Saturday, February 1, 2014

China Guangxi Province Map of 2 Cases: 1-H5N1 and 1-H7N9

The postmark on the left side of the screen is the case reported today of H5N1 in Liuzhou City.

The postmark on the right side of the map is the case reported on 1/29 of H7N9  in Babu District


#H5N1 Guangxi Announces 1 New Case

2 Articles below
From the CDC Taiwan:
Excerpt:

Guangxi Province, the new H5N1 influenza cases was 75 -year-old man with a history of exposure to poultry, 1 month 29 days hospitalized because of severe pneumonia, 2 months 1 day diagnosis is now in critical condition, said health authorities in mainland China as sporadic cases of the case, before and after the onset of travel history and no history of contact with foreigners, there are no close contacts of cases and no signs of the onset of the spread. 

http://www.cdc.gov.tw/info.aspx?treeid=45da8e73a81d495d&nowtreeid=1bd193ed6dabaee6&tid=40049CABB7E33BC2

A bit more detail on this case:
Excerpt:

Moreover, according to the Ministry of Health Bulletin, Guangxi confirmed case of human infection of H5N1 avian influenza, the patient was male, 75 years old, living in Liuzhou city with the history of exposure to poultry. January 29 this year, because of severe pneumonia in Liuzhou People's Hospital for treatment, the patient is currently in critical condition, was in full swing rescue.
http://www.gcs.gov.mo/showNews.php?PageLang=C&DataUcn=75884&Member=0 

CDC Taiwan Press Release - February 1, 2014

Press Release
Mainland China, Guangxi Province, 1 new cases of H5N1 flu cases, Zhejiang and Guangdong provinces were added four cases of H7N9 flu cases, the command center called on citizens to go abroad is important to note prevention 

Command Center today ( 2 February 1 day) and the Chinese mainland health authorities confirmed, Guangxi add one example of H5N1 flu confirmed cases, the province's first appearance on the H5N1influenza cases in 2009 was 1 month. Another Zhejiang Province and Guangdong Province were added4 cases H7N9 flu confirmed cases, showing the risks and threats of epidemic persists. Currently the command center for human bird flu outbreak suggested travel, China Guangdong, Zhejiang, Jiangxi, Jiangsu, Hunan, Shanghai, Beijing, Fujian Province and Guangxi provinces for the second stage: Alert (Alert ); Other municipalities (excluding Hong Kong and Macau) as the first stage: Note ( Watch ).Command Center plans to remind people in mainland China, it is important to avoid contact with birds, to maintain good health habits, and calls upon physicians treating patients with pneumonia, be sure to ask the patient's travel history.
Guangxi Province, the new H5N1 influenza cases was 75 -year-old man with a history of exposure to poultry, 1 month 29 days hospitalized because of severe pneumonia, 2 months 1 day diagnosis is now in critical condition, said health authorities in mainland China as sporadic cases of the case, before and after the onset of travel history and no history of contact with foreigners, there are no close contacts of cases and no signs of the onset of the spread. Another of the day to add four cases of H7N9 flu cases, the first one in Hangzhou, Zhejiang Province, Fuyang, cases of 80 -year-old male farmer, 1 month 31 days confirmed, is in critical condition, hospital treatment; Section 2 cases of Hangzhou City, Zhejiang Province, 54 -year-old man Workers, 1 month 31 days confirmed, is in critical condition, hospital treatment; first three cases of Longgang District 6 -year-old boy, 2 months 1 day diagnosed mild, stable condition; first four cases in Guangdong Huaiji County, Zhaoqing City, Province, 5 -year-old boy, 2months 1 day diagnosed, currently in a stable condition, hospital treatment.
Mainland China and Hong Kong to ( 102 ) in 10 months 1 day after the autumn so far H7N9 human cases of influenza notified cumulative 145 cases, 16 deaths, Zhejiang Province, 68 cases in Guangdong Province 42 cases, Fujian Province, 11 cases in Shanghai 8 cases , Jiangsu Province, eight cases in Beijing one example, Hunan 2 cases, Guangxi Province, an example, Hong Kong 4 cases. Also since last 3 months 31 days so far, a total of confirmed 279 cases, including 63 deaths.
The country since last 4 months 3 days will be "from H7N9 flu "as the fifth class of infectious diseases, so far a total of 529 cases of reported cases, including two infectious cases (including 1 death cases), 522patients with negative test, 5 Example inspection.
Command Center pointed out that the Chinese mainland autumn H7N9 flu cases are more concentrated in Zhejiang Province and Guangdong Province, mainland China does not rule out the epidemic has expanded south trend, the majority of cases, history of contact with live bird markets and poultry.Currently H7N9 influenza transmission to humans mainly from poultry, but there may be a limited, non-sustained human to human transmission case.
Command Center to remind physicians should be strengthened asked history and history of exposure to the patient travel, such as found in line with H7N9 influenza informed patient is defined, shall promptly notify the health authority and the cautious response; and to remind people, travel to mainland China, should avoid contact with poultry classes and access live Street markets and poultry birds, bird market, especially not to pick up dead birds; eating chickens, ducks, geese and eggs to be cooked;, and should be implemented hand-washing and other personal hygiene measures to avoid infection. When you return home if fever or flu-like symptoms, they should inform the airline personnel and airport and port of quarantine officers; such as after returning the above symptoms should wear a mask and seek medical advice and inform the physician contact history and travel history. Latest epidemic diseases and other related information can be found in the Agency website (http://www.cdc.gov.tw) the " H7N9 flu Corner "and" International Travel Information "area, or call the toll-free hotline and caring people informed epidemic 1922 ( or 0800-001922) contact.


