H7N9 situation update
22 February 2017, 17:00 hours; Rome
The next update will be issued on 8 March 2017
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: 1230 confirmed; 428 deaths (since February 2013)
Provinces/municipalities: Beijing, Shanghai and Tianjin municipalities; Anhui, Fujian, Guangdong, Guizhou, Hebei, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning, Qinghai, Shandong, Sichuan, Taiwan, Yunnan and Zhejiang Provinces of China; Hong Kong SAR; Macao SAR, Guangxi, 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 27 human cases in Anhui (5), Beijing (1), Hunan (4), Hubei (3), Jiangsu (11), Sichuan (2) and Zhejiang (1) Provinces are currently not known, these cases are therefore not shown on the map.
- 21 February, Jiangxi: Nanchang City closed all LBMs and live bird trading places for 14 days, from 22 February to 7 March [reference]. Environmental sample collected by the County CDC in a poultry trading market in Yujiang County, Yingtan city, Jiangxi Province tested positive for H7 on 13 February. The affected market was closed from 16 to 22 February [reference].
- 20 February, Taiwan: A recent H7N9 isolate from an imported human case (exposed in Guangdong) showed three additional basic amino acids inserted at the HA cleavage site; this may be a sign for increased pathogenicity in poultry [reference].
- 19 February, Guangdong: Transport of all live birds was temporary suspended from Anhui, Jiangsu, Jiangxi, Zhejiang, and other H7N9 epidemiologically high risk provinces. In addition the province also temporarily suspended transport of commercial live birds from Fujian, Guizhou, Hebei, Henan, Hunan, Hubei, Liaoning, Shandong, Shanghai, Sichuan, and others with infected cases (excluding poultry certified after negative pathogen detection test) [reference].
- 18 February, Guangdong: Highly pathogenic avian influenza A(H7N9) virus was confirmed in samples collected from a live bird market (LBM) by the National Reference Laboratory for Avian Influenza in Harbin. The affected live poultry market has been closed and surveillance is strengthened in the whole province [reference]. A similar virus was also isolated from two human cases. Both reported contact with live poultry and epidemiological investigations revealed mortalities in the respective poultry flocks. The isolates are genetically similar to the influenza A (H7N9) virus circulating in China since 2013 but showed additional basic amino acids inserted at the HA cleavage site; this may be a sign for increased pathogenicity in poultry [reference].
- Following these findings and in order to strengthen national H7N9 prevention and control, the MoA China published an emergency notice with the following immediate actions [reference]:
- Timely implementation of prevention and control activities.
- Continued strengthening of analysis and research, as well as in depth analysis of the implementation of prevention and control measures.
- Implementation of H7N9 emergency surveillance nationwide. Once an H7N9 virological positive sample is found, all poultry in the farm need to be destroyed.
- Effective strengthening of the implementation of control measures in live poultry markets. The supervision of live poultry markets is strengthened and the 1110 rule promoted: cleaning once a day, disinfection once a week, market closure once a month and no poultry allowed to stay overnight.
- The National Reference Laboratory for avian influenza closely monitors mutation of the virus and continues to explore new methods for virus detection.
- Increased awareness and timely information release on H7N9 prevention and control.
- Strengthening of timely emergency preparedness, including prevention and control mechanisms, and enhancing the emergency stockpile.
- Continued strengthening of inter-departmental collaboration and information sharing between health and planning, food and medicine, industry and commerce, and other departments. In areas with a new H7N9 human case, the local animal health sector should coordinate with the public health sector in suggesting the local government measures for market closure coordinated between animal husbandry and veterinary department and health care department.
- 18 February, Anhui: Chizhou City temporarily shut down all domestic poultry markets from 18 February for 14 days [reference].
- 14 February, Guangdong: In Zhuhai City, routine environmental influenza monitoring detected H7 positive samples from two markets in Jinwan and Doumen Districts. Both markets were temporarily closed from 15 to 17 February (3 days) [reference].
Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 22 February 2017
Click to enlarge
- Since the last update (15 February 2017), 56 new human cases have been reported in Hubei (11), Jiangsu (9), Zhejiang (8), Guangdong (7), Anhui (4), Fujian (4), Jiangxi (3), Hunan (2), Shandong (2), Sichuan (2), Liaoning (1), Yunnan (1), Guangxi (1) and Guizhou (1).
- 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 22 February 2017
Click to enlarge
Figure 3. Incidence of officially reported human cases by month, based on onset date as of 22 February 2017
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=317) 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).
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