Situation Update

** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 15 October 2013, 1700 hours; Rome Overview Situation: Avian influenza A(H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 136 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 54 positive samples mainly from live bird markets and vendors FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 2 Zhejiang 2 0 8 0 10 Fujian 0 0 0 1 1 TOTAL 3 5 32 13 53 Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 8** 0 0 8 TOTAL 0 0 0 0 69 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html Humans . Zhejiang province: a 35-year-old man in Shaoxin County was diagnosed with H7N9 avian influenza and is in serious condition. This is the first human case reported since 10 August 2013. Diagnosis and virus characteristics . Study of H7N9 genetic diversity increases as more sequences become public. A recent study showed: i) H7N9 viruses exhibit diverse genotypes; ii) the first reassortment likely occurred in wild birds and second in domestic birds; and iii) more than one H9N2 virus was involved in the creation of H7N9. Despite its diversity, H7N9 can still be detected by the current, validated diagnostic reagents. . New isolates have been submitted to GISAID and GenBank / OpenFlu database: Host GISAID GenBank / OpenFluDB Chicken 34 25 Duck 2 2 Environment 15 14 Human 57 35 Pigeon 5 3 Total 113 79

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 15 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

. Initial experiments at SERPL show existing, inactivated vaccines and available seed strains can reduce virus shedding in vaccinated chickens. The homologous Chinese H7N9 virus is still the most effective at reducing shedding. FAO actions . FAO continues supporting a-risk countries with surveillance and preparedness for H7N9 incursion. . FAO assistance funded by USAID has supported the collection and analysis of nearly 10 000 bird and environmental swabs in South and Southeast Asia. No samples have tested positive. USAID continues supporting FAO activities in surveillance and preparedness, including compensation. . FAO is finalizing H7N9 surveillance and sampling schemes for South and Southeast Asia. . FAO launched TCP projects for SAARC and ASEAN regions at a participatory workshop on 18-20 September 2013: http://www.fao.org/asiapacific/rap/home/news/detail/en/?news_uid=197054 . FAO organized a USAID technical and policy meeting in Rome, 12–13 September 2013. . On 26 April FAO called for USD 35 million to support the new global framework on H7N9. . On 26 April FAO made public its new web portal on H7N9: www.fao.org/h7n9 . FAO guidance is online: risk management, surveillance, risk assessment and lab protocols Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . Ministry of Forestry of the People’s Republic of China: www.forestry.gov.cn . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . Latest WHO review: http://ow.ly/nQDA7 . WHO recommendations on biorisk: http://ow.ly/nQDOn . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Global Initiative on Sharing Avian Influenza Data: www.gisaid.org . NCBI Influenza Virus Resource data base: http://www.ncbi.nlm.nih.gov/genomes/FLU/ Map Human cases and positive findings in bird and environment

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 15 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 17 October 2013, 1700 hours; Rome Overview Situation: Avian influenza A(H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 136 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 54 positive samples mainly from live bird markets and vendors FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 2 Zhejiang 2 0 8 0 10 Fujian 0 0 0 1 1 TOTAL 3 5 32 13 53 Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 8** 0 0 8 TOTAL 0 0 0 0 69 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html Humans . First human case since 10 August 2013: A 35-year-old man in Shaoxin County, Zhejiang Province diagnosed with H7N9 is in serious condition. Outbreak investigation is ongoing. Diagnosis and virus characteristics . Study of H7N9 genetic diversity increases as more sequences become public. A recent study showed: i) H7N9 viruses exhibit diverse genotypes; ii) the first reassortment likely occurred in wild birds and second in domestic birds; and iii) more than one H9N2 virus was involved in the creation of H7N9. Despite its diversity, H7N9 can still be detected by the current, validated diagnostic tests. . New isolates have been submitted to GISAID and GenBank / OpenFlu database: Host GISAID GenBank / OpenFluDB Chicken 34 25 Duck 2 2 Environment 15 14 Human 57 35 Pigeon 5 3 Total 113 79

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 17 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 17 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 21 October 2013, 1600 hours; Rome Overview Situation: Avian influenza A(H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 136 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 54 positive samples mainly from live bird markets and vendors FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals Zhejiang authorities confirmed one positive environmental sample in the Agricultural Trade market in Sun Duan Zhen, Shaoxing County, close to where the last reported human case lived. Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 2 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 TOTAL 3 5 32 14 54 Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 8** 0 0 8 TOTAL 0 8 0 61 69 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html

Humans . First human case since 10 August 2013: A 35-year-old man in Shaoxing County, Zhejiang Province diagnosed with H7N9 is in serious condition. Outbreak investigation is ongoing. Diagnosis and virus characteristics . The isolate of the latest human case in Zhejiang has been submitted to GISAID database. The virus sequence does not show significant changes compared to previous isolates. Host GISAID GenBank / OpenFluDB Chicken 34 25 Duck 2 2 Environment 15 14 Human 58 35 Pigeon 5 3 Total 114 79

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 21 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

FAO actions . FAO continues supporting a-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is finalizing H7N9 surveillance and sampling schemes for South and Southeast Asia. . FAO launched TCP projects for SAARC and ASEAN regions at a participatory workshop on 18-20 September 2013: http://www.fao.org/asiapacific/rap/home/news/detail/en/?news_uid=197054 . On 26 April FAO called for USD 35 million to support the new global framework on H7N9. . On 26 April FAO made public its new web portal on H7N9: www.fao.org/h7n9 . FAO guidance is online: risk management, surveillance, risk assessment and lab protocols Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . Ministry of Forestry of the People’s Republic of China: www.forestry.gov.cn . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . Latest WHO review: http://ow.ly/nQDA7 . WHO recommendations on biorisk: http://ow.ly/nQDOn . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Global Initiative on Sharing Avian Influenza Data: www.gisaid.org . NCBI Influenza Virus Resource data base: http://www.ncbi.nlm.nih.gov/genomes/FLU/ Map Human cases and positive findings in bird and environment

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 21 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 23 October 2013, 1900 hours; Rome Overview Situation: Avian influenza A(H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 137 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 54 positive samples mainly from live bird markets and vendors FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update

Animals Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 2 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 TOTAL 3 5 32 14 54 Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 8** 0 0 8 TOTAL 0 8 0 61 69 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html

Humans . Zhejiang province: A 67- year-old from Xiuzhou District, Jiaxing City, diagnosed with H7N9 is in serious condition. Outbreak investigation is ongoing. . The above-mentioned case is approximately 80 kilometres from Shanghai. Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 34 25 Duck 2 2 Environment 15 14 Human 58 35 Pigeon 5 3 Total 114 79

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 23 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 23 October 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 05 November 2013, 1700 hours; Rome Overview Situation: Avian influenza A(H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 138 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 54 positive samples mainly from live bird markets and vendors FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . MoA of China carried out proficiency testing of 31 main veterinary laboratories and 1 200 laboratories at county/city level for key animal diseases including avian influenza. MoA stated that results have significantly improved when compared with those from two years ago.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 2 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 TOTAL 3 5 32 14 54

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 8** 0 0 8 TOTAL 0 8 0 61 69 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html

Humans . New case in Guangdong province: 3.5 year-old child – diagnosed with H7N9 during Influenza Like Illness (ILI) screening – now in hospital with mild conditions. . The National Health and Planning Commission has notified a new human case in Zheijang Province: a 64 year old woman fell ill on 30 October 2013 and is in critical conditions . The National Health and Family Planning Commission informed on 4 November that H7N9 is included in the statutory infectious disease management category B list from 1 November 2013. This might imply that H7N9 is not reported immediately. . . Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 05 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Chicken 27 30 Duck 2 2 Environment 16 14 Human 95 37 Pigeon 5 5 Total 145 88

FAO actions . FAO is holding consultations with national authorities and international partners in countries at high risk for H7N9 incursion. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is finalizing H7N9 surveillance and sampling schemes for South and Southeast Asia. . On 26 April FAO made public its new web portal on H7N9: www.fao.org/h7n9 . FAO guidance is online: risk management, surveillance, risk assessment and lab protocols . On 26 April FAO called for USD 35 million to support the new global framework on H7N9. To date, USD 6.9 million has been mobilized (USD 5 million from USAID and USD 1.9 million from TCPs); this represents less than 15 percent of total funding requirements. . FAO launched TCP projects for SAARC and ASEAN regions at a participatory workshop on 18-20 September 2013: http://www.fao.org/asiapacific/rap/home/news/detail/en/?news_uid=197054

Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . Ministry of Forestry of the People’s Republic of China: www.forestry.gov.cn . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . Latest WHO review: http://ow.ly/nQDA7 . WHO recommendations on biorisk: http://ow.ly/nQDOn . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Global Initiative on Sharing Avian Influenza Data: www.gisaid.org . NCBI Influenza Virus Resource data base: http://www.ncbi.nlm.nih.gov/genomes/FLU/ Map Human cases and positive findings in bird and environment

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 05 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 05 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 06 November 2013, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 139 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 54 positive samples mainly from live bird markets and vendors FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . MoA of China carried out proficiency testing of 31 main veterinary laboratories and 1 200 laboratories at county/city level for key animal diseases including avian influenza. MoA stated that results have significantly improved when compared with those from two years ago.

Humans . New cases o Guangdong province: 3.5 year-old child was diagnosed with H7N9 during Influenza Like Illness (ILI) screening. The child is now in hospital in mild condition (source: Guandong provincial authorities). o Zheijang province: 64 year old woman fell ill on 30 October 2013 and is in critical condition (source: National Health and Family Planning Commission [NHFPC]). . On 1 November NHFPC downgraded H7N9 from a “category A” to “category B” infectious disease. The statutory list of category B diseases includes H5N1 avian influenza. These diseases fall under routine surveillance and reporting guidelines.

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 06 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 27 30 Duck 2 2 Environment 16 14 Human 95 37 Pigeon 5 5 Total 145 88 FAO actions . FAO is holding consultations with national authorities and international partners in countries at high risk for H7N9 incursion. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is finalizing H7N9 surveillance and sampling schemes for South and Southeast Asia. . On 26 April FAO made public its new web portal on H7N9: www.fao.org/h7n9 . FAO guidance is online: risk management, surveillance, risk assessment and lab protocols . On 26 April FAO called for USD 35 million to support the new global framework on H7N9. To date, USD 6.9 million has been mobilized (USD 5 million from USAID and USD 1.9 million from TCPs); this represents less than 15 percent of total funding requirements. . FAO launched TCP projects for SAARC and ASEAN regions at a participatory workshop on 18-20 September 2013: http://www.fao.org/asiapacific/rap/home/news/detail/en/?news_uid=197054 Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . Ministry of Forestry of the People’s Republic of China: www.forestry.gov.cn . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . Latest WHO review: http://ow.ly/nQDA7 . WHO recommendations on biorisk: http://ow.ly/nQDOn . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Global Initiative on Sharing Avian Influenza Data: www.gisaid.org . NCBI Influenza Virus Resource data base: http://www.ncbi.nlm.nih.gov/genomes/FLU/ Map – human cases and positive findings in bird and environment

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 06 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 15 November 2013, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 139 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 69 positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . New H7N9 surveillance results MoA China: since June 2013, 15 out of 110 000 samples tested virologically positive (0.01%). Positives from Hebei and Guangdong. Serological testing: 184 out of 230 000 (0.08%) positives. Sero-positives from chicken samples of 8 provinces (Heilongjiang, Jiangsu, Shandong, Henan, Hunan, Sichuan, Qinghai and Ningxia). Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 5 7 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 14 15 69 Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 8** 0 0 8 TOTAL 0 8 0 61 69 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html Humans . Human vaccine development: Phase 1 clinical trial of Novartis with a virus-like particle (VLP) vaccine using adjuvant showed promising results (good antibody titre, encouraging safety profile). . 1 November NHFPC downgraded H7N9 from “category A” to “category B” infectious disease. Category B includes H5N1 and falls under routine surveillance and reporting guidelines. Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 27 30 Duck 2 2 Environment 16 14 Human 95 37 Pigeon 5 5 Total 145 88

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 15 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO actions . FAO will launch its TCP project for the African region at a participatory workshop planned on 10-11 November 2013. . FAO is holding consultations with national authorities and international partners in countries at high risk for H7N9 incursion. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is finalizing H7N9 surveillance and sampling schemes for South and Southeast Asia. . On 26 April FAO made public its new web portal on H7N9: www.fao.org/h7n9 . FAO guidance is online: risk management, surveillance, risk assessment and lab protocols . On 26 April FAO called for USD 35 million to support the new global framework on H7N9. To date, USD 6.9 million has been mobilized (USD 5 million from USAID and USD 1.9 million from TCPs); this represents less than 15 percent of total funding requirements. Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . Ministry of Forestry of the People’s Republic of China: www.forestry.gov.cn . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . Latest WHO review: http://ow.ly/nQDA7 . WHO recommendations on biorisk: http://ow.ly/nQDOn . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Global Initiative on Sharing Avian Influenza Data: www.gisaid.org . NCBI Influenza Virus Resource data base: http://www.ncbi.nlm.nih.gov/genomes/FLU/ Human cases and positive findings in birds and the environment in China

