Saturday, January 11, 2014

Emergence of avian influenza A(H10N8) in human after A(H5,6,7,9,10 and N1,2,3,7,9): single intrusion or looming epidemic?

United National Library of Medicine
National Institute of Health J Infect.
2014 Jan 6. pii: S0163-4453(14)00002-4. doi: 10.1016/j.jinf.2013.12.014. [Epub ahead of print]
To KK1, Tsang AK2, Chan JF1, Cheng VC2, Chen H1, Yuen KY3  

In December 2013, China reported the first human case of avian influenza A(H10N8). A 73-year-old female with chronic diseases who had visited a live poultry market succumbed with community-acquired pneumonia. While human infections with avian influenza viruses are usually associated with subtypes prevalent in poultries, A(H10N8) isolates were mostly found in migratory birds and only recently in poultries. Although not possible to predict whether this single intrusion by A(H10N8) is an accident or the start of another epidemic like the preceding A(H7N9) and A(H5N1), several features suggest that A(H10N8) is a potential threat to humans. Recombinant H10 could attach to human respiratory epithelium, and A(H10N4) virus could cause severe infections in minks and chickens. A(H10N8) viruses contain genetic markers for mammalian adaptation and virulence in the haemagglutinin (A135T, S138A[H3 numbering]), M1(N30D, T215A), NS1(P42S) and PB2(E627K) protein. Studies on this human A(H10N8) isolate will reveal its adaptability to humans. Clinicians should alert the laboratory to test for A(H5,6,7,9,10) viruses in patients with epidemiological exposure in endemic geographical areas especially when human influenza A(H1,3) and B are negative. Vigilant virological and serological surveillance for A(H10N8) in human, poultry and wild bird is important for following the trajectory of this emerging influenza virus.

Copyright © 2014. Published by Elsevier Ltd.

#H7N9 chopping block in restaurants experts say food can be cross-infection

For the Guangzhou restaurant chopping tested positive H7N9 avian influenza virus, Zhongshan University, Head of Department of Microbiology, Dr Paul CHAN Kay believes that reflect the range of the virus spread more widely, I believe the epidemic will continue in the short term, and even more serious.
Dr Paul CHAN Kay analysis, we found the bird flu virus in the chopping block, meaning that there are problems related to the chopping block once processed chickens, if re-used kitchen utensils cutting boards or other food processing, if not chickens, there will be cross-infection.
For the State Planning Commission, said Wei, a whole stable of bird flu, Dr Paul CHAN Kay believes that just means there is no big change smoothly when the virus was discovered early, mild illness does not mean that if human infection with H7N9 avian influenza, there's the chance of serious disease is quite high.
With the discovery of the virus there chopping samples, Dr Paul CHAN Kay urged the public to be especially careful when the mainland, if not high-risk places such as chickens to market, or no contact with the chickens, has a chance to be infected with the virus, we should always maintain personal hygiene and hand washing.

#H7N9 Guangzhou Case Contacts on Tamiflu & Shenzen Case is not optimistic, on ventilator

[The Shenzen Case is not "stable".  You can read below that the 76 yo man is not doing well, even though he is "stable".  He is still in critical condition.
red editing is mine]
Translation - Excerpt:

