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#Avian #Influenza #H7N9 in #China: Preventing the Next #SARS (@WHO, Apr. 2 ‘17)

  Title : #Avian #Influenza #H7N9 in #China: Preventing the Next #SARS. Subject : Avian Influenza, H7N9 subtype (Asian Lineage), poultry e...

7 Jun 2017

#Avian #Influenza #H7N9 – #Situation #update as of 7 June 2017 (#FAO, edited)


Title: #Avian #Influenza #H7N9 – #Situation #update as of 7 June 2017.

Subject: Avian Influenza, H7N9 subtype, poultry enzootic and human cases in China.

Source: Food and Agriculture Organization (FAO), full page: (LINK).

Code: [     ][     ]

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Avian Influenza H7N9 – Situation update as of 7 June 2017

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The next update will be issued on 14 June 2017


Disclaimer

Information provided herein is current as of the date of issue. Information added or changed since the last H7N9 situation update appears in red. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health, Provincial Government websites; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisation for Animal Health [OIE]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.


Overview

  • Situation:
    • Influenza A(H7N9) virus with pandemic potential.
  • Country:
    • China; three human cases originated in China and were reported in Malaysia (1) and Canada (2).
  • Number of human cases:
    • 1542 confirmed; 582 deaths (since February 2013).
  • Number of new findings in birds or the environment since last update (31 May 2017):
    • 0
  • Number of new human cases since last update (31 May 2017):
    • 10.
  • Provinces/municipalities:
    • [China]
      • Beijing,
      • Chongqing,
      • Shanghai and
      • Tianjin Municipalities;
      • Anhui,
      • Fujian,
      • Gansu,
      • Guangdong,
      • Guizhou,
      • Hebei,
      • Henan,
      • Hubei,
      • Hunan,
      • Jiangsu,
      • Jiangxi,
      • Jilin,
      • Liaoning,
      • Qinghai,
      • Shaanxi,
      • Shanxi,
      • Shandong,
      • Sichuan,
      • Yunnan and
      • Zhejiang Provinces;
      • Hong Kong SAR;
      • Macao SAR,
      • Guangxi,
      • Inner Mongolia,
      • Ningxia Hui,
      • Tibet and
      • Xinjiang Uyghur Autonomous Regions;
    • [Taiwan];
    • [Malaysia]
      • Sabah;
    • [Canada]
      • British Columbia.
  • Animal/environmental findings:
    • around 2,500 virological samples from the environment, chickens, pigeons, ducks and a tree sparrow tested positive; positives mainly from live bird markets, vendors and some commercial or breeding farms.
  • Highly pathogenic virus findings:
    • The H7N9 highly pathogenic avian influenza virus was detected in a total of 45 poultry or environmental samples (34 chickens, 1 duck and 10 environmental samples) from 23 live bird markets (LBMs) in:
      • Fujian (Longyan City),
      • Guangdong (Dongguan, Guangzhou, Huizhou, Lufeng, Meijiang, Meizhou, Zhongshan Cities and Haifeng County),
      • Hunan (Chenzhou City) and
      • Guangxi (Guilin City) Provinces;
    • and from 7 farms in:
      • Guangxi (Guilin City),
      • Hebei (a chicken layer farm [reference]),
      • Henan (a chicken layer farm in Pingdingshan City [reference]),
      • Hunan (backyard in Chenzhou City and a large chicken layer farm in Yongzhou City [reference]),
      • Shaanxi (a chicken layer farm [reference]), and Tianjin (a chicken layer farm [reference]) Provinces.
    • Out of the 1542 confirmed human cases, H7N9 virus isolates from three human cases (two from Guangdong and one from Taiwan Provinces) were found to be highly pathogenic for chickens.
  • FAO actions:
    • liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.