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. 15 November 2013 FAO cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 28 November 2013, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 140 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 69 positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . October 2013 H7N9 surveillance results MoA China: None of the 5 873 samples taken in Chongqing, Guangdong, Guangxi, Guizhou, Henan and Shandong tested virologically positive. Serological testing: 34 out of 48 482 (0.07 percent) positives. Sero-positives are from Qinghai (25), Jiangxi (4), Guangdong (3) and Henan (2). Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 5 7 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 14 15 69 Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 0 8** 0 8 Zhejiang 0 0 0 2*** 2 TOTAL 0 0 8 63 71 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html;erroneously reported as pigeons in previous updates ***Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20616 Humans . A human case was confirmed in Zhejiang Province on 28 November 2013. The 57 year old man became ill on 20 November, was admitted to a local hospital on 22 November for treatment and is currently in critical condition [http://www.info.gov.hk/gia/general/201311/28/P201311280442.htm]. Epidemiological investigation revealed that the patient's family/home raises six chickens [http://csj.xinhuanet.com/2013-11/28/c_132926288.htm]. . Human vaccine development: Laboratory research showed that vaccination with an influenza A H7 virus-like particle preparation, developed independently from the ®Novartis vaccine recently reported, protects mice from high dose H7N9 infection even without use of an adjuvant. [http://www.sciencedirect.com/science/article/pii/S0264410X13015533]. Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 28 November 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 27 30 Duck 2 2 Environment 16 14 Human 95 37 Pigeon 5 5 Total 145 88 FAO’s global actions . The participatory launch workshop for FAO’s Africa TCP has been postponed to January 2014. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . Ministry of Forestry of the People’s Republic of China: www.forestry.gov.cn . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . WHO review: http://ow.ly/nQDA7 . WHO recommendations on biorisk: http://ow.ly/nQDOn . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Global Initiative on Sharing Avian Influenza Data: www.gisaid.org . NCBI Influenza Virus Resource data base: http://www.ncbi.nlm.nih.gov/genomes/FLU/ Human cases and positive findings in birds and the environment in China

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 28 November 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 03 December 2013, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 141 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Zhejiang, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 69 positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . October 2013 H7N9 surveillance results MoA China: Serological testing: 34 out of 48 482 (0.07 percent) positives including Qinghai (25), Jiangxi (4), Guangdong (3) and Henan (2). . Export from three Shenzhen poultry farms to Hong Kong SAR has been suspended. . Agriculture, Fisheries and Conservation Department (Hong Kong SAR) will visit 30 farms and inspect live poultry wholesale markets and bird parks to collect samples for testing, and clinical observation. Shanghai City and Nanjing City released seasonal risk based live poultry market suspension plans. In 2014, Shanghai will suspend live poultry trading from 31 January until 30 April.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 0 5 7 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 14 15 69

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61* 61 Shandong 0 0 8** 0 8 Zhejiang 0 0 0 2*** 2 TOTAL 0 0 8 63 71 *Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20481 **Nature: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12515.html ***Eurosurveillance: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20616 Humans . Hong Kong SAR confirmed its first human case on 2 December 2013. The 36-year-old woman – an Indonesian domestic helper – visited Shenzhen on 17 November and had contact with poultry. She fell ill on 21 November and was admitted to hospital on 27 November. She remains in critical condition. Close contacts have minor symptoms and are being isolated.

Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

. Hong Kong SAR raised the response level from 'alert' to 'serious' under its influenza pandemic preparedness plan and notified mainland China, Macau SAR and WHO. Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 16 14 Human 95 37 Pigeon 5 5 Total 153 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Human cases and positive findings in birds and the environment

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 07 December 2013, 0730 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 143 confirmed; 45 deaths Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 69 positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . October 2013 H7N9 surveillance results MoA China: Serological testing: 34 out of 48 482 positives (i.e. 0.07 percent) including Qinghai (25), Jiangxi (4), Guangdong (3) and Henan (2). . On 2 December 2013, China, Hong Kong SAR banned imports from three poultry farms in Shenzhen. . The Agriculture, Fisheries and Conservation Department of China, Hong Kong SAR, has inspected 30 farms, live poultry wholesale markets and bird parks. . Shanghai has planned to suspend live poultry trading from 31 January until 30 April 2014.

Virologically positive samples reported in peer-reviewed articles1,2,3 Province Duck Pigeon Chicken Environmental Total Zhejiang 0 0 0 61 61 Shandong 0 0 8 0 8 Zhejiang 0 0 0 2 2 TOTAL 0 0 8 63 71 Humans . China, Hong Kong SAR confirmed its second human case on 6 December 2013. The 80-year- old man with underlying medical condition was hospitalized for chronic illness on 3 December. He was put into isolation immediately. The sample tested positive for H7N9 virus. . Zhejiang Provincial Health Department confirmed a human case on 6 December (i.e. fifth confirmed since October). The 30-year-old man was diagnosed on 5 December. Currently receiving treatment in Hangzhou City. . China, Hong Kong SAR raised the response level from 'alert' to 'serious' under its influenza pandemic preparedness plan on 3 December and notified mainland China, Macao SAR authorities and WHO.

Page 1 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 07 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 16 14 Human 96 37 Pigeon 5 5 Total 154 88 . Genetic sequences from first human case in Hong Kong SAR have been uploaded to GISAID. FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 07 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 11 December 2013, 1730 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 143 confirmed; 47 deaths (references: 1, 2, 3) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 69 positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 10 December 2013: Environmental monitoring of Shenzhen live bird markets (LBMs) conducted by provincial and City authorities revealed 3 PCR-positive samples from 2 LBMs in Longgang District out of a total 70 environmental specimens collected from 13 LBMs in Shenzen City. . 11 December 2013: Shenzen City authorities have closed all poultry-related markets for 4 days. . Shanghai has planned to suspend live poultry trading from 31 January until 30 April 2014.

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang1,3 0 0 0 63 63 Shandong2 0 0 8 0 8 TOTAL 0 0 8 63 71 Humans . China, Hong Kong SAR confirmed its second human case on 6 December 2013. The 80-year-old man with underlying medical condition was hospitalized for chronic illness on 3 December. He was put into isolation immediately. The sample tested positive for H7N9 virus. . Zhejiang Provincial Health Department confirmed a human case on 6 December (i.e. fifth confirmed since October). The 30-year-old man was diagnosed on 5 December. Currently receiving treatment in Hangzhou City. . China, Hong Kong SAR raised the response level from 'alert' to 'serious' under its influenza pandemic preparedness plan on 3 December and notified mainland China, Macao SAR authorities and WHO.

Page 1 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 16 14 Human 96 37 Pigeon 5 5 Total 154 88 . Genetic sequences of virus A/Hong Kong/5942/2013 (from first human case in Hong Kong SAR) have been uploaded to GISAID. . Genetic analysis of the A/Hong Kong/5942/2013 virus suggests H7N9 is a “dynamic virus” that may be mixing with other viruses in poultry and causing new variants. Analysis reveals growing heterogeneity/diversity within the H7N9 gene pool in birds: three genes (NP, PA and PB1) show similarities with avian influenza genes not previously reported in H7N9 genotypes. However, the remaining five genes (PB2, HA, NA, M, NS) remain similar to previous H7N9 isolates. FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 12 December 2013, 2130 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 143 confirmed; 47 deaths (references:1, 2, 3) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: 69 positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 10 December 2013: Environmental monitoring of Shenzhen live bird markets (LBMs) conducted by provincial and City authorities revealed 3 PCR-positive samples from 2 LBMs in Longgang District out of a total 70 environmental specimens collected from 13 LBMs in Shenzen City. . Shanghai has planned to suspend live poultry trading from 31 January until 30 April 2014.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 3 5 10 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 17 15 72

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang (references: 1,3) 0 0 0 63 63 Shandong (reference: 2) 0 0 8 0 8 TOTAL 0 0 8 63 71 Humans . China, Hong Kong SAR confirmed its second human case on 6 December 2013. The 80-year-old man with underlying medical condition was hospitalized for chronic illness on 3 December. . Zhejiang Provincial Health Department confirmed a human case on 6 December (i.e. fifth confirmed since October). The 30-year-old man was diagnosed on 5 December. Currently receiving treatment in Hangzhou City. . China, Hong Kong SAR raised the response level from 'alert' to 'serious' under its influenza pandemic preparedness plan on 3 December and notified mainland China, Macao SAR authorities and WHO.

Page 1 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 12 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 16 14 Human 96 37 Pigeon 5 5 Total 154 88 . Genetic analysis of the A/Hong Kong/5942/2013 virus suggests H7N9 is a “dynamic virus” that may be mixing with other viruses in poultry and causing new variants. Analysis reveals growing heterogeneity/diversity within the H7N9 gene pool in birds: three viral genes (NP, PA and PB1) show similarities with avian influenza genes not previously reported in H7N9 genotypes. The remaining five genes (PB2, HA, NA, M, NS) remain similar to previous H7N9 isolates. FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 12 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 16 December 2013, 1520 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 145 confirmed; 47 deaths (references:1, 2, 3) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . On 12 December, all live bird markets in Longgang District, Shenzen city, closed for 1 day for cleaning and disinfection. All stalls at the two positive live bird markets closed for 7 days, with 3 days of continuous thorough cleaning and disinfection. . 10 December 2013: Environmental monitoring of Shenzhen live bird markets (LBMs) conducted by provincial and City authorities revealed 3 PCR-positive samples from 2 LBMs in Longgang District out of a total 70 environmental specimens collected from 13 LBMs in Shenzen City.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 3 5 10 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 17 15 72

Humans . 15-16 December 2013: Two new human cases were detected in Guangdong Province, both in critical condition: (1) A 39-year old man who lives in Fenggang, Dongguan City, but is registered in Nanchong City, Sichuan Province. 53 close contacts are under observation; and, (2) A 65-year old woman who lives in Jiangcheng District, Yangjiang City.

Page 1 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 16 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 . Genetic analysis of the A/Hong Kong/5942/2013 virus suggests H7N9 may be mixing with other viruses in poultry and causing new variants. Analysis reveals growing heterogeneity/diversity within the H7N9: three viral genes (NP, PA and PB1) show similarities with avian influenza genes not previously reported in H7N9 genotypes. The remaining five genes (PB2, HA, NA, M, NS) remain similar to previous H7N9 isolates. FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 16 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 18 December 2013, 2100 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 146 confirmed; 47 deaths (references:1, 2, 3) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . Dongguang City: Chinese authorities have closed and disinfected a farmer’s restaurant associated with a human case previously reported (see Update 16 December). The 39 year old man from Fenggang Township had visited the establishment 5 days before falling ill. Authorities have culled all live poultry and destroyed all frozen chicken. The restaurant will be subjected to further testing before resuming business. . 100 environmental samples from Dongguang City have resulted negative for H7N9. Authorities took the samples from 17 markets trading agricultural products and 1 wholesale market in Fenggang Township (where the above-mentioned, 39 year-old man resides).

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 3 5 10 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 17 15 72

Humans . 18 December 2013: Authorities have reported a new human case. The 62 year-old man living in Yangjiang City, Guangdong Province is currently in critical condition. . Recent studies (references: 1, 2) show some resistance of H7N9 to treatment with the antiviral drug oseltamivir (Tamiflu) in 3 out of 15 patients observed. This could reduce human case management

Page 1 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

options to administration of alternate antivirals and/or symptomatic treatment. There is no evidence of oseltamivir resistance in H7N9 strains circulating in animals or from the environment. Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 19 December 2013, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 147 confirmed; 47 deaths (references:1, 2, 3) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . Dongguang City: Chinese authorities have closed and disinfected a farmer’s restaurant associated with a human case previously reported (see Update 16 December). The 39 year old man from Fenggang Township had visited the establishment 5 days before falling ill. Authorities have culled all live poultry and destroyed all frozen chicken. The restaurant will be subjected to further testing before resuming business. . 100 environmental samples from Dongguang City have resulted negative for H7N9. Authorities took the samples from 17 markets trading agricultural products and 1 wholesale market in Fenggang Township (where the above-mentioned, 39 year-old man resides).

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 3 5 10 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 17 15 72

Humans . 19 December 2013: Authorities have reported a new human case. The 38 year-old man living in Shenzhen City, Guangdong Province became ill on 9 December 2013 and is currently in critical condition. . 18 December 2013: Authorities have reported a new human case. The 62 year-old man living in Yangjiang City, Guangdong Province is currently in critical condition.

