Via CIDRAP, Lisa Schnirring writes: No H7N9 letup as Guangxi detections prompt warning. Excerpt:
China reported nine new H7N9 influenza cases today, including the third from Guangxi province, signaling a rise in disease activity in a region that borders Vietnam along with the first reports of poultry market detections there, according to a warning today from an animal health group.
The other eight new cases are from two provinces—Guangdong and Zhejiang—that are reporting the largest portion of cases in the second wave, which has now eclipsed the first wave by a growing margin. So far 174 cases have been reported in the outbreak's second wave, compared to 136 recorded during the first spike in disease activity last spring.
Nine cases from three provinces
Zhejiang province reported four case-patients, including a 67-year-old man in severe condition, a 49-year-old man in critical condition, and two women, ages 35 and 59, who are hospitalized in severe condition, according to official statements translated and posted by Avian Flu Diary (AFD), an infectious disease news blog, and FluTrackers, an infectious disease message board.
Guangdong province also reported four cases, in a 5-year-old girl and a 49-year-old man listed in stable condition and in two men, ages 42 and 56, who are hospitalized in critical condition, according to official notices posted by AFD and FluTrackers.
The case from Guangxi province is in a 5-year-old boy who is in stable condition. The boy's infection marks the third from the province, a mountainous area located southwest of the main outbreak hot spots, notable because it borders northern Vietnam.
The boy got sick a day after an H7N9 infection was confirmed in his 41-year-old mother, the South China Morning Post (SCMP), an English-language newspaper based in Hong Kong, reported today.
The new cases raise the outbreak total to 310 cases since last February, according to a running tally maintained by FluTrackers. The unofficial fatality count remained at 67.
Health officials are investigating the source of the boy's infection and noted that he had been in close contact with his mother, who is hospitalized in critical condition, according to the SCMP report. The two infections mark the second known H7N9 family cluster during the second wave of infections.
So far, human-to-human spread in those two events hasn't been confirmed, and health officials are exploring if the patients had the same poultry exposure. The World Health Organization (WHO) has said limited human-to-human spread wouldn't be surprising, especially in people who had prolonged unprotected contact. However, the agency said there is still no evidence of sustained H7N9 transmission.
CIDRAP also has an article by Robert Roos on today's NEJM article, which argues that human-to-human transmission of H7N9 is rare.