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Published Date: 2018-02-24 13:19:40
Subject: PRO/AH/EDR> Avian influenza, human (09): China (JS), H7N4
Archive Number: 20180224.5648329
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Thu 22 Feb 2018
Source: Disease outbreak news [edited]

On [Wed 14 Feb 2018], the National Health and Family Planning Commission (NHFPC) of China notified the World Health Organization (WHO) of one case of human infection with avian influenza A(H7N4) virus. This is the 1st human case of avian influenza A(H7N4) infection to be reported worldwide [see ProMED-mail post Avian influenza, human (07): China (JS) H7N4, 1st report 20180214.5628629].

The case-patient was a 68-year-old woman from Jiangsu Province with pre-existing coronary heart disease and hypertension and she developed symptoms on [Mon 25 Dec 2017]. Seven days later, she was admitted to a local hospital for treatment of severe pneumonia and was discharged after 21 days. On [Mon 12 Feb 2018], the Chinese Center for Disease Control and Prevention (China CDC) confirmed that the case-patient's samples were positive for avian influenza A(H7N4). The NHFPC confirmed the diagnosis on [Tue 13 Feb 2018]. The case-patient had reported a history of exposure to live poultry before onset of symptoms.

Genetic sequencing of this A(H7N4) virus shows that all the virus segments originated from avian influenza viruses. This virus is sensitive to adamantanes and neuraminidase inhibitors based on genetic sequencing.

Up to 28 close contacts of the case-patient have been under medical observation. Among close contacts, no abnormal findings have been found and all throat swabs from her contacts have tested negative.

Public health response
The Chinese government conducted a risk assessment, and has enhanced prevention and control measures, surveillance and epidemiological investigations including contact tracing and laboratory testing. Public risk communication and information sharing is ongoing.

WHO is in contact with national authorities and is following the event closely. WHO is facilitating information-sharing with Member States and is closely monitoring the situation, in line with the International Health Regulations (2005).

WHO risk assessment
This is the 1st report of a human case of avian influenza A(H7N4) infection globally and the case reported exposure to live backyard poultry before illness onset. Genetic analysis of this influenza A(H7N4) virus indicates that it is of avian origin.

Close contacts of the case-patient tested negative for avian influenza A(H7N4) and remained asymptomatic. Current evidence suggests that this virus does not have the ability of sustained transmission to humans, thus the likelihood of sustained human to human transmission is low. Any animal influenza virus that develops the ability of human to human transmission can theoretically cause a pandemic.

It is possible that additional human cases of avian influenza A(H7N4) will be detected, however only one human case has been detected so far, and information on the circulation of avian influenza A(H7N4) in birds is not currently available. Further information needs to be gathered to increase the confidence in this assessment.

WHO advice
The public should avoid contact with high-risk environments such as live animal markets/farms and live poultry, or surfaces that might be contaminated by poultry feces. Hand hygiene with frequent washing or use of alcohol hand sanitizer is recommended. WHO does not recommend any specific different measures for travellers.

WHO does not advise special screening at points of entry with regard to this event, nor does it recommend that any travel or trade restrictions be applied.

Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[The emergence of this new avian influenza virus merits continuous monitoring for circulating strains, so early detection of the novel strains is possible and possible human exposures and infections can be detected for timely response.

A map of (Jiangsu, China): http://healthmap.org/promed/p/61100. - Mod.UBA]

See Also

Avian influenza, human (07): China (JS) H7N4, 1st report 20180214.5628629
Avian influenza, human (06): China (GD) H7N9 20180213.5625277
Avian influenza, human (05): human-animal interface, WHO 20180205.5606724
Avian influenza, human (01): China (FJ) H5N6 20180109.5546265
Avian influenza, human (82): human-animal interface, WHO 20171227.5523467
Avian influenza, human (81): China (YN) H7N9 20171204.5481306
Avian Influenza, human (80): China (GX) H5N6 20171121.5457466
Avian influenza, human (70): China, H7N9 20170911.5306399
Avian influenza, human (60): WHO, human-animal interface Avian influenza, human (50): China, H7N9 20170509.5019418
Avian influenza, human (40): Egypt (FY), H5N1, comments 20170402.4939591
Avian influenza, human (30): China, H7N9 20170307.4885433
Avian influenza, human (20): China (SC, YN, BJ), H7N9, death toll 20170215.4841682
Avian influenza, human (10): Indonesia (LA) RFI 20170123.4785841
Avian influenza, human (01): China (JX), H7N9 20170102.4736553
Avian influenza, human (72): China (HK) H7N9, fatal 20161229.4727495
Avian influenza, human (68): China, H7N9 20161218.4705001
Avian influenza, human (67): WHO, H5N6, H7N9, risk assessment 20161212.4689184
Avian influenza, human (66): China (GD) H7N9 20161210.4689085
Avian influenza, human (65): China (HN) H5N6 20161123.4646005
Avian influenza, human (64): China (ZJ,JS) H7N9 20161114.4624064
Avian influenza, human (60): China (JX) H9N2 20160912.4481431
Avian influenza, human (58): China, H7N9, update, WHO 20160820.4422893
Avian influenza, human (57): China, H7N9, WHO update 20160727.4370565
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