2013-04-15 Daily H7N9 Avian Influenza virus situation update

[Forwarded from aisd-ozbug Moderator]

An update on the H7N9 situation from Gary Lum at DoHA.

I’ll only forward these if there is a significant change in the situation – the rise in case numbers, and the spread beyond the Shanghai/Nanjing region is notable.

Allen

Daily H7N9 Avian Influenza virus situation update
Summary
The number of reported infected patients has increased to 61 cases with 13 deaths. There is still no evidence of human-to-human transmission.
Further Details
Cases
1. The number of cases has reached 61, including 13 fatalities, 36 severe cases and 11 mild cases. Note: case totals include 10 which are yet to be confirmed by WHO.
2. There are currently six regions affected which represents possible spread of the outbreak towards the north and west. All cases, with the exception of those identified in Beijing, have occurred in contiguous provinces, viz., Shanghai (23 cases), Jiangsu (18 cases), Zhejiang (14), Anhui (2), Henan (2) and Beijing (2).
3. Case numbers are expected to increase as China has moved from syndromic monitoring to active screening of high risk groups.
4. Two confirmed cases have been associated with possible family clusters in which one and two additional family members developed severe pneumonia, respectively. However, direct person-to-person transmission has not been confirmed in these or any other cases (WHO).
5. Active screening of contacts of the first Beijing case has detected infection of a four year old boy who is currently asymptomatic. The boy’s family are neighbours of the first confirmed Beijing case.
6. Monitoring of close contacts (>1000) of the confirmed cases is ongoing.
7. The date of symptom onset of cases was between 19 February and 11 April. The incubation period is not precisely known.
8. Median age of all cases is 54 years (range 487). Of the 54 cases where sex is known, there are 40 males and 14 females.
9. Cases have occurred in over 13 cities, some a few hundred kilometers apart. At least four cases have occurred in residents of rural areas. No comment can be made concerning contact with possible animal reservoirs due to incomplete data.
The virus
Compared with H5N1, animal to human transmissibility seems to be higher for H7N9.
Detection of this novel virus occurred through laboratory investigation of patients with severe pneumonia returned influenza A results that was not able to be further typed.
The National Avian Influenza Reference Laboratory said Thu [11 Apr 2013] that the new strain of [avian influenza virus], H7N9, has been found in two out of a total of 10 duck samples in Huzhou, Zhejiang Province. This comes after the virus was previously detected in chickens and pigeons.
Outbreak management
There is currently no vaccine available for H7N9 influenza.
All WHOcc laboratories have received live virus from the Beijing WHO Collaborating Centre.
Receipt and propagation of virus is necessary to produce reference material for diagnostic test and vaccine development.
The Department of Health and Ageing website
DoHA has provided information to clinicians including pathologists and medical laboratory scientists involved in diagnosis at http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-avianflu-china.htm This information will be revised and updated as required.
World Health Organization
WHO Update 12 April (Geneva Time)
http://www.who.int/csr/don/2013_04_12/en/index.html
Frequently Asked Questions on human infection with A(H7N9) avian influenza virus, China
Update as of 5 April 2013. See Mondays daily update for the full text.
http://www.who.int/influenza/human_animal_interface/faq_H7N9/en/index.html
WHO weekly reporting
Links to a PDF which will be updated weekly
WHO Risk assessment as of 13 April 2013
http://www.who.int/influenza/human_animal_interface/influenza_h7n9/RiskAssessment_H7N9_13Apr13.pdf PDF document
Food and Agriculture Organization update
From 12 April 2013
A new nomenclature for the virus has been agreed upon today by WHO, FAO and OIE: avian influenza A(H7N9) virus.
FAO HQ will host an expert meeting on epidemiology of H7N9 to discuss risk analysis and surveillance methodologies on 17 and 18 April.
Food and Agriculture Organization of the UN Frequently Asked Questions
These are from 12 April 2013.
http://www.fao.org/news/story/en/item/173704/icode/

Dr Gary Lum, AM
Specialist Medical Adviser
Monday, 15 April 2013
—
Allen Cheng
Associate Professor in Infectious Diseases Epidemiology
Department of Epidemiology and Preventive Medicine
Monash University

Infectious Diseases Physician
Alfred Hospital

Honorary Principal Research Fellow
Menzies School of Health Research

—
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