Tuesday, May 27, 2014

Shandong Province: Two Related H7N9 Cases

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# 8669

 

Although we’ve continued to see a smattering of H7N9 cases reported across Eastern China over the past few months, the number of cases has dropped markedly since February, likely due to the closure of many live markets.  Most of this year’s activity has been centered in Zhejiang and Guangdong Province.

 

Today, we’ve a bit of an outlier, however, as we have a father-son cluster reported in Yantai City, Shandong Province.   Until now, Shandong Province had only reported three cases, one of which was imported from Jiangsu Province.

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Credit Hong Kong’s CHP Avian Flu Report  -  VOLUME 10, NUMBER 21

 

Today’s report (h/t Sharon Sanders of FluTrackers) links two H7N9  cases. 

 

  • The first was reported 5 days ago on FluTrackers – that of a 61 year-old man (retired) who fell ill on May 11th, and was hospitalized on the 21st, and tested positive.  He has since died.
  • The second case – the man’s son (age 33) – is now hospitalized and positive for the virus as well.

 

This report from sina.com.

 

Yantai confirmed two cases of H7N9 influenza cases in which a person died

At 16:04 on May 27, 2014 China News Network

EIJING, May 27 Yantai Electric (Wang Jiao Ni) reporter on the 27th from the relevant department of Yantai City, Yantai City has confirmed two cases of H7N9 flu, the first case the patient has died, the second patient is currently receiving treatment.

It is reported that the first case of male patients Xinmou Department, 61-year-old retired worker, May 6 fever, hold breath and other symptoms, and gradually increase, on May 11 hospitalized May 21 and Yantai City, Shandong Province diagnosis of H7N9 influenza expert group confirmed cases, the acute respiratory distress syndrome, multi-organ failure, died, died on May 23.

The second patient department first patient's son, aged 33, on May 15 with fever, May 20 hospitalized, May 22 was diagnosed with H7N9 influenza cases. Expert Group currently being conducted to treat the patient.


After the outbreak, the Yantai Municipal Health Bureau organized experts to quickly carry out epidemiological surveys of close contacts under medical observation. Currently Yantai no new H7N9 influenza cases reported. (End)

 

While our ears perk up a bit anytime we see related H7N9 cases, we have no current evidence of human-to-human transmission in this case.   In fact, we don’t have any information on exposure of any kind.

 

As we’ve discussed previously, when it comes to proving human-to-human (H-2-H) transmission of an emerging virus, the bar is set pretty high.  When there are other, equally plausible explanations (e.g. shared environmental exposures), then H-2-H cannot be assumed.

 

Last August, in BMJ: `Probable Person-to-Person Transmission’ Of H7N9, we looked at some of the factors involved in determining H-2-H transmission. Even though other suspected H-2-H transmission has been suspected, it has been very difficult to prove.

 


Hopefully we’ll get a more detailed epidemiological report on these two cases in the coming days.

 

For now, the good news is that human infections remain rare. We haven’t seen the  kind of exponential growth in cases one would associate with an easily transmissible virus.  But, as we saw on Saturday (see EID Journal: H7N9 As A Work In Progress), the H7N9 virus continues to evolve.


So the threat posed by it, along with other emerging avian flu viruses, has not gone away.