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Assessing Family Clusters of A(H7N9) in the People's Republic of China
In the recent article in the NEJM entitled Preliminary Report: Epidemiology of the Influenza A (H7N9) Outbreak in China the authors note a three-member family cluster of A(H7N9) from Shanghai. The cases from this now confirmed cluster were the impetus for the initial disclosure of human infections of novel influenza A(H7N9). This three-family member cluster from Shanghai in mid-February is identified as Cluster 1 in post #1 in this FluTrackers link. Two of the family members died.
The second family cluster described in the NEJM article is a father - daughter cluster from Jiangsu Province. The daughter is a confirmed case, and although reported as receiving treatment in the NEJM article, she has since died. This woman is FluTrackers Case Number 7. While the suspected case from the February Shanghai cluster is counted within the total cases, it is not certain whether the father from the Jiangsu cluster, a suspected case, is counted in the totals from Jiangsu Province.
The third family cluster identified in the NEJM article is reported to be from Shanghai and was under investigation when the article was be authored. It is possible that this referenced third cluster is the Cluster 2 in Post #1 in this FluTrackers link. This family cluster includes a husband and wife from Shanghai who are both confirmed cases, the wife died on April 3, 2013.
Today, media reports indicate the occurrence of another family cluster, a father and son from Shandong Province (FT Link). So far, both of these cases are alive and being treated.
Conclusion
Four family clusters of confirmed and suspected A(H7N9) have been reported from China. In three of the four clusters at least one of the family members has died. The limited data suggest that caregiving behavior and intimate contact may result in limited human-to-human transmission of A(H7N9) in family clusters.
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In the recent article in the NEJM entitled Preliminary Report: Epidemiology of the Influenza A (H7N9) Outbreak in China the authors note a three-member family cluster of A(H7N9) from Shanghai. The cases from this now confirmed cluster were the impetus for the initial disclosure of human infections of novel influenza A(H7N9). This three-family member cluster from Shanghai in mid-February is identified as Cluster 1 in post #1 in this FluTrackers link. Two of the family members died.
The second family cluster described in the NEJM article is a father - daughter cluster from Jiangsu Province. The daughter is a confirmed case, and although reported as receiving treatment in the NEJM article, she has since died. This woman is FluTrackers Case Number 7. While the suspected case from the February Shanghai cluster is counted within the total cases, it is not certain whether the father from the Jiangsu cluster, a suspected case, is counted in the totals from Jiangsu Province.
The third family cluster identified in the NEJM article is reported to be from Shanghai and was under investigation when the article was be authored. It is possible that this referenced third cluster is the Cluster 2 in Post #1 in this FluTrackers link. This family cluster includes a husband and wife from Shanghai who are both confirmed cases, the wife died on April 3, 2013.
Today, media reports indicate the occurrence of another family cluster, a father and son from Shandong Province (FT Link). So far, both of these cases are alive and being treated.
Conclusion
Four family clusters of confirmed and suspected A(H7N9) have been reported from China. In three of the four clusters at least one of the family members has died. The limited data suggest that caregiving behavior and intimate contact may result in limited human-to-human transmission of A(H7N9) in family clusters.
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