niman

Croatian Veterinary Institute Poultry Centre has released 2017 H5 and N8 sequences (at GISAID) from a breeder duck in Sop Bukevski, A/breeder duck/Croatia/21/2017.

Health officials monitoring two patients after presenting birdflu signs By Charles Kizindo Lule Twenty patients in Bussi and Butembe islands on Lake Victoria are being monitored by health specialists after presenting symptoms of the deadly bird flu. The ministry of health has picked samples from them and taken to Uganda Virus Research Institute in Entebbe for further investigations. Bird flu was confirmed in Uganda this week following a mass death of birds at Lutembe beach in Entebbe, and ducks in Masaka. http://capitalradio.co.ug/health-officials-monitoring-two-patients-presenting-birdflu-signs/

The Centre for Health Protection (CHP) of the Department of Health is today (December 30) investigating a confirmed human case of of avian influenza A(H7N9) in Hong Kong, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel. The male patient, aged 70 with underlying illnesses, claimed to have developed fever, cough with sputum, shortness of breath, vomiting and diarrhoea since December 26. He attended the Accident and Emergency Department of United Christian Hospital (UCH) on December 27 and was admitted to isolation ward on December 28. His sputum specimen collected on December 28 was received and confirmed yesterday (December 29) to be positive for influenza A(H7N9) virus by the CHP's Public Health Laboratory Services Branch (PHLSB). The patient is now in stable condition and has been transferred to Princess Margaret Hospital for further management. The patient travelled to Shenzhen and Zhongshan since December 13 and returned to Hong Kong via Lo Wu on December 16. He claimed that he came across mobile stalls selling live poultry in Zhongshan. In Hong Kong, the patient recalled having purchased a chilled chicken from a shop near a wet market in Kwun Tong on December 22 but no live poultry was sold in the shop. According to the patient, he did not enter the wet market. The source of infection is still under investigation. His close contacts have remained asymptomatic so far and have been put under medical surveillance. Tracing of his other contacts in Hong Kong is underway. "The case will be notified to the World Health Organization and the national, Guangdong and Macau health authorities. We are communicating with the Mainland authority to follow up the patient's exposure and movements in the Mainland," a spokesman for the CHP said. "Our epidemiological investigations are ongoing. Since the patient had purchased a chilled chicken near a wet market in Kwun Tong, as a precautionary measure, we are working closely with the Food and Environmental Hygiene Department to assess and investigate the case," the spokesman said. Letters to doctors, hospitals, schools and institutions will be issued to alert them to the latest situation. "Locally, the first imported human case of avian influenza A(H7N9) in this winter was recently detected. The neighbouring Guangdong and Macau also reported their first human H7N9 cases in this winter. The activity of avian influenza is expected to increase in winter based on its seasonal pattern. "The public should avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel, particularly in the upcoming New Year holidays. If feeling unwell such as having fever or cough, wear a mask and seek medical advice at once. Travellers returning from affected areas should consult doctors promptly if symptoms develop and let them know their travel history," the spokesman added. The CHP's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up. The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is underway. The travel industry and other stakeholders are regularly updated on the latest information. The public should maintain strict personal, hand, food and environmental hygiene and take heed of advice below while handling poultry: When handling live chickens, do not touch them or their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume them immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs; Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done; Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and Wear a mask if fever or respiratory symptoms develop, going to a hospital or clinic, or while taking caring of patients with fever or respiratory symptoms. The public may visit the CHP's pages for more information: the avian influenza page, the weekly Avian Influenza Report, global statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel. Ends/Friday, December 30, 2016 Issued at HKT 0:47 http://www.info.gov.hk/gia/general/201612/30/P2016123000022.htm

