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04/02/2013

Bird flu: More cases, more rumours in China's spreading outbreak

Bird flu

A woman at a chicken farm in Zouping, east China's Shandong province on Monday. (AFP/GETTY IMAGES)

Rumours have been coming fast and furious in the wake of Sunday's announcement that a new bird flu strain, H7N9, has infected humans for the first time (that we know of, that is). Two men in Shanghai have died; a woman in Anhui province, some 360 kilometres away, has also fallen ill and is now in critical condition.

Earlier Tuesday, a picture was making the rounds on Twitter and Chinese media, allegedly a patient's diagnosis sheet leaked by a hospital staffer in Nanjing, capital of Jiangsu province. The person posted the picture on Chinese social networking website Weibo and said the patient was a 45-year-old poultry butcher who was confirmed as having H7N9 on March 30.

That information remains unconfirmed but now it looks like we have official word of four more cases from four different cities in Jiangsu province -- including a 45-year-old poultry butcher. Jiangsu's health department has posted a Chinese-language press release on their website announcing the additional cases -- which have not yet been confirmed by the World Health Organization.

According to a machine-translated version of the Chinese announcement, the new patients are:

* A 45-year-old female from Jiangning District who worked with poultry. She developed symptoms (fever, dizziness, body aches, fatigue) on March 19; on March 27, she went into ICU. Currently in critical condition. The Chinese CDC tested her today and she was positive for H7N9. Officials are now monitoring 49 people who have come into contact with her; none are showing any symptoms yet.

* A 48-year-old woman who worked in "sheet metal processing." Developed symptoms on March 19 and was transferred to ICU on March 30 at Nanjing Hospital. Currently in critical condition. Was confirmed to have H7N9 today by the Chinese CDC. Officials are now tracing 60 people who have come into close contact with the patient; none have any symptoms.

*83-year-old male from Suzhou Wujiang District. Developed symptoms on March 20 and was transferred to hospital on March 29. Tested positive for H7N9 on April 1. Officials are now following 15 contacts of this patient; none have yet to show any symptoms.

* A 32-year-old unemplyed woman who lives in Wuxi city. Developed symptoms on March 21 and was transferred to a hospital on March 28. She was confirmed to have H7N9 on March 31 by Jiangsu health authorities, a diagnosis that was confirmed on April 2. Health officials are monitoring 43 people who've come into contact with the patient; none have respiratory symptoms.

There are apparently no epidemiological links between the four Jiangsu cases.

Update: Some information on what Chinese authorities are doing to step up their outbreak response, from an Associated Press report by Gillian Wong:

The provincial health bureau said it was strengthening measures to monitor suspicious cases and urged the public to stay calm, joining Beijing and China's financial capital, Shanghai, in rolling out new steps to respond to the relatively unknown virus.

The latest cases follow the three earlier ones reported Sunday, including two men who died in Shanghai, resulting in the city activating an emergency plan that calls for heightened monitoring of suspicious flu cases. Under the contingency plan, schools, hospitals and retirement facilities are to be on the alert for fevers, and administrators are to report to health authorities if there are more than five cases of flu in a week.

Cases of severe pneumonia with unclear causes are to be reported daily by hospitals to health bureaus, up from the weekly norm. The plan also called for stronger monitoring of people who work at poultry farms or are exposed to birds.

The level-3 response plan, the second-lowest in a four-stage scale, reflects higher concern after the H7N9 bird flu virus led to the deaths in Shanghai and seriously sickened a woman in the city of Chuzhou 360 kilometres west.

"The health bureau will take effective and powerful measures to prevent and control the disease, to make sure the flu epidemic is effectively guarded against and to safeguard the health of the city's residents," said Xu Jianguang, head of the Shanghai Health Bureau.

Health officials said this week there was no evidence that any of the three earlier cases, who were infected over the past two months, had contracted the disease from each other, and no sign of infection in the 88 people who had closest contact with them.

Health authorities in Beijing also upped the capital's state of readiness, ordering hospitals to monitor for cases of bird flu and pneumonia without clear causes, the official Xinhua News Agency reported.

The announcements, as lacking in details as they are, show that the government is mildly more transparent in handling health crises than it was a decade ago during the SARS pneumonia epidemic. Then, as rumours circulated for weeks of an outbreak of an unidentified disease in southern Guangdong province, government silence contributed to the spread of the virus to many parts of China and to two dozen other countries.

Scientists are closely monitoring these viruses for fear they could mutate into a strain that easy spreads among people, but there's no evidence of that occurring.

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar

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