Random Analytics: H7N9 Infographics (to 22 Jul 2013)

by Shane Granger

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 21 Jul 2013 CET/EST *****

1 - H7N9_Infographic_130721

Infographic Details

There have been 134-cases reported in China, 43 of which have resulted in death. Although originating in Jiangsu there is one case reported in Taiwan without loss of life (my case numbers include known asymptomatic cases). The most recent onset confirmation occurred on 10 July in Hebei Province. The previous onset confirmation was 59-days previously from Beijing. The last fatality confirmation was on the 26 July via Xinhua.

To date 31.9% of all known cases have been fatal, close to a 1/3rd of all cases. For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health and Chinese media confirmed that to 10 July there were 85 patient discharges which equates to a Case Recovery Rate of 63% (with every chance for a slight improvement). Asymptomatic cases remain at one (0.7%).

2 - CasesbyRegion_130722

Cases by Region (including Taiwan)

The case numbers presented here are correct to 20 July 2013 and include 135 known H7N9 victims. Although there have been 43 confirmed deaths to date I have only been able to verify 31 case fatalities. A recent Jiangsu study noted eight deaths to the 27 May (only four have been confirmed via a case fatality notification). Shanghai’s high Case Fatality Rate includes 16 confirmed case fatalities, the latest update via Xinhua was released 26 June.

Note: This infographic was created using Tableau Public.

Thoughts by Crawford Kilian

It’s one thing to analyse data and to draw a picture from it but you get real impact when you have more than analytical inputs to go by. Crawford Kilian’s comments and local knowledge via his H5N1 blog were just too good to not include in this piece. Here are his thoughts:

“The map in Shane’s post is a reminder that this weekend’s case is an outlier, geographically as well as seasonally. Hebei province almost surrounds Beijing, and if memory serves, that’s where the father of Beijing’s first case purchased the birds he hoped to sell in the capital.

Langfang, the city where the 61-year-old woman contracted H7N9, is no rural backwater. Wikipedia tells us that it has a total population of 3.85 million. An hour’s drive southeast of the Beijing airport, it’s part of the Beijing-Tianjin corridor, with no fewer than 30 universities and an economy based on computer technology. Another city in the corridor is Tangshan, which in 1976 suffered a catastrophic earthquake that effectively ended the Maoist regime and paved the way for over 30 years of explosive economic growth that changed the world.

My point is that the poor woman in critical condition in Chaoyang Hospital is not some faceless nonentity; she’s a real live human being, as real as everyone living between, say, New York and Boston or Seattle and Vancouver, or Riyadh and Jeddah. If she dies it will be a real death, not just a pixel or two winking out on a screen.

She does have some advantages, including a medical system primed and ready for her (imagine the panic if an H7N9 case turned up in Los Angeles or London). But she is still just a real human being. Statistically she may be one of the unluckiest people on the planet, but she’s a real person with a name and a family, and that is why we should all care about her fate.”

Final Thoughts

With infinite patience I’ve been awaiting the final case details of the H7N9 outbreak that commenced in mid-February and looked to have quietly disappeared in late April. Chinese and World Health Organisation media sources, so free with basic information at the start of the outbreak went quiet as the cases of H7N9 decreased. At the same time cases of Middle East Respiratory Syndrome (MERS-COV) increased with a seemingly higher Case Fatality Rate (CFR), multiple source countries and scratchy reporting diluting attention from the much diminished H7N9.

Humanity has a great capacity for curiosity but it also can as easily get side-tracked or bored and lose focus on events if they move back into the shadows.

H7N9 hasn’t gone away and the latest onset, during the Northern Hemisphere Summer is a timely reminder.

Note: Bored with flublogia? Read my updated analysis and analytics of Ebola Random Analytics: Ebola (2013)!

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Note: If you are interested in getting a daily feed on this and other interesting related topics (such as the MERS-COV outbreak) then I would recommend you follow Crawford Kilian or read his H5N1 blog. If you are interested in more detailed analysis of H7N9 (and other viruses) from a medico rather than an analyst then I would recommend my fellow Queenslander Dr Ian M Mackay and his Virology Down Under blog.

Update (28/05/2013)

  • Updated main infographic with four additional recoveries and one confirmed death as reported by Xinhua.

Update (29/05/2013)

  • Updated main infographic and Map with additional Beijing case as reported by Xinhua.

Update (15/06/2013)

  • Updated main infographic with additional two deaths and one recovery as reported by Xinhua.

Update (21/07/2013)

  • Updated main infographic & map with additional case as reported by CHP and H5N1.

Update (22/07/2013)

  • Updated map with additional four verified Jiangsu fatalities via CIDRAP update.
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