Title: #Human #infection with #avian #influenza #H7N9 virus, 27 January 2017.
Subject: Avian Influenza, H7N9 subtype, sporadic human cases in several provinces of China.
Source: European Centre for Disease Prevention and Control (ECDC), full PDF file: (LINK). Summary.
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RAPID RISK ASSESSMENT
Human infection with avian influenza A(H7N9) virus, 27 January 2017
Suggested citation: European Centre for Disease Prevention and Control. Human infection with avian influenza A(H7N9) virus – fifth update, 27 February 2017. Stockholm: ECDC; 2017.
© European Centre for Disease Prevention and Control, Stockholm, 2017
Conclusions and options for response
- Since the notification of a novel reassortant influenza A(H7N9) virus on 31 March 2013, a total of 1 033 laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus have been reported.
- This is the fifth winter season in the northern hemisphere with human cases caused by A(H7N9) infections.
- During this wave, the number of human cases is already higher than during the whole of the last wave in 2015–16.
- Disease numbers are significantly higher than during the same periods in 2014–15 and 2015–16.
- A steep increase in human cases has been reported since the beginning of December 2016 from China.
- The epidemiology, however, does not seem to have changed during the current wave of infections.
- The majority of recently reported human cases are associated with exposure to infected live poultry or contaminated environments, including markets where live poultry are sold.
- The age distribution of the cases is comparable with previous waves.
- Influenza A(H7N9) viruses continue to be detected in poultry (and their immediate environment) in the areas where human cases are occurring, but more human cases are being detected in rural areas.
- The upsurge in human cases is most likely due to increased environmental contamination, mostly related to live bird markets.
- At present, the most immediate threat to EU citizens is to those living or visiting influenza A(H7N9)-affected areas in China.
- It is advisable to avoid live bird markets or backyard farms as well as contact with live poultry or their droppings.
- Food should be only consumed if properly cooked.
- The environmental contamination and the related higher risk of exposure to A(H7N9) points towards the possibility of travel-related cases, especially in relation to Chinese New Year on 28 January.
- The recent upsurge of human cases due to a higher risk of exposure indicates the possibility that cases will be imported to Europe.
- However, the risk of the disease spreading among humans within Europe is still considered low as the virus does not appear to transmit easily from human to human: investigations do not support sustained human-to-human transmission.
- Caution should be taken by people travelling to China to avoid direct exposure to poultry, live poultry markets or backyard farms.
- Travellers who have visited affected areas and develop respiratory symptoms and/or fever within 10 days of their return should consult a physician and inform him/her about their recent travel history to facilitate early diagnosis and treatment.
- People in the EU presenting with severe respiratory or influenza-like infection and a history of travel to the affected areas in China – with potential exposure to poultry or live bird markets – will require careful investigation, management and infection control.
- Adequate samples for influenza tests should be rapidly taken and processed from patients with relevant exposure history within 10 days of symptom onset.
- Early or presumptive treatment with neuraminidase inhibitors should be considered for suspect or confirmed cases, in line with relevant national and international recommendations.
- Contacts of confirmed cases should be followed up and tested.
- Postexposure prophylaxis should be considered.
- Sporadic cases imported from China do not alter ECDC’s risk assessment from February 2015.
Keywords: ECDC; European Region; Updates; China; Avian Influenza; H7N9; Human; Poultry.