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Nosocomial H7N9 Transmission at Tuen Mun Hospital HK?
Recombinomics Commentary 19:30
December 6, 2013

On December 3, he arrived in Hong Kong with his three family members via Shenzhen Bay Port Border Control Point (SBP BCP) and subsequently took a taxi there in the afternoon to the Accident and Emergency Department (AED) of Tuen Mun Hospital (TMH) where he was admitted for further management of his chronic illness on the same day.

The patient had no fever upon admission. However, he developed fever this morning and was put under isolation immediately.

The above translation from the Hong Kong press release raises concern that the latest confirmed case (80M) was H7N9 bird flu infected at Tuen Mun Hospital, which is where the first case (36F) was treated (see zoomed map).  The development of symptoms 2-3 days after admission is consistent with nosocomial transmission.  Multiple contacts of the index case have flu-like symptoms, but have tested negative on the rapid test.  However, the index case twice tested negative on the rapid test prior to PCR confirmation.

The full sequence, A/Hong Kong/5942/2013, from the index case (36F) has been published and it is novel (easily distinguished from cases in northern China as well the August case in Guangdong Province).

If the latest case (80M) is due to nosocomial transmission, the sequences should match.  The full first sequence was promptly released and sequences from most of the internal gene segments would allow for assessment of likely nosocomial transmission.

Immediate release of the sequences from the latest case would be useful.

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