Influenza A(H7N9) virus: detection numbers and graphs...

This is a static page that houses my graphs of influenza A(H7N9) virus ("H7N9") numbers produced by the various Ministries of Health for the provinces and municipalities of China, Hong Kong's Centre for Health Protection (CHP) the World Health Organization and FluTrackers.

Please be aware that these numbers are in flux during the winter epidemic. They are a guide only.

There is also an accompanying map page which for now is located here.

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Reminders: 

• The graphs above, as with all on VDU, are made for general interest only. They are also freely available for anyone's use, just cite the page and me please. The data can be downloaded by clicking on the "Download" link at the bottom-right of each dashboard. It may be that I have misinterpreted the language in the reports (sometimes a little tricky to wade through) or miscalculated some totals based on the way data have been presented.
• In any outbreak, epidemic or pandemic caused by a know or emerging pathogen, the numbers presented publicly, and used in these graphs, are expected to represent only a fraction of all the cases that have and are occurring. This is just the nature of the imperfect biological'ness of these events.
• I am only able to plot what is publicly available-you could do this too. No secret associations or back-room deals provide me with these data.

Tracking virus-related deaths using publicly available data...

Click on image to enlarge.

Here's the cumulative case chart overlaid with the cumulative deaths and PFC. see the story behind the term PFC here, created by VDU to avoid issues around case fatality rate/ratio (CFR) which relies on knowing when cases have recovered.

I have two PFC values charted here. In black dots, is my curated list based on fatal cases (n=40; red dots) that have been announced publicly. 

In yellow are the numbers gleaned from media releases and the WHO - the latest number being 52 fatal H7N9 outcomes. 

Somewhere towards the end of the initial H7N9 outbreak in May, we stopped seeing reports from China that could link fatal cases with those H7N9 cases they initially announced. If anyone knows of a complete public list of fatal H7N9 outcomes that contains all 52 cases with age/sex/date of illness onset/date of death/province, I would be most grateful to be made aware of it.

A note on case fatality risk, rate or ratio (CFR)

..used in a couple of charts on the H7N9 page. This uses numbers based on very limited testing, publicly available data, recovered case numbers or understanding of the acquisition, transmission and clinical presentations associated with avian influenza A(H7N9) virus. 

It is very early days yet however I think this number gives you an idea of our understanding at the moment. It will undoubtedly change in the coming days, weeks and years. To be pedantic, the CFR relies uses the number of discharges/recovered cases as the denominator for the CFR. However, that will sensationally inflate the result. 

The CFR is often considered most useful at the end of an epidemic/pandemic, but less so when data-in-hand is limited such as during the early days of many outbreaks. Keeping in mind that some will take the CFR and multiply it by the world's population as an estimate of how many would die if the virus reached pandemic levels, I don't believe that approach is the best way to present the CFR metric for the emergence of a novel virus (usually first identified by the worst of the clinical presentations that will eventually be attributed to the virus). 

You won't see that usage on VDU, you will see the "rolling" version though. The US CDC definition is useful here.