Beijing confirmed that a 7-year-old girl has H7N9 avian influenza and Henan province reported its first two cases, opening a new front in the spread of the virus in the world’s most populous nation.
Shanghai said today two people infected with the strain of bird flu died, taking the country’s death toll to 13. The city also reported three fresh infections today while the eastern provinces of Jiangsu and Zhejiang also confirmed new cases, raising the national tally to 60 from 49 yesterday.
The cases of the child in Beijing and two men in Henan widen the geographic spread of H7N9, adding impetus to the government’s efforts to gauge the magnitude of the infection in poultry and wild birds. Live-poultry trading has been banned in some cities and the Ministry of Agriculture last week ordered local governments to collect tissue samples from birds at markets nationwide to contain the outbreak.
“There’s no way to predict how this will spread,” Michael O’Leary, the World Health Organization’s China representative, told reporters in Beijing today. “The good news is we have no evidence of sustained human-to-human transmission. That’s a key factor in this situation.”
The source of infections remains “under active investigation,” he said. “We’re still looking intensively for the reservoir of infection but the suspicion remains in birds, chicken, ducks and poultry.”
The first three cases of H7N9 in China were announced by the central government on March 31 and until yesterday all of those infected were in eastern China.
In Henan, central China, the health bureau said today a 34- year-old male cook living near Kaifeng city in the northeast of the province is in a critical condition. A 65-year-old farmer in Zhoukou city, some 130 kilometers (82 miles) further south, who had frequent contact with poultry, is stable, it said.
Nine of the 13 deaths are in Shanghai, according to government data. The two reported in the city today were of a 67-year-old woman diagnosed April 4 and a 77-year-old man diagnosed April 9, according to a statement on the National Health and Family Planning Commission website.
The four new cases in Zhejiang today, all in a serious condition, take the province’s total to 15. The tally in Jiangsu rose to 16 today after a 50-year-old man living in the capital Nanjing and a 26-year-old male living in Yancheng city were confirmed with the virus. Anhui province has so far reported two cases.
The Beijing case is very important, said Nikki Shindo, a medical officer on the influenza team at the World Health Organization in Geneva. “Theoretically all China’s coastline provinces are touched by this virus, which means the great majority of China is at risk,” Shindo said in an e-mail yesterday, adding that early treatment with an anti-flu medicine may aid the girl’s recovery.
The child infected with H7N9 is recovering after treatment at Beijing Ditan Hospital Capital Medical University, the official Xinhua News Agency reported today, citing the city’s disease control and prevention center. Yao’s parents, who live and sell poultry in the Shunyi district of northeast Beijing, have been placed under medical surveillance and have not yet shown symptoms of infection, it said.
The recovery of the 7-year-old shows that early treatment with proper anti-viral medication can be effective, O’Leary said. “We know also that the virus when untreated is very serious,” he said, “so we advocate for early treatment and good medical care.”
Shanghai now has 24 human infections. The government said yesterday a 56-year-old man surnamed Gu, the husband of a woman diagnosed on April 4, was found with the virus.
There isn’t enough evidence to conclude that Gu, who is in a critical condition, was infected by his wife and there’s no evidence that there has been human-to-human transmission among any of the cases, the National Health and Family Planning Commission said on its website yesterday.
“We can’t say yet” if the latest Shanghai infection represents human-to-human transmission, WHO’s O’Leary said today, adding that each case must be investigated very carefully.
“In cases where there might be two people in close proximity who both have the disease, it’s also difficult to determine whether that’s because of human-to-human or because they were both exposed to the same source, for instance chickens,” he said. “That’s not so easy to sort out.”
The spread of the virus may negatively affect insurance, airlines, consumer staples and retailing, Hong Kong-based Citigroup Inc. analysts Shen Minggao and Ben Wei wrote in an April 8 report. It may also spur food-price inflation if supplies of poultry are cut, they said.
Louisville, Kentucky-based Yum! Brands Inc. (YUM:US), said April 10 that publicity associated with bird flu has had a “significant, negative impact” on sales at its KFC restaurant chain in China “within the past week.” KFC offers chicken products including sandwiches, drumsticks and wings.
Beijing has halted live-poultry trading as part of its measures to step up prevention of the disease, Zhong Dongbo, a spokesman with the Beijing Municipal Health Bureau, said in a news conference broadcast live on China Central Television yesterday. Shanghai and Nanjing are among other cities to ban such trade.
Authorities have yet to order a mass slaughter of birds across the capital because no H7N9 infections have been detected in more than 5,600 samples collected from domestic and wild birds, Xinhua reported, citing Liu Yaqing, deputy director of the city’s agriculture bureau.
“If we can determine that poultry are major sources of the infection to people then culling is one of the measures that can be taken,” WHO’s O’Leary said. “But this is a complex situation because the virus does not appear to be very lethal or even serious in animal populations so it’s more difficult to detect.”
China has enough flu medication to fight the outbreak, and the government is also preparing a vaccine that it expects will be ready within seven months, Xinhua reported April 10.
The Beijing Drug Administration has been ordered to stock up on medicines, including enough Tamiflu for 2 million people, Xinhua said yesterday. Schools in Beijing were told to increase daily temperature checks and report possible cases to the education authorities within an hour of their discovery, it said.
--Daryl Loo, Jason Gale, William Bi, Regina Tan. Editors: Nerys Avery, Jim McDonald
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