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Commentary
Guangdong H7N9 Cluster In Baiyun - 29M
& 5F
Recombinomics Commentary 03:00
February 4, 2014
Case 1 Panmou, female, 5 years old, currently residing in Baiyun District of Guangzhou City. January 14 onset, January 18 confirmed cases of human infection of H7N9 avian influenza, patients with mild symptoms currently in Guangzhou designated hospital admission.
The above translations from the Guangdong Ministry of Health January 11 and January 18 reports on two cases (29M and 5F, respectively) from the Baiyun District of Guangzhou City (see map) describe patterns seen in more recent clusters. The confirmation of a critically ill adult H7N9 bird flu case is followed by a mild case involving a child who is from the same location as the adult. Unlike more recent updates, the disease onset dates for the two cases are given in the local agency rport, fully supporting human to human (H2H) transmission. Moreover, the development of symptoms by the child after the adult is H7N9 confirmed leads to rapid hospitalization and treatment which produce a mild or stable clinical presentation of the case.
Although the January 18 announcement of H7N9 confirmation in the child fails to note the relationship between the two cases, multiple subsequent Chinese media reports note that the 5F is the daughter of the 29M index case.
However, none of the recent agency reports on Guangdong (Huai and Sanjiaozhen) or Hunan (Jianygang) clusters have noted that the cluster members were related or were contacts, althoiugh the February 3 WHO update does note the child (5M) in the Huai cluster was hospitalized the day he became symptomatic.
The acknowledgement that the above cluster was familial involving a father and daughter, increases the likelihood that each of the three recent clusters in Guangdong and Fujian Provinces are also familial, although the Ministries of Health in China, as well as WHO, fail to note the relationship of the cluster members, raising serious pandemic concerns.
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