Isolate name: A/Hong Kong/VB16189623/2016 Isolate ID: EPI_ISL_240520 Passage details/history: Original Type: A / H7N9 Lineage: Sample information Collection date: 2016-12-28 Host Human Additional host information: Zip code: Patient status: In-patient Last vaccinated: In-vivo pathogenicity test: Location: Hong Kong (SAR) Additional location information: Patient age: 70 Year(s) Gender: Male Outbreak: Treatment: Specimen source: Sputum Institute information Originating lab: Public Health Laboratory Services Branch, Centre for Health Protection Sample ID given by the sample provider: Address: Public Health Laboratory Services Branch, Centre for Health Protection Virology Division Kowloon Hong Kong Hong Kong (SAR) Submitting lab: Public Health Laboratory Services Branch, Centre for Health Protection Sample ID given by the submitting laboratory: VB16189623 Authors: Mak,G.C.; Lo,J.Y.C. Address: Public Health Laboratory Services Branch, Centre for Health Protection Virology Division Kowloon Hong Kong Hong Kong (SAR) Publication Publication In vivo antiviral resistance Phenotype Genotype Unspecified Antiviral resistance tested by experimental procedures Adamantanes: Unknown Oseltamivir: Unknown Zanamivir: Unknown Peramivir: Unknown Other: Unknown Additional information Antigenic characterization: Note: Sequence segment identifier length accession # INSDC Sequence PB2 A/Hong Kong/VB16189623/2016_s1 2280 EPI872955 PB1 A/Hong Kong/VB16189623/2016_s2 2274 EPI872956 PA A/Hong Kong/VB16189623/2016_s3 2151 EPI872954 HA A/Hong Kong/VB16189623/2016_s4 1683 EPI872958 NP A/Hong Kong/VB16189623/2016_s5 1497 EPI872951 NA A/Hong Kong/VB16189623/2016_s6 1398 EPI872957 MP A/Hong Kong/VB16189623/2016_s7 982 EPI872953 NS A/Hong Kong/VB16189623/2016_s8 838 EPI872952 Submitter information Submitter: Mak, Gannon Submission Date: 2017-01-04 Last modifier: Mak, Gannon Last modified: 2017-01-04 Address: Public Health Laboratory Services Branch, Centre for Health Protection Virology Division Kowloon Hong Kong Hong Kong (SAR)

Disease outbreak news 3 January 2017 On 30 December 2016, the Department of Health, Hong Kong Special Administrative Region (SAR) notified WHO of a case of laboratory-confirmed human infection with avian influenza A(H7N9) virus. Details of the case The case is a 70-year-old man with underlying chronic conditions, who travelled to Shenzhen and Zhongshan, Guangdong province from 13 to 16 December 2016. The patient reported having fever, productive cough, shortness of breath, vomiting and diarrhoea since 26 December. He visited a public hospital in Hong Kong SAR, China on 27 December and was admitted to an isolation ward on 28 December. A sputum sample taken on 28 December tested positive for avian influenza A(H7N9) virus RNA. The patient was in serious condition at the time of report. In Zhongshan, he passed by mobile stalls selling live poultry on 14 December but reported no direct contact with the poultry. In Hong Kong SAR, he purchased a chilled chicken from a shop near a wet market on 22 December but no live poultry was sold in the shop, and he did not enter the wet market. A total of 17 close contacts and 85 other contacts were identified as of 30 December, and put under medical surveillance. The patient’s co-traveller had a cough since 29 December and was admitted to a public hospital on the same day. His respiratory specimen tested negative for avian influenza A(H7N9) virus RNA by the hospital. To date, a total of 809 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013. Public health response The Centre for Health Protection of the Department of Health has taken the following measures: Urged the public to maintain strict personal, food and environmental hygiene both locally and during travel. Issued an alert to doctors, hospitals, schools and institutions of the latest situation. WHO risk assessment Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, further human cases can be expected. Although small clusters of human cases with avian influenza A(H7N9) virus have been reported including those involving healthcare workers, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore further community level spread is considered unlikely. Human infections with the avian influenza A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and/or its transmission behaviour to humans as it may have a serious public health impact. WHO advice WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live bird markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices. WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern. WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

The case is a 70-year-old man with underlying chronic conditions, who travelled to Shenzhen and Zhongshan, Guangdong province from 13 to 16 December 2016. The patient reported having fever, productive cough, shortness of breath, vomiting and diarrhoea since 26 December. He visited a public hospital in Hong Kong SAR, China on 27 December and was admitted to an isolation ward on 28 December. A sputum sample taken on 28 December tested positive for avian influenza A(H7N9) virus RNA. The patient was in serious condition at the time of report. In Zhongshan, he passed by mobile stalls selling live poultry on 14 December but reported no direct contact with the poultry. In Hong Kong SAR, he purchased a chilled chicken from a shop near a wet market on 22 December but no live poultry was sold in the shop, and he did not enter the wet market. http://www.who.int/csr/don/03-january-2017-ah7n9-china/en/

