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Paradigm Shift Intervention Monitoring
Guangzhou H7N9 Nosocomial Cluster In Panyu?
Wei, male, 79 years old, farmer, now living in Panyu District, Guangzhou City, February 14 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in hospital in Guangzhou Hospital Wards.
Hemou cases, male, 81 years old, now lives in Panyu District, Guangzhou City, suffering from chronic bronchitis, coronary heart disease and other chronic diseases decade. February 19 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in the Guangzhou Hospital Wards hospitalization.
The above translations describing three confirmed H7N9 bird flu cases, 78M, 79M, 81M (from the Guangdong Health and Family Planning website on February 14, 15, 20, respectively) from the Panyu district in Guangzhou City (see map) raise concerns that these three cases are connected and may represent on outbreak in a retirement home or hospital. The most recent WHO update (February 18), notes that the first two cases were hospitalized on day zero (February 7 and 4, respectively).
The WHO update had little additional detail. The report described 9 confirmed cases, but only 3 were cited as having poultry contact, and clinical status was absent on 3 of the 9 cases. The summary of cases ended with a comment stating epidemiological investigations were ongoing.
These comments raise concerns that these cases represent human to human (nosocomial?) transmission, which follows a large number of clusters in Guangdong, Guangxi, and Hunan provinces which involve relatives and/or non-random geographic designations.
The above geographic cluster also follows export of H7N9 from Guangdong province to Hong Kong, Malaysia, and Guangxi, which includes onward transmission in Guangxi and three symptomatic travelers associated with the case in Malaysia.
More information on the relationships between the three Panyu confirmed cases would be useful.