First Taiwan, then Hong Kong, now Malaysia becomes a holiday destination for an H7N9 case...[UPDATED x2]

Mike Coston has just made us aware via a Tweet that avian influenza A(H7N9) virus has escaped its usual roosting ground in southern eastern China by hitching a lift in a tourist to Malaysia. 

A more detailed post on his Avian Flu Diary wrangles the issue of language very nicely and tells us that the infected Chinese tourist has been hospitalized and is currently in a stable condition. 

Brief details..

• 66-year old female
• Fever, 01-Feb prior to leaving China
• Travelled from Guangzhou City in Guangdong province to Peninsular Malaysia 04-Feb then to Sabah, Malaysian Borneo 06-Feb then to Kota Kinabalu
• Hospitalised 07-Feb in Kota Kinabalu, Sabah, Malaysia 
• Laboratory confirmed 11-Feb and remained positive 13-Feb and 22-Feb
• No sign of R294K (N9 numbering) mutation associated with oseltamivir resistance despite virus "persistence" wihc may have been related to treatment with steroids
• 191 contacts; 6 were symptomatic but tested negative for H7N9

It is worth highlighting here that this sort of export is not unexpected and not even surprising. We live in a hyper-connected world. It's nigh on impossible to stop respiratory viruses from spreading. This case highlights that even when we're ill, we still feel the pressure to continue on with our jobs, our daily routine or our holiday. After all, we've all been a bit crook before and it has mostly been nothing much to speak of. Why should this time be any different? 

To date, H7N9 does not jump easily between humans as far as we know. The 20 negative contacts stand in testimony to that. But if you see some articles or posts or Tweets in the coming hours and days which suggest that the sky is falling...I think you can rest assured that this is not it falling. 

Not yet anyway!  

Now, go follow Mike via @Fla_Medic if you are not already.

Sources...

1. http://afludiary.blogspot.com.au/2014/02/malaysia-reports-their-1st-imported.html
2. Right-click and use Google translate (in Chrome at least)
   http://www.moh.gov.my/index.php/database_stores/store_view_page/21/479
3. Xinhua story
   http://news.xinhuanet.com/english/health/2014-02/12/c_133110102.htm
4. Avian Influenza (H7N9) Virus Infection in Chinese Tourist in Malaysia, 2014. EID. Jan 2015.http://wwwnc.cdc.gov/eid/article/21/1/14-1092_article