Fujian province cites first H7N9 case as total reaches 119

Apr 26, 2013 (CIDRAP News) – Fujian province today reported its first H7N9 influenza case—the ninth area of eastern China to be affected by the virus—as other provinces reported six more infections, raising the outbreak total to 119.

In a pattern seen throughout the outbreak so far, most of the newly reported cases are in men, and many of the patients are older.

The new case from Fujian is in a 65-year-old man who is being treated in a hospital, according to an update today from Hong Kong's Centre for Health Protection. So far none of the man's 24 close contacts have shown symptoms.

A resident of Nanchang, the provincial capital, the man is a retiree who hadn't traveled recently and had no contact with poultry, though he lives near a poultry market, according to a report yesterday from Xinhua, China's state news agency.

Fujian is about 485 miles south of Shanghai and borders both Jiangxi province, which reported its first case yesterday, and Zhejiang province, which has reported 45 cases so far, the most of any province.

About 400 labs across China have test kits for detecting the virus, so all provinces likely have the capacity to identify cases. Global influenza experts expect cases to continue to rise until the full scope of the virus's source is known. Chinese researchers have linked human illnesses to H7N9 viruses found in market poultry, but questions still remain about other types of exposure and whether other birds or animals harbor the virus.

Other cases reported today include three from Jiangsu province. A 49-year-old man is in stable condition, a 36-year-old man is in serious condition, and a 60-year-old man is in critical condition, according to the CHP.

Jiangsu health officials also reported a death from the virus, in a 32-year-old woman whose case was reported earlier this month, according to translated health bureau reports posted on the FluTrackers infectious disease message board. Her death lifts the number of H7N9 fatalities to 23.

Two patients from Jiangxi are a 69-year-old man and a 76-year-old woman. Both are in critical condition. The case from Zhejiang involves a 38-year-old man who is in serious condition, the CHP said.

In an epidemiologic update today, the European Centre for Disease Prevention and Control (ECDC) said there is no sign of sustained human-to-human transmission, but  the agency  expects the number of sporadic cases and affected areas of China, and possibly neighboring countries, to increase in the coming weeks.

Imported cases in Europe wouldn't be surprising, and countries need to be prepared to detect cases, the ECDC said.

China's agriculture ministry said today that tests on samples from poultry farms have found no positive H7N9 samples, Xinhua reported. The ministry said 68,060 samples have been collected so far from poultry markets, habitats, farms, and slaughterhouses across China, but only 46 have tested positive; 44 were from 14 live poultry markets in Jiangsu, Zhejiang, Anhui, and Henan provinces, plus the city of Shanghai. The two other positive samples were from Jiangsu and included one from a wild pigeon and another from a household farm of carrier pigeons.

In other developments, the Chinese Center for Disease Control and Prevention (China CDC) said yesterday that as of Apr 24 it would update the number of human H7N9 infections every week, which appears to signal an end to daily reports of new cases. Most provincial health departments still appear to be announcing cases as they are confirmed by lab testing.

See also:

Apr 26 CHP statement

Apr 25 Xinhua story

FluTrackers thread

Apr 26 ECDC epidemiological update

Apr 25 China CDC statement

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