China reports 3 more H7N9 cases, 1 fatal

China today reported three more H7N9 influenza cases in as many provinces, one of which was fatal, plus another death in a previously reported case.

Chinese government and media reports on the cases were translated and posted by FluTrackers, an infectious disease message board.

The fatal case involved a 75-year-old man from the Panyu district of Guangzhou, capital of Guangdong province, according to information from the province's Health and Family Planning Commission (HFPC). The man died Mar 1, and his infection was confirmed on Mar 3.

Another case was in a 59-year-old farmer who is from Jiangsu province but fell ill in Tai'an City, Shandong province, according to information from the Shandong HFPC. The report indicates that he got sick on Feb 25, is critically ill, and has chronic conditions that include hypertension and diabetes.

Information on the third case came from the Jiangsu Provincial Health Department via a Chinese media outlet, which said an infection in a 36-year-old man was confirmed today in the city of Xuzhou. The patient, who is in critical condition, was involved in live-poultry sales.

The other death was that of a patient whose case was confirmed Feb 19, according to the Guangdong HFPC. The report said the person died Mar 2 after multiple organ failure, but it gave no other details.

Unofficially, the latest cases raise the overall H7N9 count to 384 cases and 119 deaths. That includes 248 cases in the second wave, which began in October, and 136 in the first wave, which started about a year ago and subsided in the summer.

Also today, the World Health Organization (WHO) noted a previously reported case and supplied a little more information on it. It involved a 59-year-old man from Guangdong who died on Mar 2. The WHO said it was informed yesterday by China that the man was from Zhuhai city and that he fell ill on Feb 26 and was hospitalized Mar 1. He had a history of exposure to live poultry, the agency added.

Three escape quarantine

In other developments, Hong Kong authorities announced today that three people who were close contacts of an H7N9 case-patient walked out of a hospital where they were supposed to remain under quarantine until Mar 13.

The three, a couple with a son, were in an isolation ward at Queen Elizabeth Hospital, the Hong Kong Department of Health and Hong Kong Hospital Authority said in a joint statement.

The agencies did not identify the H7N9 patient to whom the three were exposed, but Hong Kong has been monitoring contacts of an 18-month-old girl who was found to have H7N9 after a recent trip to Guangdong. Her case was reported yesterday.

The statement said the family was admitted to the hospital for quarantine early on the morning of Mar 5 and left the hospital without permission that evening. It indicated that the parents tested negative for the virus in the afternoon but that test results for their son were still awaited.

"We are taking the case very seriously and the CHP [Hong Kong Centre for Health Protection] has reported this incident to the Police," a CHP spokesman was quoted as saying.

In a separate statement on the investigation of the case in the 18-month-old, the CHP said that two of the patient's close contacts were sick. One of them tested positive for an influenza H1N1 infection, while the other tested negative for influenza A.

See also:

Mar 4 FluTrackers post on new cases

FluTrackers H7N9 case list

Mar 5 WHO statement

Mar 6 statement from Hong Kong health department and hospital authority

Mar 5 Hong Kong CHP statement

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