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ARCHIVE H7N9 situation update

25 October 2017, 12:00 hours; Rome

The next update will be issued on 29 November 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

Hazard: Influenza A(H7N9) virus with pandemic potential.
Country: China; imported cases in Malaysia (1) and Canada (2).
Number of human cases: 1,622 confirmed; 619 deaths (since February 2013) please note that no human cases were reported since the last update (20 September). Nevertheless, total case numbers were updated at the end of wave 5 based on NHFPC annual reports, Hong Kong SAR weekly reports and WHO DON.
New findings in birds / environment since last update (20 September 2017): 3

New human cases since last update (20 September 2017): 0

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

Human cases and positive findings in birds or the environment
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 63 human cases in Anhui (2), Beijing (2), Guangdong (1), Guangxi (1), Hebei (3), Hunan (1), Hubei (2), Jiangsu (2), Jiangxi (6), Sichuan (2), Zhejiang (3) and unknown (38) Provinces are currently not known, these cases are therefore not shown on the map.

 

Provinces/municipalities affected: Beijing, Chongqing, Shanghai and Tianjin Municipalities; Anhui, Fujian, Gansu, Guangdong, Guizhou, Hebei, Heilongjiang, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning, Qinghai, Shaanxi, Shanxi, Shandong, Sichuan, Taiwan, Yunnan and Zhejiang Provinces; Hong Kong SAR, Macao SAR; Guangxi, Inner Mongolia, Ningxia Hui, Tibet and Xinjiang Uyghur Autonomous Regions (China); Sabah (Malaysia); British Columbia (Canada).

Highly pathogenic virus findings: Since 10 January 2017, highly pathogenic avian influenza (HPAI) type H7N9 virus was detected in a total of 54 poultry or environmental samples (42 chickens, 2 duck and 10 environmental samples); H7N9 virus isolates from 25 human cases were found to be HPAI virus.

 

Table. Number of locations testing positive for H7N9 HPAI virus (n=38) in birds and/or the environment, by province and sampling site as of 25 October 2017.

Province

LBM*

Farm

Backyard

Quarantine

Total

Anhui

0

1

0

0

1

Fujian

1

0

0

0

1

Guangdong

22

0

0

0

22

Guangxi

0

1

0

0

1

Hebei

0

1

0

0

1

Heilongjiang

0

1

0

0

1

Henan

0

1

0

0

1

Hunan

3

1

1

0

5

Inner Mongolia

0

2

0

0

2

Shaanxi

0

1

0

0

1

Tianjin

0

1

0

0

1

Unknown

0

0

0

1

1

TOTAL

26

10

1

1

38

 

*LBM: live bird market

 

 

 Situation update

Animals

  • 23 October: MoA published the results of the national animal H7N9 surveillance for the month of September. Out of a total of 23,156 virology samples collected in 23 provinces, two samples tested positive for H7N9: One duck sample from North Market, Sui Town, Zhangzhou City, Fujian Province and one chicken sample from Tieling Yingying animal husbandry Ltd., Shenjiagou Township, Tieling City, Liaoning Province. [reference]
  • 23 June: An H7N9 HPAI virus was isolated from a duck meat product confiscated from a flight passenger in Japan and the sequence posted in GenBank. [reference]

Animal/environmental findings: Since 4 April 2013 around 2500 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.

Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 25 October 2017. Data include both high and low pathogenic H7N9 viruses.

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

Figure 2. Distributions of low* and highly pathogenic H7N9 virologically positive samples (nLPAI=210; nHPAI=38) collected from birds or the environment, by sampling location, between October 2016 and September 2017 (wave 5). Samples from the same location and time are grouped.

Number of positive virological samples from birds or the environment, by province* and origin
Click to enlarge - *may contain unconfirmed HPAI at the time of publishing

Figure 3. Distributions of low* and highly pathogenic H7N9 virologically positive samples (nLPAI=252; nHPAI=44) collected from birds or the environment, by sample origin between October 2016 and September 2017 (wave 5). Samples from the same origin, location and time are grouped.

Incidence of officially reported human cases by week, based on onset date
Click to enlarge - *may contain unconfirmed HPAI at the time of publishing

 

Humans

  • Since the last update (20 September 2017), no new humans cases have been reported.
  • For detailed information on human cases, please refer to WHO's Disease Outbreak News

Figure 4. Number of officially reported human cases since February 2013 as of 25 October 2017. Data include both high and low pathogenic H7N9 viruses

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

Figure 5. Incidence of officially reported human cases by month, based on onset date as of 25 October 2017. Both high and low pathogenic H7N9 viruses are included.

Incidence of officially reported human cases by week, based on onset date
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=55), reporting dates were used instead.

 

Publications        

  • During 2016 in Guangzhou City, Guangdong Province, China, avian influenza viruses were detected in 39.8 percent of samples collected from chicken carcasses slaughtered at live poultry markets, but none from carcasses supplied to supermarkets from private poultry slaughtering industries that are bypassing live poultry markets. Promoting supply chains with high biosecurity may reduce the risk for zoonotic AIV transmission. [reference]
  • Risk-based, virological surveillance conducted in Myanmar to detect a range of zoonotic avian influenza subtypes confirmed the first detection of influenza A subtypes H5N6 and H9N2 in the country; according to study results, low pathogenic avian influenza A(H7N9) had not entered Myanmar so far. The study focused on the live bird markets in border townships, where illegal poultry importation from China takes place. [reference]
  • The European Food Safety Authority (EFSA) assessed the risk of avian influenza entering the EU and reviewed surveillance approaches and monitoring by Member States as well as their mitigation measures. The publication “Avian influenza: new scientific advice boosts EU preparedness” was based on a thorough review of information related to avian influenza outbreaks that have occurred in recent years. [reference]
  • A low pathogenic (LP) H7N9 influenza virus was compared with a highly pathogenic (HP) isolate and two of its variants, representing neuraminidase inhibitor-sensitive and -resistant subpopulations. The HP H7N9 viruses replicated efficiently in mice, ferrets, and/or nonhuman primates, and were more pathogenic in mice and ferrets than the LP H7N9 virus, with the exception of the neuraminidase inhibitor-resistant virus, which showed mild-to-moderate attenuation. [reference]

 

FAO actions:

  • FAO published a risk assessment entitled, “Chinese-Origin H7N9 Highly Pathogenic Avian Influenza: Spread in poultry and human exposure” [reference]
  • FAO guidance and risk assessments are available on a dedicated website [link]
  • Liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.

FAO’s support to countries