First Confirmed Case of Imported H7N9 Reported in Taiwan; Nationals are Reminded to Maintain Good Personal Hygiene when Traveling to H7N9 Affected Regions, Refrain from Contacting or Feeding Live Poultry, and Avoid Going to Traditional Market with Live Poultry 


The Epidemic Command Center confirmed one imported case of influenza A (H7N9) in the evening of April 24. The case is a 53-year-old Taiwanese male who worked in Suzhou, Jiangsu before the onset. He fell ill three days after returning to Taiwan, and the lab test result was confirmed on April 24. The patient is now in severe condition, and has been receiving treatment in the intensive care unit under negative pressure isolation. 

Minister of Health Chiu Wen-ta and Commander Chang Feng-yee have both gained a good grasp of the epidemic situation, and given directions for relevant handling procedures and actions. The Command Center has already reported to the WHO via IHR, and informed the correspondence unit of the mainland China in accordance with the Cross-strait Cooperation Agreement on Medicine and Public Health Affairs. 

The Command Center revealed that the patient is a Hepatitis B carrier with hypertension problems. He works in Suzhou, Jiangsu and has been traveling between Suzhou and Taiwan on long-term basis. The patient traveled to Suzhou from March 28 to April 9, and returned to Taiwan from Shanghai on April 9. The patient reported no history of poultry contact during his stay in Suzhou and consumption of not fully cooked poultry or eggs. Symptoms including fever, night sweating, and fatigue started to appear on April 12, but with no respiratory tract or gastrointestinal tract symptom. He went to a clinic for medical consultation on April 16 due to high fever, and was referred to a hospital for emergency care. He then was admitted to a single ward, and Tamiflu has been prescribed since April 16. Interstitial infiltration at lower right lobe was shown in chest X-ray on April 18. He was then transferred to a medical center on April 20 because of deteriorated condition at the night of April 19, and was intubated and admitted to the intensive care unit for negative pressure isolation due to respiratory failure. Meanwhile, two specimens taken by throat swab were sent for H7N9 test but showed negative results. In the morning of April 24, a sputum specimen was taken again by RT-PCR, which showed positive result for H7N9 test. In the evening of April 24, the case was confirmed by the National Influenza Center on the basis of genetic sequencing result. 

The Command Center also emphasize=+0d that the patient and people in contact with him have been identified; people in contact totaled 139, including 3 in close contact, 26 in ordinary contact (7-day incubation period has passed) and 110 medical care workers. Among them, 4 of the medical care workers have passed the incubation period (with no symptom shown), and only 3 of them have not worn appropriate protective gears (no symptom has been shown to date, and will be followed up until April 27). Besides, when carrying out medical care work, 3 medical care workers who have worn appropriate protective gears showed upper respiratory tract symptoms. Public health workers have given comprehensive health education and issued the Notification of Health Self-management for H7N9 for all those in contact with the patient; they are required to take the initiative to keep track of their own health until their placement under control is relieved. Once influenza-like symptoms such as fever, coughing, etc. appeared among those in contact with the patient, the public health workers will also provide active assistance for their medical consultation and treatment. 

The Command Center has continued to strengthen quarantine inspection for those who have a fever, cough, and have traveled to H7N9 affected regions in mainland China (Shanghai City, Jiangsu Province, Zhejiang Province, Anhui Province, Beijing City, Henan Province, and Shandong Province) within 7 days. The Center reminded doctors again that such patients should be reported within 24 hours as regulated by law. For unconfirmed cases, severe cases should be treated in isolation at a local hospital, while mild cases may be placed under health self-management after having specimens taken at a hospital, but patients should wear a mask and be given appropriate health education. Judgment should also be made on the prescription of anti-influenza agents. Once a H7N9 case is confirmed, isolated treatment in a suitable hospital should be given after the Commander’s evaluation. 

The Command Center appeals again: Taiwan nationals going to H7N9 affected regions in mainland China should maintain good hygienic habits such as washing hands frequently and wearing a mask, should not touch and feed birds or poultry, should avoid going to traditional markets with live poultry, and should eat only fully cooked poultry and eggs. After returning to Taiwan, if symptoms such as fever, coughing, etc. appear, consult a doctor immediately with a mask put on, and inform the doctor of your travel history. The latest updates about the epidemic and information about travel-related diseases are available at the “H7N9 Flu” page and “International Travel Info” page of the Center for Disease Control website (http://www.cdc.gov.tw). Alternatively, citizens may also call the toll-free reporting and care hotline 1922, or 0800-001922 disease prevention hotline if short-number calls cannot be made with your phone.