H5N1 infections. Two cases of H5N1 infection occurred within a family who returned home to Hong Kong on 8th February 2003 after travelling in the Fujian Province, China. The father (33 years old) and his 9 year old son fell ill while in Fujian Province and were admitted to hospital in Hong Kong SAR with pneumonia on February 11th and 12th, respectively; the father died on 17th February. Influenza A H5N1 viruses were isolated from nasopharyngeal aspirates taken from the son on 19th February and from post-mortem specimens taken from the father on 20th February. His 8 year old daughter also died of pneumonia on 4th February while in the Fujian Province; the cause of her death is under investigation. The haemagglutinins of these viruses were closely related to those of the H5N1 viruses which caused the outbreak in 1997, although the other seven genes were distinct (M. Peiris and Y. Guan, personal communication).

H7N7 infections. An outbreak of avian influenza caused by a highly pathogenic H7N7 virus began in the Netherlands at the end of February and subsequently spread to Belgium and Germany during April and May, respectively. During March and April, 86 cases of H7N7 infection were detected among people handling diseased chickens. Most suffered from conjunctivitis, a few with (mild) respiratory symptoms. One veterinarian (57 years old) died of pneumonia on 17th April. Although there was no evidence of secondary transmission associated with this case, infection of three household contacts, who had no direct exposure to infected poultry, has provided evidence of person to person transmission. No examples of coinfection with H7N7 and circulating H3 or H1 human viruses were detected. The haemagglutinins of these H7N7 viruses were closely related antigenically and genetically to H7N1 and H7N3 viruses responsible for outbreaks of disease among poultry in Italy during 1999-2000 and 2002-2003 (R. Fouchier, personal communciation).