Biological Hazard - China, Hong Kong Special Administrative Region, Hong Kong : Update H7N9

Earth Watch  Report  -  Biological Hazards

H7N9 Virus Origin Diagram expanded

This diagram depicts the origins of the H7N9 virus from China and shows how the virus's genes came from other influenza viruses in birds.
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Biological Hazard

China

Hong Kong Special Administrative Region, Hong Kong

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RSOE EDIS

Biological Hazard in China on Monday, 14 April, 2014 at 02:59 (02:59 AM) UTC.

Description The Hong Kong Centre for Health Protection (CHP) of the Department of Health (DH) is   investigating an imported human case of avian influenza A(H7N9) affecting a woman aged 85. The patient, with underlying medical conditions, traveled to Dongguan from April 4 to 5 with her husband and younger brother. They lived at their relatives’ home where their relatives have reared chickens. The patient also visited a wet market near their home there and helped in slaughtering chickens at home on April 4. She returned to Hong Kong on April 5, and developed fever, cough with blood-stained sputum and shortness of breath since April 11. She was sent to the Accident and Emergency Department of Tseung Kwan O Hospital (TKOH) by ambulance today and was subsequently admitted. She is currently managed under isolation and her condition is critical. Her respiratory specimen was positive for avian influenza A(H7N9) virus upon preliminary laboratory testing by the CHP’s Public Health Laboratory Services Branch today. This is the 10th imported human H7N9 avian flu case to date. Initial investigation revealed that the patient had visited her husband at Haven of Hope Hospital (HHH) on April 10 who was admitted due to other illness. Her husband has remained asymptomatic so far and is currently under observation at HHH. Apart from her husband, seven other family members of the patient are also considered as close contacts. One of them had sore throat since April 12 and his condition is stable. The other close contacts have remained asymptomatic so far. These close contacts will be admitted to hospital for observation and their respiratory specimens will be taken for preliminary laboratory testing. The CHP’s investigations and tracing of other contacts are ongoing. The patient’s brother who traveled to Dongguan with the patient, relevant healthcare workers, ambulance staff and patients who had stayed in the same cubicle with the patient’s husband at HHH are being traced for exposure assessment and medical surveillance. Biohazard name: H7N9 - Highly pathogenic avian influenza virus Biohazard level: 4/4 Hazardous Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release. Symptoms: Status: confirmed

