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WHO On Huaiji H7N9 Liang Familial Cluster
Recombinomics Commentary 14:15
February 11, 2014

A 42 year-old man from Zhaoqing City, Guangdong Province, who became ill on 27 January and was admitted to hospital on 28 January and transferred to another hospital on 4 February. He is currently in a critical condition. The patient has a history of exposure to live poultry.

An 11 year-old boy from Zhaoqing City, Guangdong Province, who became ill on 5 February and went to hospital on the same day. He is currently in a stable condition. The patient has a history of exposure to live poultry.
The above comments are from WHO H7N9 bird flu updates from February 7 (in red) and February 11 (in blue) describing the two cases (42M and 11M) from the Liang (machine translation is Yijun) family who are part of the 8 person cluster from Huaiji, Zhaoqing in Guangdong  (GD) Province.  WHO updates include disease onset /  hospitalization dates and clinical condition, while GD MoH updates provide the family name (machine translation as Yijun for the above two cases).  However, neither agency notes the fact that both cases are from the same family.

The older case (42M) was hospitalized relatively quickly, but was transferred to another hospital on February 4 (likely due to a deteriorating clinical presentation).  The younger case developed symptoms a day later (nine days after disease onset of the older case), but was hospitalized on the same day (February 5), strongly suggesting that hospitalization on day zero was because he was a contact of a confirmed case.

The shared name strongly suggests this is a father and his son who are H7N9 infected, and the rapid hospitalization (at a local hospital) and treatment of the son led to a stable clinical picture.  These two cases represent the third set of patients that share a surname.  Media reports have indicated that the first set (5M & 4F) are cousins (family name Oi) living in the same home, while the other set (48M & 5F with family name Li) includes the fourth child.  Thus, all four children in the Huaiji geographical cluster are in these three family clusters, but are mild/stable (one case, 4F, has already been discharged).

Although the presence of three family clusters in the same geographic region with disease onset dates between January 24 and February 5 (see updated list below) raises serious concerns, neither the GD MoH or WHO updates cite the relationships.  The withholding of this information from the large Huaji cluster, as well as clusters in Zhejiang, Hunan, and two clusters in GD (all of which are detailed in local media reports), continues to be hazardous to the world’s health.
Disease onset, age/gender, status, family name

January 24 (28M)     critical                         Kong
January 26 (4F)        mild/discharged         Oi
January 27 (42M)     critical                         Liang
January 28 (48M)     severe                         Li
January 29 (5M)       stable                          Oi
January 30 (5F)        mild                              Li
February 1 (62M)     severe                          Lin
February 5 (11M)     stable                           Liang

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