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Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 19 December 2013 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 03 January 2014, 1600 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 148 confirmed; 48 deaths (references:1, 2, 3, 4) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 24 December 2013: Hong Kong continues to suspend imports of live birds from Mainland China. . 23 December 2013: Beijing City implements 24-hour vigilance to prevent vehicles from bringing animals or their products into the city through non-designated entrances. Live poultry trading has been banned in the city and authorities are requested to actively search and stop illegal activities. Authorities were urged to step up inspection of the city's 628 poultry and household farms to ensure movement controls and heightened biosecurity measures are being followed.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 0 3 10 7 20 Jiangsu 0 2 11 0 13 Anhui 1 0 0 0 1 Henan 0 0 0 2 2 Shandong 0 0 0 3 3 Jiangxi 0 0 1 0 1 Guangdong 0 0 2 3 5 10 Zhejiang 2 0 8 1 11 Fujian 0 0 0 1 1 Hebei 10 10 TOTAL 3 5 32 17 15 72

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang (references: 1,3) 0 0 0 63 63 Shandong (reference: 2) 0 0 8 0 8 TOTAL 0 0 8 63 71 Humans . 31 December 2013: A 86-year old man from Jiangsu Province, Mainland China, travelled to Taiwan POC on 17 December, where he experienced loss of appetite and chest discomfort. He was admitted to hospital on 24 December and is currently receiving intensive treatment in Taiwan. Two of his daughters, who remained with him, have showed no symptoms to date. This is the second case diagnosed in Taiwan POC, both originating from Jiangsu. . 31 December 2013: Hong Kong implemented disease prevention and control measures at all border control points, including thermal imaging systems to check inbound travellers. Suspect cases will be immediately referred to public hospitals for follow-up investigation.

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. Real-time PCR screening of febrile patients between 15 and 25 April 2013 in an area with confirmed H7N9 cases revealed that out of 200 patients, one (0.5%) was positive for H7N9 virus. The patient experienced respiratory failure and received symptomatic and antibiotics as well as the anti-viral drug, oseltamivir. His condition substantially improved within three days. No virus was detected after 5 days. None of the 23 close contacts developed fever or other symptoms. (reference) Diagnosis and virus characteristics Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 06 January 2014, 1610 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 152 confirmed; 48 deaths (references:1, 2, 3, 4) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 4 January 2014, Guangdong: As part of routine environmental surveillance on live bird markets, one positive sample was confirmed in the Nanchao Market in Jing'an Town, Zhuhai City; while out of 20 samples taken in Xìngfa Market, Zengcheng City, 3 tested positive (2 from goose cages and 1 from sewage). Poultry present were destroyed and the markets closed for 3 days. Cleaning/disinfection commenced. Active human case search and investigation of flu/pneumonia cases are ongoing.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 3 10 7 20 Jiangsu 2 11 13 Anhui 1 1 Henan 2 2 Shandong 3 3 Jiangxi 1 1 Guangdong 2 7 5 14 Zhejiang 2 8 1 11 Fujian 1 1 Hebei 10 10 TOTAL 3 5 32 21 15 76

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang (references: 1,3) 0 0 0 63 63 Shandong (reference: 2) 0 0 8 0 8 TOTAL 0 0 8 63 71 Humans . 6 January 2014: Two new human cases were confirmed in Guangdong, both are in critical condition. The first case, a 47-year-old male poultry worker living in Foshan, developed symptoms on 25 December 2013. No symptoms have been found in his 60 close contacts to date. The second case, a 71-year-old man who lives in Yangjiang, developed symptoms on 1January 2014. He had no recent history of contact with poultry. No symptoms have been found in his 65 close contacts to date. . 4 January 2014: A new human case was confirmed in Zhejiang Province. The 34-year old woman from Zhuji City of Shaoxing City is currently in critical condition. . 3 January 2014: A new human case was confirmed in Shanghai. The 86-year-old man first developed cough and fever on 30 December 2013 and the disease progressed rapidly. Reportedly, the patient

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Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 06 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 09 January 2014, 1600 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 157 confirmed; 49 deaths (references:1, 2, 3, 4, 5) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 4 January 2014, Guangdong: As part of routine environmental surveillance on live bird markets, one positive sample was confirmed in the Nanchao Market in Jing'an Town, Zhuhai City; while out of 20 samples taken in Xìngfa Market, Zengcheng City, 3 tested positive (2 from goose cages and 1 from sewage). Poultry present were destroyed and the markets closed for 3 days. Cleaning/disinfection commenced. Active human case search and investigation of flu/pneumonia cases are ongoing.

Virologically positive samples reported in peer-reviewed articles Province Duck Pigeon Chicken Environmental Total Zhejiang (references: 1,3) 0 0 0 63 63 Shandong (reference: 2) 0 0 8 0 8 TOTAL 0 0 8 63 71 Humans . 9 January 2014: A new human case was confirmed in Zhejiang. The 51-year old woman from Tongxiang [City of Jiaxing City] is currently in critical condition. . 8 January 2014: A new human case was confirmed in Jiangsu, a 54-year old woman from Nanjing. . 8 January 2014: A new human case was confirmed in Hong Kong SAR. The 65-year old man who lives in Sham Shui Po District developed symptoms on 3 January 2014. The patient travelled to Shenzhen with his family from 1 to 2 January and visited a wet market there. . 7 and 8 January 2014: Two new human cases were confirmed in Guangdong. The first case, a 31- year old man from Shenzhen City, developed symptoms on 30 December 2013 and is in stable condition. No recent history of contact with poultry reported. His 35 close contacts in Shenzhen do not

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show any symptoms to date and 2 contacts living in Hong Kong SAR tested negative. The second case, a 51-year old woman living in Foshan City, developed symptoms on 31 December 2013. She had bought a live chicken at a market and slaughtered it at home. Her condition is critical. All 21 close contacts do not show any symptoms to date. . 6 January 2014: The second case that was reported from Dongguan, a 39-year old man from Fenggang town, died due to multiple organ failure. Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm . Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 09 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 10 January 2014, 1930 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 163 confirmed; 50 deaths (references:1, 2, 3, 4, 5, 6) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 10 January 2014, Huizhou City, Guangdong: poultry sampling to be implemented weekly at farms and twice weekly at poultry markets. Body temperature of market operators and employees to be monitored daily, with the request to promptly seek medical treatment when >38℃. In farmers' markets one clean-wash a day, one thorough cleaning a week and one market-closure a month will be implemented. On 24 January 2014 all farmers’ markets will be closed to conduct thorough cleaning and disinfection. . 10 January 2014, Guangzhou City, Guangdong: As part of environmental monitoring in connection with the human case reported on 6 January (a poultry transporter, 47 years old), 3 samples out of 17 collected from a restaurant kitchen in Haizhu District, Guangzhou City tested PCR positive. Also 8 out of 34 samples collected from the Longbei Market, Jinping District, Shantou City, tested PCR positive.

Virologically positive samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 3 10 7 20 Jiangsu 2 11 13 Anhui 1 1 Henan 2 2 Shandong 3 3 Jiangxi 1 1 Guangdong 2 18 5 25 Zhejiang 2 8 1 11 Fujian 1 1 Hebei 10 10 TOTAL 3 5 32 32 15 87

Virologically positive samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (references: 1,3) 63 63 Shandong (reference: 2) 8 8 Jiangsu (reference: 4) 1 1 TOTAL 0 0 8 63 72 Humans . 10 January 2014: Two new human cases were confirmed in Guangdong. The first case, a 59-year old woman also living in Foshan City, became ill on 29 December 29. Her 5 close contacts do not show any symptoms to date. The second case, a 42-year old female poultry worker living in Foshan City, became ill on 5 January. Her 20 close contacts do not show any symptoms to date.

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. 10 January 2014: Two new human cases were confirmed in Zhejiang, both are currently in critical condition. The first case is a 79-year old woman from Pinghu, while the second case is a 30-year old male food seller who lives in Yinzhou District, Ningbo [City] and became sick on 2 January. . 10 January 2014: A new human case was confirmed in Fujian. The 38-year old man from Hui'an County, Quanzhou City, who became sick on 3 January, died on 10 January. He had been affected by tuberculosis and pneumoconiosis in the past. . 10 January 2014: A new human case, a 54-year old man from Nanjing City, was found in Jiangsu. Diagnosis and virus characteristics . Genetic analysis of the virus isolated from the recent patient in Hong Kong SAR reveals no significant differences from viruses detected so far in Mainland China and Hong Kong SAR and no evidence of genetic reassortment with genes of human influenza origin or resistance to Tamiflu™ [Oseltamivir]. (ref.) . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

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. Human cases and positive findings in birds and the environment

Page 3 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 10 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 13 January 2014, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 174 confirmed (plus 1 suspected); 51 deaths (+1) (ref:1, 2, 3, 4, 5, 6, 7, 8) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 13 January 2014, Guangdong: Following the recent ‘wave’ of human cases, the government of Nanhai District, Foshan City, closed live bird markets (LBMs) from 13 to 14 January. . 10 January 2014, Guangzhou City, Guangdong: Samples collected from live poultry in Yijin new market, Yuexiu District, and Zhangban market, Tianhe District, are suspected to be H7N9 positive.

Positive virological samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 3 10 7 20 Jiangsu 2 11 13 Anhui 1 1 Henan 2 2 Shandong 3 3 Jiangxi 1 1 Guangdong 2 18 5 25 Zhejiang 2 8 1 11 Fujian 1 1 Hebei 10 10 TOTAL 3 5 32 32 15 87

Positive virological samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (1,3) 63 63 Shandong (2) 8 8 Jiangsu (4, 5) 1 1 2 TOTAL 0 0 9 63 73 Humans . 13 January 2014: A suspected human case was found in Guizhou (to be confirmed). The 38-year old man who lives in Meitan County of Zunyi City, but worked in Ruian City, Zhejiang Province, became ill about a month ago. His condition worsened in and died on 9 January. Confirmation awaited by CDC- China. . 11 and 13 January 2014: Four new human cases were confirmed in Guangdong. The first case, a 29-year old male tofu seller at a market in Guangzhou City, became ill on 3 January and currently is in critical condition. The second case, a 76-year old man who lives in Longgang, Shenzhen City, also became ill on 3 January and is in stable condition. He had no known exposure to poultry. The other two cases are both from Nanhai District, Foshan City, both received Tamiflu™ [Oseltamivir] treatment on 9 January. The third case, a 28-year old female poultry selling staff from Lishuizhen, became ill on

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8 January, is in stable condition. The fourth case, a 46-year old male driver from Shishanzhen, rears live poultry at home and became ill on 6 January, is in critical condition. Their close contacts do not show any symptoms to date. . 11-13 January 2014: Five new human cases were confirmed in Zhejiang. The first case is a 75-year old woman who became sick on 1 January and died on 9 January. She had exposure to poultry. The second case is a 78-year old man hospitalized in Hangzhou. Three other cases are from Ningbo City: The third case is a 34-year old man from Yinzhou District; the fourth case is a 41-year old woman from Cixi City, while the fifth case is a 59-year old woman from Jiangdong District, all in serious ~ critical condition. . 11 January 2014: Two new human cases were confirmed in Shanghai, both had exposure to poultry and are currently in critical condition. The first case is a 58-year old woman who became sick on 1 January, while the second case is a 56-year old man who became sick on 6 January. Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Human cases and positive findings in birds and the environment (Feb 2013 through mid-Jan 2014)

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 13 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 15 January 2014, 1700 hours; Rome Overview Situation: Avian influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 181 confirmed (plus 1 suspected); 52 deaths (+1) (ref:1, 2, 3, 4, 5, 6, 7, 8, 9) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . 15 January 2014, Zhejiang: Following the recent human cases in Ningbo city, city government is enforcing control measures on live bird markets such as cleaning/disinfection, regular market rest days, temporal closure of positive markets after culling operations and inspection certification prior to reopening. Commercial live bird trade from outside the city is temporally suspended. . Results from the H7N9 national monitoring conducted by the MoA in December 2013 included 18 positive samples (virus genome) out of 200 tested (9.00%) from 4 sampling sites in Zhejiang and 2 positive samples (genomic) out of 2,521 tested (0.08%) from 151 sampling sites in Guangdong.

Positive virological samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 3 10 7 20 Jiangsu 2 11 13 Anhui 1 1 Henan 2 2 Shandong 3 3 Jiangxi 1 1 Guangdong 2 18 7 27 Zhejiang 2 8 1 18 29 Fujian 1 1 Hebei 10 10 TOTAL 3 5 32 32 15 87

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. 14 and 15 January 2014: Three new human cases were confirmed in Zhejiang, all from Hangzhou City and in critical condition. The first case is a 29-year old farmer currently living in Binjiang District, the second is a 58-year old worker from Xiaoshan District, the third is a 41-year old farmer living in Yuhang District. . 14 January 2014: A new human cases were found in Fujian. The 50-year old man from Jinjiang City, Quanzhou City, is currently in critical condition. . 13 January 2014: The 65-year old patient reported on 8 January 2014 in Hong Kong SAR has died. Five close contacts were put under quarantine for 10 days from their last contact with the patient and were prescribed the antiviral TamifluTM for treatment followed medical observation. Other contacts remain under medical observation and eight of them developed non-specific symptoms. Of these, seven tested negative for H7 virus while results for one of the contacts is pending. Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases by age group and time of observation (1st wave: February to August 2013 [yellow]; 2nd wave: October 2013 to January 2014 [blue]); (n=181) Number of confirmed human H7N9 cases

Age group

* age unknown: retrospective confirmation in Shanghai by serology

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Human cases and positive findings in birds and the environment

Page 3 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 15 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 17 January 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 193 confirmed; 52 deaths (ref:1, 2, 3, 4, 5, 6, 7, 8, 9) Provinces/municipalities: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guizhou; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . Additional information reported by MoA to OIE stated that out of the 18 positive surveillance samples from Zhejiang [see update 15/01/2014], 6 were environmental and 12 were from non-specified live birds. Positive virological samples confirmed by national authorities Province Duck Pigeon Chicken Environmental Not specified Total Shanghai 3 10 7 20 Jiangsu 2 11 13 Anhui 1 1 Henan 2 2 Shandong 3 3 Jiangxi 1 1 Guangdong 2 18 7 27 Zhejiang 2 8 1 + 6 12 29 Fujian 1 1 Hebei 10 10 TOTAL 3 5 32 32 35 107

Humans: 12 new cases reported . 15 January: one new human case was reported in Fujian. The 30-year old man, a stone processing worker who lives in Quanzhou City, is currently in critical condition. . 15-17 January: six new human cases were reported in Zhejiang: Two farmers from Xiaoshan District, Hangzhou City are currently in critical condition: a 20-year old woman and a 62-year old man. Two cases from Huzhou City are in critical condition: a 66-year old retired man and a 54-year old male farmer from Wuxing District. The sixth case, a 58-year old farmer from Jiaojiang District, Taizhou City, is in critical condition. The seventh case is a 35-year old man from Hushanjiedao, Cixi City, Ningbo City.

