明尼蘇達大學CIDRAP (傳染病研究與政策中心) 中國 H7N9 avian flu禽流感案例: 419 cases

H7N9禽流感席捲中國 民眾籲當局公開信息 2017年02月16日 【記者張婷／編譯】H7N9禽流感病毒席捲中國大陸，上個月至少有79人死亡，中共當局稱，越發令人擔心的是，禽流感病毒在本季的傳播很可能會是有紀錄以來最嚴重的一次。大陸網民呼籲政府應發布最新數據。據路透社報導，今年1月死亡的人數與過去幾年的同期相比高出4倍。國家衛生和計劃生育委員會週二發布的數據顯示，自從去年10月以來，H7N9病人死亡的人數總計達100人。路透社稱，最新的禽流感數據令人擔憂，大陸恐又在重複以前的危機，就像2002—2003年爆發的嚴重急性呼吸道綜合症SARS。新浪微博的一位用戶說：「已經是2月中旬，我們卻剛得到1月份的數據。（禽流感的）死亡率幾乎趕上SARS，（政府）不應該提前發出警告嗎？」中國博客圈的其他網民也擔心流感病毒傳播的速度，並呼籲得到更新的報告。路透社稱，自從大陸爆發SARS以來，中共當局就已經開始有很長的路要走，需要「學習」如何與公眾溝通，以應對傳染病危機。中共官方發布的有關傳染報告被指責發布得太慢，而且沒有規律。大陸雞肉的價格週三跌至十多年來最低水平。肉類加工商的股價也受到了衝擊，外界擔心禽流感可能會影響到國內市場的需求。

中國大陸的高傳染紀錄 據路透社報導，中國大陸自從2013年3月首次報導了該病毒的人類感染以來，自去年12月以來H7N9病例急遽上升。從官方發布的數據來看，自去年10月以來，大陸的H7N9禽流感病例總計達306例，其中今年1月份就有192例。但來自其它機構估計的數據要比中共官方發布的數據高。明尼蘇達大學（University of Minnesota）傳染病研究與政策中心（CIDRAP）上週估計，中國這個冬天到目前為止至少有347人受感染，超過了三年前319人的紀錄。 CIDRAP在2月10日發出的一份報告中說，還很難判斷H7N9病例是否還會在中國繼續增加或是已經達到高峰。澳大利亞昆士蘭大學（University of Queensland）的病毒學家麥凱（Ian Mackay）說，在中國過去發生的一波波人類感染H7N9病毒中，一個重要措施是快速關閉活家禽市場。麥凱認為，本季節大陸似乎對疫情爆發反應比較慢，這可能會導致更多人接觸到被病毒感染的禽類。對於這次禽流感，報導的大多數人類感染病例都集中在中國南部及沿海地區。上週六北京報導了其周邊地區今年第一例人類H7N9禽流感。該病人是來自河北省廊坊市的一位68歲男子。本週二又發現一例。

H7N9 infections continue to climb in China Filed Under: H7N9 Avian Influenza; Avian Influenza (Bird Flu)  CIDRAP - Center for Infectious Disease Research and Policy Academic Health Center, University of Minnesota, Minneapolis, MN Feb 16, 2017 Eric / Flickr cc    A surge of H7N9 avian flu activity in China that began in December shows no sign of tailing off, with 61 new cases reported last week, pushing the mainland's total to at least 419 cases—100 more than the previous high reported during the second wave in 2013-14. 

Recent cases in 10 provinces The latest numbers are from an update today from Hong Kong's Centre for Health Protection (CHP) covering mainland cases reported from Feb 6 to Feb 12. The pace of cases reported for February so far puts the month on track to top the high number of cases seen in January.  The CHP said the 61 newest cases were reported from 10 of China's provinces, about half of them reported from Hubei, Zhejiang, and Jiangsu. Illness onsets range from Jan 6 to Feb 8. Patient ages range from 22 to 85 years, and investigations so far reveal that 25 patients had been exposed to poultry or live-poultry markets before they became ill.  A spokesman for the CHP said in the statement that the number of cases in this wave are much higher than the same time last winter. "This shows that the situation is abnormal." The CHP said the big rise in H7N9 cases in the mainland has also resulted in imported cases detected in Hong Kong, Macao, and Taiwan.  Yesterday Hong Kong officials met to discuss the global avian flu situation, including bird outbreaks involving the H5N6 and H5N8 strains, and plans to enhance precautions in Hong Kong.  In a statement, the CHP said it will send letters to doctors urging them to be alert for avian flu illnesses in humans. Other steps include thermal imaging at boundary checkpoints to detect fevers in inbound travelers and the activation of an electronic portal to help with early identification, testing, and notification. 

Poultry testing, market closures Chinese researchers have said that increased levels of H7N9 in poultry are likely driving the increase in human cases. Unlike other avian flu strains that cause disease in humans, H7N9 is a low-pathogenic strain in poultry, and infected birds don't usually show signs of illness.  An update yesterday from the United Nations Food and Agriculture Organization (FAO) provided a glimpse of recent poultry test findings, as well as an update on poultry market closures—a tactic used to stem past outbreaks. The FAO said the Chinese agriculture ministry, as part of January surveillance, collected about 102,000 blood samples and about 55,000 virus swabs from birds at about 6,600 locations across 26 provinces. Twenty-six swabs tested positive for H7N9, most of them samples from market poultry in four provinces: Guangdong, Guizhou, Hunan, and Jiangsu. Serum sampling yielded 33 H7-positives from Guangdong and Shandong provinces. Testing by provincial officials has also turned up positive tests that led to poultry market closures in cities in Guangdong and Hunan. After four human cases were detected in Sichuan province, authorities in one city shuttered 280 live-market stalls. On Feb 11, officials in Zhejiang province closed all poultry markets until further notice.