Hong Kong H7N9 ex-Dongguan 75M

niman · January 16, 2017

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/

niman · January 16, 2017

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.

niman · January 16, 2017

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

niman · January 16, 2017

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/

niman · January 16, 2017

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

In vivo antiviral resistance

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 #
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)

niman · January 20, 2017

In response to media enquiries, the Centre for Health Protection (CHP) of the Department of Health today (December 28) reported an update on the first imported human case of avian influenza A(H7N9) in Hong Kong this winter.

The CHP noted that the 75-year-old man, confirmed as a human case of avian influenza A(H7N9), who was admitted to North District Hospital on December 9 for management passed away on December 25.

Ends/Tuesday, December 27, 2016
Issued at HKT 14:25

http://www.info.gov.hk/gia/general/201612/27/P2016122700496.htm?fontSize=1

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Hong Kong H7N9 ex-Dongguan 75M

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