H7N9 illness total grows by 13, with 2 more deaths

Over the past 3 days, China reported 13 new H7N9 influenza infections, 2 of them fatal, from a broad swath of provinces in the eastern part of the country, including the first 2 cases of the second wave from Anhui province.

Most of the new cases involve adults, but two are in children, a 5-year-old girl and an 11-year-old boy, both from Guangdong province.

Eight of the 13 cases are from Zhejiang (5) and Guangdong province (3), which have reported by far the most cases in the second wave of infections that began in October. Other provinces reporting fresh cases include Anhui (2), Hunan (2) and Jiangsu (1).

The steady pace of reported infections has propelled the number of cases in the second wave of disease activity to 201, well above the 136 people who were sickened in the first wave after H7N9 first emerged last spring.

Also, there so far appears to be no letup in case reporting from China or its individual provinces, despite media reports from a few days ago that said the country's poultry industry groups have asked health officials to tone down their reports, due to the impact negative publicity is having on poultry sales.

Details of new cases

The patients from Zhejiang province include four men, ages 61, 62, 67, and 68, and one woman, age 47, according to provincial health reports translated and posted by FluTrackers, an infectious disease news message board, and Avian Flu Diary (AFD), an infectious disease news blog.

The three patients from Guangdong province include an 81-year-old woman who died from her infection and the two children, according to FluTrackers and AFD.

Anhui province's two patients are a 66-year-old man and a 56-year old man who died from his infection on February 7. The two case-patients from Hunan province are a 38-year-old man and a 23-year-old woman.

The new case reported from Jiangsu province is in a 53-year-old man.

The new cases boost the outbreak total to 337, according to a running tally of H7N9 cases kept by FluTrackers. The two fatalities lift the unofficial death count to 71.

WHO gives details on 15 other cases

In related developments, the World Health Organization (WHO) today reported more details about 15 case reports it received from China on Feb 7 and Feb 8.

The report confirmed a family connection with two H7N9 infections reported from Guangxi province, which borders northern Vietnam. It said the 5-year-old boy got sick on Feb 3 and is hospitalized with a mild infection and that he is a close contact of a 41-year-old woman whose infection was reported by the WHO on Feb 7. Media reports have said the woman is the boy's mother.

Thirteen of the patients had been exposed to live poultry before they got sick. Of the 14 people who have survived their infections so far, eight are hospitalized in critical condition, five are in severe condition, and one—the 5-year-old boy—has a mild illness, according to the WHO.

Patient ages in today's WHO report range from 5 to 81, and they hail from Beijing and six different provinces, though eight are from Zhejiang and Guangdong, the top two hotspots. Illness onsets range from Jan 20 to Feb 1. One death was reported among the patients, in an 81-year-old man from Fujian province.

Poultry control actions

Meanwhile, a weekly update on H7N9 activity and control measures from the WHO's Western Pacific Region office (WPRO) said the city of Shenzhen in Guangdong province has announced a market rest period for 2 weeks, from Jan 31 through Feb 13. It said all live-bird markets, including wholesale and retail, are temporarily closed, and poultry are barred from the market.

It added that Shanghai's live-bird trade suspension took effect on Jan 31 and extends until April 30, and Zhejiang province has temporarily shuttered live-bird markets until Feb 15 in areas in which several human cases have been reported. WPRO said Zhejiang plans to close live-poultry markets in its cities' main districts permanently as of Jul 1.

During the first wave of infections, live-bird market closures were shown to tamp down the pace of human cases in areas such as Shanghai.

See also:

Feb 10 FluTrackers thread

Feb 10 AFD post

FluTrackers human H7N9 case list

Feb 10 WHO statement

Feb 7 WHO WPRO update

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