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Hunan H7N9 Shuangfeng Cluster
Recombinomics Commentary 11:45
February 17, 2014

Pengmou cases, female, 21 years old, who lives in Loudi Shuangfeng, live poultry contact history. Currently the patient is in a hospital in Changsha treatment.

Ryu (male, 23 years old), who lives in Loudi Shuangfeng, is currently in a hospital in Changsha treatment.

The above translations describe two recent H7N9 cases (21F in red and 23M in blue) who live in Shuangfeng County in Loudi City in Hunan Province who are hospitalized in Changsha (see map).  The time and space relationships between these two cases raises concerns of linkage, which is confirmed in comments from the Loudi CDC that these two cases are wife and husband.

This cluster increases concerns that most recent cases in southern provinces form familial and/or geographic clusters.  A Hunan familial cluster in Jiangyong County in Yongzhou City involving a father (38M) and daughter (8F) was reported earlier.  Moreover, the two Loudi cases above follow an earlier Loudi case (59M in Louxing), and preceded two additional Loudi cases in Lianyaun (19M and 46M) which form a five person geographical cluster in Loudi (see map).

The presence of a familial cluster within a larger geographic cluster as seen in Guangdong Province (in the Baiyun region of Guangzhou (see map) as well as Huaiji Province in Zhaoqing (see map), raises concerns, as does the failure of WHO to acknowledge these familial cluster, which have significant gaps in disease onset dates within familial clusters, signaling increasing human to human transmission.

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