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. 16 January: A new human case was reported in Shanghai. The 54-year old man who is registered in Wuhu City, Anhui Province, is currently hospitalized in Shanghai City for treatment. . 16 January: two new human cases were reported in Guangdong. The first case is a 59-year old retired man from Haizhu District in Guangzhou City, currently in stable condition. The second case is a 76-year old retired woman from Chancheng District, Foshan City, who is in critical condition. . 16 January: A new human case was reported in Fujian. The 60-year old man from Luojiang District, Quanzhou City, is currently in serious condition. . 16 January: the suspected human case, a 38-year old man from Minjian Village, Guizhou Province, has now been confirmed as positive. He worked in Ruian City, Zhejiang Province as a steel plant worker. The man has died.

Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and the environment

Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 17 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 20 January 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 209 confirmed; 55 deaths (ref: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10) Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guizhou; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 17 January: Starting from 24 January, Hong Kong SAR and Mainland China will introduce serological testing on live poultry in Mainland registered farms (registered for export to Hong Kong SAR), local poultry farms and Man Kam To Animal Inspection Station. Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) / Wave 2 (July 2013 – January 2014) Environmental Not specified Province Duck Pigeon Chicken (markets, cages, Total restaurant) Shanghai 3 / 0 10 / 0 7 / 0 20 / 0 Jiangsu 2 / 0 11 / 0 13 / 0 Anhui 1 / 0 1 / 0 Henan 2 / 0 2 / 0 Shandong 3 / 0 3 / 0 Jiangxi 1 / 0 1 / 0 Guangdong 2 / 0 0 / 18 0 / 7 2 / 25 Zhejiang 2 / 0 8 / 0 0 / 7 0 / 12 10 / 19 Fujian 1 / 0 1 / 0 Hebei 0 / 10 0 / 10 TOTAL 3 / 0 5 / 0 32 / 0 13 / 25 0 / 29 53 / 54

Positive virological samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (1,3) 63 63 Shandong (2) 8 8 Jiangsu (4,5) 1 1 2 TOTAL 0 0 9 64 73 Humans: 16 new cases reported . 17-18 January: Three new human cases were reported in Fujian: Two patients from Quanzhou City are in critical condition: a 38-year old self-employed woman from Jinjiang City and a 55-year old male motorbike taxi driver from Youngningzhen, Shishi City. The third patient is a 54-year old man from Ningde County, Gutian City, currently hospitalized in Fuzhou City and in critical condition. . 18 January: Three new human cases were reported in Guangdong: Two patients from Guangzhou City: a 5-year old girl from Baiyun District with mild symptoms and an 83-year old retired woman from Liwan District who died. The third patient is a 62-year old retired man from Futian District, Shenzhen City, currently in stable condition.

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. 18-20 January: Eight new human cases were reported in Zhejiang: Four patients from Hangzhou City are in critical condition: a 72-year old retired woman and a 61-year old man from Binjian District; a 54- year old man from Xiaoshan District and a 71-year old female farmer from Yuhang District. Two patients from Shaoxing City: a 69-year old male farmer from Paojiangxin District in critical condition and a 53-year old man from Zhuji City in serious condition. The seventh patient is a 63-year old male farmer from Haining County, Jiaxing City, in serious condition and hospitalized in Hangzhou City. The eighth patient is a 55-year old male farmer from Yinzhou District, Ningbo City, in critical condition. . 20 January: Two new human cases were reported in Shanghai. The 31-year old male medical personnel and the 77-year old male farmer have both died. Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88 FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases and positive findings in birds and from market or restaurant environments

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. Page 2 of 2; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 20 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 22 January 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 219 confirmed; 60 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guizhou; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 15 January, Guangdong: The Agriculture Department of Huizhou City has increased sampling frequency in LBMs from twice a week to daily and on farms from once to twice/week. . 21 January, Macau SAR: H7 serological testing to be implemented at Mainland registered farms prior to export and before the Lunar New Year. . 21 January, Zhejiang: Xiaoshan District, Hangzhou City temporally suspended live poultry trade after six cases of H7N9 avian influenza human infection occurred.

Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) / Wave 2 (July 2013 – January 2014) Environmental Not specified Province Duck Pigeon Chicken (markets, cages, Total restaurant) Shanghai 3 / 0 10 / 0 7 / 0 20 / 0 Jiangsu 2 / 0 11 / 0 13 / 0 Anhui 1 / 0 1 / 0 Henan 2 / 0 2 / 0 Shandong 3 / 0 3 / 0 Jiangxi 1 / 0 1 / 0 Guangdong 2 / 0 0 / 18 0 / 7 2 / 25 Zhejiang 2 / 0 8 / 0 0 / 7 0 / 12 10 / 19 Fujian 1 / 0 1 / 0 Hebei 0 / 10 0 / 10 TOTAL 3 / 0 5 / 0 32 / 0 13 / 25 0 / 29 53 / 54

Positive virological samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (1,3) 63 63 Shandong (2) 8 8 Jiangsu (4,5) 1 1 2 TOTAL 0 0 9 64 73 Humans: 10 new cases reported . 22 January: One new human case was reported in Jiangsu: a 71-year old man from Nanjing City currently in critical condition. . 21 and 22 January: six new human cases were reported in Zhejiang: Three patients from Taizhou City: a 71-year old male farmer from Jiaojiang District, a 57-year old male farmer from Linhai District and a 63-year old female farmer from Wenling City. All three patients are in critical condition. The fourth patient is a 53-year old male farmer from Xiaoshan District, Hangzhou City, also in critical

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condition. Other two patients are a 49-year old male farmer from Xiaoshian District, Hangzhou City, and a 70-year old male farmer from Keqiao District, Shaoxing City, both in serious condition. . 21 January: Three new human cases were reported in Shenzhen City, Guangdong: A 39-year old woman from Longgang District currently in stable condition, and two patients in critical condition: a 59-year old woman from Luohu District and a 76-year old man from Futian District. . 21 January: The National Health and Family Planning Commission: Notice on upgrading H7N9 control measures - Surveillance, risk communication and medical assistance will be increased during the Spring Festival period, the importance of risk assessment is emphasized and missions have been undertaken jointly by the NHFPC, the MoA, the Business Administration and the State Food and Drug Administration to evaluate the situation in affected provinces and provide further guidance. Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88

FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online: www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database: www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention: http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Number of weekly incidence of human cases based on onset dates from 10 February 2013 until 12 January 2014

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Human cases and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 22 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 24 January 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 236 confirmed; 60 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guizhou; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 23 and 24 January, Zhejiang: Shaoxing, Wenzhou and Hangzhou Cities have temporarily banned live poultry trade. Shaoxing and Hangzhou closed their markets as of 23 and 24 January, respectively. Remaining poultry will be disposed of and the markets cleaned and disinfected. . 23 January, Fujian: As part of environmental sampling in farmer markets and poultry breeding places in Xiamen City, out of the 40 samples taken 2 environmental samples from a LBM tested positive. No human cases have been reported in this city. . 21 January, Fujian: Live poultry imports from other provinces were temporarily suspended. Cleaning and disinfection in poultry markets, trading areas, poultry farms and slaughter places were enhanced. Commercial bird shows or pigeon flying activities have been suspended in areas with outbreaks. Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) | Wave 2 (July 2013 – January 2014) Environmental Not specified Province Duck Pigeon Chicken (markets, cages, Total restaurant) Shanghai 3 | 0 10 | 0 7 | 0 20 | 0 Jiangsu 2 | 0 11 | 0 13 | 0 Anhui 1 | 0 1 | 0 Henan 2 | 0 2 | 0 Shandong 3 | 0 3 | 0 Jiangxi 1 | 0 1 | 0 Guangdong 2 | 0 0 | 18 0 | 7 2 | 25 Zhejiang 2 | 0 8 | 0 0 | 7 0 | 12 10 | 19 Fujian 1 | 2 1 | 2 Hebei 0 | 10 0 | 10 TOTAL 3 | 0 5 | 0 32 | 0 13 | 27 0 | 29 53 | 56

Positive virological samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (1,3) 63 63 Shandong (2) 8 8 Jiangsu (4,5) 1 1 2 TOTAL 0 0 9 64 73 Humans: 17 new cases reported . 24 January: One new human case was reported in Beijing. The man had exposure to a pigeon.

* Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. Page 1 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 24 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

. 23 and 24 January: Twelve new human cases were reported in Zhejiang, all patients are in serious or critical condition: A 71-year old male farmer from Cangnan County, Wenzhou City and a 63-year old female farmer from Deqing County, Huzhou City currently hospitalized in Hangzhou City. Three patients from Ningbo City: a 59-year old male worker and a 44-year old female independent worker from Yinzhou District and a 76-year old retired woman from Yuyao City hospitalized in Hangzhou. Three patients are from Hangzhou City: a 71-year old retired woman from Jianggan District, a 23-year old female staff from Xiaoshan District and an 82-year old retired woman from Shangcheng District. Four patients are from Shaoxing City: a 66-year old retired woman and a 73-year old retired man from Yuecheng District, a 62-year old female farmer from Keqiao District and a 33-year old male farmer from Paojiangxin District. . 23 and 24 January: Three new human cases were reported in Guangdong, all in critical condition: A 34-year old woman from Bao'an District, Shenzhen City, a 58-year old woman from Boluo County, Huizhou City currently hospitalized in Guangzhou City and a 52-year old man from Xingning County, Meizhou City. . 23 January: One new human case was reported in Shanghai: The patient is a 61-year old woman. Diagnosis and virus characteristics . Virus sequences available to public/scientific community (last updated 16 December 2013): Host GISAID GenBank / OpenFluDB Chicken 35 30 Duck 2 2 Environment 18 14 Human 96 37 Pigeon 5 5 Total 156 88

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Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 24 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 27 January 2014, 2000 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 249 confirmed; 60 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guizhou; China, Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 27 January: None of the 22 595 samples taken since 23 December 2014 from 12 000 poultry farms and households in Beijing City tested positive. . 27 January, Hong Kong SAR: Preliminary H7 PCR tests on a batch of live chicken imported from a registered poultry farm in Shunde District, Foshan City, Guangdong, were positive. . 27 January: MoA monitoring results for mid-January 2014: Two out of 180 chicken samples tested positive from retail markets in Tianhe and Yuexiu Districts, Guangzhou City, Guangdong. One environmental sample of 220 chicken, pigeon, duck and environmental samples tested positive from a market in Quanzhou City, Fujian. . 24 January: MoA surveillance summary: In 2013, 88 samples of 1 630 200 poultry and environmental samples tested positive (virus genome); positives are mainly from 26 live poultry operations sites in Shanghai, Jiangsu, Anhui, Zhejiang, Henan, Shandong, Jiangxi, Guangdong, Fujian and Hebei. Since 2014, 8 samples out of 11 400 samples from 2 402 locations tested positive (virus genome); positive samples are from 5 LBMs in Guangdong, Fujian, Guangxi and Zhejiang. . 24 January, Zhejiang: Starting from 26 January 2014, Ningbo City temporarily suspended live poultry trade and imports of foreign birds; pigeon flying activities in the city’s main districts were banned. . 24 January: For the New Year festivity period, the General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) issued an emergency notice to enhance border point controls. Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) | Wave 2 (July 2013 – January 2014) Province Duck Pigeon Chicken Environmental Not specified Total (markets, cages, restaurant) Shanghai 3 | 0 10 | 0 7 | 0 20 | 0 Jiangsu 2 | 0 11 | 0 13 | 0 Anhui 1 | 0 1 | 0 Henan 2 | 0 2 | 0 Shandong 3 | 0 3 | 0 Jiangxi 1 | 0 1 | 0 Guangdong 2 | 2 0 | 18 0 | 7 2 | 27 Zhejiang 2 | 0 8 | 0 0 | 7 0 | 12 10 | 19 Fujian 1 | 3 1 | 3 Hebei 0 | 10 0 | 10 Guangxi† ? unknown 35 | 0 35 | 0 TOTAL 3 | 0 5 | 0 32 | 2 13 | 28 35 | 29 88 | 59

* Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. † We have no information on the number of samples testing positive in Guangxi. Samples were taken from LBM(s). Page 1 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 27 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Humans: 13 new cases reported . 27 January: One new human case was reported in Hunan: The 58-year old woman from Yueyang City, Miluo City, with a history of live bird exposure. . 25-27 January: Three new human cases were reported in Jiangsu: A 57-year old man with a history of poultry exposure and a 74-year old woman, both from Suzhou City. The third case is a 76-year old man from Wuxi City. . 25 and 26 January: Five new human cases were reported in Zhejiang. Two cases are from Ningbo City: a 60-year old female farmer from Haishu District and a 48-year old female farmer from Cixi City. Two cases from Deqing County, Huzhou City, currently hospitalized in Hangzhou: a 49-year old male worker and a 65-year old male worker. The fifth case is a 40-year old male independent worker from Yuhang District, Hangzhou City. . 25 January: Three new human cases were reported in Guangdong: Two cases are from Shenzhen City: A 82-year old man from Luohu District and a 77-year old woman from Longgang District. The third case is a 68-year old farmer from Jianghai District, Jiangmen City. . 24 January: One new human case was reported in Fujian: The 46-year old female farmer from Hui'an County, Quanzhou City.

