Zhang July 10 already sick. July 13, 14, Zhang has received treatment in a community hospital, Langfang, Langfang, China Petroleum Pipeline Bureau General Hospital, two hospitals. July 18 afternoon by the local 120 referral to Beijing Chaoyang Hospital.

The next day, Chaoyang Hospital detected in patients positive for H7N9 avian influenza virus, after review by the Beijing Municipal Center for Disease Control, July 20 declaring the diagnosis. By this time, Zhang incidence from 10 days have passed from her first doctor also passed one week.

Why Zhang was removed Langfang two hospitals for treatment, from community hospitals to large hospitals were diagnosed with H7N9 bird flu? In this regard, Langfang Municipal Health Bureau official confirmed to reporters yesterday, the local two hospitals did not make H7N9 virus detection on patients sampled.

He said that the health sector has been a hospital patient visits to understand the situation, including asking doctors and retrieval of medical records. "From the medical situation, the patient was suffering from pneumonia in the left lung, the symptoms are not too severe, then the condition is chronic progressive." He said, this is also found in many national polio cases was the same as that in a week or so sudden illness worse.

The official said that after the local health department in accordance with the requirements of superiors will H7N9 bird flu prevention and control into the normal management, that is, "Not all patients are detected H7N9 virus." However, there have been asked local Large hospitals all severely ill patients for H7N9 virus detection, one by one investigation.

28 close contacts no discomfort readme

Zhang had close contact with the staff have found 30 people, including family members of patients, the same wards as well as in China Petroleum Pipeline Bureau, Langfang General Hospital medical staff in contact.

Currently, there are two close contacts Langfang due to advanced cancer deaths, and the remaining 28 were required to be under medical observation for 7 days. Among them, Zhang's four family members in Beijing isolated for observation, others by the local disease control departments to arrange home quarantine observation. 28 close contacts no readme discomfort, throat swabs were negative and found no abnormal body temperature.

In addition, patients visiting hospital hygiene and disinfection has been carried out treatment.

Interrupted H7N9 virus found in live bird markets in Langfang

Beijing News News yesterday, Langfang City, held a news briefing, said the live bird markets in the patient been found in sewage samples positive for H7N9 virus.

Beijing Municipal Health Bureau to identify patients at the June 30-July 9 daily home jolly 500 m near the vegetable market live poultry stalls.

Reporter yesterday from Langfang health department confirmed that the local epidemic prevention departments have been in the market in the patient samples collected dozens, which found an H7N9 virus-positive samples from poultry trading stalls in the sewage. Currently, Langfang City, has integrated market in the layout of the city's farmers live poultry trading disinfection, prevention and control measures such as closed.

Langfang public health emergencies has started four emergency response, requiring the implementation of zero reported outbreaks daily system. Hebei Province Health Department also issued an emergency "on further strengthening of human infection with H7N9 avian influenza epidemic prevention and control work notice", requiring the implementation of the first diagnosis responsibility system, pay attention to ask patients birds or live poultry market exposure history, to strengthen pre-triage and screening of cases, people infected with H7N9 bird flu found in suspected cases, confirmed cases reported in strict accordance with the prescribed time limit.

Patients with a single room scene without touching other patients

Zhang lived in Building B is located in Chaoyang hospital ward building 13 floors respiratory critical care treatment ward. Yesterday, a security guard outside the ward. In the quarantine area, medical personnel wearing gowns, wearing masks.

"Suctioning for patients also need to wear goggles." According to Chaoyang Hospital infection and disease control experts Kun, currently Chaoyang Hospital, Health and Family Planning Commission in accordance with the prevention and control of the entire guide, take strict precautions. She says, is responsible for treatment, care Dr. Zhang Moude, nurses are "specialized health care professionals," that is specifically for her treatment, no contact with other patients.

Zhang Chaoyang Hospital for delivery when undiagnosed, will exist in contact with other patients, Kun explained, patients with severe illness, "come to the hospital after the first time was rushed single room negative pressure isolation ward treatment." Therefore, patients and Chaoyang hospital there is no contact with other patients.

