The first H7N9 bird flu case was detected outside of China in Malaysia on February 12, according to health officials. In addition to seven newly confirmed cases in mainland China and one in Hong Kong, the total number of cases in the second wave added to 211.

In the first wave, which began in spring last year, 136 H7N9 cases were reported. Along with the 211 cases in the second wave, which began in October 2013, reported cases totalled 347. Unofficial death count stands at 72.

 

China's Guangdong province, one of the main hotspots of disease activity in the outbreak's second wave, is said to be the source of the infection, as patients who are infected with H7N9 in Hong Kong and Malaysia had travel links to the province.

 

Malaysia's patient, a 67-year-old woman, was visiting Sabah in a tour group from Guangdong province, according to a report by Bernama, Malaysia's national news agency. The woman is being treated in the intensive care unit at a private hospital in Kota Kinabalu. Malaysia's health minister, Datuk Seri Dr. S. Subramaniam said it was the first H7N9 case reported in the country and that health officials are taking steps to limit contact with the patient.

 

In Hong Kong, fifth and latest H7N9 infection was detected in a 65-year-old man who was exposed to slaughtered poultry on January 29th when he visited the city of Kaiping in China's Guangdong province. He showed symptoms while he was traveling and saw a doctor upon his return to Hong Kong on February 9th. He is in critical condition in an isolation unit, according to a Centre for Health Protection (CHP) statement. All five patients in Hong Kong have had travel links to China's mainland.

 

Seven of the man's family members in Hong Kong are asymptomatic, and five of them that are close contacts will be admitted to the hospital for observation and testing, the CHP said. Further investigations are under way into the man's travel and exposure history, and the CHP is working with mainland authorities to identify the man's contacts during his stay in Kaiping.

 

The seven latest H7N9 cases reported on mainland China include three from Guangdong province, three from Zhejiang, and one from Hunan, according to provincial health ministry reports in Chinese translated and posted by Avian Flu Diary (AFD), an infectious disease news blog, and FluTrackers, an infectious disease news message board.

 

Meanwhile, China's agriculture ministry reported five more H7N9 cases in poultry and their environments, according to report to the World Organization for Animal Health (OIE). These cases were found in four chicken in a livestock market in Guigang city in Guangxi, a province bordering Vietnam that recently reported two human cases; Zhuji city in Zhejiang province; one chicken in a live-bird market in Meizhou city in the Guangdong province; two chicken in a wholesale market in Zhuhai in Guangdong; and two chicken and a duck from a live-bird market in Yueyang city in Hunan province.

 

Of the three patients in Guangdong province, an 8-year-old boy is hospitalised in stable condition, while a 46-year-old male farmer and a 65-year-old male farmer, are both in critical condition. In Zhejiang province, all three newly-confirmed patients are adult male farmers, including an 84-year-old in critical condition, and a 58-year-old and 46-year-old both in severe condition. The patient from Hunan province is a 19-year-old man who is hospitalised.

 

The US Centre for Disease Control and Prevention (CDC) said Human infections in China linked to poultry exposure are likely to continue and that the virus could spread to people who are exposed to poultry in neighbouring countries. The CDC said the most important element in gauging the public health threat is transmissibility, and so far there is no evidence of sustained, ongoing person-to-person spread of H7N9, which would be a development of concern.

Other strains of the bird flu have also plagued other Asian countries in the region.

 

In Korea, 3.2 million chickens and ducks at 154 farms have been culled, according to the country's deputy minister of agriculture, food and rural affairs Lee Jun Won. Lee said poultry demand in South Korea has plunged by about 70% in the wake of the H5N8 avian influenza virus outbreak that emerged in January. No new outbreaks have been reported since February 6 and no human infections of H5N8 have been reported.

In at least six northern and central provinces in Vietnam, tens of thousands of chickens have contracted the H5N1 virus, Tuoi Tre News reported. Local authorities said more than 5,000 chickens and ducks in Duc Pho district of Quang Ngai province have died of the disease and about 3,000 of the birds have been incinerated. The disease has also been reported in two communes in the northern Quang Tri province, two districts in Kon Tum province; and at four communes in Quang Nam province.