Avian Influenza (H7N9) in China
The Department of Health has issued important information for GPs regarding the Avian flu virus A(H7N9). As of 28 January 2014, 238 cases, including 55 deaths, have been reported in China (including Hong Kong) and Taiwan. H7N9 is a reassortant derived from three different avian influenza viruses. This strain is distinct from the H1N1/09 swine influenza (that caused the 2009 pandemic in humans) and H5N1 avian influenza. There is currently no evidence of sustained person-to-person transmission of H7N9 influenza.
With Chinese New Year recently being celebrated, it is anticipated that during February there will be an increase in the number of incoming passengers to Australia from China. Given the steady increase of confirmed H7N9 cases since 1 January 2014, there is a possibility of cases of H7N9 presenting in Australia.
Most of the cases of H7N9 to date have presented with a severe acute febrile lower respiratory tract illness (with severe pneumonia and/or Acute Respiratory Distress Syndrome (ARDS)) although mild cases have been reported. Common causes of pneumonia and influenza should be assessed through routine investigation and testing for community acquired pneumonia and influenza, as these remain much more likely than H7N9 infection even in persons returned from China.
GPs assessing patients recently returned (less than 7 days) from China (including Hong Kong) or Taiwan who present with acute febrile lower respiratory tract infections will find further advice on the Department of Health website. Although no sustained person-to-person transmission of H7N9 has been reported, a cautious approach to infection control has been recommended:
- Ask the patient to wear a surgical face mask, if tolerated, and to follow respiratory hygiene and cough etiquette.
- Isolate the patient from other patients and staff (at least 1 metre) in a separate area, including minimising time spent in your waiting room.
- Ensure staff who come in contact with suspected cases take standard infection control precautions such as hand-washing and wear appropriate personal protective equipment.