Focus H7N9 contact with the season is not yet clear

Previously, a number of domestic and foreign experts and scholars put forward, with the arrival of summer, the temperature rises, H7N9 spread of the epidemic will be slowed down.

U.S. CDC had sent communique said, bird flu has seasonal characteristics. 10 years of the H5N1 avian influenza virus observations indicate that the virus in poultry in winter the level of activity increased, while weakening after the summer season. Correspondingly, the number of cases of human infection with avian influenza is increased in winter, summer, reduce, H7N9 virus may be true.

Why summer will appear H7N9 outbreak? Respiratory expert Tong Zhaohui said that this spring, experts on the causes and incidence of H7N9 infection have carried out a series of studies on the law, "that the disease may be more likely to occur in the spring season," but now, there have been cases in the summer.

Tong Zhaohui said that the lack of a sufficient amount of virus present epidemiological study sample size and therefore temporarily unable to clarify its peak incidence of the specific relationship with the seasons. As to whether the virus in about half the time variations appear, needs further study compared.

Edition have written / Beijing News reporter Wen Ru

(Original title: H7N9 patient was removed Hebei two hospitals undiagnosed)

http://health.sina.com.cn/news/2013-07-22/072394008.shtml
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Translation Google

Confusion flu: H7N9 virus span afraid of heat?

2013-07-22 Source: China News Network

In the spring of this year, h7n9 bird flu high-fat period, there have been many experts predict that as temperatures rise, h7n9 bird flu will be slow, but recently went to Beijing for treatment of another example of h7n9 bird flu triggered again public panic. Experts believe that it is temporarily unable to clear the peak incidence of the specific relationship with the seasons, as the virus has variation requires further study.

Spring sick?

Why summer again h7n9 virus?

China CDC deputy director of the virus ﹑ National Influenza Center Director Shu Yuelong said: "The possibility of the occurrence of new cases has always been there, I have always said that the virus will not disappear for no reason, does not disappear, then people infected will be generated. "

Chaoyang Hospital Respiratory experts Tong Zhaohui said that this spring, there are experts on the causes of morbidity and infection h7n9 laws have carried out a series of studies, that the disease may be more inclined to take place in spring and autumn, but now, there have been cases in the summer . As h7n9 virus now lack a sufficient amount of epidemiological study sample size and therefore temporarily unable to clarify its peak incidence of the specific relationship with the seasons. As to whether the virus in about half the time variations appear, needs further study compared.

Has variation?

Influenza viruses are not generally considered suitable in the summer there, Hebei new cases mean that the virus mutates?

Chinese Feng Zijian, director of CDC health emergency, "said the case did not find the mutation, because the virus is not isolated, we have to do the analysis of the sequence of the virus, so as to know whether it is what happens."

Grasping prevention?

After the summer, has been gradually discontinued over h7n9 bird flu prevention and control, emergency response, whether it is now necessary to restart?

Feng Zijian said, you can clearly see that in the past this time to take these measures, to control the outbreak of epidemic-prone areas have a significant effect. Is still necessary to strengthen surveillance of poultry and found that the new virus outbreaks continue to take place to be relevant measures, including temporary closure of poultry live bird markets, restriction interregional flows.

Person to person?

h7n9 virus can spread efficiently among humans occurred?

This is the h7n9 virus research focus. National Avian Influenza Reference Laboratory director Chen Hua-lan said, h7n9 virus non-pathogenic for poultry, allow it to exist in poultry not easily found, increasing the h7n9 virus transmitted to humans and the occurrence of more opportunities for genetic mutations, which may get the h7n9 virus spread efficiently between humans ability. She appealed to the global nature should be monitored closely, especially the crowd h7n9 virus variation.

Large outbreak?

Studies have shown h7n9 virus may spread by droplet "efficient communication", which would mean that a wide range of h7n9 infection?

