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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...

20 Sep 2016

#Avian #Influenza #H7N9, #situation #update, 20 September 2016 (#FAO, edited)

 

Title: #Avian #Influenza #H7N9, #situation #update, 20 September 2016.

Subject: Avian Influenza, H7N9 subtype, human cases and epizootics in poultry, monthly update.

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

Code: [     ][     ]

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H7N9 situation update, 20 September 2016

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The next update will be issued on 20 October 2016

 

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:
    • 803 confirmed;
    • 315 deaths (since February 2013)
  • Provinces/municipalities:
    • [China]
      • Beijing,
      • Shanghai and
      • Tianjin municipalities;
      • Anhui;
      • Fujian;
      • Guangdong;
      • Hubei and
      • Liaoning provinces;
      • Henan;
      • Hunan;
      • Jiangsu;
      • Jiangxi;
      • Shandong;
      • Zhejiang;
      • Guangxi;
      • Guizhou;
      • Jilin;
      • Qinghai;
      • Hubei;
      • Hong Kong SAR;
      • Macao SAR,
      • Ningxia Hui and
      • Xinjiang Uyghur Autonomous Regions;
    • [Taiwan] Province of China;
    • [Malaysia]
      • Sabah;
    • [Canada]
      • British Columbia.
  • Animal/environmental findings:
    • over 2,000 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.
  • FAO actions:
    • liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.

 

Map. 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 58 human cases in Fujian (28), Jiangsu (13), Zhejiang (13), Guangdong (1), Hunan (1), Hubei (1), Hebei (1) and Xinjiang (1) are currently not known. These cases are therefore not shown on the map. Imported cases in Canada (2) and Malaysia (1) are also not represented.

 

Situation update

  • Animals
    • 22 August 2016:
      • MoA published the results of the national animal H7N9 surveillance for the month of July.
      • 88,527 serum and 52,837 virological samples were collected from 4,242 locations in 27 provinces.
      • 58 serum samples tested positive for H7 antibodies in
        • Hebei (9 chicken samples from 3 markets and 1 slaughterhouse),
        • Jilin (10 chicken samples from 4 farms),
        • Shanghai (3 chicken samples from 2 markets), and
        • Sichuan (36 chicken samples from 3 farms).
      • None of the virological samples tested positive for H7N9 [reference].
    • 22 August 2016:
      • MoA released the “National Plan for HPAI Prevention and Control (2016-2020)”.
      • This plan covers both H5 and H7 influenzas and outlines scientific choices for different strategies, such as compulsory immunization, culling, surveillance and eradication, depending on AI prevalence and other criteria [reference].

 

Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 20 September 2016

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

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|-- Click to enlarge –|

 

  • Humans
    • Since the last update (20 July 2016), 8 new human cases were reported in Hebei (2), Fujian (2), Beijing (1), Henan (1), Zhejiang (1), Jiangsu (1).
    • The cases in Hebei and Beijing are reported to have been exposed to poultry in Yingtan City, Jiangxi Province.
    • For detailed information on human cases, please refer to WHO's Disease Outbreak News.

 

Figure 2. Number of officially reported human cases since February 2013 as of 20 September 2016

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 20 September 2016

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) and wave 4 (n= 32), 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).
  • Viral genome and infectious avian influenza A viruses of H5N6, H7N9, and H9N2 subtypes were detected in air sampled at live poultry markets in Guangzhou.
    • The use of de-feathering devices increased the quantity of virus-laden airborne particles while market closure reduced the amount of such particles.
    • The results highlight the risk for airborne transmission of avian influenza viruses among poultry or from poultry to humans within such settings.
    • This may explain epidemiological observations in which some patients with H7N9 infection reported to have visited markets without direct contact with live poultry or poultry stalls [reference].
  • Economic burden of hospitalized patients infected with A (H7N9) virus in Jiangsu Province, according to disease severity, was estimated at $10,996 (patients with mild symptoms), $21,001 (severe symptoms) and $33,728 (patients that died) [reference].
  • The ability of domestic chickens (Gallus gallus domesticus) to transmit H7N9 to co-housed chickens and to several other animal species was tested in an experimental live animal market.
    • Results indicated that an infected chicken failed to initiate viral shedding of H7N9 in na├»ve co-housed chickens.
    • The infected chicken did, however, successfully transmit the virus to quail (Coturnix sp.) located directly below the infected chicken cage.
    • Oral shedding by indirectly infected quail was, on average, greater than ten-fold that of directly inoculated chickens.
    • Best management practices in live animal market systems should consider the position of quail in stacked-cage settings [reference].
  • A cross-sectional survey was conducted through interviews with 791 traders in 18 Vietnamese live bird markets.
    • Markets greatly differed according to the sources from which poultry was obtained, and their connections to other markets through the movements of their traders.
    • These features, which could be informed based on indicators that are easy to measure, suggest that markets could be used as sentinels for monitoring virus strains circulating in specific segments of the poultry production sector.
    • AIV spread within markets was modelled.
    • Due to the high turn-over of poultry, viral amplification was likely to be minimal in most of the largest markets.
    • However, due to the large number of birds being introduced each day, and challenges related to cleaning and disinfection, environmental accumulation of viruses at markets may take place, posing a threat to the poultry production sector and to public health. [reference]

 

FAO’s support to countries

  • FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion
  • FAO is providing surveillance and sampling guidance for South and Southeast Asia
  • Funding to date: US$ 8.1 million mobilized (US$ 6.7 million USAID, US$ 1.9 million TCPs)
  • ECTAD Myanmar organized a workshop on qualitative risk assessment in animal health to support the veterinary authorities in making risk assessment a sustainable activity in the country [news].

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

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