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Commentary

H7N9 Taiwan Case Ex-Suzhou Jiangsu
Recombinomics Commentary 14:00
April 24, 2013

The patient is a hepatitis B carrier, high blood pressure, and long-term work in Suzhou, Jiangsu between Suzhou and Taiwan. The patient to Suzhou, 3/28 to 4/9 4/9 returned to Taiwan from Shanghai, the case during the Suzhou history of exposure to birds, no consumption of immature birds or egg. 4/12 began to have fever, night sweats, fatigue, respiratory and gastrointestinal symptoms, 4/16 due to high fever clinic, clinic physicians recommended referral then to a hospital emergency room and stay in a single ward, in 4/16 Tamiflu, 4/18 chest X-light right lower lobe interstitial infiltrates, then transferred to a medical center in 4/20 4/19 due to disease progression at night due to respiratory failure catheter into the intensive care unit negative pressure isolation, during which the two mining throat swabs sent for testing H7N9 influenza tests were negative. The present H7N9 positive by RT-PCR sputum inspection the morning of 4/24, 4/24 evening Genome Sequencing confirmed by the National Influenza Center.
 
The above Taiwan Department of Health  translation describes the first confirmed H7N9 bird flu case in Taiwan.  The patient developed symptoms three days after returning from Suzhou, Jiangsu. This case is the first outside of mainland China and is the second example of H7N9 in a case who traveled from the Shanghai area.  The earlier case (2M) was identified in Hunan (see map) and has fully recovered.

The above case was identified at the Taoyuan International Airport (see map) and is in critical condition.  He denied exposure to birds.  Health care workers (HCWs) at three Taiwan hospitals are under observation and three have upper respiratory tract symptoms.

The patient initially tested negative, raising detection concerns for mild cases, such as the three HCWs in Taiwan.

More information on the symptomatic contacts would be useful.

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