We strongly suspect Human to Human spread of H7N9 in Hong Kong, via Kowloon school children, tied to common bus routes. Currently the Creative Primary School is under intense scrutiny and testing from public health authorities as the 10 year old son of the H7N9 maid's employer attends there. We suspect the maid was actually infected by the children.
There has been a strange combination and concentration of Influenza Like Illness, Pneumonia, and Gastrointestinal symptoms in primary school children in the Kowloon section of Hong Kong; There was a resultant death on November 17th, with symptom onset around November 11th.. The pneumonia was identified as Streptococcus, and we suspect it was a coinfection with H7N9. Gastrointestinal symptoms are also strongly associated with H7N9.
Coinfection is suggested as Streptococcus Pneumonia rates and deaths have been unusually high in this group for the last few months, such an increase in amplitude would be expected with an H7N9 coinfection. Such coinfection would likely preclude H7N9 testing and make symptomatic diagnosis of H7N9 highly unlikely.
If H7N9 does become a deadly pandemic, it may be called the Orphan's Flu, as the children will infect the adults and leave themselves orphans.
Map of Kowloon schools were these combination of symptoms have been reported:
Location "A" is the Palatial Coast Estate where the maid workedLocation "D" is where one of the children attended school
Location "B"&"C" are other schools on the same route where public health authorities conducted outbreak investigations just prior to public H7N9 notification.
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Source Information:
Students are disinfected contact Creative schoolInfluenza-like illness outbreak under CHP investigation
Outbreak of acute gastroenteritis in primary school under CHP investigation
3-year-old boy killed Streptococcus pneumoniae
Pui Ching Young Park and burst flu
Girl, 5, confirmed with fatal bug as lawmakers slam vaccine plans
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