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Human infection with avian influenza A(H7N9) virus ? update (WHO, February 14 2014)

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  • Human infection with avian influenza A(H7N9) virus ? update (WHO, February 14 2014)

    [Source: World Health Organization, full page: (LINK). Edited.]


    Human infection with avian influenza A(H7N9) virus ? update

    Disease outbreak news / 14 February 2014


    The National Health and Family Planning Commission (NHFPC) of China and the Centre for Health Protection (CHP), Hong Kong, SAR, China has notified WHO of a total of eight additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus, including one death.


    The details of five cases, including one death, notified by NHFPC on 11 February 2014 are as follows:

    Five of the seven cases are male. The age range is 5 to 70 years old. Cases were reported from Zhejiang (4), Guangdong (1), Anhui (1) and Hunan (1). Currently, three cases are in a critical condition, two cases are in a severe condition and one case has recovered. Six of the seven cases are reported to have had a history of exposure to live poultry or to a live poultry market.
    • A 67 year-old farmer from Jiaxing City, Zhejiang Province, who became ill on 3 February and was admitted to hospital on 8 February. He is currently in a critical condition
    • A 47 year-old woman from Wenzhou City, Zhejiang Province, who became ill on 3 February and was admitted to hospital on 7 February. She is currently in a severe condition. The patient has a history of exposure to a live poultry market.
    • A 62 year-old farmer from Lishui City, Zhejiang Province, who became ill on 29 January and was admitted to hospital on 6 February. He is currently in a critical condition. The patient has a history of exposure to a live poultry.
    • A 56 year-old farmer from Fuyang City, Anhui Province, who became ill on 3 February and was admitted to hospital on 7 February. He died the same evening. The patient had a history or exposure to live poultry.
    • A 5 year-old girl from Guangzhou City, Guangdong Province, who became ill on 1 February and was admitted to hospital on 3 February. She recovered and was discharged from hospital on 7 February. The patient has a history of exposure to a live poultry market.

    The details of two cases notified by NHFPC on 12 February 2014 are as follows:
    • A 70 year-old farmer from Hangzhou City, Zhejiang Province, who became ill on 4 February and was admitted to hospital on 5 February and transferred to another hospital on 9 February. He is currently in a critical condition. The patient has history of exposure to live poultry.
    • A 23 year-old man from Loudi City, Hunan Province, who became ill on 8 February and was admitted to hospital on 9 February. He is currently in a severe condition. The patient has a history of exposure to live poultry.

    The details of the case notified by CHP, Hong Kong SAR, China, on 12 February 2014 are as follows:
    • A 65-year old man from Hong Kong SAR who became ill on 8 February and was admitted to a hospital on 11 February. He has underlying medical conditions and is currently in a critical condition. The patient travelled to Kaiping, Guangdong Province, in China from 24 January to 9 February and stayed with his family. Contact tracing is under way and investigations are ongoing.

    So far, there is no evidence of sustained human-to-human transmission.

    The Chinese Government continues to take the following surveillance and control measures:
    • strengthen surveillance and situation analysis;
    • reinforce case management and treatment;
    • conduct risk communication with the public and release information;
    • strengthen international collaboration and communication; and
    • conduct scientific studies.


    Sporadic human cases

    While the recent report of avian influenza A(H7N9) virus detection in live poultry exported from mainland China to Hong Kong SAR shows the potential for the virus to spread through movement of live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred. However as the virus infection does not cause signs of disease in poultry, continued surveillance is needed.

    Should human cases from affected areas travel internationally, their infection may be detected in another country during or after arrival. If this were to occur, community level spread is unlikely as the virus does not have the ability to transmit easily among human.

    Until the virus adapts itself for efficient human-to-human transmission, the risk of ongoing international spread of H7N9 virus by travellers is low.

    The overall risk assessment has not changed.

    Further sporadic human cases of avian influenza A(H7N9) infection are expected in affected and possibly neighbouring areas, especially given expected increases in the trade and transport of poultry associated with the Lunar New Year.


    WHO advice

    WHO advises that travellers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travellers should follow good food safety and good food hygiene practices.

    Travellers should follow good food safety and good food hygiene practices.
    WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.

    As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.

    WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.