Page 2 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 27 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 3 of 3; FAO / EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 27 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 29 January 2014, 1800hours; Rome Overview Situation: Influenza A(H7N9)virus with pandemic potential Country: People’s Republic of China Number of human cases: 265 confirmed; 61 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 28 January, Zhejiang: The provincial government declared the temporary closure of LBMs until 15 February 2014 in all major cities’ main districts and in areas affected by H7N9. Permanent closure of LBMs in main districts of major cities will start on 1 July 2014. . 27-29 January, Hong Kong SAR: The Cheung Sha Wan Temporary Wholesale Poultry Market from which a batch of live chicken imported from Foshan, Guangdong, resulted positive has been declared infected by the Agriculture, Fisheries and Conservation Department (AFCD) and closed until 18 February. The concerned batch, of which 2 600 birds tested positive, and 20 004 other live birds present in the market were culled. Trading of live poultry (including birds from the Mainland and local birds) will be suspended during the closure period. Surveillance in local farms is being enhanced. Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) | Wave 2 (July 2013 – January 2014) Environmental Not specified Province Duck Pigeon Chicken (markets, cages, Total restaurant) Shanghai 3 | 0 10 | 0 7 | 0 20 | 0 Jiangsu 2 | 0 11 | 0 13 | 0 Anhui 1 | 0 1 | 0 Henan 2 | 0 2 | 0 Shandong 3 | 0 3 | 0 Jiangxi 1 | 0 1 | 0 Guangdong 2 | 2 0 | 18 0 | 7 2 | 27 Zhejiang 2 | 0 8 | 0 0 | 7 0 | 12 10 | 19 Fujian 1 | 3 1 | 3 Hebei 0 | 10 0 | 10 Guangxi† ? unknown 35| 0 35| 0 TOTAL 3 | 0 5 | 0 32 | 2 13 | 28 35 | 29 88 | 59

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. † We have no information on the number of samples testing positive in Guangxi. Samples were taken from LBM(s). Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Humans: 16 new cases were reported in Zhejiang (7), Guangdong (4), Fujian (3), Hong-Kong SAR (1) and Jiangsu (1). . 29 January, Zhejiang: Among previously reported human cases, one family cluster was identified in Xiaoshan District, Hangzhou City. Before onset, all three concerned patients had a common environmental exposure. Experts are studying the exact cause of infection. . 29 January: The MoH released an updated H7N9 avian influenza human infection prevention and control program (ver.3), including case definition, cluster definition, epidemiological investigation, sampling procedures and laboratory responsibilities and procedures. (reference) . 28 January, Hong Kong SAR: The poultry worker at the wholesale poultry market transporting the live chickens that tested positive has remained asymptomatic and tested negative for the H7 virus. . 24 January: The MoH released an updated Treatment Guideline for H7N9 Avian Influenza human infection, including laboratory test descriptions and diagnosis flow-charts (reference). Diagnosis and virus characteristics . Virus isolates available to public/scientific community (last updated 27 January 2014): Host GISAID GenBank / OpenFluDB Chicken 36 29 Duck 30 20 Environment 23 19 Human 110 50 Pigeon 5 5 Total 204 123 FAO’s global actions . FAO continues supportingat-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 31 January 2014, 1700hours; Rome Overview Situation: Influenza A(H7N9)virus with pandemic potential Country: People’s Republic of China Number of human cases: 277 confirmed; 63 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 30 January: Recent scientific research demonstrates an A(H7N9) isolate of human origin capable of replicating in finches, sparrows, and parakeets. These birds shed virus through the oropharyngeal route despite showing few disease signs (reference) and may therefore facilitate virus spread. . 30 January, Guangdong: all LBMs in Shenzhen City will be temporarily closed from 31 January until 13 February. This measure will concern both wholesale and retail markets. . 28 January, Jiangsu: Suzhou Municipality is asking urban LBM managers to publicly comment on measures to be taken such as closure of LBMs that do not comply with the “Separation 4 Policy”, i.e. strict separation of live bird areas, slaughtering areas, poultry product and non-poultry product sales areas; setting up ‘one disinfection a day, one rest day a week’ in all other LBMs; safety measures for staff handling live birds; surveillance; and enforcement of banning off-market live poultry vendors. . 28 January, Hong Kong SAR: The culling operation in the affected Wholesale Poultry Market was completed. A total of 22 604 poultry, including 16 984 chickens, 2 898 silky fowls, 1 080 pheasants and 1 642 pigeons were destroyed after a consignment of silky fowls had resulted positive. Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) | Wave 2 (July 2013 – January 2014) Environmental Not specified Province Duck Pigeon Chicken (markets, cages, Total restaurant) Shanghai 3 | 0 10 | 0 7 | 0 20 | 0 Jiangsu 2 | 0 11 | 0 13 | 0 Anhui 1 | 0 1 | 0 Henan 2 | 0 2 | 0 Shandong 3 | 0 3 | 0 Jiangxi 1 | 0 1 | 0 Guangdong 2 | 2 0 | 18 0 | 7 2 | 27 Zhejiang 2 | 0 8 | 0 0 | 7 0 | 12 10 | 19 Fujian 1 | 3 1 | 3 Hebei 0 | 10 0 | 10 Guangxi† ? unknown 35| 0 35| 0 TOTAL 3 | 0 5 | 0 32 | 2 13 | 28 35 | 29 88 | 59 Positive virological samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (1,3) 63 63 Shandong (2) 8 8 Jiangsu(4,5) 1 1 2 TOTAL 0 0 9 64 73

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. † We have no information on the number of samples testing positive in Guangxi. Samples were taken from LBM(s). Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 31 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Humans: 12 new cases were reported, 11 of them in already infected provinces: Guangdong (5), Zhejiang (4), Jiangsu (1), and Hunan (1). The first human case was reported from Guangxi Province (1) on 29 January. For detailed information on human cases please refer to WHO's Disease Outbreak News. Diagnosis and virus characteristics . Virus isolates available to public/scientific community (last updated 27 January 2014): Host GISAID GenBank / OpenFluDB Chicken 36 29 Duck 30 20 Environment 23 19 Human 110 50 Pigeon 5 5 Total 204 123 FAO’s global actions . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 31 January 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 03 February 2014, 1100hours; Rome Overview Situation: Influenza A(H7N9)virus with pandemic potential Country: People’s Republic of China Number of human cases: 290 confirmed; 66 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 30 January, Guangdong: all LBMs in Shenzhen City will be temporarily closed from 31 January until 13 February. This measure will concern both wholesale and retail markets. . 28 January, Jiangsu: Suzhou Municipality is asking urban LBM managers to publicly comment on measures to be taken such as closure of LBMs that do not comply with the “Separation 4 Policy”, i.e. strict separation of live bird areas, slaughtering areas, poultry product and non-poultry product sales areas; setting up ‘one disinfection a day, one rest day a week’ in all other LBMs; safety measures for staff handling live birds; surveillance; and enforcement of banning off-market live poultry vendors. . 28 January, Hong Kong SAR: The culling operation in the affected Wholesale Poultry Market was completed. A total of 22 604 poultry, including 16 984 chickens, 2 898 silky fowls, 1 080 pheasants and 1 642 pigeons were destroyed after a consignment of silky fowls had resulted positive. . 24 January: MoA surveillance summary: Since 2014, 8 samples out of 11 400 samples from 2 402 locations tested positive (virus genome); positive samples are from 5 LBMs in Guangdong, Fujian, Guangxi and Zhejiang. Positive virological samples confirmed by national authorities Wave 1 (March - May 2013) | Wave 2 (July 2013 – January 2014) Environmental Not specified Province Duck Pigeon Chicken (markets, cages, Total restaurant) Shanghai 3 | 0 10 | 0 7 | 0 20 | 0 Jiangsu 2 | 0 11 | 0 13 | 0 Anhui 1 | 0 1 | 0 Henan 2 | 0 2 | 0 Shandong 3 | 0 3 | 0 Jiangxi 1 | 0 1 | 0 Guangdong 2 | 2 0 | 18 0 | 7 2 | 27 Zhejiang 2 | 0 8 | 0 0 | 7 0 | 12 10 | 19 Fujian 1 | 3 1 | 3 Hebei 0 | 10 0 | 10 Guangxi† ? unknown 35| 0 35| 0 TOTAL 3 | 0 5 | 0 32 | 2 13 | 28 35 | 29 88 | 59 Positive virological samples reported in peer-reviewed articles (last updated 10 January 2014) Province Duck Pigeon Chicken Environmental Total Zhejiang (1,3) 63 63 Shandong (2) 8 8 Jiangsu(4,5) 1 1 2 TOTAL 0 0 9 64 73

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. † We have no information on the number of samples testing positive in Guangxi. Samples were taken from LBM(s). Page 1 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Humans: 13 new cases were reported: Guangdong (6), Zhejiang (3), Fujian (2), and Hunan (2). For detailed information on human cases please refer to WHO's Disease Outbreak News. The patients reported from Fujian returned recently from Shanghai and Zhejiang, respectively. The first human case was reported from Guangxi Province on 29 January. Diagnosis and virus characteristics . Virus isolates available to public/scientific community (last updated 27 January 2014): Host GISAID GenBank / OpenFluDB Chicken 36 29 Duck 30 20 Environment 23 19 Human 110 50 Pigeon 5 5 Total 204 123 FAO’s global actions . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 2 of 2; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 04 February 2014, 1100hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 299 confirmed; 69 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 30 January: Recent scientific research demonstrates an A (H7N9) isolate of human origin capable of replicating in finches, sparrows, and parakeets. These birds shed virus through the oropharyngeal route despite showing few disease signs (reference) and may therefore facilitate virus spread. . 30 January, Guangdong: all LBMs in Shenzhen City will be temporarily closed from 31 January until 13 February. This measure will concern both wholesale and retail markets. Provincial distribution of positive virological samples from birds or the environment sorted by Province

Positive virological samples sorted by type of sample

73 additional positive virological samples (9 chickens, 64 environmental) were reported in peer-reviewed articles (1, 2, 3, 4, 5). Humans: Since Friday 31 January, 22 new cases were reported: Guangdong (9), Zhejiang (7), Fujian (2), Hunan (2), Guangxi (1) and Jiangsu (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. . 29 January, Guangxi: Following the report of the first human case in Lingfeng Township, local health authorities have taken 38 environmental samples from Aiqun Village, Lingfeng Township market and 5 other live bird markets in Hezhou City. All samples were negative for avian influenza A (H7N9).