Isolate name: A/Hong Kong/VB16184091/2016 Isolate ID: EPI_ISL_239994 Passage details/history: Original Type: A / H7N9 Lineage: Sample information Collection date: 2016-12-19 Host Human Additional host information: Zip code: Patient status: In-patient Last vaccinated: In-vivo pathogenicity test: Location: Hong Kong (SAR) Additional location information: Patient age: 75 Year(s) Gender: Male Outbreak: Treatment: Specimen source: Nasopharyngeal Institute information Originating lab: Public Health Laboratory Services Branch, Centre for Health Protection Sample ID given by the sample provider: Address: Public Health Laboratory Services Branch, Centre for Health Protection Virology Division Kowloon Hong Kong Hong Kong (SAR) Submitting lab: Public Health Laboratory Services Branch, Centre for Health Protection Sample ID given by the submitting laboratory: VB16184091 Authors: Mak,G.C.; Lo,J.Y.C. Address: Public Health Laboratory Services Branch, Centre for Health Protection Virology Division Kowloon Hong Kong Hong Kong (SAR) Publication Publication In vivo antiviral resistance Phenotype Genotype Unspecified Antiviral resistance tested by experimental procedures Adamantanes: Unknown Oseltamivir: Unknown Zanamivir: Unknown Peramivir: Unknown Other: Unknown Additional information Antigenic characterization: Note: Sequence segment identifier length accession # INSDC Sequence PB2 A/Hong Kong/VB16184091/2016_s1 2280 EPI869670 PB1 A/Hong Kong/VB16184091/2016_s2 2274 EPI869671 PA A/Hong Kong/VB16184091/2016_s3 2151 EPI869669 HA A/Hong Kong/VB16184091/2016_s4 1683 EPI869673 NP A/Hong Kong/VB16184091/2016_s5 1497 EPI869666 NA A/Hong Kong/VB16184091/2016_s6 1398 EPI869672 MP A/Hong Kong/VB16184091/2016_s7 982 EPI869668 NS A/Hong Kong/VB16184091/2016_s8 838 EPI869667 Submitter information Submitter: Mak, Gannon Submission Date: 2016-12-23 Last modifier: Mak, Gannon Last modified: 2016-12-23 Address: Public Health Laboratory Services Branch, Centre for Health Protection Virology Division Kowloon Hong Kong Hong Kong (SAR)

220866 Confirmed Asia/Hong Kong, SAR/Administrative unit not available National Administrative unit not available / Lat.: 22.408705, Long.: 08/12/2016 20/12/2016 Influenza - Avian H7N9 LPAI 1 Human Geocoords. Quality: Centroid Admin1 http://empres-i.fao.org/eipws3g/

The Centre for Health Protection (CHP) of the Department of Health is tonight (December 19) investigating the first imported human case of avian influenza A(H7N9) in Hong Kong this winter, and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel. The male patient, aged 75 with underlying illnesses, travelled to Changping, Dongguan alone on November 28 and attended a hospital there for chest discomfort on December 8. He returned to Hong Kong via Lo Wu on December 9 and was directly admitted to North District Hospital by ambulance for cough with sputum, shortness of breath, runny nose and chest discomfort. His nasopharyngeal swab tested positive for enterovirus/rhinovirus and negative for influenza virus upon testing by the CHP's Public Health Laboratory Services Branch (PHLSB). The patient subsequently developed fever on December 17 and the clinical diagnosis was pneumonia. His nasopharyngeal aspirate collected today was confirmed to be positive for influenza A(H7N9) virus by the PHLSB tonight. He is now in serious condition and is under isolation and further management. The patient denied recent exposure to poultry or wet market. His home contacts have remained asymptomatic so far and have been put under medical surveillance. Tracing of his other contacts in Hong Kong, if any, is underway. "The case will be notified to the World Health Organization and the national, Guangdong and Macau health authorities. We are communicating with the Mainland authority to follow up the patient's exposure and movements in the Mainland. Based on information available thus far, it is classified as an imported case. Epidemiological investigations are ongoing," a spokesman for the CHP said. "Recently, Guangdong reported the first human case of avian influenza A(H7N9) in this winter. Human H7N9 cases have also been detected in Zhejiang, Jiangsu and Fujian while human H5N6 cases in Hunan and Guangxi since November. Locally, four faecal dropping samples of birds collected from Mai Po Nature Reserve in late November were detected with H5N6 virus. Our risk assessment shows that the activity of avian influenza viruses is expected to increase in winter based on their seasonal pattern," the spokesman said. "The public should avoid touching birds, poultry or their droppings and visiting poultry markets or farms during travel, particularly in the upcoming Christmas and New Year holidays. If feeling unwell such as fever or cough, wear a mask and seek medical advice at once. Travellers returning from affected areas should consult doctors promptly if symptoms develop and let them know your travel history," the spokesman added. This is the 17th imported human case of avian influenza A(H7N9) confirmed in Hong Kong. From 2013 to date, 783 human cases of avian influenza A(H7N9) have been reported by the Mainland health authorities. Letters to doctors, hospitals, schools and institutions will be issued to alert them to the latest situation. The CHP's Port Health Office conducts health surveillance measures at all boundary control points. Thermal imaging systems are in place for body temperature checks on inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up. The display of posters and broadcasting of health messages in departure and arrival halls as health education for travellers is underway. The travel industry and other stakeholders are regularly updated on the latest information. The public should maintain strict personal, hand, food and environmental hygiene and take heed of advice below while handling poultry: When handling live chickens, do not touch them or their droppings. Do not blow at their bottoms. Wash eggs with detergent if soiled with faecal matter and cook and consume them immediately. Always wash hands thoroughly with soap and water after handling chickens and eggs; Eggs should be cooked well until the white and yolk become firm. Do not eat raw eggs or dip cooked food into any sauce with raw eggs. Poultry should be cooked thoroughly. If there is pinkish juice running from the cooked poultry or the middle part of its bone is still red, the poultry should be cooked again until fully done; Wash hands frequently, especially before touching the mouth, nose or eyes, before handling food or eating, and after going to toilet, touching public installations or equipment such as escalator handrails, elevator control panels or door knobs, or when hands are dirtied by respiratory secretions after coughing or sneezing; and Wear a mask if fever or respiratory symptoms develop, going to a hospital or clinic, or while taking caring of patients with fever or respiratory symptoms. The public may visit the CHP's pages for more information: the avian influenza page, the weekly Avian Influenza Report, global statistics and affected areas of avian influenza, the Facebook Page and the YouTube Channel. Ends/Monday, December 19, 2016 Issued at HKT 23:32