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  • #2
    Re: Human infection with avian influenza A(H7N9) virus ? update (WHO, February 14 2014)

    Friday, February 14, 2014

    WHO Updated FAQ On H7N9 ? Feb 14th




    # 8300


    The World Health Organization has released an updated FAQ (Frequently Asked Questions) document on the H7N9 virus ? the second such update in just over two weeks (see January 29th H7N9 FAQ). As more is learned about this emerging virus, updates like this are very important.

    A quick comparison of the January 29th vs. the February 14th FAQ shows that while much remains the same across the 23 Q&A sections, sections 7. How are people becoming infected with H7N9 virus? and 12. Is the source of human infection poultry and live poultry markets?, contain an interesting change.
    In the past, transmission has been described as:
    Although there have been clusters* of infection (infections in people in close proximity to one another), the virus does not appear to transmit easily from one person to another and further, onward, or sustained human-to-human transmission has not been reported despite investigations and follow up of cases and close contacts of cases.
    While maintaining the same description as above, the new FAQ adds:
    A minority of cases appear to have resulted from limited person to person transmission.
    While hardly a bombshell, given recent reports out of China, this is nonetheless an important change in the FAQ. Follow the link below to read the entire updated FAQ. Due to its size, I?ve only included a few excerpts (bolding mine).
    Frequently Asked Questions on human infection caused by the avian influenza A(H7N9) virus
    Update as of 14 February 2014
    (EXCERPT)

    6. Is the H7N9 virus different from influenza A(H1N1) and A(H5N1) viruses?
    Yes. All three viruses are influenza A viruses but they are distinct from each other. H7N9 and H5N1 viruses are considered animal influenza viruses that sometimes infect people. H1N1 viruses can be divided into those that normally infect people and those that normally infect animals.
    7. How are people becoming infected with H7N9 virus?
    The available epidemiological and virological information strongly indicates that most known human H7N9 infections result from direct contact with infected poultry, or indirect contact with infected poultry (for example, by visiting wet markets and having contact with environments where infected poultry have been kept or slaughtered). A minority of cases appear to have resulted from limited person to person transmission. Because H7N9 infections do not cause severe disease in poultry, this infection can spread ?silently? among poultry. Under such circumstances, the exact exposure for individual cases of human infection may be difficult to establish.
    Although there have been clusters* of infection (infections in people in close proximity to one another), the virus does not appear to transmit easily from one person to another and further, onward, or sustained human-to-human transmission has not been reported despite investigations and follow up of cases and close contacts of cases.
    * A ?cluster? is defined as two or more persons with onset of symptoms within the same 14-day period and who are associated with a specific setting, such as a classroom, workplace, household, extended family, hospital, other residential institution, military barracks or recreational camp.
    8. How can infection with H7N9 virus be prevented?
    It is always prudent to follow basic hygienic practices to prevent infection. They include ensuring hand and respiratory hygiene and taking food-safety precautions.
    Hand hygiene
    • Wash your hands before, during, and after you prepare food; before you eat; after you use the toilet; after handling animals or animal waste; when your hands are dirty; and before and after providing care to anyone in your home who is sick. Hand hygiene will also prevent the spread of infections to yourself (from touching contaminated surfaces) and in hospitals to patients, health care workers and others.
    • Wash your hands with soap and running water when hands are visibly dirty; if hands are not visibly dirty, wash them with soap and water or use an alcohol-based hand cleanser.

    Respiratory hygiene
    • When coughing or sneezing, the person should cover her/his mouth and nose with a medical mask, tissue, or a sleeve or flexed elbow; throw the used tissue into a closed bin immediately after use; perform hand hygiene after contact with respiratory secretions.

    Food safety
    • (see below)

    <SNIP>
    12. Is the source of human infection poultry and live poultry markets?
    Most known human infections results from direct or indirect contact with infected poultry or contaminated environments. A minority of cases appear to have resulted from limited person to person transmission. It cannot yet be confirmed that infected poultry are the only source of infection; and other possible animal or environmental sources of infection cannot be excluded.
    (Continue . . .)

    Posted by Michael Coston at <a class="timestamp-link" href="http://afludiary.blogspot.com/2014/02/who-updated-faq-on-h7n9-feb-14th.html" rel="bookmark" title="permanent link"><abbr class="published" itemprop="datePublished" title="2014-02-14T08:08:00-05:00">8:08 AM</abbr>

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