Late Wednesday afternoon, the New England Journal of
Medicine published the first epidemiological report of
the H7N9 outbreak in China. To date, the new bird flu strain hassickened
108 people and killed 22; Taiwan has also reported the first case outside of mainland China, a
53-year-old man who recently visited Suzhou and Shanghai (both H7N9 hotspots).
The report covers up to April 17, at which
point there were 82 confirmed cases and two suspected cases, and it is
chock-full of numbers and statistics. Here are some of the highlights:
63 is the median age of confirmed cases. 73 per cent are
male. 86 per cent live in urban areas.
76 per cent of patients have underlying medical conditions
59 patients -- 77 per cent of the total -- were
recently exposed to animals: 76 per cent to chickens, 20
per cent to ducks, seven per cent to swine. Two reported
exposures to cats and one to a dog; six said
they encountered wild birds and one was exposed to a pet bird.
Four patients worked as poultry workers, three slaughtered
poultry at live markets andone transported poultry
Seventeen patients and one suspected case died of acute respiratory distress
syndrome or multiorgan failure a median of 11 days after
becoming sick.
Among 23 patients where
detailed histories could be collected, the median incubation period for the
virus was six days.
There have been three family
clusters in two provinces, but only detailed information fortwo of
them. In the first family, a man visited a live poultry market and observed the
slaughter of a chicken which he purchased, cooked and ate two weeks before
getting sick; in the second family, a man visited a live poultry market seven
days before becoming ill.
Among 81 patients with
available data, the median time from the onset of illness to the first medical
visit was one day; the median time between getting sick and being
hospitalized was 4.5 days.
As of April 17, investigators had detailed
information on 678 close contacts of the confirmed patients. 62
per cent were health care workers, 20 per cent were
relatives, 18 per cent were social contacts. Respiratory
symptoms developed in 19 people who had contact with an H7N9
patient, including 15 health care workers and one
medical intern;zero tested positive for H7N9.
The mortality rate for H7N9 is 21 per
cent (although the rate will be lower if expanded surveillance efforts
find more people who are asymptomatic cases).
Jennifer Yang is the Star’s global
health reporter. She previously worked as a general assignment
reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining
disaster. Follow her on Twitter: @jyangstar
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