Following the announcement of three patients presenting with a novel influenza A virus on 31 March 2013, the health bureau of Jiangsu province of China confirmed four more cases of influenza A(H7N9) from different cities in the province on 2 April 2012. Jiangsu province is bordering Shanghai province and Anhui province, where the three initial cases were reported.
All four new cases are reported to be in critical condition. Three of the four new cases are female, aged 45, 48 and 32 years, and the fourth is an 83-year-old male. One of the female cases has been exposed to poultry in her workplace while no information on poultry exposure is known regarding the other cases.
On 3 April 2013, the Zhejiang Provincial Health Department notified two additional cases from their province, which is bordering Anhui and Shanghai provinces. One of them, a 38-year-old male cook, who was working in Jiangsu Taicang, fell ill on 7 March and was reported to have died 20 days later. The other case, a 67-year-old retired male from Hangzhou was admitted to hospital on 25 March.
The onset of symptoms of these six newly reported cases was between 7 and 21 March 2013 and the date of hospitalisation between 25 and 30 March 2013. There is no epidemiological link between the cases. 350 close contacts of the new cases from are being followed-up and all are reported to be asymptomatic to date.
With these six newly reported cases, there are now nine confirmed cases including three deaths from avian influenza virus A(H7N9) reported in Eastern China.
There is currently no evidence of human-to-human transmission of the influenza A(H7N9) virus.
ECDC continues to monitor the situation. More cases are expected to be reported.
This epidemiological update does not change the conclusions and recommendations of ECDC’s Rapid Risk Assessment of 2 April 2013.
WHO: question and answers on human infection with influenza A(H7N9) virus, China (updated 3 April 2013)
Chinese Center for Disease Control and Prevention: question and answers about human infection with A(H7N9) avian influenza virus (published 31 March 2013)