Southern News yesterday afternoon, the Guangdong Provincial Health and Family Planning Commission Bulletin, Guangzhou, Shenzhen, were reported confirmed cases of H7N9 avian influenza case of human infection. As of yesterday, Guangdong Province reported a total of 14 cases of H7N9 confirmed cases of human infection, including Dongguan and 1 died. Since entering in 2014, within 11 days of Guangdong on the report of eight cases of human infection with H7N9.
  The next patient was live poultry stalls in Guangzhou unloading points
  According to Provincial Planning Commission informed Wei, Guangzhou Panmou case for patients, male, 29 years old, currently residing in Baiyun District of Guangzhou City and streets in Tianhe District, Longgang Road, Sha East market operators tofu. January 3, 2014 the disease, avian influenza H7N9 infection in sentinel local hospital on January 9, to give "Tamiflu" treatment.
  Guangzhou CDC deputy director Yang Zhicong introduction, the case was the first case of human infection with the H7N9 Guangzhou native bird flu cases, the source of infection for the live poultry stalls nearby sand East market. Patients have already moved south hospital intensive care unit, is currently in critical condition, the hospital is organizing experts trying to treat. Its 39 close contacts have been tracking in place and have been preventive medication Tamiflu, which has two young children (child patient), currently No abnormality was found.
  It is understood that after the outbreak, Guangzhou Tianhe District health, agriculture, industry and commerce departments have conducted the night of live poultry culling the market, harmless treatment and thorough cleaning and disinfection, from the 11th onwards the market closed for three days. Tianhe District to take a two-week emergency monitoring. After disinfection, the market is still a risk? Yang Zhicong introduced, which depends on the market situation of pollution, light pollution, if the risk is low, high pollution, the risk is high. The extent of the infection in this market, 杨智聪 claimed to have 39 on the surrounding environmental sampling, sample results Not out.
  Patients are not in direct contact with live birds, how infection? 杨智聪 said the survey found that there are four sand East market stalls selling poultry shop every day unloading shop next to the patient, the patient may be the cause of infection. However, there is no evidence that H7N9 has sustained human to human evidence.
  Shenzhen newly diagnosed patient's condition is not optimistic
  Provincial Planning Commission informed Guardian said Zhao Shenzhen case for patients, male, 76 years old, currently residing in Buji, Longgang District, no live poultry exposure history. January 3, 2014 the disease, avian influenza H7N9 infection in sentinel local hospital on January 9, to give "Tamiflu" treatment. Currently, the patient's condition is stable.
  Shenzhen Third People's Hospital Zhoubo Ping revealed that the patient because of advanced age and suffering from tuberculosis, hypertension and diabetes and other underlying diseases, poor immunity, by the H7N9 bird flu virus after the current has basically lungs loss of function, there have symptoms of hypoxia, must rely on ventilator to breathe.Because the older the patient, and the rapid progression of the disease, the current condition is not optimistic. However Zhoubo Ping said that the patient is more fortunate, his body did not appear superbugs, Founder homes currently using Tamiflu and other antiviral drugs, and a clearer sense of the patient himself.
  Shenzhen CDC experts said it has close contacts of 37 cases in Shenzhen were under medical observation, yet found an exception.
  Prior to the first patient in Shenzhen confirmed a European living in Longgang South Bay streets, adjacent to the Buji Street, then this case is associated with two of it? Experts believe that the current survey and research point of view, two cases are not directly linked, it is still no clear evidence to prove the disease from person to person possible.

KO: Hong Kong has multiple risk management #H7N9 #H1N1


Core Tip: Haizhu District of Guangzhou, a restaurant chopping boards and two live chickens were found to have H7N9 bird flu virus, food  Board Secretary Ko Wing-man, said yesterday that the current supply of live chickens in Hong Kong have multiple risk management, affected by avian flu low risk, without a "one size fits all" approach to limit the mainland live chickens to Hong Kong. In addition, Yin Liang HA Chief Executive, said influenza seasons, influenza season and face the threat of avian flu, the occupancy rate in excess of 120% of the acute wards, suspended non-emergency surgery, the doctor will work overtime to cope with the Chinese New Year public hospitals Non-emergency services or postponed.


In addition, the beam  Yin said yesterday that the face of the peak of the flu and the threat of avian influenza, acute hospital beds were full, emergency ward occupancy rate of 120%, urged the public to take care of themselves, experiencing mild symptoms, try to avoid the emergency room, "enter influenza season, into the accident and emergency department of public often have to wait four to five hours, "Lunar New Year, the need to postpone some non-emergency surgery, but emergency surgery is not affected. 

WHO Human infection with avian influenza A(H7N9) virus – update January 10, 2014

The Centre for Health Protection, China, Hong Kong SAR, notified WHO on 8 January 2014 of an additional laboratory-confirmed case of human infection with avian influenza A(H7N9) virus. 

The patient is a 65-year-old man with underlying illness. He became ill on 3 January and was admitted to hospital on 7 January with a chest infection and transferred to the intensive care unit later that day. He tested positive for avian influenza A(H7N9) virus on 8 January. The patient is currently under isolation and in a critical condition. The patient had travelled to Shenzhen, Guangdong province, with a family member from 1 to 2 January. They passed by a wet market in Shenzhen on 1 January. In Hong Kong, the patient did not enter a wet market, but may have passed a market entrance in the mornings. 

