MALAYSIA – Health officials announced an H7N9 avian flu infection in Malaysia today, the first case detected outside of China, along with eight other newly confirmed cases—one in Hong Kong and seven more from the mainland. The patients who are sick with H7N9 infections in Hong Kong and Malaysia had travel links to China’s Guangdong province, one of the main hotspots of disease activity in the outbreak’s second wave. Today’s new cases lift the number of H7N9 cases reported in the second wave, which began in October, to 211, compared with 136 reported during the first wave last spring. For both waves, the total is 347, according to a list of confirmed cases kept by FluTrackers. The unofficial death count remains at 72. Malaysia’s patient is a 67-year-old woman who was part of a tour group from Guangdong province, according to a report today from Bernama, Malaysia’s national news agency. The group was visiting Sabah. The woman is being treated in the intensive care unit at a private hospital in Kota Kinabalu. The country’s health minister, Datuk Seri Dr. S. Subramaniam said it was the first H7N9 case reported in the country and that health officials are taking steps to limit contact with the patient. The US Centers for Disease Control and Prevention (CDC) today issued a statement on the Malaysian H7N9 case, which said the agency has been expecting the detection of H7N9 cases exported from China, including the scenario of an infected traveler. It said the illness in a traveler to Malaysia doesn’t change its risk assessment for the H7N9 virus. The CDC said the most important element in gauging the public health threat is transmissibility, and so far there is no evidence of sustained, ongoing person-to-person spread of H7N9. It emphasized, however, that the case underscores how important international surveillance is for H7N9 and other viruses that have pandemic potential.
Human infections in China linked to poultry exposure are likely to continue, the CDC said, and the virus could spread to neighboring countries, where it could infect people who are exposed to poultry. The most worrisome development would be if the virus gained the ability to spread easily among people, a possibility that the CDC said it and other international health partners are closely monitoring. Meanwhile, Hong Kong’s Centre for Health Protection (CHP) said it has detected an H7N9 infection in a 65-year-old resident who started having symptoms while visiting the city of Kaiping in Guangdong province. The case is the fifth H7N9 infection detected so far in Hong Kong, and all have had travel links to China’s mainland. During the patient’s stay in Kaiping between Jan 24 and Feb 9, his family bought a slaughtered chicken in the village on Jan 29. Upon his return to Hong Kong on Feb 9 he saw a doctor, and yesterday the man was hospitalized and is now in critical condition in an isolation unit, according to a CHP statement. Seven of the man’s family members in Hong Kong are asymptomatic, and five of them that are close contacts will be admitted to the hospital for observation and testing, the CHP said. Further investigations are under way into the man’s travel and exposure history, and the CHP is working with mainland authorities to identify the man’s contacts during his stay in Kaiping. Extinction Protocol