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Yangjiang H7N9 Case Expands Guangdong Reach
Recombinomics Commentary 16:15
December 16, 2013

Patients Zhang, female, 65 years old, who lives in Yangjiang City, as retirees, current patients in critical condition. After receiving the report, the Ministry of Health and Family Planning Commission sent the day of epidemiologists and clinical experts to assist in the epidemiological investigation of Yangjiang and guiding patient treatment,

The above translation from the Guangdong Province Ministry of Health website (and many local media sites) describes another confirmed H7N9 critical case (65F) in Guangdong Province.  This report follows the report of a case (39M) from Fenggang City in Dongguan, which is near Longgang (see map), where three positive samples were identified at two wet markets.  This location is linked to the index case (36F) who was treated at Tuen Mun Hospital in Hong Kong, where a subsequent case (80M) was also treated.

These four cases have all been recently reported, with the most recent case being in Yangjiang City, which is about 100 miles from the prior three cases (see map).  This latest case raises concerns that H7N9 is widespread in Guangdong Province, and detection of human cases is largely linked to critical cases.  There were two earlier cases, including one (3M) that was mild, but the sequence differences between the August case, A/Guangdong/1/2013, and the Hong Kong index case, A/Hong Kong/5942/2013, signal multiple independent introductions over a large area within Guangdong Province.

Sequences from the more recent cases and environmental sites have been withheld, raising concerns that sequences from the two cases treated at Tuen Mun are very closely related.  Release of these sequences, which likely contain H9N2 internal genes related to prior isolates from Hong Kong and Guangdong Province, would be useful.

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