The patient’s close contact has remained asymptomatic and is under quarantine for 10 days since the last contact with the patient. Contact tracing for other contacts, including hospital patients as well as healthcare workers and relevant hospital visitors, are under way. The infection is considered to have occurred outside Hong Kong. The investigation is ongoing. 

On 9 January 2014, the National Health and Family Planning Commission of China notified WHO of an additional laboratory-confirmed case of human infection with avian influenza A(H7N9) virus.

The patient is a 51 year old woman from Jiaxing City in Zhejiang Province. She became ill on 28 December and was admitted to the hospital on 6 January. She is currently in critical condition. The source of infection is still under investigation. 


Continental H7N9 cases surge ‭ ‬ stop imports of live chickens in Hong Kong to promote group

translation/editing is mine
Hong Kong, a group of Democratic Party members marched to the government headquarters in Admiralty, emphasizing the continent from north to south proliferation of bird flu, Beijing, Zhejiang, Guangdong Dongguan, Shenzhen and Hong Kong have a human infection Requested the Government to fully stop the importation of live chickens from the mainland, and the introduction of live chickens H7 serum antibody testing, strengthen prevention work.

Hong Kong Legislative Council Helena WONG: Now just stop the importation of live chickens in Hong Kong Government from Shenzhen farms, chicken farms and did not stop all the continent, there is no way to know that we now enter our chickens are completely safe to eat.

Continental has been at least 157 confirmed human cases of H7N9 avian influenza. Hong Kong already accumulated three cases. In addition, the mainland Chinese experts published an article in the scientific journal, found that H7N9 virus has mutated, limited human-to-human transmission started specific ability. 

#H7N9 Guangdong 5 Days: 7 Cases~ 5 Critical~2 Mild~3 No Poultry Contact

*Edit:  Updated information, makes 5 critical and 2 stable.  The 76(M) from Shenzhen is in critical conditon on a vent.  
[according to the Confirmation date]

Date of Report:  1/6/14
Name:  47(M) Xiemou – Poultry worker
From:  Lishui Town, Nanha Dist., Foshan City, poultry worker
Onset:  12/25
Adm:  1/3/14 ICU First Affiliated Hosp. Guangzhou
Confirmed:  1/6/14
Notes:  60 contacts

Date of Report:  1/6/14
Name:  71(M) Lee -Farmer
From:  Yangjiang City, Yangdong County
Onset:  1/1/14
Adm:  1/2/14 People’s Hospital outpatient
Adm:  1/4  ICU
Confirmed:  1/6/14
Notes:  Exposure not clear.  65 close contacts

Date of Report:  1/7/14
Name:  31(M) Ou
From:   Hung Wai Street, Jiefang Road, Luohu Dist, Shenzhen City
Onset:  12/30/13 fever, fatigue.  Self-medication
12/31:  worse
1/3:  Adm - Bao’an Dist People’s Hospital
1/5:  Transferred to ICU
1/6:  Confirmed
1/7:  Transferred to Shenzhen Third People’s Hosp.
current status 1/8:  Stable.
Notes:  No live poultry exposure.  35 contacts.  All test negative

Date of Report:  1/9/14
Name:  51(F)  Choi [Cui Xing Nvzi]
From:  Jiujiang Town, Nanhai, Foshan City
12/31 – to vegetable market buy chickens to slaughter @ home
Markets:  Luopu, Yi Feng – closed both.
Onset:  12/31 fever 40, cough, take expectorant
Adm:  1/1 Hospital in Foshan, Jiujiang, 2nd anti-infect. treatment
Adm:  1/3 ICU First People’s Hospital Foshan City, Significant cough, shortness of breath
1/3:  intubated
1/4:  ICU
Confirmed:  1/7 Foshan City CDC
Sym’s on Adm: fever, low blood condition
Breathing more difficult after a few hours.
After 10 hours:  breathing machine
Note:  21 contacts .  Contact with poultry.

Date of Report:  1/10/14
Name:  42(F) Liu/Ryu
From:  Yanbu, Nanhai District, Foshan City
Onset:  1/5
Adm:  1/8, local hospital given tamiflu
Adm:  1/9 Hospital, mild case
Confirmed:  1/10
Note:  20 conacts.  Poultry worker.

Date of Report:  1/10/14
Name:  59(F) Liu
From:  Nanhai District, Foshan (retirement home)
Onset:  12/29
Adm:  1/2 , tamiflu, mild case
Confirmed:  1/10
Note:  No poultry contact.  5 contacts.

