In thelate afternoon of December 31, 2013, the H7N9 Central Epidemic Command Center(CECC) confirmed the second imported case of H7N9 avian influenza in a86-year-old male from Changzhou, Jiangsu, China. The patient was travelling to Taiwan during December 17-24 with a 25-member tourist group. He developed his illness on December 19 and was hospitalized on December 24 due to bilateral pneumonia and acute respiratory distress syndrome. On December 26, he was administrated oseltamivir. On December 27, a throat swab specimen was collected for laboratory test. The specimen was tested positive for avian influenza A (H7N9) virus by real-time RT-PCR at the National Influenza Center on December 31. He is currently in a severe condition and being treated at the Intensive Care Unit (ICU).

At the time of writing, except for 22 package tour members returning to China on December 24, CECC has obtained the list of 163 people who have come into close contact with the confirmed case, including his two daughters, a tour guide, a driver, healthcare workers (HCWs) and the patients staying at the same ward for investigation and follow-up activities. Thus far, only three HCWs developed mild symptoms of upper respiratory infection. They were issued with “Self-Health Management Advice for H7N9 Influenza”, and the public health authority will be following up with them closely until the period of voluntary contact tracing is lifted. On the other hand, additional 500 potential contacts have been under investigation as well. Although 6 of them have ever developed syndromes of upper respiratory infection, such as fever, cough, runny nose, sore throat, etc, 5 have relieved symptoms. When a contact develops influenza-like illness symptoms such as fever and cough, the public health authority will voluntarily assist the individual inseeking medical attention. Throat swab specimens takefrom the daughters, tour guide and 3 HCWs were tested negative for influenza virus.

CECC has reported the second imported case of H7N9 avian influenza to the World Health Organization (WHO) through the IHR National Focal Point. In addition, CECC hasalso informed the point of contact in Chinaof the event with the list of 22 package tour members returning to China, according to the Cross-Strait Cooperation Agreement on Medicine and PublicHealth Affairs.

Due to the fact that the threaten of H7N9 avian influenza infection has dramatically increased, CECC once again urges travelers visiting China to practice good personal hygiene such as washing hands frequently and putting on a mask, take preventive measures such as avoiding direct contact with poultry and birds ortheir droppings, avoiding visiting traditional markets with live poultry,consuming only thoroughly cooked poultry and eggs. If symptoms such as feverand cough develop after returning to Taiwan, please put on a surgical mask and seek immediate medical attention. Moreover, please inform the physician of the recent travel history to facilitate diagnosis and treatment. For more information, please call the toll-free Communicable Disease Reporting and Care Hotline, 1922, or 0800-001922 if calling from a cell phone, or visit the Taiwan CDC’s website at http://www.cdc.gov.tw.