On January 14, 2014, officials from the China Health and Family Planning Commission confirmed three new H7N9 influenza infections in Zhejiang Province and Fujian Province, indicating the risk and threat of H7N9 influenza transmission remain. Currently, the Taiwan Centers for Disease Control (Taiwan CDC) has issued a travel notice of Level 2: Alert for avian influenza to Guangdong Province, Zhejiang Province, Jianxi Province, Jiangsu Province, Hunan Province, Shanghai City, Beijing City and Fujian 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. Travelers visiting China are urged to practice good personal hygiene and avoid contact with poultry and birds.

Among the three newly confirmed cases, two patients are men aged 29 and 58 from Hangzhou City, Zhejiang Province and both were diagnosed on January 13 and are currently hospitalized with severe infections. The other patient from Quanzhou City, Fujian Province is a 58-year-old male who was diagnosed on January 14 and is currently hospitalized in critical condition.

Since October 1, 2013, a cumulative total of 41 H7N9 influenza infections, including 5 deaths, have been confirmed in China and Hong Kong. Among the cases, 16 were confirmed in Zhejiang Province, 15 were confirmed in Guandong Province, 3 were confirmed in Shanghai City, 2 were confirmed in Jiangsu Province, 2 were confirmed in Fujian Province, and 3 imported from Guangdong Province were confirmed in Hong Kong. On the other hand, since March 31, 2013, a cumulative total of 175 H7N9 influenza infections, including 52 deaths, have been confirmed in China and Hong Kong.

Since “H7N9 influenza” was listed as a Category V Notifiable Infectious Disease in Taiwan on April 3, 2013, thus far, a cumulative total of 490 suspected H7N9 cases have been reported to Taiwan CDC. Infection with avian influenza A (H7N9) has been confirmed in two imported cases. The possibility of H7N9 infection has been ruled out in 485 cases. The test results for 3 cases are still pending.

The Central Epidemic Command Center (CECC) for H7N9 influenza points out that since fall 2013, additional H7N9 cases have been confirmed in China. As a result, it can be inferred that the ongoing outbreak in southern China may be spreading. Travelers visiting China are advised to avoid visiting traditional markets with live poultry and direct contact with poultry and birds or their droppings/dead bodies. At the same time, physicians are reminded to reinforce inquiry about patients’ travel and contact history in order to facilitate diagnosis of H7N9 infection and notify any suspected cases to the health authority immediately to help implementation of subsequent measures that can prevent further transmission of the disease.

CECC for H7N9 influenza once again reminds travelers visiting China to practice good personal hygiene such as washing hands frequently and putting on a mask when coughing, 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 the above-mentioned 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 history to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922, or 0800-001922 if calling from a cell phone.