A new report out of Hong Kong states that 63 people are under a one week quarantine after coming in contact with "Andy" the 3 year old boy who was reported as being H7N9 positive yesterday. See the known time-line of his infection here: The quarantine number is up from the 7 to 9 people who were originally stated as being under quarantine.
We have marked this as an Alert because the high number of people being quarantined; we suspect this is actually indicative of a cluster. Given claimed poultry transmission route, it certainly seems strange that they would quarantine persons supposedly associated with ANDY rather than the supposed infection source. Especially since the first photos of Andy in isolation show him and his visitor not wearing masks PPE.
So far, two health care workers and Andy's father are reported to have the flu, but are supposedly not testing positive for H7N9. It seems there is more to this case than is being let on; we'll wager that were this case not in close proximity to Hong Kong, there would be a near information blackout on this case similar to what is occurring in Jiaxing with the 64yr old infect female farmer. That case may be tied to its own cluster, see that report here.
UPDATE: 28 of the quarantined individuals are school children all of whom are reported to be asymptomatic. More troubling however is that medical personnel are also in quarantine.
Other factors of concern are:
(1) None of the market chickens have tested positive
(2) There are a large number of people with Influenza Like Illnesses in the area,
BUT THERE IS ONLY A LIMITED CAPACITY TO TEST THESE INDIVIDUALS FOR H7N9.
Under these conditions, and given the long time it took to diagnose "Andy", a large quarantine group looks like a stop gap measure. We seek a significant risk of spread from this situation. On the positive side, there is no large reported death count yet; hold your breath for worse news within the next 10 days.
Expect a very strong push in the USA for Seasonal Flu vaccination.
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