Disease outbreak news 23 December 2016 On 20 December 2016, the Department of Health (DOH), Hong Kong Special Administrative Region (SAR) notified WHO of a case of laboratory-confirmed human infection with avian influenza A(H7N9) virus. Details of the case The case is a 75-year-old man who travelled to Dongguan, Guangdong province from 28 November to 9 December 2016. He developed chest discomfort on 8 December and he visited a hospital there. He returned to Hong Kong SAR on 9 December and was directly admitted to hospital from point of entry by ambulance for cough with sputum, shortness of breath, runny nose and chest discomfort. His nasopharyngeal swab taken on 9 December tested positive for enterovirus/ rhinovirus and negative for influenza virus. His nasopharyngeal aspirate (NPA) taken on 19 December was positive for avian influenza A(H7N9) virus RNA. He was reported to be in severe condition at the time of report. His condition further deteriorated to critical on 21 December. He had visited a wet market in Dongguan and bought a dressed chicken. DOH's investigation is ongoing, and DOH is communicating with the Guangdong health authority. To date, a total of 808 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013. Public health response The Centre for Health Protection of the Department of Health has taken the following measures: Urged the public to maintain strict personal, food and environmental hygiene both locally and during travel. Issued an alert to doctors, hospitals, schools and institutions of the latest situation. WHO risk assessment Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, further human cases can be expected. Although small clusters of human cases with avian influenza A(H7N9) virus have been reported including those involving healthcare workers, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore further community level spread is considered unlikely. Human infections with the avian influenza A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and/or its transmission behaviour to humans as it may have a serious public health impact. WHO advice WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live bird markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices. WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern. WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

The case is a 75-year-old man who travelled to Dongguan, Guangdong province from 28 November to 9 December 2016. He developed chest discomfort on 8 December and he visited a hospital there. He returned to Hong Kong SAR on 9 December and was directly admitted to hospital from point of entry by ambulance for cough with sputum, shortness of breath, runny nose and chest discomfort. His nasopharyngeal swab taken on 9 December tested positive for enterovirus/ rhinovirus and negative for influenza virus. His nasopharyngeal aspirate (NPA) taken on 19 December was positive for avian influenza A(H7N9) virus RNA. He was reported to be in severe condition at the time of report. His condition further deteriorated to critical on 21 December. He had visited a wet market in Dongguan and bought a dressed chicken. DOH's investigation is ongoing, and DOH is communicating with the Guangdong health authority. http://www.who.int/csr/don/23-december-2016-ah7n9-china/en/

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=18hzYEnr0cRj2MpRMciJAN_b2e6s&ll=22.07513644657155%2C113.20540359326174&z=9

220233 Confirmed Asia/Macau/Administrative unit not available National Administrative unit not available / Lat.: 22.198327, Long.: 13/12/2016 14/12/2016 Influenza - Avian H7N9 LPAI 1 Human Geocoords. Quality: Centroid Admin1 http://empres-i.fao.org/eipws3g/

