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Posted

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/

Posted

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.

Posted
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

 

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)
Posted

 

     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

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