Fujian Province Reports 1 New Case, A Chef, with #H7N9

February 1, 2014  
 Health and Family Planning Commission of Fujian Province 2 months 1 day briefing, the province two months a Nisshin diagnosed a case of human infection with H7N9 avian influenza. Patients Lin Moumou, male, 35 years old, chef, now living Xiamen City, the current severe illness, isolation and treatment at a hospital in Xiamen. ( Emergency Management Office )
http://www.fjphb.gov.cn/show.aspx?ctlgid=246246&Id=90167 

Guangdong & Zhejiang Report Total 4 Cases #H7N9; Report 1 Death, and 1 Discharge

The following is the case that has been discharged:

Guangdong
Date of Report:  1/21/14
Name:  39(F) Kongmou
From:  Longgang District, Shenzhen City
Onset:  1/13
Adm:  1/19 Shenzhen, Serious
Confirmed:  1/21
Discharged:  1/31

The following is the case that has died:
Date of Report:  1/31/14
Name:  82(M) tan
From:  Chancheng Foshan
Adm:  ICU Foshan
Confirmed:  1/30
DOD:  1/31
 


   Guangdong Provincial Health and Family Planning Commission February 1 Bulletin, Shenzhen and Zhaoqing new H7N9 avian influenza were confirmed cases of one case of human infection. 
    Case 1 Lee, male, 6 years old, currently residing in Buji Street. February 1 confirmed human cases of avian influenza H7N9 infection, in patients with mild symptoms currently in stable condition. 
    Case 2 European, male, 5 years old, currently residing in Zhaoqing Huaiji County Huai town.February 1 confirmed human cases of avian influenza H7N9 infection, the patient's condition is currently stable in Zhaoqing City, the designated hospital admission. 
    Another Shenzhen January 21 confirmed cases and Kongmou Xu, were cured and discharged on January 31. Foshan City, January 31 confirmed cases of Tanmou, He died on Jan. 31 death.
http://www.gdwst.gov.cn/a/zwxw/2014020111302.html



2014 On February 1 day
  Zhejiang Provincial Health and Family Planning Commission Feb. 1 date of notification, the province additional two cases of human infection of H7N9 avian influenza.
  1 , patients Yang Moumou, male, 80 years old, farmer, Hangzhou, Fuyang City People. 1 month 31days confirmed human infection of H7N9 avian influenza. Is now in critical condition , in Hangzhou, a hospital for treatment.
  2 , patients Xu, male, 54 years old, workers, Hangzhou City people. 1 month 31 days confirmed human infection of H7N9 avian influenza. Is now in critical condition , in Hangzhou, a hospital for treatment.

