this link is now talking about h5n1.

Two more cases reported on Saturday

http://www.freemalaysiatoday.com/category/world/2014/01/12/china-reports-one-more-h7n9-bird-flu-death/

World Health Organization
Global Alert and Response (GAR)

Human infection with avian influenza A(H7N9) virus – update

13 JANUARY 2014 - On 10 January 2014, the National Health and Family Planning Commission of China notified WHO of 6 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus, including 1 death.

Details are as follows:

[link to www.who.int]

Human infection with avian influenza A(H7N9) virus – update

Disease outbreak news

17 JANUARY 2014 - On 15 January 2014, the National Health and Family Planning Commission of China notified WHO of four additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus.

Details of the cases are as follows:

A 35 year old man from Shanghai who became ill on 1 January and was admitted to hospital on 12 January. He is currently in a critical condition. The patient has a history of exposure to poultry.
A 41 year old man from Hangzhou City, Zhejiang Province, who became ill on 5 January and was admitted to hospital on 9 January and then transferred to another hospital on 12 January. He is currently in a critical condition.
A 48 year old man from Foshan City, Guandong Province, who became ill on 2 January and was admitted to hospital on 12 January. He is currently in a critical condition.
A 55 year old man from Dongguan City, Guandong Province, who became ill on 1 January and wrestrictions
to hospital on 9 January. He is currently in a critical condition. The patient has a history of exposure to poultry.
The source of infection is still under investigation. So far, there is no evidence of sustained human-to-human transmission.

The Chinese government continues to take the following 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.
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

http://www.who.int/csr/don/2014_01_17/en/index.html

Reuters January 20, 2014, 4: 06 PM
WHO confirms 23 more cases of H7N9 bird flu in China



LONDON Another 23 people in China have been infected with the H7N9 strain of bird flu in recent days, the World Health Organisation (WHO) said on Monday, adding to at least 24 new cases last week and confirming a fresh surge in the virus.

Among the new cases, reported from several different provinces of China, was a 38-year-old man who died on Jan. 9 and a five-year-old girl from Guangdong province who became ill on Jan. 14 and is now stable in the hospital.

Many of the other new patients were either in a serious or critical condition in hospitals, the WHO said. Several had reported recent exposure to poultry or poultry markets, but the WHO said the source of infections was still under investigation.

The H7N9 bird flu virus emerged in March last year and has so far infected at least 199 people in China, Taiwan and Hong Kong, killing 52 of them, according to an update from the WHO's spokesman Gregory Hartl.

Several clusters of cases in people who had close contact with an infected person have been reported in China, but WHO reiterated on Monday that “so far, there is no evidence of sustained human-to-human transmission".

Hartl told Reuters last week that the United Nations health agency had noted the recent rapid increase in human H7N9 infections and was keeping a watchful eye.

“So far we haven't seen anything that causes us to change our risk assessment,” he said.

The WHO's assessment is that “the current likelihood of community-level spread ... is considered to be low.”

Experts say the Northern Hemisphere's winter flu season is probably largely to blame for a significant increase in the number of cases of human H7N9 infection in recent weeks after they dwindled to almost nothing in July and August of 2013.

But they have cautioned that public health authorities and doctors must be on alert for any signals that the more widely circulating virus might be adapting or mutating to become easily transmissible between people.

Virology Down Under

There have been 5 small family clusters, but no sustained H2H. One or more of these clusters had the potential for H2H. In August a woman carried her sick father to the hospital and contracted it herself. There is no sign of sustained H2H as of yet although the WHO is reporting "sporadic H2H".

China had 134 cases last year with 44 deaths or 33.5%. So far this year the number is already up to 40.

We've been down this path already with H5N1 and that isn't easily transmissible H2H yet.

H7N9 is resistant to Tamiflu or Relenza.

23 JANUARY 2014 - On 22 January 2014, the National Health and Family Planning Commission of China notified WHO of 10 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus.

Details of the cases are as follows:

A 71 year old man from Nanjing City, Jiangsu Province, who became ill on 10 January. He was admitted to hospital on 16 January and is in a critical condition. The patient has a history of exposure to poultry.

A 57 year old man from Taizhou City, Zhejiang Province, who became ill on 8 January. He was admitted to hospital on 10 January and is in a critical condition. The patient has a history of exposure to poultry.

A 70 year old man from Shaoxing City, Zhejiang Province, who became ill on 10 January. He was admitted to hospital on 14 January, transferred to another hospital on 17 January, and is in a serious condition.

A 49 year old male from Hangzhou City of Zhejiang Province, who became ill on 13 January. He was admitted to hospital on 17 January, transferred to another hospital on 19 January, and is in a serious condition. The patient has a history of exposure to poultry.

A 39 year old woman from Shenzhen City, Guangdong Province, who became ill on 13 January. She was admitted to hospital on 19 January and is in a serious condition.

