In the late afternoon of April 24, 2013, the Central Epidemic Command Center (CECC) confirmed the first imported case of H7N9 avian influenza in a 53-year-old male Taiwanese citizen who worked in Suzhou, Jiangsu Province, China prior to illness onset.
He developed his illness three days after returning to Taiwan. Infection with avian influenza A (H7N9) was confirmed on April 24, 2013.
The patient is currently in a severe condition and being treated in a negative-pressure isolation room.
Minister of Health, Dr. Wen-Ta Chiu, and Commander of CECC, Dr. Feng-Yee Chang, have full knowledge of the situation and have instructed implementation of subsequent prevention and control measures.
In addition, CECC has reported the case to the World Health Organization through the IHR Focal Point.
Furthermore, according to the Cross-strait Cooperation Agreement on Medicine and Public Health Affairs, CECC has also reported the case to the contact point in China CECC indicated that the case is a hepatitis B carrier with history of hypertension.
Due to the fact that he worked in Suzhou, Jiangsu Province before his illness, he had been traveling back and forth regularly between Suzhou and Taiwan for a long time.
During March 28 and April 9, 2013, the patient traveled to Suzhou. On April 9, he returned to Taiwan from Shanghai. According to the case, he had not been exposed to birds and poultry during his stay in Suzhou and had not consumed undercooked poultry or eggs.
On April 12, he developed fever, sweating, and fatigue, but no respiratory or gastrointestinal symptoms. On April 16, he sought medical attention at a clinic when he developed high fever and was transferred to a hospital by the physician. He was then hospitalized in a single-patient room for further treatment.
On April 16, he was administered Tamiflu. On April 18, his chest x-ray showed interstitial infiltrate in the right lower lung. On the night of April 19, his conditions worsened.
On April 20, he was transferred to a medical center for further treatment. He was then intubated due to respiratory failure and placed in the negative-pressure isolation room in the intensive care unit.
During his stay in the hospitals, two throat swab specimens were collected and both tested negative for avian influenza A (H7N9) virus by real-time RT-PCR. On April 22, the medical center collected a sputum specimen from the patient and the specimen was tested positive for influenza A.
In the morning of April 24, avian influenza A (H7N9) virus was detected in the sputum specimen using real-time RT-PCR. In the later afternoon of April 24, the National Influenza Center in Taiwan confirmed the identification and completed the genome sequencing of the virus.
At the time of writing, CECC has obtained the list of 139 people who have come into contact with the confirmed case, including 3 close contacts, 26 regular contacts (past the 7-day incubation period), and 110 healthcare workers, for investigation and follow-up activities.
Of the 110 healthcare workers, 4 have passed the 7-day incubation period and shown no symptoms. Only three contacts failed to put on appropriate personal protective equipment when the contact occurred. Thus far, the three have not developed symptoms, but they will be followed up until April 27, 2013.
On the other hand, while delivering healthcare services, three healthcare workers who were geared with appropriate personal protective equipment developed symptoms of upper respiratory infection.
The public health authority have conducted thorough health education activities for all contacts, issued them with “Self-Health Management Advice for H7N9 Influenza”, and will be following up with them closely until the period of voluntary contact tracing is lifted.