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area. Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 04 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Provincial distribution of officially reported human cases

Province with newly reported cases

Weekly distribution of officially reported human cases (by onset date)

Diagnosis and virus characteristics . Virus isolates available to public/scientific community (last updated 27 January 2014): Host GISAID GenBank / OpenFluDB Chicken 36 29 Duck 30 20 Environment 23 19 Human 110 50 Pigeon 5 5 Total 204 123 FAO’s global actions . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 04 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 04 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 situation update FAO / EMPRES – Animal Health 11 February 2014, 1830hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China Number of human cases: 337 confirmed; 83 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Hong Kong SAR and Taiwan Province of China; Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update China New Chinese province recently affected: Guangxi  Positive LBM findings reported on 24.01.2014.  Three human cases reported on 29.01., 4. and 5.02.2014, respectively,

the latest two were most likely exposed in Guangdong Province (*).  Guangxi is bordering Viet Nam – implications for international spread  FAO is initiating an awareness campaign and promoting increased Viet Nam surveillance in the Vietnamese provinces bordering Guangxi.  Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. Animals . 10 February, Guangdong: Zhongshan City’s LBMs (243 in total) will be closed for two weeks and thoroughly disinfected (reference). Two human cases were reported in this city early February. . 10 February, Hunan: Following the report of two human cases, Jiangyong County of Yongzhou City has temporarily closed its LBMs (reference). . 9 February, Anhui: Anqing City Animal Husbandry Bureau declared the emergency closure of all LBMs in Susong County of Anqing City (reference). The first human case in this city was reported on 9 February. . 8 February: MoA has published the animal H7N9 avian influenza monitoring results for late January 2014: pathological samples testing positive were 1/2730 (0.04%) from Zhejiang, 3/60 (5.00%) from Hunan, 3/2426 (0.12%) from Guangdong and 4/386 (1.04%) from Guangxi. In addition, 3/1684 (0.18%) serum samples collected in Guangxi tested serologically positive (reference). . 6 February, Hunan: Miluo City of Yueyang City closed all its LBMs from 6 to13 February (reference). . 5 February, Guangdong: the provincial government intends to change the market method in the long- term to centralized slaughtering of poultry and supply of chilled poultry (reference). . 29 January, Guangdong: following the detection in a Hong-Kong market of an H7N9 positive consignment of silky fowls imported from Shunde District of Foshan City, the Provincial Agricultural Department conducted emergency sampling in Shunde District: 83 chicken samples and 12 environmental samples were collected from 24 poultry farms and wholesale markets. All tested negative (reference).

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for 77 additional samples (35 in wave 1, 42 in wave 2). 73 additional positive virological samples (9 chickens, 64 environmental) were reported in peer-reviewed articles (1, 2, 3, 4, 5).

Humans: Since Tuesday 4 February, 38 new cases were reported: Zhejiang (14), Guangdong (11), Hunan (4), Jiangsu (3), Anhui (2), Fujian (2), Guangxi (1), and Beijing (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. . 10 February: The MoH published a Notifiable Disease Situation Report: during January 2014, a total of 127 new human cases and 31 new human deaths were reported (reference). Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date)

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Research . 8 February, Shanghai: a genetically-engineered H7N9 vaccine developed by the Shanghai Institute of Infectious Diseases and Re-emerging Diseases has completed two rounds of in-vitro tests and is expected to conclude its third and last round within a month. Once completed, the vaccine will undergo clinical trials (reference). FAO’s global actions . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 18 February 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 356 confirmed; 86 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Hong Kong SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update First human case reported in a new country: Malaysia  A 67-year old female tourist who was travelling from Guangdong Province (China) to Sabah State (Malaysia).  First symptoms appeared four days prior to departure.  The patient is in stable condition, hospitalized in Malaysia.  None of her close contacts tested positive Animals . 18 February, Hong Kong SAR: As the temporary closure of wholesale poultry markets is ending today, the Government is identifying suitable sites for the separate holding of imported and local live poultry awaiting test results. In the meantime, the import of live poultry from Mainland China for slaughter and consumption will be suspended, initially for four months (reference). . 18 February, Anhui: Lujiang County has decided to close its LBMs for two weeks (reference). . 14 February, Zhejiang: The Industry and Commerce Bureau of Hangzhou will implement permanent closure of all LBMs in main urban districts of Hangzhou City. LBMs are already closed temporarily since 24 January (reference). . 11 February, Guangdong: According to the MoA circular on surveillance results, 11 findings reported in the update of 11 February as of unknown origin have now been identified as 9 chicken, 1 duck and 1 environmental sample. Positive virological samples from birds or the environment, by province* and time period

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for 66 additional samples (35 in wave 1, 31 in wave 2). 73 additional positive virological samples (9 chickens, 64 environmental) were reported in peer-reviewed articles (1, 2, 3, 4, 5).

Humans: Since Tuesday 11 February, 19 new cases were reported: Guangdong (8), Zhejiang (3), Hunan (3), Anhui (2), Jiangsu (1), Hong-Kong (1), and Malaysia (1). Both cases in Hong-Kong and Malaysia had travelled from Guangdong. For detailed information on human cases please refer to WHO's Disease Outbreak News.

Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date)

Information sources for human cases: WHO, National and Provincial Government websites

Sequence data The following new sequences are available in online databases (submission date after 27 January 2014): . GISAID: 6 human (China), 2 environment (China) and 1 silky chicken (HK SAR) . OpenFlu: 2 environment (China) and 1 human (China)

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 25 February 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 370 confirmed; 114 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 20 February: The MoA issued a document entitled National Eradication Plan for Poultry H7N9 Influenza (reference). Main points are: -Losses in the poultry industry due to H7N9 are evaluated to reach 60 billion yuan in the first half of 2013 and 40 billion yuan since the beginning of 2014. -So far, most positive H7N9 samples were collected in live bird markets, but existence of the virus in poultry farms cannot be ruled out. -The plan aims to enhance laboratory capacity and surveillance at all levels to improve early detection of H7N9 in poultry and reduce the risk of transmission to humans. -Provinces, cities and counties will be stratified into “high-risk areas” and “low-risk areas” and surveillance strategies will be adjusted in regard to this stratification. -The plan proposes that transportation of poultry among different provinces requires a H7N9-free certificate from farms certified as H7N9-free for the previous 21 days. A quarantine period of 21 days will also be observed before the imported birds are mixed with local poultry. -If a positive sample is found in a LBM, local governments are advised to close the market for 21 days Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 25 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 18 February, 14 new cases were reported: Guangdong (11), Hunan (1), Anhui (1), and Jilin (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. . 21 February, Jilin: The province reported its first human case in Changchun City on 21 February. Patient is engaged in poultry and has no recent travel history, suggesting the infection may have been locally acquired. No positive findings have been reported from bird or environmental samples in this province. Jilin Province shares borders with both the Democratic People’s Republic of Korea and the Russian Federation.

Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between October 2013 and February 2014

Information sources for human cases: WHO, National and Provincial Government websites Research . 19 February: An article was published in Emerging Infectious Diseases which reports the first finding of a H7N9 viropositive wild bird during surveillance performed in Shanghai. Out of 2,198 samples collected from wild birds, a tracheal swab from an apparently healthy tree sparrow, tested positive. The sample was inoculated into an egg and the virus was isolated. Cloacal swab from the same bird tested negative (reference). Sequence data The following new sequences are available in online databases (submission date after 27 January 2014): GISAID: 6 human (China), 2 environment (China) and 1 silky chicken (HK SAR) OpenFlu: 2 environment (China) and 1 human (China)

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 25 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** - Develop long term market management plans including rest and cleaning days - Increase advocacy at political, provincial and market level for H7N9 . FAO-RAP and FAO-Vietnam have met with the Ministry of Agriculture and Rural Development of Vietnam to discuss the “Action plan for emergency response to dangerous avian influenza virus strains which can transfer to the human beings” which was approved on 14 February. . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date:US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 25 February 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 04 March 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 379 confirmed; 119 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 25 February: MoA published the national H7N9 monitoring results for mid-February: 17,605 serological samples and 16,157 pathological samples were collected in 1,205 locations. 64 sero-positive samples were found from 8 places in Hunan: 23 samples were collected in live bird markets, 39 in backyard farms and 2 in commercial poultry farms. In addition, two positive pathological samples were found in Hunan: one positive chicken sample out of 40 samples taken (13 samples from chicken, 12 samples from ducks and 15 environmental samples) at Changsha City Gelin Xincheng market, where 138 birds have been culled, and one positive out of 45 chicken samples taken at Loudi City Shuangfeng County Chengbei market, where 22 birds were destroyed (reference). . 18 February: MoA published the national H7N9 monitoring results for early February: 11,963 serological samples and 13,992 pathological samples were collected in 1456 locations. All samples tested negative (reference). Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for 64 additional samples (35 in wave 1, 29 in wave 2). 73 additional positive virological samples (9 chickens, 64 environmental) were reported in peer-reviewed articles (1, 2, 3, 4, 5).

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 04 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 25 February, 9 new cases were reported: Zhejiang (3), Hunan (3), Guangdong (2), and Jiangsu (1). All three patients reported in Zhejiang were children, two of them suffering from severe illness. This marks the first time that severe illness caused by H7N9 was reported in children. (For detailed information on human cases please refer to WHO's Disease Outbreak News. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between October 2013 and February 2014

Information sources for human cases: WHO, National and Provincial Government websites

Research . 26 February: Journal of virology published an article on the role of poultry in the spread of H7N9. (reference). After intranasal inoculation of the virus, chickens, Japanese quail, pigeons, Pekin ducks, Mallard ducks, Muscovy ducks, and Embden geese showed an infection but without any clinical signs. Virus shedding in quail and chickens was higher and prolonged compared to other species. Quail effectively transmitted the virus to direct contacts but pigeons and Pekin ducks did not. In all species, virus titres from oropharyngeal swabs were significantly higher than from cloacal swabs.

FAO’s global actions . FAO-RAP organized a regional meeting on contingency planning for H7N9 in Pattaya, Thailand, 17-19 February. All countries from South Asia and Southeast Asia were invited for this meeting. Major outcomes: all countries agreed to - Increase their targeted surveillance - Update their emergence preparedness and response plans to include increased surveillance, market closures, cleaning and disinfection upon detection of H7N9 - Develop long term market management plans including rest and cleaning days - Increase advocacy at political, provincial and market level for H7N9 . FAO-RAP and FAO-Viet Nam have met with the Ministry of Agriculture and Rural Development of Viet Nam to discuss the “Action plan for emergency response to dangerous avian influenza virus strains which can transfer to the human beings” which was approved on 14 February. . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam.

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 04 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 04 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 11 March 2014, 1750hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 388 confirmed; 122 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 7 March: The Chinese MoA launched the 2014 Spring Campaign for Major Animal Disease Prevention and Control, including arrangements for early warning and strengthening of border controls; the importance of H7N9 control is being stressed. (reference) . 5 March: The Chinese MoA published the national H7N9 monitoring results for the last third of February: 37,504 serological samples and 7,010 pathological samples were collected in 1,531 locations. 41 sero-positive samples from 8 free ranging farms in Hunan (32), Jilin (8) and Zhejiang (1) were found positive for H7. In addition, six positive pathological samples were found in Hunan (3, from 2 LBMs) and Guangdong (3, from 1 LBM): all samples were from chickens (reference). . 4 March, Guangdong: Following the detection of a human case, Zhuhai City closed all LBMs on 5 March and the affected LBM from 3-5 March 2014 for cleaning and disinfection (reference). . 28 February: The Democratic People’s Republic of Korea has banned the import of poultry from countries and areas where H7N9 occurs and strengthened quarantine policies (reference). Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 04 March, 9 new cases were reported: Guangdong (5), Jiangsu (1), Fujian (1), Shandong (1) and Hong-Kong SAR (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites Officially reported human cases, by week (onset date), between February 2013 and March 2014

Information sources for human cases: WHO, National and Provincial Government websites Officially reported human cases, by week (onset date) in Zhejiang Province, between October 2013 and February 2014

Officially reported human cases, by week (onset date) in main Zhejiang cities, in January and February 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Sequence data The following new sequences are available in online databases (submission date after last Update): OpenFlu: 1 chicken, 1 environment and 2 human (Guangzhou)

FAO’s global actions . FAO and WHO held a joint briefing session on H7N9 for the diplomatic community in Hanoi (news) . FAO-RAP organized a regional meeting on contingency planning for H7N9 in Pattaya, Thailand, 17-19 February. All countries from South Asia and Southeast Asia were invited for this meeting. Major outcomes: all countries agreed to - Increase their targeted surveillance - Update their emergence preparedness and response plans to include increased surveillance, market closures, cleaning and disinfection upon detection of H7N9 - Develop long term market management plans including rest and cleaning days - Increase advocacy at political, provincial and market level for H7N9 . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 11 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 18 March 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 394 confirmed; 123 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, ducks, pigeons and environmental samples: positive virological samples mainly from live bird markets and vendors. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 15 March, Macao SAR: Environmental samples from two chicken stalls in Xiahuan Market and Yingdi Market tested positive for H7 avian influenza. No result in regard to the Neuraminidase has yet been officially reported (reference). Prior to this, on 12 March a live poultry consignment imported into Macao SAR from a registered farm in Doumen District, Zhuhai City, Guangdong tested positive for H7 while in quarantine. All chickens were culled, and all live poultry sales have been suspended for 21 days (reference) . 15 March, Hunan: One environmental sample from Mei Jiang LBM of Changde city tested positive for H7N9. There has been no human case in this city so far (reference). . 12 March: Results of the MoA avian influenza monitoring for the first 1/3 of March were published. Eight out of 30434 serum samples tested positive for H7 serology. All samples were from a chicken farm in Lianyungang City, Jiangsu. 8056 pathological samples were also collected and all tested negative for H7N9 (reference).