A 59 year old woman from Shenzhen City, Guangdong Province, who became ill on 13 January. She was admitted to hospital on 19 January and is in a critical condition. The patient has a history of exposure to live poultry markets.

A 76 year old man from Shenzhen City, Guangdong Province, who became ill on 9 January. He was admitted to hospital on 20 January and is in a critical condition. The patient has a history of exposure to live poultry markets.

A 53 year old man from Taizhou City, Zhejiang Province, who became ill on 9 January. He was admitted to hospital on 12 January, transferred to another hospital on 16 January, and is in a critical condition. The patient has a history of exposure to poultry.

A 71 year old man from Taizhou City, Zhejiang Province, who became ill on 31 December 2013. He was admitted to hospital on the same day, transferred to another hospital on 8 January, and is in a critical condition.

A 63 year old woman from Taizhou City, Zhejiang Province, who became ill on 9 January. He was admitted to hospital on 13 January, transferred to another hospital on 18 January, and is in a critical condition. The patient has a history of exposure to poultry.

The source of infection is still under investigation. So far, there is no evidence of sustained human-to-human transmission.

The Chinese government continues to take the following 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.

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.

http://www.who.int/csr/don/2014_01_23/en/index.html

The virus h7n9 has mutated. I got this search data but the link is down.

H7N9 mutation confers antiviral resistance | SmartBrief

The same applies to your post, Med. Seems a lot of us are on the same page.

Amid the reported H7N9 resistance or susceptibility issue's regarding the influenza virus inhibitor medicines, Tamiflu and Relenza. The latest report found on the CDC website indicates, that as of September  2013 :  H7N9 is ' likely susceptible ' to Tamiflu or Relenza.

I cannot find this. The last report I see is Jan 23 that lists 10 reported on Jan 22. These seem to be a different 10 according to ages, gender etc.

Current H7N9 wave rivals last spring's case total
Filed Under: Avian Influenza (Bird Flu); H7N9 Avian Influenza
Lisa Schnirring | Staff Writer | CIDRAP News | Jan 27, 2014

China's agriculture ministry said tests showed no H7N9 in farm poultry, but Hong Kong reported the virus in chickens imported from a mainland farm.
China's steady rise in H7N9 avian flu cases continued over the past 3 days, with 14 new cases from five provinces, as the latest test results in poultry showed a conflicting picture of the virus on farms, including positive samples found today in birds sent to Hong Kong.

The fresh round of infections—coming at a pace matching last year's peak—could soon eclipse last spring's outbreak totals and come as poultry trade and consumption are high in the lead-up to Lunar New Year celebrations later this week.

So far 116 cases have been reported since October 2013, a number that could soon reach or exceed the 136 H7N9 illnesses reported during the outbreak's first wave last spring, a number that includes 2 July cases.

Though the virus doesn't currently appear to spread easily among humans through the airborne route, China's cultural traditions involving live poultry, where the virus spreads silently, put exposed people at risk for zoonotic infections that can quickly progress to severe pneumonia.

Hot spots report more cases, WHO provides more details

Hong Kong's Centre for Health Protection (CHP), in two separate statements, announced initial details for eight new H7N9 illnesses: five reported on Jan 25 and three reported on Jan 26. Five of those patients are from Zhejiang province, two from Jiangsu, and one from Guangdong.

In addition, four provinces reported six new cases today, two from Fujian province, two from Guangdong, one from Hunan, and one from Jiangsu.

According to provincial statements in Chinese translated and posted by Avian Flu *****, and infectious disease news blog, the patients include three men ages 68, 69, and 72, and three women ages 58, 74, and 77. The 68-year-old man died from his infection, according to the statement from Guangdong province.

The World Health Organization (WHO) fleshed out more details about 19 cases reported over the past 4 days, including the ones reported yesterday, according to separate statements from Jan 25 and today. Patient illness onsets range from Jan 10 through Jan 20. All are adults, ranging in age from 23 to 82. Ten are men and nine are women.

Eleven of the patients are in critical condition, and eight in serious condition. Investigations so far have found that 10 patients had been exposed to poultry and four had been exposed to live-poultry markets.

Over the past few weeks, China has averaged about five to seven new H7N9 cases each day, and the new cases reported over the past 3 days boosts the outbreak total to 252, according to a case list compiled by the ******* infectious disease message board.

Less clear is the number of deaths. Most of the patients reported over the last several weeks were said to be in severe or critical condition and may still be hospitalized. China's Center for Disease Control and Prevention (China CDC) said today that 19 deaths have been reported so far this year among 96 cases reported so far, Xinhua, China's state news agency reported. The unofficial number of deaths is 57.

Shu Yuelong, director of the Chinese National Influenza Center, told Xinhua that the case-fatality rate (CFR) ranges from 20% to 30% and that the risk assessment is unchanged, because so far no H7N9 virus mutations that could affect transmissibility have been found, and so far there is no sign of sustained human-to-human transmission.