Friday, January 31, 2014

#H7N9 Zhejiang Family of 3 Cluster

According the the ProMed article posted directly before this, and the posts at Flutrackers:  http://www.flutrackers.com/forum/showthread.php?t=217682
there is a 3 family confirmed cluster.  Index case is the Father, followed by the Daughter and then the Mother.  Because I cannot find specific information confirming the death of the 49 yo index case, I have registered him as approximately 1/27/14.

A 49-old-man in Hangzhou City was confirmed on January 20 to have been infected with the virus. His wife and daughter who accompanied him to the hospital, were later confirmed to also have flu, according to the provincial health and family planning commission. The man has since died, his daughter is in a serious condition and his wife is comfortable.
http://www.chinadaily.com.cn/china/2014-01/30/content_17265525.htm 
From the Zhejiang Health Department Website:
2014-01-29 January of this year, I appointed people infected announced confirmed cases of H7N9 avian influenza, there is Hangzhou Xiaoshan District, a family clusters of cases occur, three people sick. Before the onset of three patients in the presence of a common environmental exposure, there are close contacts, the exact cause of the infection, the national and provincial experts are studying, one has the final official results announced immediately to the public.
http://wst.zj.gov.cn/art/2014/1/29/art_362_407436.html 

These are the cases - from my list:

Zhejiang – Contact Case
Date of Report:  1/21/14
Name:  49(M) Yu, Farmer
From:  Xiaoshan District, Hangzhou
Onset:  1/13
Adm:  1/17 Hangzhou, Serious
Adm:  1/19 transferred
Confirmed:  1/20
Note:  Exposure to poultry
Confirmed contacts:  Daughter & Wife
Daughter:
Date of Report:  1/24/14
Name:  23(F) Yu
Wife is:
Date of Report:  1/28/14
Name:  43(F) Wang, Farmer 
DOD:  Approx 1/27 




Zhejiang – Contact Case
Date of Report:  1/24/14
Name:  23(F) Yu- Daughter of Confirmed
From:  Xiaoshan District, Hangzhou
Onset:  1/20
Adm:   1/22 Hangzhou, Severe
Confirmed:  1/23
Note:  Exposure to live poultry market.
3 Family Cluster:
Father is: Date of Report:  1/21/14
Name:  49(M) Yu, Farmer
Mother is: 
Date of Report:  1/28/14
Name:  43(F) Wang, Farmer



Zhejiang – Contact Case
Date of Report:  1/28/14
Name:  43(F) Wang, Farmer – Husband & Daughter Confirmed
From:  Xiaoshan District, Hangzhou
Adm:  Hangzhou, mild
Confirmed:  1/27
Note:  A 3 family Cluster:
Husband: Date of Report:  1/21/14
Name:  49(M) Yu, Farmer
Daughter: Date of Report:  1/24/14
Name:  23(F) Yu-

Hangzhou, a three stained #H7N9 deaths in which a determined person to person

[hat-tip to all the good people at Flutrackers.com]
2014-01-30 06:43 Source: Xinhua News Agency
  
According to Xinhua News Agency yesterday, Hangzhou City, Zhejiang Province, Wei Planning Commission informed of human infection with H7N9 avian influenza cases family aggregation progress of the investigation. In January, a family Xiaoshan District, Hangzhou clusters of cases occur, three human cases, the exact cause of infection national and provincial experts are studying.
  
His wife and daughter after the onset of men infected
  
Previously, Zhejiang Province, Wei Planning Bulletin, January 20, 49-year-old Yu Moumou Hangzhou Xiaoshan patient was diagnosed with human cases of avian influenza H7N9 infection. Three days later, the 23-year-old daughter was diagnosed. Both were diagnosed as severe. 27, the hospital again diagnosed, the patient's wife surname Wang Yu Moumou also infected with the H7N9 bird flu, the disease is mild.
  
