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ARCHIVE H7N9 situation update

06 February 2019, 17:00 hours; Rome

The next update will be issued on 06 March 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 (09 January 2019): 0

New human cases since last update (09 January 2019): 0

Note: H7N9 LPAI viruses have recently been detected in wild bird feces collected on 23 January 2019 from Pungcheon, Cheonan City, Chungnam Province, the Republic of Korea [reference1, reference2]. No evidence so far that the virus is closely related to the ones circulating in China; no evidence of infection in domestic poultry.

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 wave (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.

 

Table. Number of locations testing positive for H7N9 HPAI virus (n=43) in birds and/or the environment, by province and sampling site as of 06 February 2019.

Province

LBM*

Farm

Backyard

Airport

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

Liaoning 0 1 0 0 1

Inner Mongolia

0

2

0

0

2

Ningxia Hui

0

2

0

0

2

Shaanxi

0

2

0

0

2

Shanxi

0

1

0

0

1

Tianjin

0

1

0

0

1

Unknown

0

0

0

1

1

TOTAL

26

15

1

1

43

*LBM: live bird market

 

 Situation update

Animals

Since the beginning of wave 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.

Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 06 February 2019. 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=246; nHPAI=43) collected from birds or the environment, by sampling location, between October 2016 and 06 February 2019. 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=280; nHPAI=49) collected from birds or the environment, by sample origin between October 2016 and 06 February 2019. 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 (09 January 2019), no human cases were reported.
  • For detailed informationon human cases, please refer to WHO report.

Figure 4. Number of officially reported human cases from February 2013 to 06 February 2019. 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 from October 2013 (Beginning of wave 2) to 06 February 2019. 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 2 (n=2), wave 3 (n=146), wave 4 (n=27) and wave 5 (n=55), reporting dates were used instead.

 

 Publications

  • Roche, X., von Dobschuetz, S., Song, J., Qi, Y., Fusheng, G., Brioudes, A., Sims, L., Kamata, A., Kalpravidh, W., Makonnen, Y., El Idrissi, A., & Lubroth, J. Chinese-Origin H7N9 Avian Influenza: Spread in poultry and human exposure – a Qualitative Risk Assessment Update. FAO Animal Health Risk Analysis – Assessment, Issue No. 8, February 2019. Rome, FAO. [reference]. For the period February to May 2019, which is characterized by increased influenza virus activity and major festivals in the region, risk of H7N9 spread in poultry and human exposure was assessed to be low. Nevertheless, the recent adaptation of H7N9 and other H7 (i.e. H7N2 and H7N3) highly pathogenic avian influenza viruses to domestic ducks warrants close attention. Countries in the region should maintain vigilance and monitoring for viral incursion.
  • Zhu, W., Yang, L., & Shu, Y. Did the Highly Pathogenic Avian Influenza A(H7N9) viruses emerged in China raise increased threat to public health? Vector-Borne and Zoonotic Diseases, January 2019. [reference]. This study provides an overview of the emergence, epidemiology and biological characterization of the H7N9 HPAI viruses emerging in China for public health risk assessment.
  • Guo, L., Hou, M., Ning, R., Li, W., Yang, Z., Li, H., Chu, M., Yu, L., & Liu, L. A family cluster of two fatal cases infected with influenza A(H7N9) virus in Kunming China, 2017. Infection, Genetics and Evolution, 2018 December;66:152-158. [reference]. This article provides information on the two imported family cases of fatal H7N9 infection in Kunming, China, that were reported in 2017. Epidemiological investigation showed that the two family members had both been exposed to sick chickens in a poultry market. Analysis of the virus strains isolated from the two patients revealed high sequence similarity (≥ 99%) and homology to each other. Further epidemiological study demonstrated that five family members who had close contacted with the patients were free of illness and negative for the H7N9 genomic test. The H7N9 viruses described in the study are thus still limited to transmit efficiently from human-to-human.
  • Lei, X., Jing, S., Zeng, X., Lin, Y., Li, X., Xing, Q., Zhong, X., & Østbye, T. Knowledge, attitudes and practices towards avian influenza among live poultry market workers in Chongqing, China. Preventive Veterinary Medicine, 2019 January 1;162:151-159. [reference]. This study aimed at assessing the knowledge, attitude and preventive practices regarding avian influenza among live poultry market (LPM) workers in Chongqing, China. LPM workers showed low level of knowledge, weak perception of susceptibility to avian influenza and inadequate preventive behaviors.
  • Chen, L., Ruan, F., Sun, Y., Chen, H., Liu, M., Zhou, J., & Qin, K. Establishment of sandwich ELISA for detecting the H7 subtype influenza A virus. Journal of Medical Virology, 2019 January 24. [reference]. In this study, a batch of H7 subtype-specific monoclonal antibodies (mAbs) were developed and a pair of mAb were used to establish a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) to quantify H7 protein and detect influenza A virus baring H7 subtype HA. The ELISA could not only detect the prevailing H7N9 virus, but also antigenic drift H7 subtype viruses, showing excellent sensitivity and high specificity.

 FAO actions

  • FAO updated its risk assessment entitled, “Chinese-Origin H7N9 Avian Influenza: Spread in poultry and human exposure”, published on 4 February 2019 [link].
  • Report of the WHO Vaccine Composition Meeting September [link] and February 2018 [link]
  • 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 published a risk assessment update entitled, “Chinese-origin H7N9 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