An updated risk assessment from the WHO last week said so far the CFR is not as high as the first wave of infections last spring, and that virus samples from the second wave are similar to the first wave, as well as to strains recommended for H7N9 vaccine development.

Mixed signals from H7N9 tests on farms

Meanwhile, China's agriculture ministry said today that tests on farms so far this year have found no H7N9 in poultry, according to a separate report from Xinhua. It said no positives were found among 33,400 samples tested from 2,402 sites.

It added, though, that eight positive samples were found among samples from live-poultry markets in Guangdong, Fujian, Zhejiang, and Guangxi Zhuang autonomous region.

In a report today to the World Organization for Animal Health (OIE), China's agriculture ministry described H7N9 findings at agricultural markets in Guangdong and Fujian provinces. Of 185 chicken specimens collected in Guanzhou in Guangdong, two from different markets were positive, and 1,200 birds were culled to curb the spread of the virus.

In the Fujian province city of Quanzhou, tests on 220 specimens—from chickens, pigeons, ducks, and environments—found only one H7N9-positive result, in an environmental sample.

A similar pattern was seen during agriculture ministry testing after the virus was first detected last spring: no positive samples were found on farms, and only a few were detected in poultry market samples. The results are puzzling, because provincial health ministry reports have said several of the patients infected with the virus were farmers, and official reports say large percentage of H7N9 cases were exposed to poultry or visited live-poultry markets.

Fueling more questions about H7N9 circulation on China's poultry farms, Hong Kong's government today said it detected the virus in a number of samples from a shipment of live chickens that were imported from a registered poultry farm near the Guangdong province city of Foshan, according to a statement posted on the government's Web site.

Hong Kong said it has been testing live poultry imported from the mainland since April 2013, and the findings are the first for H7. In response, the government is closing the agricultural market that received the birds for 21 days and will cull 20,000 poultry that are at the site.

Ko Wing-man, MBBS, secretary for food and health, said in a statement that officers will also inspect Hong Kong poultry to ensure that local birds aren't infected with the virus.

CDC updates H7N9, H5N1 testing recommendations

In other avian developments, the US Centers for Disease Control and Prevention (CDC) has updated its testing recommendations in separate documents for H7N9 and H5N1.

For each virus, the CDC describes testing recommendations based on clinical illness and exposure criteria. For both viruses, CDC recommends testing of severely ill hospitalized patients for whom no other infectious cause has been identified.

The exposure criteria for each virus are customized to reflect the geographic areas where the virus has been found.

CDC's guidance updates are part of a larger effort to modify the information, based on the latest data, and to combine guidance for the two viruses, when appropriate. For example, the agency recently revised its interim recommendations that combine healthcare infection control information for both H7N9 and H5N1.

I thought this info was helpful. Haven't been around long enough to know why Suzi's post needed cleaning up. Are there rules about posts over a certain length or something?

Good to know. Seems a sober and reasonable policy.

Saskabush - oftentimes when you paste an article you end up with a bunch of ads, links, unrelated pictures or text, or big gaps as Suzi mentioned. Sometimes it takes a little work to make it easier to read.

Where to start with this article?

So Hong Kong is detecting infected poultry coming from Guandong, but China can't find any. I think we can all draw our own conclusions on that one...

Of the 19 cases mentioned, there are none classed as mild infections - eleven are critical and eight are in serious condition. If trends from last year hold, the Chinese government will keep them alive at all costs - for months if necessary - to keep the CFR low, but many of them will succumb to the virus (or secondary infections) eventually anyway. Once the number of serious/critical patients exceeds the number of ICU beds and respirators available to Chinese doctors, we'll begin to see the mortality rate this virus could have if it progresses to a pandemic strain.

And now the CDC is nervous enough about both H7N9 and H5N1 that they're recommending testing of symptomatic patients for whom all other tests have come up negative. They know it's going to explode soon, and they're getting everyone ready for the first cases outside of China.

QUOETE: Meanwhile, China's agriculture ministry said today that tests on farms so far this year have found no H7N9 in poultry, according to a separate report from Xinhua. It said no positives were found among 33,400 samples tested from 2,402 sites.

It added, though, that eight positive samples were found among samples from live-poultry markets in Guangdong, Fujian, Zhejiang, and Guangxi Zhuang autonomous region.


The chickens only catch it when they know they're gonna be sold and eaten...their way of saying they want to continue to live on a clean, disease free farm!!!

Albert wrote: ...This bucket of bolts is not like ft...

LOL

"The Chinese government continues to take the following 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."

I don't think these measures are working!

New wording has been added to the Disease Outbreak Reports from the WHO. This is quite a significant seeing they haven't changed it for two years. I cut and pasted for your viewing pleasure..

Bird Flu Isn’t Just China’s Problem Anymore

With the Chinese New Year and the Olympics on the horizon, health officials can only watch and wait for a potential pandemic

inShare7

Read Later

Jan 1-15      35 new cases
Jan 16-30     85 new cases

And they can find it in only a small % of poultry. If that is true then humans get it from poultry easily.