Tuesday, November 5, 2013

UPDATE 11/8: Cluster Alert! Additional H7N9 Case in Jiaxing City, China

On October 25th we reported via Twitter that there were UNCONFIRMED reports of an H7N9 cluster in Jiaxing City China, related to the case of a 67 year old male farmer whose infection was announced on October 23rd.

Today (11/5/13) we have confirmation, via Macau, that a 64 year old female farmer from Jiaxing was reported as being H7N9 positive on November 4th.  In a giant warning sign, the Chinese have only reported minimal information on this situation. 

We suspect that situation is related to the rumored cluster in Jiaxing; bear in mind that the Zhenhang province is a disaster area from Typhoon Flooding in October. 

UPDATE 11/7:  As we suspected, the Jiaxing is a cluster, the 64 yr old female lives across the river from another H7N9 victim, likely the 67 yr old male farmer. The Chinese authorities are looking for further cases and have the area under strict qurantine and are taking disinfection actions.

Here is the direct machine translated quote:
"the emergence of cases it makes sense. The patient at home, chicken, close contact with poultry, and her home and family on one case in Jiaxing patients are separated by only a river. "An indication that the area may have a virus spread, the need for strict quarantine disinfection measures do, and pay close attention to whether there will be a third cases."

One thing to note is that things the rest of the world call rivers are typically referred to as creeks here in the USA.  Shown below is a Google map of the general location where we believe the infected area is located.

While information is still scarce, the mainland Chinese media are now reporting on this case publicly.

So what ever happened in this cluster, it took 2 weeks for the Chinese to either clear it up, clean it up, or otherwise feel comfortable about the outcome.

Based on the news black out time period  length (Oct 25-Nov 8th) and the known  H7N9 incubation periods, the Chinese likely suspected that this cluster could be explosive (no doubt the typhoon flooding did not help matters).  Our SWAG is that there was a concurrent outbreak of Influenza Like Illness [ILI] in this location, and that the Chinese believed it was H7N9 related.

It is plausible that such a ILI outbreak was actually H7N9; the Chinese reaching such a conclusion would be the obvious cause of their apparent policy shift that the food shortages from an H7N9 cull / market shutdown would have a greater impact than the spread of H7N9.

If this conjecture holds true, expect the Chinese media to dial back any hysteria or panic causing reports related to H7N9.  The question still remains though, how different will the impact and spread of H7N9 be once it gains a foot hold outside of the Chinese population.

A different H7N9 pandemic expression in the rest of the world's population is a wild card that should not be underestimated as the Chinese public as a whole has taken preventative Traditional Chinese Medicine "self help" countermeasures. Moreover, the Spring 2013 H7N9 outbreak may have served to inoculate many Chinese against the ravages of a otherwise more severe Fall 2013 outbreak. In that regard, the rest of the world may still be a sitting duck. The next few weeks will tell us just how dangerous this current incarnation of H7N9 really ends up being.

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