Thursday, December 26, 2013

Hong Kong: Epidemiological Update On H7N9

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# 8107

 

Via Hong Kong’s CHP’s bi-weekly online journal Communicable Diseases Watch, we get an Update on the situation of avian influenza A(H7N9) infection reported by Dr Conan Tsang, Medical and Health Officer, Respiratory Disease Office, Surveillance and Epidemiology Branch, CHP. 

 

This update – dated December 24th - adds 14 new cases since the last update in August of 2013.  I’ve only included a few excerpts, follow the link to read it in its entirety.

 

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Geographic spread of cases  - Credit HK CHP

 

Update on the situation of avian influenza A(H7N9) infection

Reported by Dr Conan Tsang, Medical and Health Officer, Respiratory Disease Office, Surveillance
and Epidemiology Branch, CHP.


Since the publication of last issue concerning avian influenza A(H7N9) infection (http://www.chp.gov.hk/files/pdf/cdw_v10_16.pdf), 14 more confirmed cases of human infection with avian influenza A(H7N9) virus were reported (as of December 20, 2013). Among these cases, two of them were likely imported cases from Shenzhen and were confirmed in Hong Kong (HK) on December 2 and 6 respectively, whereas 6 cases were reported from Guangdong Province between August 10 and December 19, 2013.

As of December 20, 2013, the National Health and Family Planning Commission (NHFPC) has reported 144 cases of human infection with avian influenza A(H7N9) virus across 10 provinces and 2 municipalities, including 47 deaths. The health authority of Taiwan also reported one imported case from Jiangsu Province on April 24, 2013. Including the 2 cases confirmed in HK, there are a total of 147 cases. The geographical distribution of the cases is summarized in Figure 1.


Based on the available information, the age of the cases ranged from 2 to 91 years (median: 60 years) and involved 104 males and 43 females. Forty-seven cases died with a case fatality rate of around 32%. The onset dates of the confirmed cases were between February 19 and December 11, 2013 (Figure 2).

(Continue . . . )

 

While obviously a huge concern, thus far we’ve not seen any evidence of sustained or efficient human-to-human transmission of the H7N9 virus.The WHO Avian Flu Risk Assessment – December, provides the following risk assessment on this emerging avian flu virus:

 

Overall public health risk assessment for avian influenza A(H7N9) virus: Sporadic human cases and small clusters would not be unexpected in previously affected and possibly neighbouring areas/countries of China. The current likelihood of community-level spread of this virus is considered to be low.

Continued vigilance is needed within China and neighbouring areas to detect infections in animals and humans. WHO advises countries to continue surveillance and other preparedness actions, including ensuring appropriate laboratory capacity. All human infections with non-seasonal influenza viruses such as avian influenza A(H7N9) are reportable to WHO under the IHR (2005). 

 

Similarly, the ECDC recently published an  Epidemiological Update on H7N9, which is current through the last reported case in Shenzhen on Wednesday of last week.

 

After reviewing the data to date, the ECDC’s Risk Assessment at the end of this report illustrates the concern which many scientists and public health officials have regarding this virus.  They warn that public health authorities in the EU should be prepared for the importation of this virus, and close by stating::

 

ECDC’s view is that if this virus persists in poultry, it will represent a significant long-term threat, either as a zoonosis or perhaps a pandemic virus. Both eventualities should be prepared for.

 

So we watch these scattered cases carefully, looking for any signs that this virus is moving closer to becoming a serious public health threat.

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