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Third H7N9 Zhejiang Case Raises Concerns
Recombinomics Commentary 18:30
November 5, 2013

WHO ‏@WHO 1h
China has notified WHO of 2 new laboratory-confirmed #H7N9 cases in Guangdong and Zhejiang #influenza

Gregory Härtl‏@HaertlG
Two #H7N9 cases in different parts of China on the same day. Winter is starting.

The above tweets from WHO and Gregory Hartl, WHO head of social media / public relations, indicate two new H7N9 bird flu infections have been reported today by China.  The case from Guangdong Province (3M) has been widely reported in the media, but an update on a case in Zhejiang Province (see map) has been lacking.

However, two earlier cases in Zhejiang Province were reported by WHO (67M on Oct 24 and 35M on Oct 16), which followed reports of a case in Guangdong province (51F on Aug 11).  Sequences from each region indicated two distinct H7N9 sub-clades were circulating, with differences in four internal gene segments (PB2, PB1, NP, NS).

The latest report increases concerns that both sub-clades are emerging again and levels will likely be higher in the winter than the spring of 2013.

More information on the latest case in Zhejiang, as well as detail on poultry exposure for the case in Guangdong Province (which has not been cited thus far) would be useful.

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