Friday, April 21, 2017

HK CHP Notified Of 27 New H7N9 Cases From The Mainland

Fifth Wave - FAO - April 12th



#12,400


After weeks of declining numbers following the mandated closure of many live bird markets, China's NHFPC has notified Hong Kong's CHP of 27 new H7N9 infections, the largest weekly report we've seen since the end of February. 
Seven of these cases are from Beijing, a story we've been following closely all week (see here, here, and here).
Aside from the obvious concern that H7N9 may have gotten a foothold in poultry inside one of China's largest cities (pop. 21 million) - its first major appearance in the nation's seat of power, just months before their 19th National Congress of the Communist Party of China - may have some political implications as well.

Even without Beijing's 7 cases, today's tally is the highest in a month, with hard-hit Hunan Province adding 5 more cases, and 3 each from Hebei and Sichuan. These three are the first reported from Hebei Province this year, and brings Sichuan Province - which until February of this year had never reported a case - up to 17 cases.
Somewhat surprisingly, and for the fourth week running, Guangdong Province has not reported any H7N9 cases.
As for what may account for this abrupt increase in cases, we simply don't have enough information to say. It could be as simple as - after 2 months of forced market closures - live markets in some areas may be operating again (legally, or illegally).

One week's report, however, it too small of a sample to make much of.  The next few weeks will tell us if this week's report is an aberration, or something more serious.
Today's report moves us solidly over the 620 case mark for the year (614 mainland, 5 Hong Kong, 2 Macao, 1 Taiwan), which is nearly double the largest yearly total ever recorded (2014- 320 cases).
While any revival in this year's epidemic would be concerning, we've seen no evidence of sustained or efficient transmission of the virus between humans, and the lack of recently imported cases to either Hong Kong or Macao remains reassuring.

That said, H7N9 is a continually evolving and adapting, and this year has shown subtle behavioral changes (see Eurosurveillance: Preliminary Epidemiology & Analysis Of Jiangsu's 5th H7N9 Wave), which makes it a virus we dare not ignore.

This from HK's CHP:

The Centre for Health Protection (CHP) of the Department of Health today (April 21) received notification from the National Health and Family Planning Commission that 27 additional human cases of avian influenza A(H7N9), including seven deaths, were recorded from April 14 to 20, and strongly urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.
 

The 16 male and 11 female patients, aged from 34 to 79, had onset from March 22 to April 18, of whom seven were from Beijing, five from Hunan, three each from Hebei and Sichuan, two each from Shandong and Zhejiang, and one each from Anhui, Gansu, Guangxi, Jiangxi and Liaoning. Among them, 21 were known to have exposure to poultry, poultry markets or mobile stalls.

Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchase of live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry.

 Travellers returning from affected areas should consult a doctor promptly if symptoms develop, and inform the doctor of their travel history for prompt diagnosis and treatment of potential diseases. It is essential to tell the doctor if they have seen any live poultry during travel, which may imply possible exposure to contaminated environments. This will enable the doctor to assess the possibility of avian influenza and arrange necessary investigations and appropriate treatment in a timely manner.

While local surveillance, prevention and control measures are in place, the CHP will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments.

The CHP's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up.

The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is under way. The travel industry and other stakeholders are regularly updated on the latest information.
 

The public should maintain strict personal, hand, food and environmental hygiene and take heed of the advice below while handling poultry:
 

  • Avoid touching poultry, birds, animals or their droppings;
  • When buying live chickens, do not touch them and their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume them immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs;
  • Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done;
  • Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to the toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and
  • Wear a mask if fever or respiratory symptoms develop, when going to a hospital or clinic, or while taking care of patients with fever or respiratory symptoms.

     The public may visit the CHP's pages for more information: the avian influenza page, the weekly Avian Influenza Reportglobal statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel.
Ends/Friday, April 21, 2017
Issued at HKT 17:00

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