Date of Report:  1/11/14
Name:  76(M) Zhao
From:  Buji, Longgang District, Shenzhen
Onset:  1/3
Adm:  1/9, ICU on ventilator, tamiflu
Note:  no poultry exposure.  Co-morbidities.

#H7N9 Zhejiang Province: 6 Days = 5 Cases~1 Death-~4 Critical

Date of Report:  1/5/14
Name: 34(F) Cai
From:  Zhuji
Onset:  12/29
Adm:  1/2/14 First Affiliated Hospital, Hangzhou
1/4/14:  Zhejiang Univ. School of Medicine
Confirmation:  1/4
Status:  Critical Condition

Date of Report:  1/9/14
Name:  51(F)
From:  Zhejiang
Adm:  Hangzhou Hospital
Status:  Severe

Date of Report:  1/10/14
Name:  79(F) Huang
From:  Pinghu, Zhejiang
Confirmed:  1/9
Adm:  ICU Jiaxing

Date of Report:  1/10/14
Name:  30(M) Liu
From:  Yinzhou District, Ningbo City,  Zhejiang
Confirmed:  1/9
Onset:  1/2  fever, cough
Adm:  1/7 ICU Ningbo
Note:  Food Sales

Date of Report:  1/11/14
Name:  75(F)
From:  Zhuji, Zhejiang
Onset:  1/1
Adm:  1/5 Hangzhou
DOD:  1/9
Confirmed:  1/10

Taiwan MAC will be included in Fujian yellow travel alert #H7N9

(Xinhua)) Given the new one in Fujian Province confirmed cases of H7N9 avian influenza, Mainland Affairs Council announced tonight, according to the Central Epidemic Command Center decided to Fujian column Travel into the yellow warning area, and it is necessary to remind local people to remain vigilant.
MAC said that the epidemic command center, today announced the mainland Fujian, Jiangsu and each new one confirmed cases of H7N9 avian influenza, and propose to upgrade to the Fujian Provincial Tourism epidemic in Guangdong, Zhejiang, Jiangxi, Jiangsu, Hunan, Shanghai and Beijing provinces with the second stage: Alert (Alert).
MAC So remind people pay special attention to tourism safety, and to consider whether the local. If necessary go, should strengthen self-health care and vigilance.
In addition, the MAC Again, H7N9 virus persistence in the environment, the threat of infection has not been released, will still be the risk of human infection with the threat of vigilance.
MAC said that at this stage does not exclude the southern continent has a tendency to expand the epidemic, people should pay attention to the mainland of self health care, keeping wash their hands, wearing masks health habits, do not touch any of the feeding birds, avoid going to have live poultry traditional market, be sure to eat cooked poultry meat and eggs.
After returning to the country, such as the symptoms of fever, cough, please wear a mask doctor immediately and inform the physician travel history.

#H7N9 Case List Correction

 I will be changing and correcting the data on my Case List for the 34(F) in Zhejiang reported on 1/5/14.

January 6 --From CIDRAP:
Meanwhile, a 34-year-old woman from Zhejiang province is hospitalized in critical condition with an H7N9 infection, according to a separate CHP statement. Her symptoms began on Dec 29 and she was hospitalized on Jan 2; the virus was confirmed in her respiratory samples 2 days later. She is in critical condition.
The woman is from the city of Zhuji, and her illness is the first H7N9 case reported in Zhejiang province this year, Xinhua, China’s state news agency, reported yesterday...

Therefore, I am changing the location on my list of the 34(F) from "Shaoxing City" to Zhuji.  We will now have two people from Zhuji.  Today's reported death is from Zhuji, Zhejiang.  The Correction will be edited and noted on my case list post, on the previous page of this blog.  

#H7N9 Case List 2014 -- 21 Cases -- 2 Dead -- 14 Critical Condition

This is my personal list.  The numbers represent the ages.

