Taiwan reports 2nd case of imported H7N9 in 2013 (update)



Taipei, Dec. 31 (CNA) Health authorities confirmed Tuesday that a Chinese tourist in Taiwan has been infected with the H7N9 strain of bird flu, marking the second imported H7N9 infection this year.

The infected, an 86-year-old man from Jiangsu Province, is still in Taiwan receiving treatment, though most of his 25-person tour group has already returned to China, according to the Centers for Disease Control (CDC).

Two of his daughters have stayed with him but have thus far shown no symptoms associated with the virus.

The man entered Taiwan Dec. 17 and began showing symptoms two days later, starting with a loss of appetite. On Dec. 23, he reported tightness of the chest before being rushed to an emergency room the next day, where he was put on a ventilator to treat pneumonia.

An infectious diseases experts familiar with the case said he was not surprised by the second case of H7N9 coming from China following the first back in April.

Even so, this patient's symptoms were slightly different from previously reported infections, indicating that doctors still face some difficulty in diagnosing the virus, he added.

The man's infection could mean that H7N9 has become prevalent across all of southern China even though, puzzlingly, major duck and chicken farms in the region have been found disease-free.

"Beware of the virus if you see any ducks in the Jiangnan (south of the Yangtze River) area," he cautioned.

(By Chen Ching-fang and Wesley Holzer)
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Man, 86, may have picked up H9N2 bird flu at Shenzhen market

Mainland health officials believe the Shenzhen-based Hong Kong man infected with H9N2 bird flu is likely to have contracted the virus at a market that he visited every day.

But the live poultry stall at the wet market near where the 86-year-old patient lived was open again yesterday after briefly closing for disinfection.

He Hianfeng of the Centre for Disease Control and Prevention of Guangdong said yesterday that the man visited the market every day although he did not come into contact with live poultry.

The man was in a stable condition yesterday under isolation in Princess Margaret Hospital.

An infectious diseases expert warned, meanwhile, that without more stringent controls on mainland chickens, more Hongkongers were likely to be infected with the H9N2, H7N9 and H10N8 bird flu strains.

"Three different strains of bird flu appear to be spreading from birds to humans this year. It shows that the virus has been very active," University of Hong Kong microbiologist Professor Yuen Kwok-yung said.

"Since there is a large number of live poultry on the mainland, the chance of cross-infection will increase too, and there may be a higher chance of it spreading to humans."

Fifty-one medical staff at North District Hospital, where the man sought help after crossing the border, and an officer who handled the man on his entry at Lo Wu control point remained under medical surveillance.

But the Hong Kong Centre for Health Protection said his home contacts in Shenzhen had not displayed any symptoms so far. One hospital staff member developed a cough and sore throat, the centre's spokesman said.

Influenza A viruses including H9N2 can infect humans from contaminated environments since they can persist on inanimate surfaces for 12 hours to two days, according to a research paper by Yuen and his team.

"Visits to wet markets without direct contact with poultry have been shown to be an independent risk factor for acquiring avian influenza A," they wrote, adding that many H9N2 infections might have been overlooked due to the relatively mild symptoms in patients with normal immunity.

The paper, published in the Journal of Infection in 2011, said the virus had adapted to land-based poultry in Southeast Asia and had also been detected in pigs in the region.

http://www.scmp.com/news/hong-kong/article/1394228/man-86-may-have-picked-h9n2-bird-flu-shenzhen-market

The whole thing in China just scares the hell out of me! There are so many strains circulating in chickens, hogs and humans, and they all live in such close proximity, sooner or later there's bound to be an explosion!

And how long before H1N1 crosses the Big Pond again and adds to the mix? It's been said many times here "Not if but when"? I believe it's inevitable!

I agree with you about H1N1. So many people had it in '09 and the vaccine is a good match so unless something changes in it's make up it's nothing more than a very serious seasonal flu. It's very serious though! A friend of mines very healthy 30 year old son went to work Monday morning and with in hours had to leave because of headache and fever. By Tuesday he was so weak he could hardly stand. They took him to the hospital Tuesday afternoon. He did not get a flu shot! This bug hits fast and hard!   

arirish wrote: The whole thing in China just scares the hell out of me! There are so many strains circulating in chickens, hogs and humans, and they all live in such close proximity, sooner or later there's bound to be an explosion!

