Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 42, 13-19 October 2013
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Influenza A(H7N9) - China - Monitoring human cases
Opening date: 31 March 2013 Latest update: 15 October 2013
Epidemiological summary
On 31 March 2013, Chinese authorities announced the identification of a novel reassortant A(H7N9) influenza virus in patients in eastern China.
Since then, 136 cases of human infection with influenza A(H7N9) have been reported from: Zhejiang (47 cases), Shanghai (34), Jiangsu (27), Henan (4), Anhui (4), Beijing (2), Shandong (2), Fujian (5), Hunan (3), Jiangxi (5), Hebei (1), Guangdong (1) and Taiwan (1).
In addition, the virus has been detected in one asymptomatic case in Beijing.
Most cases have developed severe respiratory disease.
Forty-five patients have died (case-fatality ratio=33%). The median age is 58 years, ranging between four and 91 years; 39 of 136 patients are female, with gender being unknown in five cases.
Since the end of May 2013, only sporadic cases have been reported.
A new case was reported on 15 October in a 35 year old male from Zhejiang Province, who was admitted to a hospital on 8 October and was transferred to the intensive care unit in another hospital on 11 October 2013. This is the first new confirmed case since 11 August 2013. The patient is currently in critical condition. Information on history of exposure is not available.
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ECDC assessment
Influenza A(H7N9) is a zoonotic disease that has spread in poultry in parts of eastern China, causing severe disease in humans.
There is no evidence of sustained person-to-person transmission.
Close to 3 000 contacts have been followed-up, and only a few are reported to have developed symptoms, as part of three small family clusters.
Many unanswered questions remain regarding this outbreak, e.g. the reservoir, the route of transmission, the spectrum of disease and the reason for an unusual age��gender imbalance.
Authorities have employed strict control measures including closing live poultry markets and culling poultry in affected areas. Following these measures, the number of reported cases have dropped.
It is not possible to determine at this point whether this new case marks the resurgence of the outbreak. ECDC's earlier risk assessment remains valid.
EU citizens in China are strongly advised to avoid live bird markets. The risk of the disease spreading to Europe via humans is considered low.
However, it is not unlikely that people presenting with severe respiratory infection in the EU and a history of potential exposure in the outbreak area will require investigation in Europe.
Actions
The Chinese health authorities continue to respond to this public health event with enhanced surveillance, epidemiological and laboratory investigation including scientific research.
ECDC is closely monitoring developments.
ECDC published an updated Rapid Risk Assessment on 8 May 2013. A case detection algorithm and an EU case definition has been developed and shared with EU Member States. ECDC guidance for Supporting diagnostic preparedness for detection of avian influenza A(H7N9) viruses in Europe for laboratories was published on 24 April 2013.
(?)
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COMMUNICABLE DISEASE THREATS REPORT
Week 42, 13-19 October 2013
(?)
Influenza A(H7N9) - China - Monitoring human cases
Opening date: 31 March 2013 Latest update: 15 October 2013
Epidemiological summary
On 31 March 2013, Chinese authorities announced the identification of a novel reassortant A(H7N9) influenza virus in patients in eastern China.
Since then, 136 cases of human infection with influenza A(H7N9) have been reported from: Zhejiang (47 cases), Shanghai (34), Jiangsu (27), Henan (4), Anhui (4), Beijing (2), Shandong (2), Fujian (5), Hunan (3), Jiangxi (5), Hebei (1), Guangdong (1) and Taiwan (1).
In addition, the virus has been detected in one asymptomatic case in Beijing.
Most cases have developed severe respiratory disease.
Forty-five patients have died (case-fatality ratio=33%). The median age is 58 years, ranging between four and 91 years; 39 of 136 patients are female, with gender being unknown in five cases.
Since the end of May 2013, only sporadic cases have been reported.
A new case was reported on 15 October in a 35 year old male from Zhejiang Province, who was admitted to a hospital on 8 October and was transferred to the intensive care unit in another hospital on 11 October 2013. This is the first new confirmed case since 11 August 2013. The patient is currently in critical condition. Information on history of exposure is not available.
(?)
ECDC assessment
Influenza A(H7N9) is a zoonotic disease that has spread in poultry in parts of eastern China, causing severe disease in humans.
There is no evidence of sustained person-to-person transmission.
Close to 3 000 contacts have been followed-up, and only a few are reported to have developed symptoms, as part of three small family clusters.
Many unanswered questions remain regarding this outbreak, e.g. the reservoir, the route of transmission, the spectrum of disease and the reason for an unusual age��gender imbalance.
Authorities have employed strict control measures including closing live poultry markets and culling poultry in affected areas. Following these measures, the number of reported cases have dropped.
It is not possible to determine at this point whether this new case marks the resurgence of the outbreak. ECDC's earlier risk assessment remains valid.
EU citizens in China are strongly advised to avoid live bird markets. The risk of the disease spreading to Europe via humans is considered low.
However, it is not unlikely that people presenting with severe respiratory infection in the EU and a history of potential exposure in the outbreak area will require investigation in Europe.
Actions
The Chinese health authorities continue to respond to this public health event with enhanced surveillance, epidemiological and laboratory investigation including scientific research.
ECDC is closely monitoring developments.
ECDC published an updated Rapid Risk Assessment on 8 May 2013. A case detection algorithm and an EU case definition has been developed and shared with EU Member States. ECDC guidance for Supporting diagnostic preparedness for detection of avian influenza A(H7N9) viruses in Europe for laboratories was published on 24 April 2013.
(?)
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