Avian Flu Scan for May 14, 2014

News brief

Guangdong province reports China's newest H7N9 case

A new case of H7N9 avian influenza has been reported in China, according to postings today on FluTrackers, an infectious disease news message board.

The case-patient is a 71-year-old man from Meizhou Xingning in Guangdong province. His case was diagnosed yesterday, say the postings, and he is reportedly receiving treatment and in stable condition.

The overall case total now stands at 437, with at least 156 deaths, says FluTrackers. The case total includes 301 in the current, second wave of the outbreak, compared with 136 in the first wave last spring.
May 14 FluTrackers H7N9 thread
Most recent (May 9) previous CIDRAP News scan on H7N9

Guangzhou study finds range of H7N9 symptoms

A study of 21 cases of H7N9 avian flu in Guangzhou—the southern China port city near Hong Kong—revealed a spectrum of clinical presentations and a 2-person family cluster, according to a report today in Emerging Infectious Diseases.

Researchers from the Guangzhou Center for Disease Control and Prevention and the University of Hong Kong analyzed data from all patients confirmed as having H7N9 flu in the city of 13 million people from Apr 1, 2013, to Mar 7, 2014. All told, 16 patients were identified through pneumonia surveillance, 3 from throat swabs, 1 from testing of poultry workers, and 1 through contact tracing.

Of the 21 cases, 16 were classified as severe, 4 as mild, and 1 (the poultry worker) was asymptomatic. All 4 mild cases were in children ranging from 4 to 17 years old, whereas ages ranged from 29 to 83 in the severe cases, with a median of 66.

Sixteen of the patients had direct or indirect contact with poultry, while poultry-contact information was unknown for the rest. Twelve had underlying medical conditions.

The father in the case cluster worked in a live-poultry market. His 5-year-old daughter, the patient discovered through contact tracing, had close, unprotected contact with him while he had a severe cough and heavy sputum. She had no known poultry exposure in the 12 days before she became ill, so the authors said the cluster suggests human-to-human transmission, which has been reported multiple times in China.

The authors conclude, "Our results show that targeted surveillance during a period of elevated disease activity improved identification of mild or asymptomatic infections."
May 14 Emerg Infect Dis study

News Scan for May 14, 2014

News brief

Cases of chikungunya in Haiti soar above 1,500

Confirmed cases of chikungunya in Haiti have skyrocketed from 14 to 1,529 in recent days, the Associated Press (AP) reported today.

Ronald Singer, a spokesman for Haiti's health ministry, said about 900 cases of the mosquito-borne disease have been in West department, where Port-au-Prince, Haiti's capital, resides. Another 300 cases were confirmed in the country's northwest.

Just 2 days ago the European Centre for Disease Prevention and Control (ECDC) put the number of confirmed cases in the country at 14. The illness was expected in Haiti, the story said, after the neighboring Dominican Republic started reported cases. That country now has more than 7,500 suspected cases, the ECDC reported.

The chikungunya outbreak, which is the first in the Americas, began in December on the small island of St. Martin, which now has more than 3,000 suspected and almost 1,100 confirmed or probable cases, according to ECDC data.
May 14 AP story

Pakistan to require polio vaccination for travelers leaving country

Beginning Jun 1, everyone leaving Pakistan will be required to get a polio vaccination, according to an AP brief yesterday.

The country's health ministry announced the new requirement in response to the World Health Organization's (WHO's) declaration last week that polio has become an international public health emergency as cases continue and occur in countries previously considered polio-free.

All provinces in Pakistan have been provided with guidance and materials to convene vaccination stations at hospitals and airports.

Pakistan, one of three countries in which polio is still endemic, is also one of three nations identified by the WHO as having allowed polio to spread across its borders. The other countries with endemic polio are Afghanistan and Nigeria; Syria and Cameroon are the other countries where the disease has crossed borders.
May 13 AP brief
May 5 CIDRAP News story on WHO emergency declaration