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Commentary

Asymptomatic Beijing H7N9 Raises Pandemic Concerns
Recombinomics Commentary 21:13
April 14, 2013

active screening monitoring 4-year-old bamboo surname boys H7N9 avian influenza virus nucleic acid positive. The boy is currently no clinical symptoms 

The above translation describes an asymptomatic contact (4M) of the index case (7F) in Beijing.  The case was identified through screening of contacts of the earlier case.  The detection of H7N9 is an asymptomatic contacts raises concerns that H7N9 is far more widespread than represented by the 61 confirmed cases (see map), which includes 13 fatalities.
 
The confirmed cases have a case fatality are of more than 92% (13 fatalities out of 14 outcomes).  All of the other confirmed cases are hospitalized, including the above case who was hospitalized for observation.

Sequences from this case would be useful.  There are 4 public sequences and all 4 have E627K.  These sequences are from fatal cases.  Avian isolates are lacking E627K, but have Q226L.  Differences between severe / fatal cases and mild / asymptomatic cases remain to be determined.

However, the detection of H7N9 in an asymptomatic contact raises serious pandemic concerns.

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