H7N9 situation update
20 July 2016, 17:00 hours; Rome
The next update will be issued on 20 September 2016
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.
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: 795 confirmed; 314 deaths (since February 2013)
Provinces/municipalities: Beijing, Shanghai and Tianjin municipalities; Anhui; Fujian; Guangdong; Hubei and Liaoning provinces; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Qinghai; Hubei; Taiwan Province of China; Hong Kong SAR; Macao SAR, Ningxia Hui and Xinjiang Uyghur Autonomous Regions; Sabah (Malaysia); British Columbia (Canada).
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
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 56 human cases in Fujian (28), Jiangsu (12), Zhejiang (12), 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.
- 20 July 2016: MoA published the results of the national animal H7N9 surveillance for the month of June. 98,797 serum and 21,771 virological samples were collected from 3,893 locations in 20 provinces. 76 serum samples tested positive for H7 antibodies in
- Inner Mongolia Autonomous Region (14 chicken samples and 13 goose samples from 4 farms),
- Hebei Province (5 chicken samples from 2 farmers’ markets),
- Sichuan Province (10 chicken samples from a farmer’s market),
- Shaanxi Province (3 chicken samples from a farm) and
- Xinjiang Uygur Autonomous Region (31 chicken samples from 15 chicken farms and 4 farmer’s markets).
None of the virological samples tested positive for H7N9 [reference].
- 6 July 2016: As of 6 July, the nationwide implementation of electronic certification issuance for inter-provincial transportation of livestock was initiated and hand-written certificates are no longer valid [reference].
- 23 June 2016: MoA published the results of the national animal H7N9 surveillance for the month of May. 59,791 serum and 17,511 virological samples were collected from 3,020 locations in 20 provinces. One virological sample from a chicken in a market in Guangzhou City, Guangdong Province tested positive for H7N9 and 8 chicken serum samples tested positive for H7 antibodies in a farmer’s market in Shanghai City [reference].
- 22 June 2016, Macao SAR: an environmental sample randomly collected at a bird stall in Youhan street market tested positive for H7N9. Live poultry sale in Macao SAR was suspended for three days with immediate effect, and places like wholesale, slaughter and retail are to conduct comprehensive cleaning and disinfection. Close contacts (the stall owner and two staff) received a 10-day mandatory quarantine. They tested negative for H7N9 and showed no symptoms [reference].
Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 20 July 2016
Click to enlarge
- Since the last update (22 June 2016), no new human cases were reported.
- 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 July 2016
Click to enlarge
Figure 3. Incidence of officially reported human cases by month, based on onset date as of 20 July 2016
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= 24), reporting dates were used instead.
- 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).
- A challenge study showed that starlings can get asymptomatic H7N9 infections. Wild European Starlings (Sturnus vulgaris), which are common peridomestic birds in the Northern Hemisphere, were inoculated with the Chinese H7N9 strain. The birds receiving lower doses showed no excretion of H7N9, nor did the controls, however, two of the six birds in the high-dose group did excrete the virus for up to 7 days despite not showing any clinical signs. The authors suggest that the birds can excrete the H7N9 virus "in quantities sufficient to infect other European Starlings, poultry, and potentially humans" [reference].
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