China reports H7N9-H3N2 coinfection, more deaths


Chinese health officials reported another infection with the novel H7N9 virus, a 15-year-old boy who was sick in April with a seasonal H3N2 influenza coinfection and has since recovered, the World Health Organization (WHO) said yesterday.

The boy, from Jiangsu province, got sick on Apr 25 and was hospitalized the next day. He recovered and was discharged on May 2. Molecular testing showed the boy was positive for H3N2 and the new H7N9 virus, according to the WHO, which received the information on the new case from China's National Health and Family Planning Commission.

Jiangsu health officials consulted with national and other provincial experts about the case on Jul 1.

Details of the boy's case are consistent with an H7N9-H3N2 coinfection case reported by Chinese researchers in the Jun 15 issue of The Lancet. The team wrote that he was a previously healthy student who was treated with oseltamivir (Tamiflu) in the hospital.

They also noted that dual infections are a possible source of reassortment between human and avian flu virus strains

The boy's illness raises the outbreak total to 133 confirmed cases. All are from China except one case in a Taiwanese man who had traveled to China's outbreak area for work.

The WHO also said it has been informed that there are 43 deaths from the disease, which is 8 more than the group last reported on May 29. That total likely includes a man from Shanghai whose death was reported by the media on Jun 26.

Some of the severely ill patients have been hospitalized for several weeks, and the rise in the fatality number may suggest that some of them have died.

At a WHO media briefing today in Geneva to update reporters on the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak and to announce the formation of an emergency committee as part of the response, Keiji Fukuda, MD, the WHO's assistant director-general of health security and environment, said H7N9 remains a concern but that right now surveillance systems aren't detecting any H7N9 activity.

"This is a normal pattern for flu viruses. Both avian and seasonal flu tend to get a lot quieter in the summertime," he said. "We are very mindful that when we get to the colder months, we may then see new H7N9 cases or see them in other countries."

Fukuda told reporters it was probably premature to think about convening an emergency committee for H7N9, adding that health officials were focused on making sure countries can detect new H7N9 cases.

See also:

Jul 4 WHO statement

Jun 14 CIDRAP News scan "H7N9-H3N2 coinfection reported in Chinese teen"

Jun 26 CIDRAP News story "Shanghai man dies from H7N9 infection"

This week's top reads