中国-世界卫生组织人感染H7N9禽流感联合考察组通报稿

中华人民共和国国家卫生和计划生育委员会 

 　　早上好！感谢各位出席今天的通报会。

　　大家都知道，受中国国家卫生和计划生育委员会的邀请，由世界卫生组织召集的国际专家与中方专家共同组成联合考察组，对中国人感染H7N9禽流感疫情形势进行评估，并就疫情防控工作提出建议。

　　考察组由卫生计生委和世卫组织共同领导，由国际和国内流感流行病学、病毒学、临床等领域专家组成。

　　4月19日-23日，我们在上海考察了实验室、医院、诊所、活禽市场，与北京和上海的专家进行了公开和坦率的交流和讨论。非常高兴和大家分享我们的发现。
首先，中国政府的应对工作给我们留下了深刻印象。在中国政府的坚强领导和高度重视下，应对了这起由新型流感病毒引起的严重疾病暴发，所采取的健康教育、沟通和关闭活禽市场等措施得力有效。

　　卫生部门准备充分，反应迅速、有效、专业。在中国国内，并根据《国际卫生条例》通过世卫组织与国际社会分享病毒基因序列等信息和毒株。

　　联合考察组在上海考察了活禽市场和报告病例的居住环境。根据现有证据，病毒所感染的鸟类、特别是禽类，以及病毒污染的环境是最可能的传染来源。感染风险主要集中在活禽市场。

　　几乎所有的病例属于散发，但是发现了个别家庭聚集病例。然而，还不能确定这种家庭聚集是共同暴露或者是有限的人传人所致。现有证据不足以证明发生了人传人。而且，也没有发现持续的人际传播。

　　需要指出的是，如果将来发生有限的人传人，也不足以为奇。要早期发现这种情况应加强监测。
　　形势仍然复杂、严峻，并且处于发展之中。世卫组织与中国将继续密切合作来抗击这一新威胁。
　　联合考察组对下一步人感染H7N9疫情防控工作提出以下建议：

　　一、有必要采取深入的、有针对性调查研究，以查明人间病例的感染来源、采取防止病毒继续传播的紧急措施、减少对人和动物潜在的严重健康威胁。

　　二、即使像其他许多禽流感病毒一样，人感染H7N9禽流感病毒导致的人感染病例在夏季可能会减少，也必须对H7N9病毒保持高度的警觉，充分准备、有效应对，因为该病毒带来的风险严重，且许多基本信息尚不明确。

　　三、十分有必要在中国所有省份开展并加强对人和动物的流行病学与实验室监测，以发现病毒的跨区域播散和病毒感染人能力的变化。

　　四、H7N9禽流感病毒的威胁需要卫生、农业、林业部门间联合应对，确保卫生计生委、农业部和林业局间信息及时互通共享、密切交流，并根据需要协调和开展联合调查研究。

　　五、H7N9禽流感病毒是全球共同面对的威胁和共同关注的问题，因而有必要继续保持与世界卫生组织和国际伙伴的高层科学合作、信息交流，共享毒株和基因序列。

　　六、有必要鼓励开展流行病学科学研究，从而提升对疾病的认知和理解。
最后，有必要继续开展应对准备和加强国际卫生条例要求的其他核心能力建设，因为这种投入在应对包括H7N9在内的卫生安全风险和紧急情况方面可以起到重要作用。谢谢。

OPENING　STATEMENT

Good morning and thank you for your attendance today.

As you know, at the invitation of the China National Health and Family Planning Commission (NHFPC), a joint team of domestic and international experts convened by the World Health Organization were asked to assess the H7N9 situation in China and provide recommendations on the prevention and control of the disease.

The team, which is jointly led by NHFPC and WHO, is comprised of international and Chinese influenza experts in epidemiology, virology, clinical management, and other areas related to influenza.

During 19-23 April, we visited laboratories, hospitals, clinics, markets, and affected areas in Shanghai and had discussion with staff and experts from both Beijing and Shanghai.  We had open and direct exchanges and discussions with our counterparts in Beijing and Shanghai.  We would like to share some of our findings today.

First of all, we are impressed with the response by the Government of China.  China has responded to this serious outbreak caused by a new influenza virus with strong leadership and a high level of commitment, and sound and effective strategies such as health education, communication and closure of live poultry market. 

Health authorities were well prepared and acted quickly, effectively and professionally.  Information including genetic sequence data and virus were shared in a timely way within China and with the international community through WHO under the International Health Regulations.

The joint team visited poultry market and the neighbourhood in Shanghai where some infections were reported.  According to available evidence, birds infected by the virus, especially poultry, and the environment contaminated by the virus are the most likely sources of infection. The risk of infection appears most concentrated in live poultry markets.

Almost all cases have been sporadic cases, but a few family clusters have been identified. However, we are not sure if the clusters were caused by common exposure to a source of virus or due to limited person to person transmission.  Evidence so far is not sufficient to conclude there is person to person transmission. Moreover, no sustained person to person transmission has been found.

We want to note that if limited person to person transmission is demonstrated in the future, it will not be surprising. Enhancing surveillance is the way to early detect such occurrence.

The situation remains complex and difficult and is evolving. WHO will continue to work closely with China in combating this new threat.

For next steps to prevent and control H7N9, the joint mission team would like to make following recommendations.

First, it is important to undertake intense and focused investigations to determine the source(s) of human H7N9 infections with a view to taking urgent action to prevent continuing virus spread and its potentially severe consequences for human and animal health.

Second, it is critical to maintain a high level of alert, preparedness and response for the H7N9 virus even though human cases might drop in the summer, as occurs with many other avian influenza viruses, because of the seriousness of the risk posed by this virus and because much basic information remains unknown.

Third, it is critical to continue to conduct and strengthen both epidemiological and laboratory-based surveillance in human and animals in all Provinces of China to identify changes that might indicate the virus is spreading geographically and gaining the ability to infect people more easily.

Fourth, it is important to ensure that there is frequent two-way sharing of information, close and timely communications and, when appropriate, coordinated or joint investigations and research between ministries of health, agriculture and forestry because this threat requires the combined efforts of these sectors.   

Fourth, it is important to continue high level scientific collaborations, communications and sharing of sequence data and viruses with WHO and international partners because the threat of H7N9 is also an international shared risk and concern.

Fifth, it is important to encourage and foster the scientific and epidemiological studies and research needed to close major gaps in critical knowledge and understanding

Last but not the least, it is important to continue preparedness planning and other IHR core capacity strengthening work because such investments make major differences in being ready to address health security risks and emergencies, including H7N9. 

Thank you.