Zhejiang:  5 (51)

A.    Jhuji 2 (34) (75)
B.    Pinghu 1 (79)
C.    Ningbo City  1
I.      Yinzhou District 1 (30)

Shanghai:  3
A.   Shanghai City 3  (86) (58) (56)

Jiangsu:  2
A.   Nanjing City 2 (54F) (54M)

Guangdong:  8
A.   Foshan:  5
I.      Nanhai District 4 (59) (42)
a.    Lishui Town 1 (47)
b.    Jiujiang Town 1 (51)

B.   Yangjiang City 1
I.      Yangdong County 1 (71)

C.   Shenzhen City 2
I.      Luohu District 1 (31)

II.    Longgang District 1 (76)

Fujian:  1
A.   Quanzhou City
I.      Hui’an County 1 (38)

Hong Kong:  1
A.   Sham Shui Po District 1 (65)

Guangzhou:  1
A.   Guangzhou City
I.      Baiyun District (29)

#H7N9 Hong Kong CHP Update: 5 Cases-- 3 Critical, 1 Death

January 11, 2014
Press Release

The Centre for Health Protection (CHP) of the Department of Health (DH) today (January 11) received notification of five additional human cases of avian influenza A(H7N9) respectively in Guangzhou (one case) and Shenzhen (one case) from the Health and Family Planning Commission of Guangdong Province, and in Shanghai (two cases) and Zhejiang (one case) from the National Health and Family Planning Commission.

     In Guangzhou, the male patient aged 29 is currently in critical condition. He lives in Baiyun. The case in Shenzhen involved a man aged 76 who is now in stable condition. He lives in Longgang and had no known poultry exposure. Both became ill on January 3 and were admitted to local hospital for medical treatment on January 9. Epidemiological investigations and medical surveillance over close contacts are underway.

     Regarding the two cases in Shanghai, both patients are in critical condition. The female patient aged 58 became ill on January 1 and was admitted to hospital on January 8 for medical treatment. Her specimen was laboratory confirmed on January 10. The other male patient aged 56 became ill on January 6 and was admitted to hospital for treatment on January 9. The case was laboratory confirmed today. Both patients described poultry exposure.

     In addition, in Zhejiang, the female patient aged 75 became sick on January 1 and was admitted to hospital for treatment on January 5. She died on January 9 and the case was laboratory confirmed on January 10. She also had poultry exposure.

     As of 9pm today, a total of 163 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (56 cases), Shanghai (36 cases), Jiangsu (30 cases), Guangdong (14 cases), Jiangxi (six cases), Fujian (six cases), Anhui (four cases), Henan (four cases), Beijing (two cases), Hunan (two cases), Shandong (two cases) and Hebei (one case).

#H7N9 Guangdang Foshan Case Rptd on 1/10 Poultry Worker - finds positive samples in personal vehicle

[this article describes 2 cases recently reported, and the referral to the "first case" below is 42(F) from Nanhai District, Foshan City, rptd on 1/10]

January 11, 2014

Foshan Municipal Health Bureau, said the current four confirmed cases in Foshan, are sporadic cases, no epidemiological association, all close contacts of cases under medical observation, No abnormality was found.

Another epidemiological investigation of the first case detected collecting samples, detected four positive samples in their vehicles carrying poultry, the vehicle has been thoroughly disinfected.

Full article:

#H7N9 2 New Cases -- Guangzhou and Guangdong

January 11, 2014
International online news (reporter Chen Huiting, correspondent Guangdong Wei Xuan) January 11 afternoon, the Guangdong provincial CDC report: Guangzhou appear first case of human H7N9 avian influenza infection, Shenzhen and added one new case.
  Guangzhou Panmou patient, male, 29 years old, currently residing in Baiyun District of Guangzhou City and the streets, in the Tianhe District, Longgang Road, Sha East market operators tofu. January 3 disease, avian influenza H7N9 infection in sentinel local hospital on January 9, to give "Tamiflu" treatment. Currently, patients in critical condition.

Shenzhen patient Zhao, male, 76 years old, currently residing in Buji, Longgang District, no live poultry exposure history.January 3 disease, avian influenza H7N9 infection in sentinel local hospital on January 9, to give "Tamiflu" treatment.Currently, the patient's condition is stable.
  Two health department is carrying out active treatment for patients, who do a good job in close contact with medical observation, epidemiological and environmental disinfection prevention and control work.