Human infection with avian influenza A(H7N9) virus – China Disease outbreak news 19 December 2016 On 14 December 2016, the Health Bureau, Macao Special Administrative Region (SAR) (China) confirmed a case of human infection with avian influenza A(H7N9) virus affecting a 58-year old male. On 13 December 2016, a batch of poultry from Guangdong province in China was found positive for the H7 antigen in a wholesale market in Macao SAR (China) during routine inspection. Following protocol, an epidemiological investigation commenced and two close human contacts of the infected poultry were identified, including a poultry vendor and driver. The poultry vendor discharged the concerned batch of poultry from the truck in the early morning of 13 December. The vendor was referred to hospital for further investigation. He tested positive for avian influenza A(H7N9) by RT-PCR in three specimens at the public health laboratory. He has not had any influenza-like symptoms so far. He is under observation and being treated with antivirals at a government hospital. His wife who also works in the same wholesale market was identified as a close contact of the case. She tested negative and is under observation for the next 10 days. To date, a total of 807 laboratory-confirmed human infections with avian influenza A (H7N9) virus have been reported through IHR notification since early 2013. Public health response Authorities in Macao SAR (China) have taken the following measures: Conducted a risk assessment. Management of the case and observation of close contacts. Communicated with authorities in mainland China to follow-up on the driver identified as a close contact of infected poultry. Enhanced surveillance of individuals working in the wholesale market where the case works. Provided health education in the wholesale market where the case works. Held a press conference to share information on the situation and response. WHO risk assessment Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. Since the virus continues to be detected in animals and environments, further human cases can be expected. Although small clusters of human cases with avian influenza A(H7N9) virus have been reported including those involving healthcare workers, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore further community level spread is considered unlikely. Human infections with the avian influenza A(H7N9) virus are unusual and need to be monitored closely in order to identify changes in the virus and/or its transmission behaviour to humans as the virus may have a serious public health impact. WHO advice WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live bird markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices. WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern. WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

On 14 December 2016, the Health Bureau, Macao Special Administrative Region (SAR) (China) confirmed a case of human infection with avian influenza A(H7N9) virus affecting a 58-year old male. http://www.who.int/csr/don/19-december-2016-2-ah7n9-china/en/

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=18hzYEnr0cRj2MpRMciJAN_b2e6s&ll=26.040832362023295%2C119.19692515405268&z=11

220234 Confirmed Asia/China/FuzhouNationalFujian Sheng / Lat.: 26.00369, Long.: 119.11538613/12/201613/12/2016Influenza - AvianH7N9 LPAI 1 Human Geocoords. Quality: Centroid Admin2 http://empres-i.fao.org/eipws3g/

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=18hzYEnr0cRj2MpRMciJAN_b2e6s&ll=24.251403457795433%2C115.97902226879876&z=10

220137 Confirmed Asia/China/MeizhouNationalGuangdong Sheng / Lat.: 24.162855, Long.: 116.14896709/12/201609/12/2016Influenza - AvianH7N9 LPAI 1 Human Geocoords. Quality: Centroid Admin2 http://empres-i.fao.org/eipws3g/

Map Update https://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=18hzYEnr0cRj2MpRMciJAN_b2e6s&ll=31.401475395992748%2C120.67772215795901&z=9

Human infection with avian influenza A(H7N9) virus – China Disease outbreak news 17 November 2016 On 11 November 2016, the National Health and Family Planning Commission (NHFPC) of China notified WHO of two additional cases of laboratory-confirmed human infection with avian influenza A(H7N9) virus. Details of the cases A 77-year-old female who lived in Zhejiang Province developed symptoms on 6 October 2016. She had an exposure history to live poultry before the onset of symptoms. She was reported to be in a severe condition. An 89-year-old male who lived in Jiangsu Province developed symptoms on 20 October 2016. He had no known exposure history to live poultry. He was reported to be in a severe condition. A total of 800 laboratory-confirmed human cases with avian influenza A (H7N9) virus infection have been reported through IHR notification since early 2013. Public health response The Chinese Government has taken the following surveillance and control measures: Strengthen surveillance and assessment analysis. Further enhance medical care of the cases. Conduct public risk communication. WHO risk assessment Most human cases had history of exposure to the A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets. As long as the virus continues to be detected in animals and environments, further human cases can be expected. Although small clusters of human cases with influenza A(H7N9) viruses have been reported including those involving healthcare workers, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore further community level spread is considered unlikely. Human infections with the A(H7N9) virus are unusual and should be monitored closely in order to identify changes in the virus and/or its transmissibility in humans which may have a serious public health impact. WHO advice WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live bird markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices. WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern. WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.

An 89-year-old male who lived in Jiangsu Province developed symptoms on 20 October 2016. He had no known exposure history to live poultry. He was reported to be in a severe condition. http://www.who.int/csr/don/17-november-2016-ah7n9-china/en/