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Imported human case of avian influenza A(H7N9) under CHP investigation
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The Centre for Health Protection (CHP) of the Department of Health (DH) is today (April 9) investigating an imported human case of avian influenza A(H7N9) affecting a woman aged 82.The patient, with underlying medical conditions, lives in Liwan, Guangzhou with her family. She has presented with cough with blood-stained sputum since April 7 but had no fever.
She came to Hong Kong with her two family members by car via Lok Ma Chau Spur Line Control Point yesterday (April 8). Upon arrival, she was directly transferred to the Accident and Emergency Department of North District Hospital by ambulance and was admitted for further management under isolation on the same day. Her current condition is stable.
Her sputum specimen was tested positive for avian influenza A(H7N9) virus upon preliminary laboratory testing by the CHP's Public Health Laboratory Services Branch tonight.
The patient has been transferred to Princess Margaret Hospital for isolation and treatment.
Her exposure history to poultry is under investigation.
The CHP's investigations and contact tracing are ongoing. The patient's family members in Hong Kong, relevant healthcare workers, ambulance staff and immigration officer at Lok Ma Chau Spur Line Control Point are being traced for exposure assessment and medical surveillance.
"The Serious Response Level under the Government's Preparedness Plan for Influenza Pandemic remains activated and the CHP's follow-up actions are in full swing," a spokesman for the CHP remarked.
This is the ninth confirmed human case of avian influenza A(H7N9) in Hong Kong. The CHP will notify the World Health Organization (WHO), the National Health and Family Planning Commission as well as health and quarantine authorities of Guangdong and Macau.
Locally, enhanced surveillance of suspected cases in public and private hospitals is underway. The CHP will continue to maintain liaison with the WHO, the Mainland and overseas health authorities to monitor the latest developments. Local surveillance activities will be modified upon the WHO's recommendations.
"In view of human cases of avian influenza A(H7N9) confirmed locally and in the Mainland, further cases are expected in affected and possibly neighbouring areas. Those planning to travel outside Hong Kong should maintain good personal, environmental and food hygiene at all times," the spokesman urged.
"All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Random temperature checks by handheld devices have also been arranged. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.
Regarding health education for travellers, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are proceeding.
The spokesman advised travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, to immediately wear masks, seek medical attention and reveal their travel history to doctors. Healthcare professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces.
"We have enhanced publicity and health education to reinforce health advice on the prevention of avian influenza," the spokesman said.
As of 4pm today, the CHP's hotline (2125 1111) for public enquiries has received 217 calls since the first confirmed human case of avian influenza A(H7N9) in Hong Kong.
Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:
* Do not visit live poultry markets and farms. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
* Avoid entering areas where poultry may be slaughtered and contact with surfaces which might be contaminated by droppings of poultry or other animals;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear masks when respiratory symptoms develop or when taking care of fever patients.
The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf) for more information on avian influenza-affected areas and provinces.
Ends/Wednesday, April 9, 2014
Issued at HKT 22:18
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Imported human case of avian influenza A(H7N9) under CHP investigation
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The Centre for Health Protection (CHP) of the Department of Health (DH) is today (April 13) investigating an imported human case of avian influenza A(H7N9) affecting a woman aged 85.The patient, with underlying medical conditions, travelled to Dongguan from April 4 to 5 with her husband and younger brother. They lived at their relatives' home where their relatives have reared chickens. The patient also visited a wet market near their home there and helped in slaughtering chickens at home on April 4. She returned to Hong Kong on April 5, and developed fever, cough with blood-stained sputum and shortness of breath since April 11. She was sent to the Accident and Emergency Department of Tseung Kwan O Hospital (TKOH) by ambulance today and was subsequently admitted. She is currently managed under isolation and her condition is critical.
Her respiratory specimen was positive for avian influenza A(H7N9) virus upon preliminary laboratory testing by the CHP's Public Health Laboratory Services Branch today.
Initial investigation revealed that the patient had visited her husband at Haven of Hope Hospital (HHH) on April 10 who was admitted due to other illness. Her husband has remained asymptomatic so far and is currently under observation at HHH.
Apart from her husband, seven other family members of the patient are also considered as close contacts. One of them had sore throat since April 12 and his condition is stable. The other close contacts have remained asymptomatic so far.  These close contacts will be admitted to hospital for observation and their respiratory specimens will be taken for preliminary laboratory testing.
The CHP's investigations and tracing of other contacts are ongoing. The patient's brother who travelled to Dongguan with the patient, relevant healthcare workers, ambulance staff and patients who had stayed in the same cubicle with the patient’s husband at HHH are being traced for exposure assessment and medical surveillance.
The CHP will liaise with the relevant Mainland health authority to follow up on the patient's contacts during her stay in the Mainland.
"The Serious Response Level under the Government's Preparedness Plan for Influenza Pandemic remains activated and the CHP's follow-up actions are in full swing," a spokesman for the CHP remarked.
This is the tenth confirmed human case of avian influenza A(H7N9) in Hong Kong. The CHP will notify the World Health Organization (WHO), the National Health and Family Planning Commission as well as health and quarantine authorities of Guangdong and Macau.
Locally, enhanced surveillance of suspected cases in public and private hospitals is underway. The CHP will continue to maintain liaison with the WHO, the Mainland and overseas health authorities to monitor the latest developments. Local surveillance activities will be modified upon the WHO's recommendations.
"In view of human cases of avian influenza A(H7N9) confirmed locally and in the Mainland, further cases are expected in affected and possibly neighbouring areas. Those planning to travel outside Hong Kong should maintain good personal, environmental and food hygiene at all times," the spokesman urged.
"All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Random temperature checks by handheld devices have also been arranged. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.
Regarding health education for travellers, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are proceeding.
The spokesman advised travellers, especially those returning from avian influenza-affected areas and provinces with fever or respiratory symptoms, to immediately wear masks, seek medical attention and reveal their travel history to doctors. Healthcare professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas and provinces.
"We have enhanced publicity and health education to reinforce health advice on the prevention of avian influenza," the spokesman said.
As of 4pm on April 11, the CHP's hotline (2125 1111) for public enquiries has received 217 calls since the first confirmed human case of avian influenza A(H7N9) in Hong Kong.
Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:
* Do not visit live poultry markets and farms. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
* Avoid entering areas where poultry may be slaughtered and contact with surfaces which might be contaminated by droppings of poultry or other animals;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear masks when respiratory symptoms develop or when taking care of fever patients.
The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf) for more information on avian influenza-affected areas and provinces.
Ends/Sunday, April 13, 2014
Issued at HKT 22:39
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