According to experts in the diagnosis and treatment of avian influenza H7N9, Professor Liang Weifeng, deputy director of the School of Medicine, Division of Infectious Diseases, First Affiliated Hospital, Zhejiang University, introduced in a three-mouth, his father first onset. From 21, had chaperoned daughter began to appear over 俞某某 throat, fever appears from the 22nd, after the hospital virus detection, diagnosis of human infection of H7N9 avian influenza. 22, accompanying her husband's surname Wang had also appeared throat discomfort associated with cough, sputum, etc., and on the 27th was diagnosed human cases of avian influenza H7N9 infection. Currently, Yu Moumou have died due to ineffective treatment.
  
Gathered undetermined etiology
  
The reason for the gathering of disease, some experts believe that there are three common poultry exposure history; while some experts think that the existence of interpersonal secondary transmission between them, the first onset husband passed more likely his wife and daughter. Currently, no clear conclusion of experts.
  
Chinese Academy of Engineering, said Li Lanjuan, even if it is from the family clusters of cases ultimately recognized as limited human to human transmission, we do not have to panic. Issued by the State from the current perspective, sustained human to human transmission has not yet appeared, but simply do not rule out limited non-sustained human-to-human transmission. "The so-called 'limited' refers to the limited scope of infection is the case in nature, rather than the breadth of human to human transmission; while the so-called 'non-sustainable' means that there is no continuous passage of the situation, there is only a mass of individual B, but found no ethylene propylene re-transmission of three generations of cases. "Li Lanjuan academician said.
  
H7N9 prevention and control expert, Zhejiang Chen Zhi Ping, deputy director of the CDC also said that limited human to human transmission is divided into two successor and efficient human to human transmission. Limited human to human transmission is the probability of infection is very low viral interpersonal phenomenon. In this outbreak, some people are predisposed, it is easy to be infected with the virus, but generally does not appear multiple generations of infection, is transmitted up to a person and complete stop after infection.

http://www.dzwww.com/xinwen/guoneixinwen/201401/t20140130_9595931.htm

-------------------------------------------------------------
Translation Google


Avian influenza, limited human to human transmission: the provincial CDC expert Q & A Reporter

January 30, 2014 07:22:21 Hangzhou Network
  
Prevention and control of avian influenza in the province at present the situation is very serious, and have been found to have limited non-sustained human-to-human transmission cases. Experts said that from the current study to see, this particular case showed only a limited non-sustained human-to-human transmission, the virus mutates from the situation, not yet widespread phenomenon of human transmission, the public need not panic too much. However, there are still questions about people's minds: How to understand a limited human to human transmission? As at 12:00 on January 27, the province of human infection with H7N9 avian influenza increased the death toll to 12 people, why the sudden increase in the number of cases of death? Suffering from the flu during the Spring Festival, how doctor? To this end, the reporter interviewed the deputy director of the Center for Disease Control and Prevention Province Chen Zhi Ping, to answer them.

How to understand the limited human to human transmission
  
Reporter: How to correctly understand the limited human to human transmission?
  
Chen Zhi Ping: From the perspective of epidemiological analysis, human to human transmission is divided into two limited human to human transmission of and effective people. Limited human to human transmission is the probability of infection is very low viral interpersonal phenomenon. In this outbreak, some people are predisposed, it is easy to be infected with the virus, but generally does not appear multiple generations of infection, is transmitted up to a person and complete stop after infection, the patient will not be three generations or more on behalf of patients, it does not happen in the school, in the workplace or party. This is the concept of limited human to human transmission.
  
And effective human transmission is different. Such as seasonal flu, influenza, etc. belong to this category. A patient can infect a number of patients, the patients will find even second-generation multi-generational phenomenon patient. Chain of transmission of the virus is also very clear that such phenomena, especially in crowds gathering area, such as schools, communities, units occur.
  
From the current research worldwide, the experts were unable to come up with valid evidence of H7N9 virus from person to person.

Reporter: there is more from our family clustering of cases, how to explain this phenomenon?
  