Respiratory disease experts ﹑ Chinese Academy of Engineering, Zhong Nanshan, analysts say, in general, laboratory studies not mean the epidemic can not be equated, human epidemiological data transmission must be able to prove. Laboratory studies have shown that there is this possibility. In addition, there are several variations of amino acids that may be converted to human bird flu, so to draw attention. "But from February to now, there is not a very clear evidence of human to human transmission, so I think the laboratory work gives us a wake-up call, but we also need to epidemiological evidence." Reporters on behalf of Lili

Original title [flu confusion: H7N9 virus span afraid of heat? ]

Above from: China News Network

[Editor: Li Shuai]

http://big5.gmw.cn/g2b/health.gmw.cn/dzb/2013-07/22/content_1825771.htm
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Despite the questions raised by this new case of H7N9 in Hebei, until the infected chickens continue to be around, and taken into account the avian-like preference for warmer temperature, human cases are anticipated to occur in future.

In addition, the summer seasonal influenza peak may contribute to alter the immune response of people against the novel strain, as suggested by some researchers (the so called A.D.E. theory).

Essentially, the most Dangerous factor behind human cases is the persistence of infected chickens in the market, and the lack of a enhanced surveillance (or the results of it) among industrial farmed chickens.

GM
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Translation Google

News News> Local News> Text
News

Langfang H7N9 patients in critical condition two cases observed contacts lifted

At 23:30 on July 23, 2013 Hebei Youth Daily, I have something to say (two participants)

In response to H7N9, Langfang City area all 12 live poultry slaughter market have been closed.

The two confirmed cases of close contacts under medical observation for seven days, yesterday released medical observation.

Treated patients in Beijing yesterday, no significant change in the condition, remains extremely critical.

Currently, not yet found infected with H7N9 avian bird flu situation.

Two cases of close contacts discharged medical observation

After the outbreak, Langfang implement zero for the epidemic reporting system daily newspaper.

While requiring daily reports of human infection with H7N9 avian influenza in close contacts of the very fact of observation conditions.

Reporter yesterday from the Langfang Municipal Health Bureau, the first two close contacts under medical observation full seven days (from the last calculation in contact with Miss Zhang), has been released under medical observation, you can work and live normally.

Close contact with the rest of health monitoring well, the temperature is normal, not fever, cough and other flu-like illness symptoms.

Langfang Municipal Health Bureau will further strengthen the close contacts under medical observation, abnormal, and immediately disposed of.

No significant changes were still very critical

Yesterday, the Beijing Chaoyang Hospital, news release, people infected with H7N9 avian influenza (severe cases) the very fact that yesterday's disease patients with no significant change, remains extremely critical.

Compared with 22, in addition to viral pneumonia, acute respiratory distress syndrome, acute renal failure, disseminated intravascular coagulation, the patients also appear hypoalbuminemia, septic shock, and removal of the gallbladder.

Treatment, anti-infective therapy have not been adjusted, hospitals continue to strengthen the anti-infection, enhance immunity and other targeted therapies.

Meanwhile, the close monitoring of circulation, gastrointestinal and other important organs, continue to protect the gastric mucosa treatment.
Been found infected with H7N9 bird

Reporters learned yesterday from the Health Department of Hebei Province, as of now, all 12 Langfang City area of ​​live poultry slaughter market all closed, and has completed hygiene and disinfection treatment.

Provincial Forestry Department, as of now, the province was not found infected with H7N9 avian bird flu epidemic.

Provincial Forestry Department, Wildlife Conservation station Zhang said most of the migratory birds in the province currently has basically ended, only a small part of the summer breeding birds stay in the province.

In accordance with the Provincial Forestry Department urged all localities to strengthen the wetlands, reservoirs, parks, nature reserves and bird market, zoos and other wildlife domestication and breeding places of monitoring and inspections.

Provincial Forestry Department in coordination with the Health Department of the eight national wild animal epidemic sources and disease monitoring stations for deployment, the current sampling task has been completed, is being detected.

Zhang warned that the public should stay away from wild animals, do not pick up, do not touch dead wild animals, abnormal timely report to the local forestry department.