John - if it drags on much longer (or I think I have a chest infection/bronchitis/pneumonia starting) it'll be off to the docs to get some antibiotics. For now I'm staying hydrated, and using an albuterol inhaler and mucinex to try to clear my chest. The cough is driving me nuts and once I start it goes on and on, but I'm keeping an eye on my temperature and making sure what I'm coughing up is staying clear. So far I'm good, but I've had enough chest infections and a bout of pneumonia to know it can progress quickly. My wife wants me to go now, but I'm a guy, so...
And thank you

My doctor's good and I'm sure he'd write me prescription if I called him. No change of color yet so I'm waiting to see if things improve (I'm not getting worse, fortunately). I'm hesitant to start an antibiotic regimen because of the reasons you mentioned, although I'm not so naive to think that one person holding off will turn the tide of drug resistant bacteria, especially given the amount that we're prophylactically administering to food animals. But if I see anything that makes me think this is progressing in the wrong direction I'll call my MD immediately. Thanks again, John

Hundreds monitored in Taiwan after bird flu case

Updated Thu 2 Jan 2014, 3:12am AEDT

Officials in Taiwan say authorities are monitoring hundreds of people who may have had contact with a mainland Chinese tourist infected with the H7N9 strain of bird flu.

The 86-year-old man from the eastern Chinese province of Jiangsu is in stable condition in hospital in Taiwan, where he was on an eight-day tour, the Centers for Disease Control (CDC) said in a statement.

As many as 500 people may have had contact with him, all of whom are being asked to report to doctors should they develop possible symptoms, the statement added.

The 149 people who may have had close contact include two family members accompanying him on the tour, the tour guide, bus driver, medical personnel and patients sharing the same hospital ward, it said.

"Three medical personnel have shown symptoms of upper respiratory tract infections and taken medicines as preventative treatment," the statement said, adding that they should monitor their condition for two weeks while awaiting the outcome of tests.

They have not been placed in quarantine.

Taiwan in April reported the first H7N9 case outside mainland China, after a 53-year-old man who had been working in the eastern Chinese city of Suzhou showed symptoms three days after returning to Taiwan via Shanghai.

The Taiwanese government has issued a travel advisory for residents planning to travel to China, upgrading Jiangsu to "alert" level.

Guangdong province in the southeast has also been placed in the alert category.

An 80-year-old man infected with the H7N9 strain died on Thursday in Hong Kong, the first H7N9 death in the city since the virus emerged there last month.

He had been taken to hospital after returning to Hong Kong from the neighbouring city of Shenzhen in mainland China, where he lived.

Taiwan's CDC warned people to avoid touching and feeding birds or visiting markets with live poultry when visiting Chinese regions with H7N9 cases.

AFP

55 people on preventive medication over H7N9 concerns



Taipei, Jan. 2 (CNA) Fifty-five of the 163 people known to have come into close contact with a Chinese tourist infected with the H7N9 strain of avian flu have begun taking preventive medication, a Centers for Disease Control (CDC) official said Thursday.

Among them were three medical care providers who began to show respiratory symptoms and were asked to stay at home for self-health management, said CDC Deputy Director-General Chuang Jen-hsiang.

In addition, Chuang said, sputumn samples were collected from them for testing.

"They all tested negative," Chuang said after the examination results became available around Thursday noon, showing that none of the trio were infected with the virus.

The infected Chinese tourist, 86, arrived in Taipei Dec. 17 last year and was hospitalized Dec. 24 for treatment for pneumonia. He had visited major tourist destinations in seven cities and counties around Taiwan before his hospitalization.

The CDC confirmed Dec. 31 that the elderly man, from China's Jiangsu Province, was infected with the deadly H7N9 virus, marking Taiwan's second imported H7N9 infection.

Chuang said the man is currently in a "serious yet stable condition."

Epidemiological survey results as of Thursday morning showed that 663 people had been in contact with the man, Chuang said.

Of them, 163 had what doctors described as close contact with him, and had sputum samples taken for testing.

Moreover, 55 were deemed to at particularly high risk of infection, including his two daughters, tour guide, bus driver, hotel staff and the three medical care providers, all of whom began a 10-day course of Tamiflu Tuesday as a preventive measure, Chuang said.

As the virus spreads mainly through bird-to-human transmission, the possibility of those with close contact with the man falling victim to infection should be low, Chuang went on, adding that neither of the man's two daughters had so far shown any symptoms.

Nevertheless, he cautioned China-bound travelers to stay away from live poultry markets during their trips.

The H7N9 strain was confirmed to have made the jump from birds to humans for the first time in March 2013, when China's state media revealed that two people in Shanghai had died after being infected with the virus the previous month.

Other deaths soon followed, prompting officials to shut down meat markets and cull poultry in several Chinese cities amid fears of a potential epidemic. However, the WHO said earlier that there had been no evidence of sustained human-to-human transmission of the virus.

The number of human H7N9 infections in China has dropped significantly in recent months. As of early November, there had been 139 confirmed human cases of H7N9 and 45 deaths reported since April, according to the WHO.

Taiwan's first imported H7N9 case was reported last April, involving a Taiwanese businessman who fell ill after returning from a trip to Jiangsu Province. He made a full recovery after a month of intensive treatment.

(By Chen Ching-fang and Sofia Wu)
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