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Epidemiological update of 10 April: novel influenza A virus A(H7N9) in China

10 Apr 2013

On 31 March 2013, the Chinese health authorities announced that they identified a novel influenza A(H7N9) virus in three seriously ill patients.

As of 9 April 2013, 26 human cases of infection with influenza A(H7N9) virus have been reported in four provinces of China: Shanghai (13), Jiangsu (8), Zhejiang (3) and Anhui (2). Of these patients, 8 people have died, 15 are severe cases and 3 are mild cases. No epidemiological link has been identified among cases.

The source of these infections and the mode of transmission are yet to be determined. This is the first time that human infection with influenza A(H7N9) virus has been identified.

No vaccine is currently available for this subtype of the influenza virus. Preliminary test results suggest that the virus is susceptible to the neuraminidase inhibitors (oseltamivir and zanamivir).

At this time, there is no evidence of on-going human-to-human transmission. More sporadic cases are expected to be reported. The risk of disease spread to Europe is considered low, although individual cases coming from China cannot be ruled out.

ECDC is working closely with WHO and the European Commission and will continue to monitor the situation.

ECDC agrees with the position of WHO and other Centres for Disease Control (the United States and Chinese CDC) that there is no need to change travel plans for persons going to or coming from China because of the recent appearance of a novel avian influenza virus A(H7N9) that has affected humans in China. 
However, ECDC is repeating its standing advice to European citizens living in or visiting China that because of the presence of the novel influenza viruses, other avian influenza and zoonotic infections in live bird and animal markets (so called “wet markets”) in China and other countries in Asia should avoid visiting these markets. Direct contact with bird and animal faeces, untreated bird feathers and other animal and bird waste should also be avoided. In addition, basic rules of hand hygiene should be followed including regular hand-washing and use of alcohol-based hand rubs. This is the same advice ECDC has had in place since 2006.
This epidemiological update does not change the conclusions and recommendations of ECDC’s Rapid Risk Assessment of 2 April 2013.

Figure 1: Distribution of influenza A(H7N9) cases by date of onset of symptoms, age, gender, status and province in China, as of 9 April 2013 (n=26).

 

Date of onset

Age

Sex

Status

Severity

Province

19/02/2013

87

M

dead

severe

Shanghai

27/02/2013

27

M

dead

severe

Shanghai

07/03/2013

38

M dead severe Zhejiang

15/03/2013

35

F

alive

severe

Anhui

19/03/2013

45

F

alive

severe

Jiangsu

19/03/2013

48

F

alive

severe

Jiangsu

20/03/2013

83

M

dead

severe

Jiangsu

20/03/2013

61

F alive severe Jiangsu

21/03/2013

32

F

alive

severe

Jiangsu

21/03/2013

79

M alive severe Jiangsu

22/03/2013

67

F alive severe Shanghai

25/03/2013

67

M

alive

severe

Zhejiang

25/03/2013

59

M alive severe Shanghai

27/03/2013

52

F dead severe Shanghai

28/03/2013

48

M dead severe Shanghai

28/03/2013

74

M alive severe Shanghai

28/03/2013

55

M alive severe Anhui

28/03/2013

85

M alive severe Jiangsu

29/03/2013

64

M

dead

severe

Zhejiang

29/03/2013

66

M

alive

mild

Shanghai

29/03/2013

67

M alive mild Shanghai

30/03/2013

25

F

alive

severe

Jiangsu

31/03/2013

4

M

alive

mild

Shanghai

01/04/2013

64

M

dead

severe

Shanghai

01/04/2013

62

M alive severe Shanghai

01/04/2013

77

M alive severe Shanghai

 

 

 

Figure 2: Distribution of influenza A(H7N9) cases in China by week of onset of symptoms, as of 9 April 2013 (n=26).

Influenza A(H7N9) in China by week of onset 9 April 2013

 

Figure 3: Distribution of cumulative number of confirmed influenza A(H7N9) cases by province in China, from 19 February to 9 April 2013.

Influenza A(H7N9)in China cumulative number by province 9 Apr 2013

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