■ text / reporter Chen Xue Zhang Lei

http://news.sina.com.cn/c/2013-07-23/233027751843.shtml
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

[Source: Ifeng, full page in Chinese: (LINK). Automatic translation.]


H7N9, Beijing: Hebei bird flu patient suffers for septic shock

At 02:34 on July 24, 2013 Source: Beijing Morning News

Original title: H7N9 is now critically ill patients with septic shock


Morning News (Reporter Xu Jingjing Xiao Dan) Municipality reports of severe H7N9 bird flu first appeared Zhang septic shock, and because organ failure, the gallbladder has been removed. Yesterday, the Chaoyang Hospital, announced his Tong Zhaohui, vice president, head of the School of expert consultation results. Compared with the day before, the patient slightly elevated body temperature at night is still "extremely severe."

Reporters in the patient's medical records report that the patients with bilateral miosis, light reflex slow, did not respond to the call. Lung breath sounds very low heart rate, Qi, limb edema. It is reported that, at present, Zhang still using ECMO "artificial lung" plus mechanical ventilation.

After the diagnosis, the patient infected with human H7N9 avian influenza viral pneumonia with severe, with acute respiratory distress syndrome, septic shock, acute renal failure, disseminated intravascular coagulation, hypoalbuminemia.

It is reported that, in the treatment program, the hospital stepped up anti-infection treatment, continue to breathe and ECMO support treatment. Meanwhile, in order to prevent secondary infection, strengthen ECMO puncture wound dressing desiccant and closely monitoring loop, gastrointestinal and other vital organ functions.

In addition, the reporter learned that, due to close contacts are observed in isolation, so I did not have relatives to accompany Zhang side.

Yesterday, the Beijing Municipal Health Bureau said the city will not change the norm for the H7N9 avian influenza management strategies, but will be emphasized to all medical institutions to increase vigilance against H7N9 avian influenza.

For July 21, Langfang, Hebei confirmed human cases of avian influenza H7N9 infection, the Beijing Municipal Bureau of Agriculture animal disease prevention and control center yesterday on the border with Hebei Langfang two neighboring towns to carry out emergency monitoring of poultry were detected in 480 samples , of which 240 parts of etiology, serology 240 copies, serology and pathogen monitoring results were negative, the city has not yet found H7N9 avian influenza infection in animals.


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Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Hebei H7N9 no change in patients with life-threatening infection

Reporter from the Beijing Chaoyang hospital learned, Hebei to Beijing visit H7N9 avian flu patients compared with yesterday, no significant change in condition, remains a critical, life-threatening. content Hong Beijing July 24 News reporter from the Beijing Chaoyang hospital learned, Hebei to Beijing visit H7N9 avian flu patients compared with yesterday, no significant change in condition, remains a critical, life-threatening. this year, in the morning (July 24), Vice President of the Beijing Chaoyang hospital Tong ZhaoHui as leader of Group consultation, compared with yesterday, patients with no significant changes, is still critically ill, in danger. Continued monitoring cycle, in vital organs such as gastrointestinal function, maintain the current plasma support, enhance immunity and protection of gastric mucosa in the treatment of thymus peptide, nutrition support, and strict isolation, focus on medical staff protection. it is understood that certain, female, 61 years old, as it '5 days of fever, cough, difficulty breathing 2 day' on July 18, 2013 income Beijing Chaoyang hospital respiratory intensive care units. Hospital 7th days, RICU 7th day 7th day tracheal intubation. Patients currently live ward for respiratory intensive care unit in a negative pressure isolation ward. Current diagnosis: human infection H7N9 avian influenza viral pneumonia (severe cases), acute respiratory distress syndrome, infection toxic shock, acute renal failure, and disseminated intravascular coagulation, low protein blood syndrome, after cholecystectomy.



http://www.dfdaily.com/html/33/2013/7/24/1039541.shtml
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

[Source: Ifeng, full page: (LINK). Automatic translation from Chinese.]


