Confirmed H7N9 Cases Increase To 33

Recombinomics Commentary 13:00
April 10, 2013

REVIEW: As of April 10, the Mainland has confirmed 31 cases of human infection with the H7N9 avian flu cases, including nine deaths. Located in the Yangtze River Delta region, 13 cases (5 deaths), Jiangsu 10 cases (one death), Zhejiang six cases (two deaths), Anhui 2 cases (1 death).
 
The above translation summarizes 31 confirmed H7N9 cases, which was obsolete just after posting.  Ttwo additional cases were reported in Shanghai (see map), increasing the number of confirmed cases to 33, which includes 9 fatal cases and 1 discharged case (case fatality rate of 90%).  This rate of increase is markedly higher than human H5N1 bird flu cases

The reporting of these cases is now following an easily discernible pattern.  The number reported slowly increases each day.  The WHO confirmed cases (currently 24 confirmed cases, 7 deaths), WHO tweets lag by one day (up to 28 confirmed), while local media has most current data (33 cases, 9 deaths, 1 discharged).

More recent reports have more cases described as mild or stable, but most are elderly and the total number is likely orders of magnitude higher, based on a 90% CFR and a majority of those hospitalized in critical condition.

The CDC has activated its Emergency Operations Center which is currently at level 2 (highest alert is level 1).  The number of H7N9 sequences remains at 4 human and 3 avian.  The six most recent sequences have H7 Q226L or L226I and the human PB2 sequences have E627K, which is not present in the avian sequences.

Although the reports out of China remain steady, the WHO continues to claim no sustained H2H transmission, which is based on limited testing of milder cases, and unreliable phone interviews to claim no H2H spread.

A realty check requires a confirmation outside of China.