Introduction to the Prevention and Control of Human Infection with H7N9 Avian Influenza

Recently, there were confirmed human infections with Influenza A(H7N9) virus in Shanghai Municipality, Jiangsu, Anhui and Zhejiang Province. As of 24 Hours April 7, this Commission has been notified of a total of 21 human cases. Among them, there are 10 cases in Shanghai (4 cases of death), 6 cases in Jiangsu, 2 cases in Anhui, and 3 cases in Zhejiang (2 cases of death). The above cases are distributed in a sporadic manner, and there is no epidemiological link found. Currently the situations of 621 close contacts are closely followed, and no abnormal symtoms have yet been found.

The Party Central Committee and the State Council attached great importance to the epidemic. General Secretary Xi Jinping, Premier Li Keqiang respectively made important instructions on patient treatment and epidemic prevention and control. Deputy Premier Liu Yandong convened two meetings to make arrangements on the epidemic control. This commission, jointly with relevant departments and local governments, is earnestly implementing the instructions of state leaders, including treatment of patients, infection source investigation, epidemic surveillance and control, timely release of information, publicity and health education in order to contain the spread of disease and safeguard health and security of the people.

Work has been done is as follows: First, approved by the State Council, a joint prevention and control working mechanism on Influenza A(H7N9) has been established. It was led by this Commission with participation of many other relevant departments. This mechanism will, as a whole, guide and coordinate all related departments and regions to implement the prevention and control measures, and organize supervision and inspection to the prevention and control work. In the meantime, a leading working group on Influenza A(H7N9) was established with this Commissionin to coordinate epidemic prevention and control in the national health system.

Second, we made our utmost in patient treatment. In order to guide patient diagnosis and treatment, this Commission developed and distributed protocols of patient diagnosis and treatment as well as hospital infection, sent experts to guide local work, and conducted training to health care workers. Health authorities of those places with reported cases set up medical treatment expert groups, pooled quality medical resources in designated hospitals to strengthen patient treatment.

Third, we actively conducted infection source investigation and situation analysis. Experts strengthened the pathogenic and epidemiological research to track the possible mutation of the virus. Animal epidemic monitoring has been strengthened by the agricultural sector. According to the information of the Ministry of Agriculture, at present, the agricultural sector has detected H7N9 avian flu virus in pigeons, chickens and environmental samples. In the meantime, through various channels, we collected related information, organized experts to analyse and assess the public health risks and put forward recommendations on prevention and control work.

Fourth, we implemented the prevention and control measures. According to the principle to “hlighting the priority and providing differentiated guidance”, we strengthened work in the following areas: surveillance of pneumonia cases of unknown origin and influenza-like illness, epidemiology investigation, management of patients and close contacts, and hospital infection control. The Chinese Center for Disease Prevention and Control developed and distributed virus diagnostic reagents to all provincial CDCs and those prefecture-level CDCs with confirmed cases. At the same time, this Commission strengthened emergency duty work to make sure the epidemic reporting system functional. On April 5, this Commission sent working groups to Shanghai, Jiangsu, Zhejiang, and Anhui to guide the local implementation of prevention and control measures.

Fifth, we released information in a timely manner in accordance with the law and actively promoted health education. We released the epidemic information in a timely manner to the public. We organized expert interviews, released Q&A on epidemic prevention and control knowledge, gave full play to the role of the 12320 health hotline, disseminated extensive knowledge of disease prevention and control, and settled concerns of the public.

Sixth, we strengthened international cooperation and communication. According to the requirements of the International Health Regulations (2005), we notified the confirmed cases in a timely manner to the World Health Organization, Hong Kong, Macao and Taiwan regions and relevant countries. We accepted field visits of foreign experts. We also provided H7N9 avian influenza virus strains to the World Health Organization.

According to the current investigation and research results, the experts believe that the H7N9 avian flu virus is a new reassortant virus which evolved from birds. Currently cases are distributed in a sporadic manner and there is no evidence of human-to-human transmission. At present, due to the limited knowledge of the disease etiology characteristics and epidemic features, there is still some uncertainty in the epidemic prevention and control work.

For the next-step, this commission will conscientiously implement the decisions of the Party Central Committee and the State Council, place people's health and security in the first place, adhere to the principle of “scientific, regulated and unified prevention and control according to law”, highlight priority, give differentiated guidance and conduct prevention and control in a scientific manner. First, give full play to the role of the joint prevention and control working mechanism and the expert groups in close collaboration with other departments, regions to ensure the prevention and control measures in place. Second, continue to strengthen epidemic situation analysis, collect and analysis the domestic and foreign related research progress and results, conduct dynamic risk assessment, develop prevention and control strategies and measures in a scientific manner. Third, continue to make efforts in patient treatment. In accordance with the requirements of “early detection, early reporting, early diagnosis, early treatment”, we will improve the early detection capacities of medical institutions, especially those at the primary level. With the principle of “pooling experts and resources to treat patients in designated hospitals”, we will strengthen the clinical treatment of severe cases, reduce death as much as possible, and resolutely put an end to delayed treatment due to high cost. Fourth, continue to strengthen the epidemic surveillance focusing on the unexplained pneumonia and influenza-like illness, strengthen the close contact tracing and management and hygiene management of the places with reported cases. Fifth, continue to release the epidemic information in an open and transparent manner and respond to social concerns in a timely manner. At the same time, we will further strengthen technical communication and cooperation with World Health Organization and other relevant international organizations, countries and regions.