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 11 March, 6 new cases were reported: Guangdong (3), Anhui (1), Hunan (1) and Hong-Kong SAR (1). Onset of symptoms of this last case was in Shenzhen City, Guangdong; travelled to Hong-Kong SAR afterwards. For detailed information on human cases please refer to WHO's Disease Outbreak News. Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites Officially reported human cases, by week (onset date), between February 2013 and March 2014

Information sources for human cases: WHO, National and Provincial Government websites

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and February 2014

Officially reported human cases, by week (onset date) in main Guangdong and Zhejiang cities, in January and February 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Sequence data The following new sequences are available in online databases (submission date after last Update): OpenFlu: no new sequences GISAID: 1 human (Hong Kong SAR)

FAO’s global actions . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO has updated its qualitative risk assessment: http://www.fao.org/docrep/019/i3631e/i3631e.pdf . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO Frequently Asked Questions:http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 18 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 25 March 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 400 confirmed; 126 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 24 March: The MoA published an assessment of the market price situation: prices for eggs, live chickens, layer chicks and broiler chicks are respectively 3.5%, 7.7%, 10.3% and 14.4% lower than last year at the same period (i.e. a week before the announcement of the first H7N9 human cases). These prices have however slightly increased compared to the previous week: +1% for eggs, +0.1% for live chickens, +1.4% for layer chicks and +4.3% for broiler chicks (reference). . 21 March: The MoA published the national animal H7N9 monitoring results for the second third of March. In addition to the four virological findings in a Zhuhai farm (see below), 2 other pathological samples out of 15,191 collected tested positive in Guangzhou City, Guangdong: one chicken sample from a market in Luogang District (369 poultry were culled) and one chicken sample from a market in Yuexiu District. None of the 15,129 serum samples tested positive for H7 (reference). . 14 March, Guangdong: Following the detection of a H7-positive consignment of chickens in Macao quarantine, the farm of origin in Zhuhai City was investigated and four samples tested H7N9 positive. This is the first reported virological finding on a poultry farm. The farm was quarantined and all 80,000 chickens culled. Financial compensation from the local government will be provided (reference). Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 25 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 18 March, 6 new cases were reported: Guangdong (4), Hunan (1), and Anhui (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites Officially reported human cases, by week (onset date), between February 2013 and March 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and March 2014

Officially reported human cases, by week (onset date) in main cities, in January and March 2014: Guangdong Zhejiang

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 25 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Peer reviewed journals: . An article was published on a mouse model for H7N9 infection and transmissibility research: A human H7N9 isolate efficiently infected mice, causing lethal symptoms. The virus was transmitted to uninfected mice via direct contact and caused morbidity and pathological changes (reference). Sequence data The following new sequences are available in online databases (submission date after last Update): GISAID: 2 human (Hong Kong SAR) FAO’s global actions . FAO and the Veterinary Bureau of China held a three day workshop in Guangzhou on strengthening capacity for surveillance, biosecurity and value chain analysis. Participants included senior staff from the Veterinary Bureau, China Animal Disease Prevention and Control Centre, staff of the China Animal Health and Epidemiology Center (CAHEC), provincial Directors or their deputies and the Field Epidemiology Training Programme for Veterinarians (FETPV) network. . Joint risk assessments are now routinely conducted between WHO, FAO and government counterparts in Viet Nam. . FAO is initiating an awareness campaign and promoting increased surveillance in the Vietnamese provinces bordering Guangxi through its TCP project and USAID funding. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO FAQ: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 25 March 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 01 April 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 404 confirmed; 127 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 1 April: MoA published the results of the national H7N9 monitoring for the third part of March 2014: 32 out of 27668 serum samples tested positive for H7 serology. Sixteen were from Shanghai City and 16 from Anyang City, Henan Province. None of the 9354 pathological samples tested postive (reference). . 27 March, Guangdong: The provincial government announced piloting the model of central slaughtering and marketing of chilled poultry products in Guangzhou City from 1 May 2014. Raising poultry in urban areas will be prohibited to citizens (reference). . 24 March, Hunan: Changde City CDC announced that on 13 of March live bird markets of the city were tested for H7N9 nucleic acid and one environmental sample was found positive. The same market was revisited the next day for further sampling and three environmental specimens out of the five collected also tested positive. The live poultry section of the market was closed for three days (reference). . 22 March, Guangdong: Following the detection of H7N9 nucleic acid in samples collected from Zhuhe Market in Shantou City, all live bird stalls of the market were closed for three days. Normal operation was resumed on 25 March (reference). . 21 March, Jiangsu: Nanjing City administration announced the temporary closure of live bird markets in six districts from 1 April until 31 August. In addition, only imports of birds destined to the city's centralized slaughterhouse will be allowed to enter these districts (reference). . 2 February: MoA published its Official Veterinary Bulletin, containing a summary of the surveillance results obtained through national H7N9 monitoring, including wild birds and pigs, during the month of January 2014. Eighty-six pathological wild bird samples from five different habitats and 130 pathological samples from pigs were collected and all tested negative for avian influenza (reference). Positive virological samples from birds or the environment, by province* and time period

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 01 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Positive virological samples of known origin, from birds or the environment

Humans: Since Tuesday 25 March, 4 new cases were reported: Guangdong (1), Hunan (1), Fujian (1) and Jiangsu (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites Officially reported human cases, by week (onset date), between February 2013 and March 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and March 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 01 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Officially reported human cases, by week (onset date) in main cities, in January and March 2014: Zhejiang Guangdong

Sequence data The following new sequences are available in online databases (submission date after last Update): Genbank/OpenFluDB: 3 human FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort). Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO FAQ: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm Human cases* and positive findings in birds and from market or restaurant environments *Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 01 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 08 April 2014, 1730hours; Rome

Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 419 confirmed; 131 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . 3 April, Macau SAR: live bird imports from mainland have resumed. Enhanced quarantine and surveillance measures have also been implemented (reference). . 31 March, Zhejiang: Zhuji City of Shaoxing City will resume live poultry trade on 11 May. Stricter market control measures including enhanced cleaning and disinfection and mandatory rest days will be implemented (reference).

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 08 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 08 April, 6 new cases were reported: Guangdong (4), and Hong Kong SAR (2). The two cases from Hong Kong seem to have been exposed in Guangdong Province: the first case is from Guangzhou City, Guangdong and travelled to Hong Kong after the onset of symptoms; the second visited relatives in Dongguan City where she was helped slaughter poultry a few days before onset of symptoms. For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites.

Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites

Officially reported human cases, by week (onset date), between February 2013 and March 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and March 2014

Sequence data No new sequences were deposited in GenBank/OpenfluDB or in GISAID.

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 08 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9 . Funding to date: US$6.9 million mobilized (US$ 5 million USAID,US $1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO FAQ: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 08 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 15 April 2014, 1630hours; Rome

Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 421 confirmed; 145 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . 15 April, Taiwan Province: Taiwan CDC announced the deactivation of their H7N9 influenza Central Epidemic Command Center (CECC). H7N9-related prevention and control activities will be maintained under regular operation mechanisms instead (reference). . 14 April: MoA has published the results of its National H7N9 monitoring for the first third of April: a total of 13820 serum samples and 6128 pathological samples were collected in 751 locations in 17 provinces and all tested negative (reference).

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 15 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 08 April, 8 new cases were reported: Guangdong (4), Hong Kong SAR (2), Jiangsu (1), and Hunan (1). The two cases from Hong Kong seem to have been exposed in Guangdong Province: the first case is from Guangzhou City, Guangdong and travelled to Hong Kong after the onset of symptoms; the second case visited relatives in Dongguan City where she assisted in the slaughter of poultry a few days before onset of symptoms. For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites.

Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites

Officially reported human cases, by week (onset date), between February 2013 and March 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and March 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 15 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Peer-reviewed literature: . Plos One published an article comparing the characteristics of H7N9 patients living in rural and urban areas of Zhejiang Province. The amount of cases who had been exposed to poultry was significantly higher (p=0.038) for rural cases (14/15, 93%) then for urban cases (16/25, 64%). Bird species involved in exposure were chickens, ducks and pigeons. Types of exposure to poultry in rural and urban cases were reported as: buying poultry (43% vs. 56%), visiting a poultry market (7% vs. 13%), breeding poultry (43% vs. 19%), and killing poultry (31% vs. 6%), respectively. Overall, 76% (29/38) of patients had underlying medical conditions (reference).

FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 15 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 22 April 2014, 1700hours; Rome

Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 427 confirmed; 147 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . 22 April: MoA has published the results of its National H7N9 monitoring for the second third of April: a total of 5802 serum samples and 931 pathological samples were collected in 341 locations in 5 provinces and all tested negative (reference). . 19 April, Macao SAR: One environmental sample collected from Nam Yue wholesale market tested positive for H7N9. More than 8000 birds were culled and the market was thoroughly disinfected. Live poultry trade has also been suspended in Macao for 21 days (reference).

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 22 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 15 April, 6 new cases were reported: Jiangsu (3), Anhui (1), Guangdong (1) and Hunan (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites.

Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites

Officially reported human cases, by week (onset date), between February 2013 and April 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and April 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 22 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 22 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 29 April 2014, 2300hours; Rome

Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 432 confirmed; 147 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . 29 April, Shanghai: The city will resume live poultry trade on 1 May. However the Jing’an District Commission of Commerce indicated that the district will not resume live bird trading in May but continue promoting the fresh poultry meat sales (reference). . 29 April, Guangdong: Guangzhou City CDC expert said that the recent surveillance results indicated that 60% of the markets they tested in the city were contaminated by H7N9; >15% of samples (e.g. poultry stalls sewage, chopping boards, plucking machines) tested were positive (reference). . 26 April, Guangdong: Guangzhou City will start implementing and promoting centralized slaughtering and setting up cold chains for delivery/transport of poultry carcasses or products in four pilot districts from 5 May for 6 months (reference).

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 22 April, 5 new cases were reported: Taiwan (2), Jiangsu (1), Jiangxi (1) and Anhui (1). The two cases reported in Taiwan Province were travelling from mainland China: one had visited Beijing and Kunshan City, Jiangsu Province and the other is from Nanjing City, Jiangsu Province. Note: this is the first reported human case in Jiangxi Province since May 2013. For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites.

Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites

Officially reported human cases, by week (onset date), between February 2013 and April 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and April 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 April 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 06 May 2014, 1700hours; Rome

Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 435 confirmed; 148 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update Animals . 06 May: MoA has published the results of its national H7N9 monitoring for the third part of April. 46,991 serum samples and 30,082 pathological samples were collected in 2,510 locations in 17 provinces. Five pathological samples collected from chickens in LBMs tested positive for H7N9 in: Boluo County, Huizhou City, Guangdong Province (1 chicken), Lee Tong District, Wuzhong City, Ningxia Hui Autonomous Region (1), Fuzhou City, Fujian Province (2) and Xiamen City, Fujian Province (1). In addition, 6 serum samples collected on ducks were seropositive for H7 in Haixia poultry wholesale market in Fuzhou City, Fujian Province (reference);,a positive chicken was also confirmed in this market. . MoA has published its veterinary bulletin for the months of February and March. In addition to the environmental and domestic bird sampling mentioned in previous updates, 716 samples from wild bird and 479 swine samples were collected and tested negative (reference: MoA Veterinary Bulletins for February and March). Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 06 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 29 April, 3 new cases were reported: Hunan (1), Jiangxi (1) and Guangdong (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites.

Officially reported human cases, by province* and time period

Information sources for human cases: WHO, National and Provincial Government websites

Officially reported human cases, by week (onset date), between February 2013 and April 2014

Officially reported human cases, by week (onset date) in Zhejiang and Guangdong Provinces, between October 2013 and April 2014

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 06 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . 28-30 April: FAO and WHO, with support from USAID, conducted a sub-regional technical consultation in Yangon, Myanmar to review H7N9 preparedness, surveillance and response in Viet Nam, Myanmar and Lao PDR with emphasis on collaboration of animal and public health sectors. To date, no H7N9 virus has been detected through surveillance activities in these countries. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 06 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 13 May 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 437 confirmed; 156 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update China Human case detected in Jilin Province, close to the border with Democratic People’s Republic of Korea (DPRK)  On 9 May 2014 a human case was reported in East-Jilin: A 63-year old male from Yanji City with underlining illness (alcoholic cirrhosis) for the DPRK past 2-years, currently in critical condition.  The Eastern border of Jilin Province is shared with DPRK – international implications  Another human case had been reported in Central-Jilin on 21.02.2014: a farmer from Chanchung City.

