CHINA – Chinese health authorities have reported four more H7N9 infections in three different areas of eastern China over the past 3 days, including the first detection in Shanghai since last April. Also, animal health officials in China have reported more positive H7N9 findings in environmental samples from a live poultry market, supporting the suspicion that such markets are fueling the outbreak in humans. The patient from Shanghai is an 86-year-old man whose H7N9 illness was confirmed Jan 3, according to a statement yesterday from Hong Kong’s Centre for Health Protection (CHP). Few details about his illness were available in official and media reports, other than that he is hospitalized. Meanwhile, a 34-year-old woman from Zhejiang province is hospitalized in critical condition with an H7N9 infection, according to a separate CHP statement. Her symptoms began on Dec 29 and she was hospitalized on Jan 2; the virus was confirmed in her respiratory samples 2 days later. She is in critical condition. The woman is from the city of Zhuji, and her illness is the first H7N9 case reported in Zhejiang province this year, Xinhua, China’s state news agency, reported yesterday. In the middle of December the province reported two cases, in a 57-year-old man and his 30-year-old son-in-law.
The other two cases are both in southern China’s Guangdong province, where most of China’s most recent cases were detected. The CHP said today that one of the patients is a 47-year-old man who is a poultry worker from Foshan and became ill on Dec 25. He was hospitalized in Guangzhou on Jan 3 and is in critical condition. Provincial health officials are monitoring 60 of the man’s close contacts, but no far no other H7N9 infections have been detected. Guangdong province’s other new case involves a 71-year-old man from Yangjiang who got sick on Jan 1 and was admitted to a hospital on Jan 4 where he is in critical condition, according to the CHP. He had no history of recent contact with poultry. Authorities have 65 of his close contacts under medical surveillance, but so far no other cases have been found. In a related development, the World Health Organization (WHO) today confirmed two earlier reported H7N9 infections in Guangdong province. One of them is in a 62-year-old man with a history of exposure to live poultry who started having symptoms on Dec 11, was admitted to a hospital on Dec 16, and remains in critical condition. The other patient is a 38-year-old man who got sick on Dec 9 and was hospitalized on Dec 18, according to the WHO. He is still in critical condition. The four new cases push the number of H7N9 cases on China’s mainland to 148, according to the CHP. Additionally, four cases with ties to the mainland have been reported elsewhere—two in Hong Kong and two in Taiwan. Extinction Protocol