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Commentary
Guangdong H7N9 Cluster In Huaiji Grows - 28M 5M
4F 42M 5F
Recombinomics Commentary 630
February 5, 2014
Case 2 Yijun, male, 42 years old, workers, now living Huaiji County, Zhaoqing City, February 4 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition, were treated at a local hospital sentinel.
The above translation from the February 5 H7N9 bird flu update from the Guangdong Ministry of Health describes two more cases from Huaiji County, Zhaoqing City, increasing the number of confirmed cases from this location to five. The first two cases (28M and 5M) formed a pattern seen in multiple clusters in Guangdong and Hunan Provinces. The clusters involved a severe critical adult who was hospitalized several days after disease onset, followed by a mild / stable child who was hospitalized 0-1 days after disease onset.
Since H7N9 surveillance in China targets hospitalized severe case, mild/stable cases who are hospitalized 0-1 days after disease onset are largely limited to contacts of confirmed cases, suggesting confirmed H7N9 cases that are geographically linked and form the above pattern are clusters formed via human to human transmission.
The initial cluster of two in Huai town in Huaiji County increased to three when another case (4F) was reported. Recent media reports indicated the two children were cousins living in the same home. The media reports were silent on a relationship with the index case.
The two latest cases form another cluster involving an adult (42M) and another stable child (5F). Local agency reports have stopped including disease onset dates, and the precise location of the recent Huaiji County cases has been withheld, but the localization of the first three cases to Huai town suggests that the two most recnt cases are also in Huai town.
More information on the relationships between the five confirmed cases and precise locations would be useful. WHO updates have provided disease onset dates fro the first two cases (which were 6 days apart). Disease onset and hospitalization dates for the three most recent cases would be useful.
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