Ten new H7N9 cases push outbreak total past 300

Ten new H7N9 influenza cases, along with three deaths, were reported from five China provinces today, vaulting the outbreak case total over the 300 mark after less than a year of disease activity.

All of the new lab-confirmed cases involve adults, except for one, a 4-year-old girl from Guangdong province. Seven of the 10 patients are men.

The second wave of cases, which began in October but rapidly increased last month, reached 165 with the new reports, compared with last spring's total of 136.

The infections boost the 2013-14 outbreak total to 301 cases, according to a running tally compiled by the FluTrackers infectious disease news message board. That total in less than a year appears to be unprecedented for human cases of avian flu. By comparison, the most active calendar year for the H5N1 strain, in 2006, saw 115 cases, according to data from the World Health Organization (WHO).

The three newly reported deaths lift the unofficial fatality count to 67.

Second wave's southerly hot spots

Eight of today's cases were reported from Zhejiang and Guangdong provinces, and the brisk pace of cases from those more southern provinces is driving most of the H7N9 activity in the second wave of infections. Of the 165 cases reported in the second wave, 125 have been reported from those two provinces: 73 from Zhejiang and 52 from Guangdong (see table below).

For comparison, during the first wave, the main hot spots were north of there, with Zhejiang (46), Shanghai (34), and Jiangsu (28) reporting 108 of 136 illnesses. Only one case was detected in Guangdong province during the first wave.

Ten cases from 5 provinces

According to provincial health ministry statements today translated and posted by the Avian Flu Diary infectious disease blog and the FluTrackers infectious disease news message board, Zhejiang province has four new infections, all in men, ages 42, 51, 56, and 84. Two are hospitalized in severe condition, and two are listed in critical condition.

Guangdong province reported three case-patients, the 4-year-old girl who is in stable condition, and two men, ages 52 and 76, both of whom died from their infections.

Guangxi province reported its second case so far in the outbreak, in a 41-year-old woman who is in critical condition. Cases from that province are notable, because they edge the reach of known cases south and west of the main outbreak area in an area that borders northern Vietnam.

Elsewhere, Jiangsu province reported one new case, in a 59-year-old woman who is in critical condition, as well as the H7N9 death of a previously confirmed case, believed to be a 76-year-old man whose illness was first reported in January.

The tenth case reported today is from Fujian province, in a 36-year-old man who is in critical condition.

Epi details from the WHO

In other developments today, the WHO provided fresh details about five case reports it received from China on Feb 2. Investigations revealed that three had been exposed to live-poultry markets and two had been exposed to live poultry. Illness onsets range from Jan 26 through Jan 30.

The patients include a 44-year-old man from Zhejiang province who is in serious condition, an 8-year-old girl from Hunan who is in serious condition, a 35-year-old man from Fujian province who is in serious condition, and two men from Guangdong province, a 37-year-old who is in critical condition and a 63-year-old man who died from his infection.

See also:

Feb 4 AFD post

Feb 4 FluTrackers thread on today's cases

FluTrackers H7N9 human case count

Feb 4 WHO statement

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