Canadian has first H7N9 case in North America

Canadian officials announced today that a British Columbia resident who recently returned from China is recovering from an H7N9 avian flu infection, marking the first known case in North America.

In a statement, the Public Health Agency of Canada (PHAC) said the risk to others is very low, because evidence suggests that the virus does not spread easily from person to person.

A public health official in British Columbia said the patient is a woman and that a man who traveled with her was also sick recently, according to a Canadian Press (CP) report today. The official, Bonnie Henry, MD, said additional testing is under way to find out if the man also was infected.

The PHAC said the infected patient, who was not identified, didn't get sick until after arriving in Canada. The person was not hospitalized and is now recovering in "self-isolation," the agency said. Her companion also was not hospitalized and is recovering, according to the CP report.

"All close contacts of the [infected] individual have been identified and their health is being monitored by provincial public health authorities," the statement said.

Saying the government wants to provide Canadians with all the information they need, the agency disclosed that the patient was a passenger on Air Canada flight 8, but it didn't reveal the date he or she flew.

Active H7N9 circulation in China

The case comes at a time of active H7N9 circulation in China, with new cases reported nearly every day in recent weeks. Chinese officials have reported six new cases in the past few days (see below).

Human H7N9 illness first emerged in China in February 2013. A total of 530 cases have been identified since then, according to a case list maintained by FluTrackers, an infectious disease news message board. About a fourth of these have been fatal, but there are no official records of the death toll.

Nearly all the cases have occurred in China and Hong Kong. One case was reported in February 2014 in Malaysia, in a visiting Chinese woman, and Taiwan has reported at least three cases, all in people who had been in China recently, according to information from past CIDRAP reports and FluTrackers.

Almost all H7N9 patients so far reported contact with poultry, usually in live-poultry markets, the PHAC statement noted.

Today's announcement comes a bit more than a year after Canada announced North America's first known—and as yet only—human case of H5N1 avian flu. It involved a young nurse from Alberta woman who had visited Beijing in December 2013 and died on Jan 3, 2014, about a week after returning home.

Six cases in Guangdong province

As mentioned, Chinese officials have reported six new H7N9 avian flu cases, all in Guangdong province, the hardest-hit region so far this year, according to three updates in recent days from Hong Kong's Centre for Health Protection (CHP).

The six cases are in five separate cities. Today the CHP confirmed H7N9 infections in a 52-year-old man in Jieyang and a 20-year-old woman in Shanwei. The man is listed in critical condition, and the woman is in serious condition.

Yesterday the agency confirmed that a 78-year-old woman in Shanwei is hospitalized in serious condition and a 62-year-old man in Dongguan is hospitalized in critical condition. On Jan 24 the CHP confirmed H7N9 in a 46-year-old man in Meizhou and a 77-year-old man in Chaozhou, both of whom are in critical condition.

In a separate press release on Jan 24, the CHP updated its report on the second case imported to Hong Kong from the mainland this winter, which the agency first noted on Jan 23. The CHP said it is monitoring 62 contacts, including 7 close contacts, 2 of whom are family members who have not had symptoms.

Editorial director Jim Wappes contributed to this story.

See also:

Jan 26 PHAC statement

Jan 26 Canadian Press story

Jan 8, 2014, CIDRAP News story on Canadian H5N1 case

Jan 26 CHP update

Jan 25 CHP update

Jan 24 CHP update

Jan 24 CHP news release on imported case

FluTrackers H7N9 case list

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