The ongoing H7N9 outbreak in China remains rampant and Yunnan Province has reported an H5N6-related death. As the winter and spring breaks are upon us, the Taiwan Centers for Disease Control (Taiwan CDC) urges travelers visiting China to heighten their vigilance for avian influenza and practice good personal hygiene and avoid contact with poultry and birds and consume only thoroughly cooked poultry and eggs in order to ward off infection.

In the evening of February 9, 2015, Yunnan Province announced the world’s third human H5N6 infection, which is also this year’s first H5N6 case, in a 44-year-old male. Prior to his disease onset, he had contact with wild poultry. On January 27, he developed symptoms. On February 3, he was hospitalized for medical treatment. On February 6, he died. Thus far, none of his contacts has developed suspected symptoms. The competent authority stated that the case is a sporadic case and there is no evidence of sustained human-to-human transmission. In response to the death, Taiwan CDC has raised the travel notice level for Yunnan Province to Level 2: Alert for avian influenza.

In addition, a total of 36 additional H7N9 cases were reported in China last week and most of the cases occurred in Fujian Province and Guangdong Province. The cumulative number of H7N9 cases and deaths reported in China in January 2015 are both lower than those reported during the same period in 2014. The competent authority stated that there has not been obvious fluctuation in the epidemic trend, most cases are sporadic, and there been has no sustained human-to-human transmission. Since October 1, 2014, a cumulative total of 131 H7N9 influenza infections have been confirmed in China, including 45 in Guangdong Province, 36 in Fujian Province, 18 in Zhejiang Province, 14 in Jiangsu Province, 8 in Xinjiang Uyghur Autonomous Region,3 in Shanghai City, 1 in Beijing City, 1 in Jiangxi Province, 1 in Shandong Province (imported from Jiangsu Province), 2 in Hong Kong (imported from Guangdong Province), and 2 in Canada (imported). Since March 31, 2013, a cumulative total of 584 H7N9 influenza infections, including 204 deaths, announced by WHO on February 6, 2015 have been confirmed in China (565), Hong Kong (12), Taiwan (4), Canada (2), and Malaysia (1). Currently, Taiwan CDC has issued a travel notice of Level 2: Alert for avian influenza to Xinjiang Uyghur Autonomous Region, Jiangsu Province, Zhejiang Province, Guangdong Province, Fujian Province, Shanghai City, Jiangxi Province, and Yunnan Province, and a travel notice of Level 1: Watch for avian influenza to the other provinces and cities in China, excluding Hong Kong and Macau.

Taiwan CDC once again urges travelers visiting China to practice good personal hygiene such as washing hands frequently and putting on a mask when coughing and take preventive measures such as avoiding direct contact with poultry and birds or their droppings/dead bodies, and consuming only thoroughly cooked poultry and eggs. If influenza-like illness symptoms develop upon arriving in Taiwan, please voluntarily notify the airline crew and the quarantine officer at the quarantine station in the airport. If symptoms such as fever and 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 and exposure history to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).