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ARCHIVE H7N9 situation update

06 March 2019, 17:00 hours; Rome

The next update will be issued on 03 April 2019

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: 1,567 confirmed; 615 deaths (since February 2013).
New findings in birds / environment since last update (06 February 2019): 0

New human cases since last update (06 February 2019): 0

Map. 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. Regarding the fifth period (October 2016-September 2017), precise location of 20 human cases in Guangdong (1), Guangxi (1), Hebei (3), Hunan (1), Hubei (1), Jiangsu (1), Jiangxi (5), Zhejiang (2) and unknown (5) 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 58 poultry or environmental samples (46 chickens, 2 duck and 10 environmental samples); H7N9 virus isolates from 32 human cases were found to be HPAI virus.

 

 Situation update

Animals

Since the beginning of period 7 (1 October 2018), no H7N9 outbreak or H7N9 positive animal or environment findings were reported.

 

Animal/environmental findings: Since 4 April 2013 around 2500 virological samples from the environment, chickens, pigeons, ducks, turkeys, a tree sparrow and a magpie robin tested positive; positives mainly from live bird markets, vendors and some commercial or breeding farms.

 

For table, graphs, and pie-charts showing data on H7N9 positive virological samples from birds or the environment and officially reported human infections, from February 2013 to June 2018, see Update 06/02/2019.

 

Humans

  • Since the last update (06 February 2019), no human cases were reported.
  • For detailed informationon human cases, please refer to WHO report.

Figure 1. Incidence of officially reported human cases by month, based on onset date from October 2014 (beginning of period 3) to 06 March 2019. Both high and low pathogenic H7N9 viruses are included.

Number of positive virological samples from birds or the environment, by province* and origin
Click to enlarge - Note: For cases with unknown onset dates from period 2 (n=2), period 3 (n=146), period 4 (n=27) and period 5 (n=55), reporting dates were used instead.

Figure 2. Phylogenetic relationships of A(H7) Eurasian HA genes, including Chinese-origin H7N9

Phylogenetic relationships of A(H7) Eurasian HA genes, including Chinese-origin H7N9
Click to enlarge - Source: WHO’s Vaccine Composition Meeting Report, February 2019. [reference]. Note: the available Candidate Vaccine Viruses (CVV) are in red. The proposed CVV is indicated by a red dot (). Human viruses are in bold font. The viruses tested in haemagglutination inhibition assay are indicated by hashes (#). NA subtypes other than N9 are specified. The tree was built from the nucleotide sequences coding for the mature HA1 protein. The scale bar represents the number of substitutions per site. Bootstrap supports of topology are shown above selected nodes. A/duck/Hong Kong/293/78 (N2) is used to root the tree.

 

 Publications

  • Li, Z., Fu, J., Lin, G., & Jiang, D. Spatiotemporal Variation and Hotspot Detection of the Avian Influenza A(H7N9) Virus in China, 2013-2017. International Journal of Environmental Research and Public Health. 2019 February 22;16(4). pii: E648. [reference]. This study aims to describe the spatial and temporal characteristics of human infections with H7N9 virus in China using data spanning 19 February 2013 to 30 September 2017. There was a strong seasonal pattern in A(H7N9) virus infection, with high activity in the first quarter of the year, especially in January, February, and April, and a gradual decline in the third quarter. Spatial distribution analysis indicated that Eastern China contained the most severely affected areas, such as Zhejiang Province, and the distribution shifted from coastline areas to inland areas over time.
  • Su, K., Ye, S., Li, Q., Xie, W., Yu, H., Qi, L., & Li, Y. Influenza A(H7N9) virus emerged and resulted in human infections in Chongqing, southwestern China since 2017. International Journal of Infectious Diseases. 2019 February 21. pii: S1201-9712(19)30075-X. [reference]. This study aimed to describe the epidemiological characteristics of the first epidemic in the province of Chongqing. Influenza A(H7N9) virus, which was introduced into Chongqing most likely between late 2016 and early 2017, swept across half of Chongqing territory and resulted in human infections within months. The most impacted premises and populations by the epidemic were LPMs and poultry related workers.

 FAO actions

  • Report of the WHO Vaccine Composition Meeting – February 2019 [link]
  • FAO published a risk assessment update entitled, “Chinese-origin H7N9 avian influenza: spread in poultry and human exposure” [reference]
  • A webinar entitled “Pros and cons of avian influenza vaccination” was presented by Leslie Sims on 14 May 2018 with technical support from FAO HQ. A recording of the webinar is available [link].
  • 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