On 31 March 2013, the Chinese health authorities announced that they identified a novel influenza A(H7N9) virus in three seriously ill patients. As of 9 April 2013, 26 human cases of infection with influenza A(H7N9) virus have been reported in four provinces of China: Shanghai (13), Jiangsu (8), Zhejiang (3) and Anhui (2). Of these patients, 8 people have died, 15 are severe cases and 3 are mild cases. No epidemiological link has been identified among cases. The source of these infections and the mode of transmission are yet to be determined. This is the first time that human infection with influenza A(H7N9) virus has been identified. No vaccine is currently available for this subtype of the influenza virus. Preliminary test results suggest that the virus is susceptible to the neuraminidase inhibitors (oseltamivir and zanamivir).

1. http://www.ecdc.europa.eu/en/press/news
ECDC Portal > English > Media Centre > News
Epidemiological update of 10 April: novel influenza A virus A(H7N9) in
China
10 Apr 2013
On 31 March 2013, the Chinese health authorities announced that they identified a novel influenza A(H7N9) virus in three ECDC
seriously ill patients.
As of 9 April 2013, 26 human cases of infection with influenza A(H7N9) virus have been reported in four provinces of China:
Shanghai (13), Jiangsu (8), Zhejiang (3) and Anhui (2). Of these patients, 8 people have died, 15 are severe cases and 3 are mild
cases. No epidemiological link has been identified among cases.
The source of these infections and the mode of transmission are yet to be determined. This is the first time that human infection
with influenza A(H7N9) virus has been identified.
No vaccine is currently available for this subtype of the influenza virus. Preliminary test results suggest that the virus is susceptible
to the neuraminidase inhibitors (oseltamivir and zanamivir).
At this time, there is no evidence of on-going human-to-human transmission. More sporadic cases are expected to be reported.
The risk of disease spread to Europe is considered low, although individual cases coming from China cannot be ruled out.
ECDC is working closely with WHO and the European Commission and will continue to monitor the situation.
ECDC agrees with the position of WHO and other Centres for Disease Control (the United States and Chinese CDC) that there is no
need to change travel plans for persons going to or coming from China because of the recent appearance of a novel avian
However, ECDC is repeating its standing advice to European citizens living in or visiting China that because of the presence of the
novel influenza viruses, other avian influenza and zoonotic infections in live bird and animal markets (so called wet markets ) in
China and other countries in Asia should avoid visiting these markets. Direct contact with bird and animal faeces, untreated bird
feathers and other animal and bird waste should also be avoided. In addition, basic rules of hand hygiene should be followed
including regular hand-washing and use of alcohol-based hand rubs. This is the same advice ECDC has had in place since 2006.
This epidemiological update does not change the conclusions and recommendations of ECDC s Rapid Risk Assessment of 2 April
2013.
Figure 1: Distribution of influenza A(H7N9) cases by date of onset of symptoms, age, gender, status and province
in China, as of 9 April 2013 (n=26).
Date of
Age Sex Status Severity Province
onset
19/02/2013 87 M dead severe Shanghai
27/02/2013 27 M dead severe Shanghai
07/03/2013 38 M dead severe Zhejiang
15/03/2013 35 F alive severe Anhui
19/03/2013 45 F alive severe Jiangsu
19/03/2013 48 F alive severe Jiangsu
20/03/2013 83 M dead severe Jiangsu
20/03/2013 61 F alive severe Jiangsu
21/03/2013 32 F alive severe Jiangsu
21/03/2013 79 M alive severe Jiangsu
22/03/2013 67 F alive severe Shanghai
25/03/2013 67 M alive severe Zhejiang
25/03/2013 59 M alive severe Shanghai
27/03/2013 52 F dead severe Shanghai
28/03/2013 48 M dead severe Shanghai
28/03/2013 74 M alive severe Shanghai
28/03/2013 55 M alive severe Anhui
28/03/2013 85 M alive severe Jiangsu
29/03/2013 64 M dead severe Zhejiang
29/03/2013 66 M alive mild Shanghai
29/03/2013 67 M alive mild Shanghai
30/03/2013 25 F alive severe Jiangsu
31/03/2013 4 M alive mild Shanghai
01/04/2013 64 M dead severe Shanghai

2. 01/04/2013 62 M alive severe Shanghai
01/04/2013 77 M alive severe Shanghai
Figure 2: Distribution of influenza A(H7N9) cases in China by week of onset of symptoms, as of 9 April 2013 (n=26).
February to 9 April 2013.
Read more:
ECDC Rapid Risk Assessment Severe respiratory disease associated with a novel influenza A
virus, A(H7N9) China, 2 April 2013
Epidemiological update 9 April 2013: Novel influenza A virus A(H7N9) in China
Epidemiological update 5 April 2013: Seven new confirmed cases of novel influenza A virus, A
(H7N9) in China
Epidemiological update 3 April 2013: Six new confirmed cases of novel influenza A virus, A
(H7N9) in China

3. External links:
WHO: question and answers on human infection with influenza A(H7N9) virus, China (updated
5 April 2013)
Chinese Center for Disease Control and Prevention: question and answers about human
infection with A(H7N9) avian influenza virus (published 31 March 2013)
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European Center for Disease Prevention and Control (ECDC) 2005-2013
http://www.ecdc.europa.eu