DisclaimerInformation provided herein is current as of the date of issue. Information added or changed since the last H7N9 situation update appears in red. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health, Provincial Government websites; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisation for Animal Health [OIE]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.
OverviewSituation: Influenza A(H7N9) virus with pandemic potential.
Country: China; three human cases originated in China and were reported in Malaysia (1) and Canada (2).
Number of human cases: 1486 confirmed; 559 deaths (since February 2013). Number of new findings in birds or the environment since last update (3 May 2017): 4.
Number of new human cases since last update (3 May 2017): 25.
Provinces/municipalities: Beijing, Chongqing, Shanghai and Tianjin Municipalities; Anhui, Fujian, Gansu, Guangdong, Guizhou, Hebei, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Jilin, Liaoning, Qinghai, Shaanxi, Shandong, Sichuan, Taiwan, Yunnan and Zhejiang Provinces; Hong Kong SAR; Macao SAR, Guangxi, Ningxia Hui, Tibet and Xinjiang Uyghur Autonomous Regions; Sabah (Malaysia); British Columbia (Canada).
Animal/environmental findings: around 2,500 virological samples from the environment, chickens, pigeons, ducks and a tree sparrow tested positive; positives mainly from live bird markets, vendors and some commercial or breeding farms. Highly pathogenic virus findings: The H7N9 highly pathogenic avian influenza virus was detected in a total of 42 poultry or environmental samples (31 chickens, 1 duck and 10 environmental samples) from 23 live bird markets (LBMs) in: Fujian (Longyan City),Guangdong (Dongguan, Guangzhou, Huizhou, Lufeng, Meijiang, Meizhou, Zhongshan Cities and Haifeng County), Hunan (Chenzhou City) and Provinces; and from 3 farms in: Guangxi (Guilin City), Hebei (a chicken layer farm in Xingtai City [reference 1, reference 2])and Hunan (backyard in Chenzhou City and a large layer farm in Yongzhou City [reference1, reference2]) Provinces.
Out of the 1486 confirmed human cases, H7N9 virus isolates from three human cases (two from Guangdong and one from Taiwan Provinces) were found to be highly pathogenic for chickens.
FAO actions: liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.
Map 1. Human cases and positive findings in birds or the environment
Click to enlarge - Note: Human cases are depicted in the geographic location where they were reported; for some cases, exposure may have occurred in a different geographic location. Precise location of 23 human cases in Anhui (2), Beijing (2), Guangdong (1), Guangxi (1), Hebei (2), Hunan (1), Hubei (2), Jiangsu (1), Jiangxi (6), Sichuan (2) and Zhejiang (3) Provinces are currently not known, these cases are therefore not shown on the map.
Situation updateAnimals- 5 May, Hebei: The National Avian Influenza Reference Laboratory confirmed an H7N9 avian influenza outbreak observed on 28 April in a layer chicken farm in Xingtai County, Xingtai City. About 8,500 chickens showed clinical signs related to avian influenza and 5,000 died. In response, 80,057 birds were culled and the outbreak is now under control [reference 1, reference 2].
- 3 May, Inner Mongolia: Tongliao City CDC suspected H7N9 avian influenza infection in poultry during routine monitoring of live birds. The poultry batch was reported to originate from Weifang City, Shandong Province. The affected live bird market in Horgin District was temporarily closed for epidemiological investigation and mitigation measures, including culling of the affected batch as well as cleaning and disinfection of the market. Confirmation from the national reference laboratory in Harbin is awaited. To date, no virologically positive samples were detected in the province [reference].
- 1 May, Shaanxi: After the first human case report, municipal governments of Xi’an and Xianyang Cities decided to close all urban and suburban live poultry markets, and conduct investigation and thorough disinfection in all large farms and households [reference].
- 1 May, Macao SAR started to ban the import and sale of live poultry [reference]
- 29 April, Chongqing: Live poultry samples collected on 27 and 28 April from Shihuishi and Xuetianwan farmers markets tested positive for influenza A H7N9 avian influenza virus [reference]. Earlier, on 20 April, H7N9 avian influenza was also detected at poultry trading area in the Sanya Bay Fish Market, Yubei District. The live poultry trading area of the market has been closed from 30 April to 20 May 2017 for 21 days [reference].
- 20 April, Sichuan: Environmental samples collected at a live poultry slaughter point in Jizhou market, Nanjiang County tested positive for the H7 subtype [reference].
- 18 April, Guangdong: 1 environmental sample out of 10 collected in Wanshengyang Market, Chenghai District, Shantou City tested positive for H7 nucleic acid. The positive sample was from a game bird stall (knife and chopping board). Live poultry markets in the whole city were closed from 21 to 23 April [reference].
Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 10 May 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.
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Humans- Since the last update (3 May 2017), 25 new human cases have been reported inHebei (7), Sichuan (5), Shaanxi (3), Guangxi (2), Anhui (1), Beijing (1), Chongqing(1), Fujian (1), Gansu (1), Henan (1), Hunan (1), Jiangsu (1).
Figure 2. Number of officially reported human cases since February 2013 as of 10 May 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.
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Figure 3. Incidence of officially reported human cases by month, based on onset date as of 10 May 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.
Click to enlarge - Note: For cases with unknown onset dates from wave 1 (n=7), wave 2 (n=2), wave 3 (n=146), wave 4 (n= 27) and wave 5 ( n=563) reporting dates were used instead.
Publications- In addition to the surveillance findings by MoA and MoH, 1,728 virologically positive samples have also been reported in 12 peer-reviewed articles (1, 2, 3, 4, 5, 6, 7, 8, 9,10, 11, 12). A total of 71,920 samples have been collected in these studies since April 2013, of which 1,728 (2.4%) were positive for H7N9 (1,215 environmental samples, 501 chickens, 1 goose and 1 tree sparrow).
- A study aimed to investigate the epidemiological, clinical, and virologic characteristics of avian influenza A(H7N9) in two family clusters in Southeast China. Results demonstrate that one family cluster was infected through common exposure to live poultry or contaminated environments, while human-to-human infection was more likely for the other [reference].
- An influenza A(H7N9) human case epidemiological investigation in China based on epidemiological, clinical, virological data and genome analyses suspected a person-to-person transmission in a ward. The second human case was in close contact with the index case and thus thought to be exposed to the virus [reference].
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