H7N9 in Malaysia

Travel feb 4 Guandong to Kuala Lumpur (by air ?), feb 5 from Kuala Lumpur to Sandakan (Sabah) (eastern point of Borneo, something like a 1000 km east of Kuala Lumpur), also by air ? From there she went to Kota Kinabalu some 60 kilometres west of Sandakan feb 6 by road. On feb 7 she was referred to local hospital where on feb 11 they found out that the woman had H7N9. 

The hospital in Kota Kinabalu reported an H1N1 (????) flu outbreak around the time the H7N9-case was hospitalized. (http://www.thestar.com.my/News/Nation/2014/02/07/Likas-hosp-h1n1-ok/ )

H7N9 Case Detected in Malaysia
Still no sustained human-to-human spread; risk assessment unchanged

February 12, 2014 – The Malaysian Ministry of Health today reported a human infection with avian influenza A (H7N9) or "H7N9". The case reportedly occurred in a traveler from China who had developed symptoms before traveling, making this an "imported" case of H7N9.

This is the first case of H7N9 detected outside of China.

Human infections with a new H7N9 virus were first reported in China in March 2013. Since that time, 337 cases had been detected in China as of February 11, 2014. Most H7N9 infections are believed to result from exposure to infected poultry or contaminated environments. No evidence of sustained, ongoing person-to-person spread of H7N9 has been found. The new H7N9 virus has not been detected in people or birds in the United States.

The H7N9 case detected in Malaysia is reportedly in traveler from an area of China already affected by H7N9. H7N9 has not been detected in poultry in Malaysia at this time.
CDC has predicted for some time that one or more human cases of H7N9 would be detected outside of China; including the scenario where a case was detected in a traveler from China. The detection of H7N9 in a traveler from China to Malaysia does not change the risk assessment for this virus. The most important factor in the public health risk assessment is the transmissibility of the virus. There is no evidence of sustained, ongoing person-to-person spread of H7N9.
However, the detection of H7N9 in Malaysia in a traveler from China underscores the importance of international surveillance for H7N9 and other influenza viruses with pandemic potential.
H7N9 is one such threat. H7N9 human infections associated with poultry exposure will most likely continue to occur in China. H7N9 also may spread to poultry in neighboring countries and human cases associated with poultry exposure also may be detected in those neighboring countries. Most concerning about this situation is the possibility that this virus could gain the ability to spread easily and sustainably among people, triggering a global outbreak of disease (pandemic).
CDC is following the H7N9 situation closely and coordinating with domestic and international partners. The U.S. Government has been providing funding to support international surveillance for H7N9 and other influenza viruses with pandemic potential. CDC takes routine preparedness actions whenever a new virus with pandemic potential is identified, including developing a candidate vaccine virus (CVV). That CVV has been used to produce limited amounts of an H7N9 vaccine currently undergoing clinical trials to assess its suitability for use in the event this virus were to emerge as pandemic.

CDC