H7N9, Beijing: No improvements for the first Hebei birdflu patient, still critical

At 17:03 on July 27, 2013 Source: CCTV


CCTV News [Hebei discovered H7N9 bird flu "any time of danger"]

Last weekend, one of the patients from Langfang City in Beijing confirmed human cases of avian influenza H7N9 infection.

Currently, all close contacts of the patient has been discharged under medical observation, Langfang No new cases of newly discovered H7N9, but has confirmed the patient, physical condition is still not optimistic, any time of danger.

(CCTV reporter Cai Li)


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Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Langfang H7N9 infection close contact 2 people died of terminal cancer

Finally released from medical observation as specified in 3 close contacts news network, July 27 in Langfang, Hebei (Hebei daily reporter Sun Ya reporter Sun Zhanwen) to today, widely H7N9 avian influenza infection in patients with a final 3 close contacts, expiry of medical observation, no abnormal symptoms, released from medical observation, as required. on July 20, Langfang City got a provincial health department about a Beijing doctor was diagnosed in patients with confirmed cases of human infection H7N9 avian influenza report, prompt start of the four-level emergency response to public health emergencies, some close contacts were placed under investigation. After epidemiological investigations, were identified 30 close contacts, management in Beijing, Langfang management 26, 4. Among them, Langfang died of terminal cancer has two close contacts, close contacts of all remaining 28 according to the provisions under medical observation for 7 days. as of today, patients with a final expiry of 3 close contacts are under medical observation, no abnormal symptoms, released from medical observation, as required. at 9 o'clock in the morning today, Langfang is not newly discovered suspected and confirmed cases of human infection H7N9 avian influenza.


http://hebei.sina.com.cn/news/s/2013-07-28/090261389.html
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Langfang terminated H7N9 avian flu four-level response to public health emergencies


CNS, Langfang, August 1 (reporters Song Mintao and Makoshi and Wang Ying)-official 1st revealed in Langfang city, Hebei province, Langfang human infection H7N9 avian influenza terminated on July 31, four-level response to public health emergencies, work to business as usual. according to reports, Langfang 1 informed the Beijing visit Beijing, July 20 after the diagnosis in patients with confirmed cases of human infection H7N9 avian influenza, Langfang city on July 21, the Government launched a four-level emergency response to public health emergencies, carry out epidemic prevention and control work. on July 10 after the onset of confirmed cases, 21 consecutive days without a new case, and 27th all close contacts were all released from medical observation. According to national related emergency plans, and Hebei province, with provincial, municipal and district level joint expert group assessment, agreed by the Government of Langfang city, July 31, 2013, ending human infection H7N9 avian flu four-level response to public health emergencies, the conversion of the working normal. according to the outbreak situation in Langfang city, Hebei province, city and district level analysis argues that the joint expert group, this human infection H7N9 avian influenza outbreak in Langfang spread epidemic risk rating is lower, but do not exclude the possibility of recurrence of cases. According to reports, there is currently no evidence that H7N9 avian flu virus was transmitted from, the epidemic in the anti-controlled state. 1807: press the page drew _acK ({aid:1807,format:0,mode:1,GID:1,serverbaseurl:'me.AFP.chinanews.com/'}); prevention and control experts suggest that after termination of response, we will continue to adhere to the intensification of surveillance, case investigation, joint defense measures such as control, establishing long-term mechanism, a solid job in normalizing prevention and control work. (End


http://www.chinanews.com/gn/2013/08-01/5113173.shtml
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

[Source: Ifeng, full page in Chinese: (LINK). Automatic translation.]


H7N9, Beijing: Hebei patient removed from ECMO, improved

At 00:00 on August 3, 2013 Source: Beijing Youth Daily

Original title: Hebei H7N9 critically ill patients removed "artificial lung"


After 16 days of treatment Chaoyang Hospital, Langfang H7N9 patients Aunt Zhang finally got better, the first time the temperature dropped to 37 ℃ or less, no longer swollen limbs, eyes pupillary light reflex sensitivity.