Friday, January 10, 2014

#H7N9 Guangdang Foshan 51(F) Update - Incresed Critical Condition

Foshan first case of human infection with H7N9 patients in critical condition or nothing to do with poultry pathogens
Yesterday was the second day of Foshan local people diagnosed the first case of H7N9 infection in patients after. According to the latest results of the consultation admitted to hospital in Foshan City, a hospital, the patient's condition yesterday no signs of improvement compared to a few days ago, is still very serious. After a few days of treatment, the vice president of chapter into the country said that as the case has been three years history of diabetes, and weight suspected lung disease, while patients after the onset of live poultry slaughtered in history, consultation Group believes the etiology of this case or nothing to do with birds.  

Serious illness treatment difficult The Hospital of Foshan City, a first case of human infection with the H7N9 patients Choi, female, 51 years old, Nanhai Jiujiang people diagnosed with the disease in the evening after 8, the hospital is still in the ICU for treatment. The latest diagnostic results for patients infected with avian influenza (critical type), severe pneumonia, severe sepsis, septic shock, multiple organ dysfunction syndrome (respiration, circulation, blood, kidneys, nerves), viral myocarditis, cardiac decompensation, type Ⅱ diabetes mellitus, hypokalemia, hyponatremia. 

 At present, for the patient, chapter into the country, said the hospital has organized expert consultation every effort to rescue, but the patient's condition is still critical, still need mechanical ventilator, vasopressors to maintain blood pressure, any time of danger. In addition, the patients in 2013 in Jiujiang hospital for chest CT examination showed lung lesions, and continued progress, the Guangzhou Institute Professor call consultation considered the possibility can not be ruled out lung cancer, the patient's long-term prognosis is poor, treatment is difficult .

Zhang introduced into the country, three days later the patient came to the city, a hospital has been taking Tamiflu, after increasing the dose increased treatment, the disease is also no signs of improvement, the patient's lung infection yesterday opposite the area increases, the situation is very critical. Live poultry before the onset of disease, or history of exposure to base the main reason
According to Yu, deputy director of the hospital ICU iron Gull introduced before the patient had a history of diabetes for 3 years, while half of the patients had been previously suspected tuberculosis disease, accompanied by a long-term cough, expectoration, but before the patient has been In Jiujiang hospital. 

According to patient reports feeling often cough, Jiujiang hospital before the patient has been suspected tuberculosis, but has been unable to confirm the diagnosis. Fitch iron Gull, due to low immunity in patients with diabetes, the greater the likelihood of being infected, if it is also suffering from other underlying diseases, it will make possible significant increase in H7N9's suffering. He admitted, obesity, malnutrition, cancer patients after surgery, the patient is recovering from heart disease is slow, long-term use in patients with hypertension and immunological preparations and other patients who are chronic infections in high-risk populations H7N9.

 Fitch iron Gull introduced before the patient Choi has been engaged in financial and other clerical work at a gas station, work content much in contact with poultry. Although patients who lives next to Jiujiang, a farmers market, but patients said after the onset of the day, only to slaughter live poultry behavior. Therefore, chapter into the country, said the etiology of the patient may be unrelated to poultry, severe underlying disease may induce infection is the most important reason. In this regard, he further explained, on the one hand the long-term close contact with the patient's family has not yet found signs of infection, and these days in close contact with the patient seven city hospital medical workers currently in the normal hand, and Foshan adjacent Yangjiang 10 live bird markets have 9 found H7N9 epidemic, but the city only three cases of human infection with H7N9 cases, which also belongs to distribute three patients state, similar to the Foshan two patients have been diagnosed case , but so far only two cases previously diagnosed patients in Zhejiang is kinship, there may be cases of human to human transmission, while the rest occurred in people infected are in sporadic outbreaks, human to human transmission is unlikely. So he told the people not to be too worried, as long as pay more attention to exercise, attention to indoor air, eat cooked food, once coughing, fever promptly to the hospital, it can greatly avoid serious infections.  

Case treatment schedule The evening of 31 December 2013 fever to 40 ℃, cough, expectoration.
January 1, 2014, the 2nd anti-infection treatment to hospitals in Foshan Jiujiang, fever symptomatic treatment support, the condition temporarily improved.
January 3 to Foshan City, a hospital fever clinic, there are significant cough, expectoration, shortness of breath, infected subjects treated in the hospital.
At 19:20 on January 3 respiratory failure, endotracheal intubation with mechanical ventilation.
At 16:10 on January 4 into the hospital ICU emergency treatment.
January 7, Foshan City, CDC reports H7N9 nucleic acid testing positive patients diagnosed with severe infection of H7N9 avian influenza.