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As noted in the previous post, there have been at least 460 human cases of H7N9 reported in the current H7N9 outbreak between November 1, 2016 and February 27, 2017. Of great concern is a possibility that many of these cases are a result of human-to-human transmission. There is little publicly available information about the relationships, if any, among these hundreds of cases. To date, only four two-person clusters have been reported by the World Health Organization (WHO, January 17 and February 20) with family members comprising three of the clusters. For all four of these clusters, the WHO notes that human-to-human transmission cannot be ruled out. One important clue to the nature of the outbreak is the geographic distribution of the reported cases. An indirect signal of human-to-human transmission can be multiple cases occurring in a localized geographic area within a short period of time. The recent WHO line listing of H7N9 cases from China ( Influenza at the Human Animal Interfa...

Although more than 400 people have been infected with A(H7N9), reports of clusters of cases are rare. Based on publicly available information, only 14 H7N9 human cluster have been reported. Most of these clusters are family or neighborhood clusters of 2-3 individuals. These clusters are almost never officially reported by the Chinese public health authorities. The most recent reported cluster is family cluster of two sisters from Dongyang in Zhejiang Province. An extended media report details the identifications and treatment of 3 children infected with H7N9 from Dongyang.[1] Computer translation of the article reports that three infected children with ages ranging from 2-8 were identified over the course of four days in February, 2014.[2]   Two of the children were sisters from one family with different onset dates. The two children apparently observed, but did not participate, in the slaughter of several chickens by one of the parents. The report is not clear whether the third c...

An important ahead-of-print article on the possible origins of the H7N9 virus has been published by researchers from the Zhejiang Provincial Center for Disease Control and Prevention in Hangzhou, China in the journal Zoonoses and Public Health . The researchers conducted genetic analyses of environment samples, human samples, and domestic and wild avian samples of the H7N9 virus from several provinces in the eastern portion of the People‘s Republic of China (PRC). The article, entitled Hypothesis On The Source, Transmission and Characteristics of Infection of Avian Influenza A (H7N9) Virus – Based On Analysis of Field Epidemiological Investigation and Gene Sequence Analysis is behind a John Wiley & Sons paywall. However, within the freely available abstract, these Chinese researchers propose that the H7N9 virus now infecting people and domestic poultry originated with migratory bird populations in the Taihu Lake area of Zhejiang Province. Their analysis suggests that . . . avi...

Since novel A(H7N9) human infections were first discovered last year in the People's Republic of China, Zhejiang Province has reported the most cases. The map below depicts in aggregate, the general locations of 80 confirmed and unconfirmed cases through January 21, 2014. The cases are concentrated in the northern portion of the country in the Hangzhou and Huzhou. About 70% of all H7N9 cases reported from Zhejiang are from these two prefectures.