Sunday, December 8, 2013

ALERT! Hong Kong: Tuen Muen Hospital Likely H7N9 Infection Point

Update 12/12/13:
Today two new cases of symptomatic individuals were reported at the Tuen Muen Hospital, these are individuals who shared the same room with the 80 year old male. Its unclear exactly how many person from the hospital show symptoms; some are patients and some are healthcare workers. All are on (and have been on) antivirals. Asymptomatic individuals are being held in quarantine else where.  So far it has been reported that all these individuals test negative; frankly thats not very reassuring. It appears they are only using rapid tests.  

On December 6th we broke the news (on Twitter),  that an 80 year old male H7N9 patient had likely picked up a HOSPITAL ACQUIRED  H7N9 INFECTION  at the Tuen Muen Hospital in Hong Kong.  The Hong Kong authorities are dead set against acknowledging that likelihood.  We find this obfustication concerning because the MATH  (see below) of the situation clearly points towards the hospital as the likely infection source .  Assuming that the authorities are not incompetent, the situation likely means the authorities are hiding something, and that is what we find concerning.

 Based on  previously known  H7N9 infections, it has been reported in The Lancet:

(1)The MOST LIKELY time to H7N9 symptom onset is 2.4 days.
(2) The mean time to symptom onset is 3.1 days, with a Standard deviation of 1.4 days.
(watch the video above for more detail on the math, expressed in straightforward terminology)

 Here is what we know about the Tuen Muen Hospital (TMH):

(1)  3 days after entering TMH the 80 year old male tested positive for H7N9
(2)  TMH is currently having infection control difficulties as evidence by a Vancomycin Resistant Enterococci outbreak. 
(3) From Nov 27 to Nov 30th , TMH was treating a 36 year old female H7N9 patient
(4) On Dec 3rd the 80 year old male went to TMH for weakness related to heart problems and diabetes
he had no flu symptoms or fever, moreover he had no exposure to live chickens or other H7N9 sources.
(5) Another exposed patient at TMH has developed flu symptoms and fever
(6) A health care worker at TMH has developed flu like symptoms


Comparative epidemiology of human infections with avian influenza A H7N9

[H7N9 TRIAGE DEATH PANEL] ONE Day delay in Hospital Admission may Significantly reduce ICU Loads & Costs

Vancomycin Resistant Enterococci outbreak.

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