On March 31, 2013, the China Health and Family Planning Commission announced three cases of human infection with influenza A(H7N9), including two deaths and one in critical condition. Some of the cases have been exposed to poultry prior to disease onset. Investigations thus far have found no epidemiologic links between the three patients. In light of the human H7N9 infections in China, the Taiwan Centers for Disease Control (Taiwan CDC) has reinforced quarantine activities at airports and seaports and strengthened fever screening of travelers arriving from China, Hong Kong and Macau. Anyone with a fever who has traveled to China during the past ten days and been exposed to poultry will be rushed to a hospital for further examination and treatment till the possibility of avian influenza infection is ruled out. Further, Taiwan CDC has also notified the healthcare sector to report any severe pneumonia of unknown origin, clusters of pneumonia, pneumonia of unknown origin among healthcare professionals to the health authority. Taiwan CDC reminds travelers visiting China should take preventive measures such as avoiding direct contact with poultry and birds or their droppings, consuming only thoroughly cooked poultry and eggs, and washing hands frequently. If symptoms as described above develop after returning to Taiwan, please put on a mask and seek immediate medical attention. Moreover, please inform the physician of the travel history to facilitate diagnosis and treatment.

The two patients who died were from Shanghai: an 87-year-old man who developed the disease on February 19 and died on March 4 and a 27-year-old man who developed the disease on February 27 and died on March 10. The third patient is a 35-year-old woman from neighboring Anhui province who developed the disease on March 15 and is currently hospitalized in critical condition. The Chinese Center for Disease Control and Prevention (China CDC) laboratory confirmed the cases on March 29. All three cases developed symptoms of respiratory tract infection, including fever and coughing, with progression to severe pneumonia and breathing difficulties. As of now, no epidemiological link between the three cases has been identified.

According to the surveillance data compiled by the agriculture authorities, H7N3 and H7N7 are the dominant avian flu virus strains in Taiwan. No H7N9 has ever been previously isolated in birds in Taiwan. From October, 2012 till now, Taiwan CDC has tested specimens from three thousand over cases of influenza-like illness and none was tested positive for H7N9. In addition, during the same period, specimens from 136 cases of pneumonia of unknown origin have been tested. Of the cases, H3N2 was identified in three cases and H1N1 was identified in one case. No cases were found to be positive for H7N9.

For any questions or further 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.