WHO On Guangdong H7N9 Cluster In Sanjiaozhen – 37M & 2F
February 3, 2014
A 37 year-old man from Zhongshan City, Guangdong Province, who became ill on 26 January and was admitted to hospital on 29 January and then transferred to the another hospital on 30 January. He is in a critical condition. He has a history of exposure to a live poultry market.
A 2 year-old female from Zhongshan City, Guangdong Province, who became ill on 31 January and was admitted to hospital on the same day. She is currently in a mild condition. The patient has a history of exposure to live poultry and a live poultry market.
The above comments from the WHO February 4 and February 5 updates on H7N9 bird flu cases once again defines a cluster with a significant gap in disease onset date (5 days for the above cluster) and generates the same pattern showing the adult (who is the child’s father, as noted in multiple media reports) in critical condition due to delays in admission and treatment, while the child is admitted on day 0, because she is being monitored because her father has already been H7N9 confirmed. Her clinical presentation is mild because she was being observed when she developed symptoms, which is why the children in the series of recent clusters have been mild or stable, while their parents have been severe or critical.
This cluster from Sanjiaozhen in Zhongshan City in Guangdong Province is a concern, because the recently confirmed cluster in Hengxian, Guangxi (involving a mother, 41F and son, 5M) was imported from Zhongshan City.
Like the above WHO description of the Sanjiaozhen cluster and the Guangdong DoH description of the same cluster, the Guangxi DoH report did not note that the confirmed cases had a parent / child relationship, even though multiple media reports confirmed the father / daughter (37M/2F) relationship for the above cluster, as well as the mother / son (41F / 5M) relationship for the Guangxi cluster.
The withholding of these relationships by WHO and local provincial health departments in China continues raise serious pandemic concerns, which are exacerbated by frequent media reports citing scientists claiming that the human to human transmissions in the cluster are due to bird exposures.