Chen Zhi Ping: For the family clustering of cases occurred in the province of view, I think it causes more complex cases, including both common exposure, there are factors that limited human to human existence. After careful analysis of these cases found that patients often have blood relations, and are in the process too intimate care on the infection.

Why the sudden increase in deaths
  
Reporter: Zhejiang previously reported one case of deaths, why would the recent report of 11 new cases of deaths?
  
Chen Zhi Ping: This is for a reason. First B infectious H7N9 is legal, according to the Communicable Disease Control Act and people infected with H7N9 prevention and control programs, the situation H7N9 is by the local health administrative departments regularly published on the website of the community each month. Our province is in strict accordance with the national prevention and control programs to outside information published and will be released on April 15th of each month epidemic, the middle will be the time difference. So please be concerned about the circumstances of the province H7N9 epidemic users keep an eye Provincial Health and Family Planning Commission's official website to understand the situation.
  
From January 1 to play Jan. 27, the province a total of 49 cases of human infection with H7N9 avian influenza cases, 12 cases of which died, the mortality of 24.4%. The same time period, the national mortality rate was 28.33%. And this value is compared to slightly lower mortality in our province, but that does not mean that people can relax their vigilance, hope the general public must do individual preventive work.

http://health.hangzhou.com.cn/new_4107962.html

ProMED: Avian influenza: China #H7N9 cluster unresolved

Published Date: 2014-01-31 14:14:15

A 49-year-old-man in Hangzhou City was confirmed on [20 Jan 2014] to have been infected with the virus. His wife and daughter who accompanied him to the hospital, were later confirmed to also have flu, according to the provincial health and family planning commission. The man has since died, his daughter is in a serious condition, and his wife is comfortable. Experts have reached no firm conclusion on how the virus spread between the family members [see also ProMED-mail Avian influenza, human (45): China (ZJ) H7N9, suspected cluster 20140130.2243613]. They all may have had contact with poultry, or the father may have transmitted the flu to his wife and daughter. Even if the case is confirmed as person-to-person transmission, there is no need to panic, said Li Lanjuan, an academician at the Chinese Academy of Engineering and a specialist in H7N9 prevention. "So far there have not been any cases in which one person transmits the flu to another, and the latter transmits the virus to a 3rd person," said Li.

In this year's [2014] epidemic, transmission has been limited to a 2nd person, who does not transmit the virus to a 3rd. H7N9 is not likely to be spread in schools, workplaces, or at gatherings, said Chen Zhiping, deputy head of the provincial disease control and prevention center. The probability of continuous person-to-person transmission is very slim, said Feng Zijian, deputy head of the Chinese Center for Disease Control and Prevention.

Three new human H7N9 cases were reported in Zhejiang on Wednesday [29 Jan 2014], bringing the number of infections in the province this year to 56. All 3 are in a critical condition. In neighboring Fujian Province, a 2-year-old child tested positive for bird flu, according to the provincial health commission. The patient is now recovering.

South China's Guangxi Zhuang Autonomous Region also reported one new case on Wednesday [29 Jan 2014]. A 56-year-old woman showed flu symptoms for a week before she tested positive for bird flu and is now critical, according to local health authorities. It is the 1st human H7N9 case in the region.

The National Health and Family Planning Commission said on Wednesday [29 Jan 2014] that live poultry markets would close if a case of H7N9 was detected. In places where no H7N9 cases have been reported, the commission suggested that live poultry markets be cleaned every day and disinfected once a week. Chicken has been a required dish on Chinese dining tables for centuries during Spring Festival, which begins this Friday [31 Jan 2014]. Chinese farmers have traditionally raised chickens using free range methods, especially in the countryside, which is seen by experts an additional risk.

Live poultry trading has been halted in the cities of Hangzhou, Ningbo, and Jinhua in Zhejiang, with the most human H7N9 cases of any province. The province has launched emergency surveillance of poultry farms, parks, and migratory bird haunts, and has halted the flying of domestic pigeons.

Continued:  http://www.promedmail.org/direct.php?id=2246597