Map 1. Human cases and positive findings in birds or the environment

Human cases and positive findings in birds or the environment

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|-- Click to enlarge –|

Note: Human cases are depicted in the geographic location where they were reported; for some cases, exposure may have occurred in a different geographic location. Precise location of 24 human cases in Anhui (2), Beijing (2), Guangdong (1), Guangxi (1), Hebei (3), Hunan (1), Hubei (2), Jiangsu (1), Jiangxi (6), Sichuan (2) and Zhejiang (3) Provinces are currently not known, these cases are therefore not shown on the map.


Situation update

  • Animals
    • 1 June, Shaanxi:
      • The H7N9 influenza outbreak observed on 23 May in a chicken layer farm of Yuyang District, Yulin City was confirmed to be due to the highly pathogenic strain [reference 1].
    • 2 June:
      • The national avian influenza reference laboratory completed developing a recombinant H5+H7 bivalent inactivated vaccine.
      • A total of 10 companies will receive the H7 subtype avian influenza vaccine strains, and organize production [reference].
  • Humans
    • Since the last update (31 May 2017), 10 new human cases have been reported in:
      • Shaanxi (2),
      • Shandong (2),
      • Anhui (1),
      • Chongqing (1),
      • Guangxi (1),
      • Hebei (1),
      • Inner Mongolia (1),
      • Sichuan (1).
    • For detailed information on human cases, please refer to WHO's Disease Outbreak News.


Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 7 June 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Number of positive virological samples from birds or the environment, by province* and origin

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|-- Click to enlarge –|


Figure 2. Number of officially reported human cases since February 2013 as of 7 June 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Number of officially reported human cases since February 2013

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|-- Click to enlarge –|


Figure 3. Incidence of officially reported human cases by month, based on onset date as of 7 June2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Incidence of officially reported human cases by week, based on onset date

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|-- Click to enlarge –|

Note: For cases with unknown onset dates from wave 1 (n=7), wave 2 (n=2), wave 3 (n=146), wave 4 (n= 27) and wave 5 (n=199) reporting dates were used instead.


Publications

  • In addition to the surveillance findings by MoA and MoH, 1,728 virologically positive samples have also been reported in 12 peer-reviewed articles (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12).
    • A total of 71,920 samples have been collected in these studies since April 2013, of which 1,728 (2.4%) were positive for H7N9 (1,215 environmental samples, 501 chickens, 1 goose and 1 tree sparrow).
  • A comparison of case characteristics between human cases infected with the highly pathogenic and low pathogenic strains of H7N9 in China was performed.
    • Eight cases infected with the highly pathogenic strain from three provinces in southern China were included in this analysis.
    • Cases infected with the highly pathogenic strain were more likely to have had exposure to sick and dead poultry in rural areas and were hospitalized earlier than cases infected with the low pathogenic strain [reference].
  • A study aimed to evaluate attitudes of consumers and live-poultry workers towards a new central slaughtering policy in Guangdong.
    • An overall refusal or slowness to accept the policy was observed due to concern about food safety and dietary preference of consumers, while live poultry traders were reluctant because of fears about a drop in trading volume and insufficient governmental subsidies.
    • Policy-makers are recommended to promote health education and alleviate policy impact on trade with a reformed subsidy policy to increase acceptability [reference].
  • A study reported a fatal case of a patient in China who was infected with an A(H7N9) virus having a polybasic amino acid sequence at its hemagglutinin cleavage site suggesting high pathogenicity in birds and a neuraminidase mutation associated with drug resistance.
    • The patient had a history of exposure to sick and dying poultry.
    • None of his close contacts became infected suggesting that human-to-human transmission did not occur [reference].
  • An epidemiological investigation was conducted on laboratory confirmed cases across the five H7N9 epidemics in China (2013-2017).
    • Age distribution and case exposure sources have changed gradually across epidemics since 2013, while clinical severity has not changed substantially [reference].


FAO’s support to countries


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Keywords: FAO; Updates; H7N9; Avian Influenza; Human; Poultry; China.

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