July 18 this year, 61-year-old rural patients Langfang Aunt Zhang was transferred to Beijing Chaoyang Hospital for treatment and was soon diagnosed with H7N9 severe cases, respiratory intensive care unit and was admitted to the isolation ward. At that time, the hospital to the community after expert consultation, the patient's condition is extremely critical, heart, lung, kidney, liver and other organ failure began to appear.

Aunt Zhang hospital to spend the best treatment of respiratory failure in the instrument?? Artificial lung, while also undergoing hemodialysis, drug antiviral therapy and strengthening the immune system therapy.

Yesterday, the Chaoyang Hospital, spread the good news, Zhang aunt's condition has improved, has removed the artificial lung, but still use the ventilator.

Binocular pupillary light reflex sensitivity by a slow turn, the temperature dropped to 37 ℃ the following first, limb edema disappeared, these are signs of improvement in the condition. Aunt Zhang disease experts will level from "extremely critical" reduced "critical."

Hospital said Aunt Zhang still stable condition, and some organs began to improve, but some organs yet to see improved, is still in need of antiviral treatment and strengthening the immune system therapy.


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Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

[Source: Ifeng, full page in Chinese: (LINK). Automatic translation.]


H7N9, Beijing: Hebei patient showing further improvements, still critical

At 00:00 on August 6, 2013 Source: Beijing Youth Daily


Original title: Hebei Langfang H7N9 patient is conscious can eat

Reporters learned yesterday from the Chaoyang Hospital, Beijing from Hebei Langfang Aunt Zhang treated H7N9 patient condition improved markedly, she can be break off the ventilator. She currently conscious, and can eat water.

Yesterday, the hospital released the latest news, Aunt Zhang can be interrupted in patients from the ventilator, lung function has been restored, the infection has been partially controlled, conscious, she can eat drink, but renal function has not been restored.

Yesterday morning, in order to Tong Zhaohui, vice president, head of the School of expert consultation conducted her again, that Aunt Zhang "H7N9 avian influenza with severe pneumonia," her condition improved, but still heavy. 17:00 yesterday, the Beijing Municipal Health Bureau to the British Secretary dedicated to the Chaoyang Hospital Respiratory Care Unit visited Aunt Zhang and condolences to the fighting in the front line of medical personnel.

As of yesterday, Aunt Zhang Chaoyang Hospital has been in hospital emergency respiratory intensive care unit for 17 days. She just has happened multiple organ failure at admission, deep coma, no spontaneous breathing, relying on "artificial lung" breathing, dying, hospital several times to the family issued a critical condition. But after careful treatment of persistent hospital, Zhang aunt's condition gradually improved, last week, her eyes pupillary light reflex sensitivity, from the "artificial lung", relying on ventilator to breathe.


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Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013)

Hebei to Beijing H7N9 avian flu patients brought rescue died

The Hebei to Beijing have been infected with H N 7 9 bird flu patients brought rescue died as soon as possible after 25 days of full rescue, from Hebei to Beijing for treatment of persons infected with H N 7 9 avian influenza to patients. Although the respiratory function better, but in the end the infection, multiple organ failure rescue invalid last night when 22 deaths.

http://news.sohu.com/20130812/n383985001.shtml
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013) - died

H7N9 patient dies in Beijing


BEIJING, Aug. 12 (Xinhua) -- A [wo]man infected with the H7N9 avian influenza died of multiple organ failure on Monday, local authorities said.

The 61-year-old patient was transferred from the city of Langfan in north China's Hebei Province to Beijing Chaoyang Hospital for treatment on July 18. He tested positive for the H7N9 virus on July 20.

A single human infection of H7N9 was confirmed in south China's Guangdong Province on Friday, bringing the total number of infections on the Chinese mainland to 134 this year. Forty-four of the infections have resulted in death.

Authorities halted their emergency response to the H7N9 outbreak in late May. However, a spokesman for the National Health and Family Planning Commission said authorities have been monitoring the situation and are preparing for possible outbreaks in the coming fall and winter.

