1 FEBRUARY 2014 - On 30 January 2014, the National Health and Family Planning Commission (NHFPC) of China notified WHO of seven additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus including one death.

Of these seven cases, four are male. The age range is 56 to 78 years old. The cases have been reported from Guangdong (1), Guangxi (1), Jiangsu (1) and Zhejiang (4). For Guangxi Province, this is the first laboratory confirmed case of human infection with avian influenza A(H7N9). Six of the cases are currently in critical or serious condition. Seven of the cases are reported to have had exposure to poultry or a live poultry market.

Details of the cases notified by NHFPC are as follows:

A 75-year-old farmer from Ningpo City, Zhejiang Province, who became ill on 21 January and was admitted to hospital on 24 January. He is currently in a critical condition The patient has a history of exposure to a live poultry market.
A 76 year-old man from Ningpo City, Zhejiang Province, who became ill on 21 January 2014 and was admitted to hospital on 24 January and transferred to another hospital on 27 January. He is currently in a critical condition. He has a history of exposure to a poultry market.
A 78-year-old farmer from Hangzhou City, Zhejiang Province, who became ill on 25 January and was admitted to hospital on 27 January and transferred to another hospital on 29 January. He is currently in a critical condition. The patient has a history of exposure to a live poultry market.
A 64-year-old man from Ningpo City, Zhejiang Province, who became ill on 13 January and was admitted to hospital on 16 January. He is currently in a critical condition. The patient has a history of exposure to a live poultry market.
A 75-year-old woman from Nanjing City, Jiangsu Province, who became ill on 18 January and was admitted to hospital on 25 January. She is currently in a critical condition. The patient has a history of exposure to a live poultry market.
A 67-year-old woman from Jiangmen City, Guangdong Province, who became ill on 24 January and was admitted to hospital on 25 January. She died on 28 January 2014. The patient had a history of exposure to live poultry.
A 56 year-old woman from Hezhou City, Guangxi Province, who became ill on 20 January and was admitted to hospital on 27 January. She is currently in a critical condition. The patient has a history of exposure to a live poultry market.
So far, there is no evidence of sustained human-to-human transmission.

The Chinese Government continues to take the following surveillance and control measures:

strengthen surveillance and situation analysis;
reinforce case management and treatment;
conduct risk communication with the public and release information;
strengthen international collaboration and communication; and
conduct scientific studies.
Sporadic human cases

While the recent report of avian influenza A(H7N9) virus being detected in live poultry imported from the mainland to Hong Kong SAR, shows the potential for the virus to spread through live poultry, at this time there is no indication that international spread of avian influenza A(H7N9) has occurred through humans or animals.

Further sporadic human cases of A(H7N9) infection are expected in affected and possibly neighbouring areas, especially given expected increases in the trade and transport of poultry associated with the upcoming Lunar New Year.

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid poultry farms, or contact with animals in live bird markets, or entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water. Travellers should follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.

As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns, in order to ensure reporting of human infections under the IHR (2005), and continue national health preparedness actions.