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Paradigm Shift Intervention Monitoring
Guangdong H7N9 Cluster In Sanjiaozhen - 37M
Liang Yijun, female, two and a half, now living Triangle Town, Zhongshan City. February 2 confirmed cases of human infection of H7N9 avian influenza, the patient's condition is currently stable, treated at a local hospital sentinel.
The above translations from the Guangdong Ministry of Health website describes two recent H7N9 bird flu cases (37M & 2F) in Guangdong Province in Sanjioazhen (translated above as Triangle Town), Zhongshan (see map). These two cases were reported one day apart and the confirmation of a child with mild or stable H7N9 that is geographically and temporally linked to a severe or fatal adult case raises concerns that these young cases are contacts of the severe cases.
China has focused surveillance on severe hospitalized cases, but recently has cited milder cases, with these linkages in time and space. Sequences from these clusters have been largely lacking, but these associations are far from random.
The above cluster in Guangdong Province is distinct from an earlier Guangdong cluster that is within 100 miles of a Hunan cluster and each is less than 50 miles from the first H7N9 case (56F) in Guangxi province (see map)..
The latest Guangdong cluster extends this pattern involving a severe confirmed case followed by a mild case in a child in the same location as the severe adult case.
These cases and clusters raise concerns that the efficiency of human to human (H2H) H7N9 transmission is increasing.
Release of sequences from these clusters, as well as the relationships between the cluster members, would be useful.