Earlier this month, researchers in east China's Jiangsu Province said the H7N9 virus may be capable of human-to-human transmission. However, they added that such transmissions are limited and non-sustainable.


http://news.xinhuanet.com/english/china/2013-08/12/c_132624608.htm
 
Re: H7N9, Beijing: An Hebei woman diagnosed with bird flu (Ifeng, July 20 2013) - died

[Source: Municipality of Beijing Department of Health, full page in Chinese: (LINK). Automatic translation.]


H7N9, Beijing: Hebei patient died of multi-organ failures

Time :2013 -08-12 Source: Beijing Municipal Health Bureau


After 25 days of rescue and Hebei to Beijing for medical treatment of people infected with H7N9 avian influenza in patients with severe, although once respiratory function improved, but in the end due to infection increased, died of multiple organ failure on the evening of 11 August 2013 22:00 about death.

This case development and evolution of the disease and treatment process on the future treatment of human infection with H7N9 avian influenza severe cases have important implications.

Patients Zhang, female, 61 years old, living in Langfang City, Hebei Province, for "five days fever, cough, dyspnea two days" on at 18:00 on July 18, 2013 by Langfang City 120 go to Beijing Chaoyang Hospital.

The patient was admitted to hospital, his condition deteriorated rapidly, admissions doctors based on patient characteristics fever and respiratory symptoms, the hospital expert consultation, and rapidly carry out the new flu virus checks and by the Beijing-level expert consultation in July 2013 the 20th confirmed human infection of H7N9 avian influenza in severe cases.

The patients with concomitant acute respiratory distress syndrome, severe sepsis, acute renal failure, disseminated intravascular coagulation, and other serious complications.

Beijing Chaoyang Hospital, set up headed by a vice president of the medical treatment group of experts, to carry out treatment.

During the period of rapid progression, unstable vital signs, repeatedly issued to the families of patients in critical condition notice.

The full treatment, after 1 August 2013 the patient was once signs of improvement in respiratory function, August 4 from the ventilator can be intermittent after spontaneous breathing function recovery exercise, infection was part of the control, consciousness regained conscious, you can eat water.

August 9 review H7N9 virus nucleic acid test results were negative, indicating the effect of antiviral therapy.

Aug. 10 patients with recurrence of infection increased, August 11 quickly developed into sepsis, septic shock, leading to multiple organ failure. At 21:00 on August 11th, patients with decreased heart rate, blood pressure can not be maintained, 21:22 heart rate drops to 0, respiratory arrest, blood pressure is 0, the active rescue, breathing, heartbeat is still not restored, died at 22:01 declared clinically dead. Death diagnose human infection of avian influenza H7N9 pneumonia (severe cases), acute respiratory distress syndrome, acute renal failure, septic shock.

August 12 morning, the Beijing Chaoyang Hospital, organize experts to death were discussed. Experts believe that: The patient's condition improved in the course of severe pneumonia increased again, the rapid development of sepsis, septic shock, leading to multiple organ failure, although the rescue, and finally failed to save lives.

The case where the process of evolution and progression of human infection with H7N9 avian influenza on severe cases have three inspirations:

First, anti-viral treatment for people infected with H7N9 avian influenza remains critically ill patients is necessary also effective.

The patients with severe human infection of H7N9 avian influenza patients, but after antiviral therapy viral stock has been effectively controlled, the final test result is negative, combined with extracorporeal membrane oxygenation (artificial lung) applications, once signs of improvement in respiratory function, so human infection with H7N9 avian influenza on critically ill patients to be active antiretroviral therapy.

Second, except for the treatment of severe cases concern the treatment of viral infection, attention should also be multi-organ protection and support to improve the overall success rate. The early onset patients with acute renal failure, have not been able to break away hemofiltration, and ultimately the development of multiple organ failure, indicating that the avian flu patients with severe multiple organ will be hit hard, with severe human infection with the H7N9 avian flu is always there life-threatening.

Three for severe cases, conventional mechanical ventilatory support in difficult circumstances, the timely application of extracorporeal membrane oxygenation (artificial lung) therapy is effective measures.


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