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China maintains H7N9 assessment

Xinhua, August 9, 2013

• China said Thursday that it maintains its assessment on the public health risks of H7N9 avian flu, despite a recent research paper indicating possible human-to-human transmission.

  Deng Haihua, spokesman with the National Health and Family Planning Commission, confirmed that health authorities were aware of the cases mentioned by the research paper, which was published by the British Medical Journal on Tuesday.

  "The report on the British Medical Journal does not change China's judgement of public health risks imposed by the disease," said Deng.

  A father and his daughter were both killed by H7N9 in east China's Jiangsu Province in April.

  Researchers with the Jiangsu Provincial Center for Disease Prevention and Control studied the two cases and concluded that the virus may have spread from father to daughter but the transmission was limited and non-sustainable.

  It is very likely that the H7N9 bird flu was "transmitted directly from the 60-year-old father to his daughter," according to the report on the British Medical Journal based on research conducted by the center.

  The information about the two patients was not new to the commission, Deng said.

  Medical experts with the commission and the World Health Organization had studied the two patients in Jiangsu as well as two other cluster infections among family members in Shanghai and could not rule out person-to-person transmission.

  Tang Fenyang, an official with the Jiangsu center, said the new discovery is no cause for panic, but it is still not something to be taken lightly.

  Tang said the Jiangsu case is an isolated one with special circumstances, and the disease remains relatively inefficient in spreading among human beings.

  It is not surprising that the H7N9 virus could spread among people as some other strains of bird flu, such as the H5N1 virus, also have the characteristics of human-to-human transmission, said Tang.

  "We should not take the prevention and treatment of H7N9 infections lightly," he said.

  He warned researchers and public health staff to closely monitor cluster cases for the human-to-human transmission of the H7N9 virus. "The more clusters of cases found, the stronger transmission efficiency is represented."

  The H7N9 infections of the father and his 32-year-old daughter from Wuxi City in Jiangsu were confirmed in March.

  The father had been exposed to live poultry at a poultry market in the week before he grew ill. Six days after he was admitted to the hospital, his daughter was also confirmed to be infected with the virus. Though she had not had any contact with live poultry, she had taken care of her father while he was sick.

  The similarity between samples of the virus taken from each of them was more than 99.6 to 99.9 percent.

  "Based on epidemiological and etiological evidence, we can confirm that both of the patients have human-to-human transmission characteristics," said Bao Changjun, a researcher with the center.

  "In spite of this, we found that the transmission capacity of the H7N9 virus is still very limited. Human-to-human transmission could only happen under some special circumstances," he said.

  The other 43 people who had close contact with the infected father and daughter include their family members, medical staff and other patients in the same hospital ward. None of them were infected by the virus.

  It is possible that the transmission had a genetic component, because the man's son-in-law was not infected after caring for him in the hospital, said Bao.

  The Chinese mainland has reported over 130 human infections with H7N9 including 43 that ended in death, mostly in spring, since the virus emerged in February. The latest case was a woman from north China's Hebei Province infected in July.

  China ended the emergency response to the H7N9 avian flu outbreak in late May.

  The country has been monitoring the situation and is preparing for any possible outbreaks in the coming autumn and winter, according to Deng Haihua.

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