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Sanjiaozhen H7N9 Familial Cluster Raises Concerns
Recombinomics Commentary 19:00
February 6, 2014

According to Triangle Town Lianglian Ying, deputy director of publicity office, the town appeared in the first case of familial aggregation of cases, the patient is a father and daughter, 37-year-old father LiangMou on February 1 confirmed human infection of H7N9 avian influenza, which half years old daughter in February 2 was diagnosed with the case.

According Lianglian Ying introduced the day before the specified isolation and treatment of Zhongshan Hospital treating physician has revealed that 37-year-old patient was in critical condition, "spent two days if there is no danger," and returned from the hospital today, the good news, the patient out of danger, his daughter also achieved some therapeutic effect.

The above translation provides an update on the familial H7N9 cluster in Sanjiaozhen (Triangle Town in the above translation.  The condition of the father (37M) has improved, and his daughter (2M) is still hospitalized (her condition was described as “mild” in the WHO February 5 update).

Although the father / daughter relationship between these two confirmed cases (WHO reported the father in its February  4 update) has been widely reported in China media, neither the Guangdong MoH report on the daughter (February 2) or the WHO update  of February 5 noted the fact that the 2M was the daughter of a confirmed case. 

IHR regulations are designed to keep member nations informed of the status of novel influenza viruses, such as H7N9, and the presence of a familial cluster is a critical component of the notification system.  The daughter had a mild presentation, but she was hospitalized on day 0. Indicating she was being monitored because she was a contact of an H7N9 confirmed case.  Thus, although the Guangdong MoH and WHO undoubtable were aware of this important relationship, neither agency cited the relationship when the daughter’s H7N9 confirmation was reported and her father was confirmed. 

Moreover. the mother (41F) in the Guangxi Hengxian familial cluster (including her son, 5M), developed symptoms while in Zhongshan City, the location of Sanjiaozhen (and the Guangxi MoH also failed to note the familial relationship when reporting the confirmation of H7N9 bird flu in her son..

An explanation of these reporting failures is clearly warranted.

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