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ARCHIVE LATEST H7N9 situation update

4 May 2017, 11:00 hours; Rome

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

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: 1461 confirmed; 551 deaths (since February 2013).

Number of new findings in birds or the environment since last update (26 April 2017): 37.
Number of new human cases since last update (26 April 2017): 17
.
Provinces/municipalities: Beijing, Chongqing, Shanghai and Tianjin Municipalities; Anhui, Fujian, Gansu, Guangdong, Guizhou, Hebei, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning, Qinghai, Shaanxi, Shandong, Sichuan, Taiwan, Yunnan and Zhejiang Provinces; Hong Kong SAR; Macao SAR, Guangxi, Ningxia Hui, Tibet and Xinjiang Uyghur Autonomous Regions; Sabah (Malaysia); British Columbia (Canada).
Animal/environmental findings: around 2,500 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.

Highly pathogenic virus findings: Out of the 1461 confirmed human cases, H7N9 virus isolates from three cases (two from Guangdong and one from Taiwan Provinces) were found to be highly pathogenic for chickens. The H7N9 highly pathogenic avian influenza virus was detected in a total of 41 poultry or environmental samples (30 chickens, 1 duck and 10 environmental samples) from 23 live bird markets (LBMs) in: Fujian (Longyan City), Guangdong (Dongguan, Guangzhou, Huizhou, Lufeng, Meijiang, Meizhou, Zhongshan Cities and Haifeng County), Guangxi (Guilin City) and Hunan (Chenzhou City) Provinces; and from 3 farms in: Guangxi (Guilin City) and Hunan (backyard in Chenzhou City and a large farm in Yongzhou City [reference]) Provinces.

FAO actions: liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.

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 23 human cases in Anhui (2), Beijing (2), Guangdong (1), Guangxi (1), Hebei (2), Hunan (1), Hubei (2), Jiangsu (1), Jiangxi (6), Sichuan (2) and Zhejiang (3) Provinces are currently not known, these cases are therefore not shown on the map.

 

 

 Situation update

Animals

  • 3 May, Shaanxi Province: While no virological positive samples from animals have ever been reported, a first H7N9 human case occurred in Qindu District, Xianyang City, with onset on 23 April. A specimen of the male patient tested positive for H7N9 virus nucleic acid on 30 April and he died on 1 May due to multiple organ failure [reference].
  • 2 May, the Chinese Ministry of Agriculture issued the monthly surveillance report for March including a part of the results from the H7N9 intensified surveillance conducted from 25 January to 28 February. 453,951 samples were collected from 21,978 sites. 1533 out of 290,836 serological samples tested positive for H7 subtype and 55 out of 163,115 virological samples were H7N9 positive [reference].
  • Figure 1 summarizes test results from the intensified surveillance held in the whole country from 25 January to 28 February using percentage of virological positive locations (LBM or farm) by province. Fujian and Guangdong provinces show the highest positivity rate with 3.07% (19 out 618 locations) and 1% (18 out 1803 locations) respectively. Liaoning, Jiangxi, Hubei, Hunan, Sichuan and Guizhou provinces have a positivity rate between 0.2 and 0.6% while other provinces are under 0.15%. Only those provinces reporting virologically positive results are included in the graph. Note: No samples were taken in Gansu and Hainan provinces. [reference1, reference2]

Figure 1. Percentage of locations (live bird markets or farms) testing virologically positive during intensified surveillance (undertaken between 25 January and 28 February) by province as of 03 May 2017. Only those provinces reporting virologically positive results are listed. Note: No samples were taken in Gansu and Hainan provinces

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


  • Macao SAR government has decided to ban the import and sale of all live poultry in Macao from 1 May onwards, to prevent diseases, protect the community and maintain a stable socio-economic development [reference].
  • Sichuan Province: Since the beginning of April, under routine environmental monitoring, the province detected H7N9 virus in 6 counties namely Suzhou, Yumen, Guazhou counties in Jiuquan City, and Ganzhou, Shandan, Gaotai counties in Zhangye City [reference].

Figure 2. Number of positive virological samples from birds or the environment, by province and origin as of 03 May 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

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


Humans

  • Since the last update (26 April 2017), 17 new human cases have been reported in Sichuan (3), Beijing (2), Guangdong (2), Jiangsu (2), Shandong (2), Chongqing (1), Fujian (1), Henan (1), Hubei (1), Hunan (1), Shaanxi (1).

Figure 3. Number of officially reported human cases since February 2013 as of 03 May 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Number of officially reported human cases since February 2013
Click to enlarge

Figure 4. Incidence of officially reported human cases by month, based on onset date as of 03 May 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

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=541) reporting dates were used instead.


Publications

  • 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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