Animals . 28 April: Shanghai resumed live bird trade from 1 May except for Jing’an, Hongkou and Yangpu Districts which have kept the ban. Resuming trade is only a transitional measure as large cities are supposed to switch to marketing chilled poultry products (reference). Positive virological samples from birds or the environment, by province* and time period

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 13 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for 64 additional samples (35 in wave 1, 29 in wave 2); 74 additional positive virological samples (9 chickens,1 tree sparrow, 64 environmental) were reported in peer-reviewed articles (1, 2, 3, 4, 5, 7). Humans: Since Tuesday 06 May, 2 new cases were reported: Jilin (1), close to the border with the DPRK, and Guangdong (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and April 2014

Sequence data The following new sequences are available in online databases (submission date after 1 April 2014): GISAID: 3 chicken, 4 human

FAO’s global actions . 28-30 April: FAO and WHO, with support from USAID, conducted a sub-regional technical consultation in Yangon, Myanmar to review H7N9 preparedness, surveillance and response in Viet Nam, Myanmar and Lao PDR with emphasis on collaboration of animal and public health sectors. To date, no H7N9 virus has been detected through surveillance activities in these countries. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin Page 2 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 13 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO FAQ: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Page 3 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 13 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 4 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 13 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 20 May 2014, 1730hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 441 confirmed; 156 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update

Animals . 15 May, Guangdong: Guangzhou CDC mentioned recent surveillance results in a press release, one week after Guangzhou City's fresh poultry marketing pilot project started. In the past week, 12.5% of markets found H7N9 virus (6.66% of positive samples) in the non-pilot areas, while pilot-participating areas showed a 0% positive rate [reference]. . 14 May: MoA published their national H7N9 monitoring results for the first part of May: 10,428 serum samples and 3,251 pathological samples were collected in 526 locations in 12 provinces (Hebei, Liaoning, Jiangsu, Zhejiang, Jiangxi, Shandong, Hunan, Guangdong, Guangxi, Hainan, Chongqing and Sichuan). All samples tested negative [reference]. . Emerging Infectious Diseases published an article which summarizes the results of the surveillance implemented in Guangzhou by the CDC. During April–October 2013, 3 of 3,355 environmental samples collected from 24 LBMs were positive for influenza A(H7N9) virus. From November 2013 to 7 March 2014, 141 (2.70%) out of the 5,220 samples collected from 48 LBMs tested positive [reference]. Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 20 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 13 May, 4 new cases were reported: Guangdong (3) and Jiangsu (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and May 2014

Sequence data Distribution of OPENFLU genetic sequences per species, per wave and per sequence size

Distribution of GISAID genetic sequences per species, per wave and per sequence size 160 120 139 104 140 100 120 100 80 human partial genome avian 80 60 48 60 full genome environment 37 40 40 23 20 wild bird 16 20 7 4 20 1 1 1 2 0 0 0 wave 1 wave 2 lab strain wave 1 wave 2

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 20 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . 28-30 April: FAO and WHO, with support from USAID, conducted a sub-regional technical consultation in Yangon, Myanmar to review H7N9 preparedness, surveillance and response in Viet Nam, Myanmar and Lao PDR with emphasis on collaboration of animal and public health sectors. To date, no H7N9 virus has been detected through surveillance activities in these countries. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 20 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 27 May 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 446 confirmed; 157 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 22 May: MoA published their national H7N9 monitoring results for the second part of May: 2,589 serum samples and 1,527 pathological samples were collected in 159 locations in 8 provinces (Liaoning, Jiangsu, Zhejiang, Fujian, Jiangxi, Shandong, Hunan, and Guangxi or Hainan [unclear]). All samples tested negative [reference]. Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for 64 additional samples (35 in wave 1, 29 in wave 2); 218 additional positive virological samples were reported in peer-reviewed articles (1, 2, 3, 4, 5, 7, 8). Humans: Since Tuesday 20 May, 5 new cases were reported: Anhui (3) and Shandong (2). For detailed information on human cases please refer to WHO's Disease Outbreak News. Research A longitudinal study investigating seroprevalence to H7N9 virus among poultry workers and the general population in southern China was recently published. While none of the study participants had virologically confirmed H7N9 infection, a high proportion of poultry workers with serologic evidence of H7N9 infection

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 27 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** was confirmed between May (7.2%; 36/501) and December (14.9%; 56/375) 2013, suggesting a substantial risk of mild H7N9 infections in this group. [reference] Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and May 2014

Sequence data Genetic sequences available in OPENFLU by wave, species and extent of sequencing

Genetic sequences available in GISAID by wave, species and extent of sequencing

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 27 May 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 weekly situation update FAO / EMPRES – Animal Health 03 June 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 449 confirmed; 158 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 1 June: Macao SAR restarted importing live poultry from mainland China. The first live poultry consignment from Guangdong Province (14,400 chickens and 2,000 pigeons) has been quarantined and tested for H7N9 by both antigen and serum antibody tests, which all resulted negative [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Humans: Since Tuesday 3 June, 3 new cases were reported: Jiangsu (2) and Guangdong (1). For detailed information on human cases please refer to WHO's Disease Outbreak News.

Research A serological study conducted among veterinarians in Guangdong collected a total of 400 serum samples from practicing veterinarians in four cities (Guangzhou, Shenzhen, Huizhou and Zuhai) between February and August 2013. None of the samples tested positive for H7 AIV infection by HI assay using a ≥20 cut-off antibody titer. [reference]

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 June 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and May 2014

Sequence data The following new sequence is available in online databases: GenBank: 1 human (Shanghai) Genetic sequences available in OPENFLU by wave, species and extent of sequencing

Genetic sequences available in GISAID by wave, species and extent of sequencing

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 June 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** FAO’s global actions . From 26 to 30 May 2014, FAO held an epidemiology and laboratory training workshop in Addis Ababa, Ethiopia. Participants were national epidemiologists and laboratory specialists from 10 African countries considered to be at low to moderate risk of influenza A(H7N9) incursion (Cameroon, Côte d’Ivoir, Democratic Republic of the Congo, Egypt, Ghana, Kenya, Nigeria, Senegal, Tanzania, Zambia), along with experts from FAO, the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe) and the African Union Interafrican Bureau for Animal Resources (AU-IBAR). The epidemiology training focused on risk assessment, risk management, targeted risk-based surveillance and risk communication, while for laboratory specialists practical training was provided in performing the different tests in line with the algorithms used to detect the virus or its serological evidence. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 03 June 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO / EMPRES – Animal Health 17 June 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 449 confirmed; 162 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 12 June, Guangdong: In the framework of surveillance conducted by the Guangzhou CDC from 26 December 2013 to 4 May 2014 6,581 environmental samples were collected in 199 markets. A total of 346 specimens (5.3%) from 67 markets (33.7%) tested positive for H7N9 nucleic acid. After implementation of the centralized slaughtering pilot project since 5 May 2014, 432 environmental samples were collected in 28 markets (including 10 pilot markets). H7N9 nucleic acid was detected in 6 specimens (1.4%) from 3 markets (10.7%), all of them were non-pilot markets [reference]. . 12 June, Hong-Kong SAR: Given that no new case of H7N9 has been detected in the past two months, the influenza response level in Hong-Kong was reduced from “Serious” to “Alert” [reference]. . 4 June: MoA published their national H7N9 monitoring results for the third part of May: 47,576 serum samples and 15,684 pathological samples were collected in 2,582 locations in 20 provinces. Nine pathological samples from two LBMs in Jiangsu Province tested positive: 5 chicken and 3 duck swab samples in Changzhou City and 1 chicken swab in Hongze County. All serum samples tested negative [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 17 June 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: Since Tuesday 3 June, 3 new cases were reported: Jiangsu (2) and Guangdong (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and May 2014

Sequence data Genetic sequences available in OPENFLU by wave, species and extent of sequencing

60 80 50 66 50 60 40 35 human 40 30 avian 40 partial genome 20 28 20 environment full genome 8 20 10 4 7 6 1 1 0 wild bird 1 0 0 wave 1 wave 2 wave 1 wave 2 lab strain

Genetic sequences available in GISAID by wave, species and extent of sequencing 139 120 104 150 100 80 human 100 60 48 avian partial genome environment 37 full genome 40 23 50 20 20 20 wild bird 1 5 2 0 7 4 1 0 0 wave 1 wave 2 wave 1 wave 2 lab strain

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 17 June 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO / EMPRES – Animal Health 01 July 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 450 confirmed; 162 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 26 June: MoA published their national H7N9 monitoring results for the first half of June: 5,312 serum samples and 6,239 virological samples were collected in 317 locations in 7 provinces. One serum sample from a chicken in a wholesale market of Huizhou City (Guangdong Province) was positive for H7 and two swabs collected from chickens in two markets of Puyang City (Henan Province) were positive for H7N9 [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Humans: Since Tuesday 17 June, 1 new cases wasreported in Zhejiang (1). For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 01 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Officially reported human cases, by week (onset date), between February 2013 and June 2014

Publications: . A recombinant H7N9/PR8 vaccine containing HA and NA genes from a wild-type H7N9 was synthesized and a monovalent H7N9 split vaccine prepared from this virus was shown to be immunogenic in both mice and ferrets. When given intramuscularly to mice (two doses), it conferred full protection from a normally lethal H7N9 virus challenge. This vaccine could be a potential candidate for further clinical evaluation and human use (reference).

. Researchers from US and Chinese CDC performed a retrospective case-control study on 89 laboratory confirmed human patients and 339 matched controls. Main risk factors identified were direct or indirect contact with poultry, contact with poultry prior or during slaughtering and processing and visits in LBMs, with or without exposure to poultry. Concurrent disease such as obesity, chronic obstructive pulmonary disease and the use of immunosuppressive medication were also risk factors. Poultry consumption was shown to not be a risk-factor and the level of education and/or annual income had no impact on the risk-level. The study also reveals that men are not visiting LBMs more frequently than women are (reference).

. A statistical model was developed to predict risk of H7N9 market infection in Asian countries. Data sets of the locations of 8,943 LBMs in China were assembled and combined with environmental data and anthropogenic variables to identify areas with high suitability for H7N9 infection which could be priority targets for surveillance and control measures (reference).

Sequence data Genetic sequences available in OPENFLU by wave, species and extent of sequencing

60 80 50 66 50 60 40 35 human 40 30 avian 40 partial genome 20 28 20 environment full genome 8 20 10 4 7 6 1 1 0 wild bird 1 0 0 wave 1 wave 2 wave 1 wave 2 lab strain

FAO’s global actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance is online:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$ 5 million USAID, US$1.9 million TCPs), which is less than 15 percent of total appeal (i.e. US$ 35 million for FAO global framework on H7N9 for a 12 month comprehensive response/rehabilitation effort).

Page 3 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 01 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Page 4 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 01 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO / EMPRES – Animal Health 15 July 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 451 confirmed; 167 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples: positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 4 July: MoA published its national H7N9 monitoring results for the third part of June: 34,212 serum samples and 18,372 virological samples were collected in 1,778 locations in 20 provinces. No H7N9 virus was found, but four serum samples were positive for H7 in Guangdong Province (no details available) [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Humans: Since Tuesday 1 July, 1 new case was reported in Hunan Province. For detailed information on human cases please refer to WHO's Disease Outbreak News.

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 15 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Graphs: Information sources for human cases are WHO, National and Provincial Government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and June 2014

Publications: Emerging Infectious Diseases published ahead of print an article focusing on a virus strain isolated from a four-year-old boy with mild influenza symptoms in the early stage of the epidemic (March 2013). Although identified in an infected human, the isolate is less adapted to humans than other known human 2013 H7N9 isolates. Most of the internal genes are more closely related to avian H9N2 subtype strains isolated from the influenza season of 2011–2012 than to other recently emerged strains of the H7N9 subtype. This suggests the strain may be a precursor of more-evolved H7N9 subtypes co-circulating in humans [reference].

Sequence data Since the last Update (1 July 2014), four new isolates (3 human; 1 environmental) from Shangai were submitted to the OpenFlu database. Genetic sequences available in OPENFLU by wave, species and extent of sequencing

60 70 66 50 50 60 40 35 human 50 40 40 30 avian 28 partial genome 20 30 20 environment full genome 11 20 10 10 4 wild bird 7 1 2 0 10 1 0 0 wave 1 wave 2 wave 1 wave 2 lab strain

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 15 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO / EMPRES – Animal Health 29 July 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 451 confirmed; 167 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples. Positive virological samples are mainly reported in live bird markets and vendors; with only one positive farm. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update

Animals . 11 July: MoA published its national H7N9 monitoring results at the beginning of July: 9,374 sera and 3,178 virological samples were collected from 504 locations in 10 provinces. No positive samples were found [reference]. . 15 July: Jiashan County of Jiaxing City, Zhejiang province announced additional measures at county level: starting 1 August, authorities will close main LBMs in the district and allow live bird trade only in authorized markets in areas other than the main areas [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for additional 64 samples (35 in wave 1, 29 in wave 2), From non-governmental sources, additional 218 virologically positive samples were reported in peer-reviewed articles (1, 2, 3, 4, 5, 7, 8) and 346 in press releases (1).

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: . Since Tuesday 15 July, no new human cases were reported. For detailed information on human cases, please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, national and provincial government websites. Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and June 2014

Publications: . Emerging Infectious Diseases published an article about a human H7N9 case in Jilin Province associated with poultry. Farm investigation revealed silkie chickens and guinea fowl with clinical signs. Nineteen of 84 poultry and environmental samples tested positive for influenza A(H7N9) and A(H9N2). One sample was positive for A(H7N9), and three for A(H9N2) [reference].The birds were infected with multiple pathogens; it is unclear which pathogen caused these clinical signs. H7N9 virus might be one of the contributing factors.

Human cases and positive findings in birds and from market or restaurant environments

Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 29 July 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO / EMPRES – Animal Health 12 August 2014, 1800 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: People’s Republic of China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 451 confirmed; 168 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings in animals: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples; positive virological samples mainly from live bird markets and vendors; one farm tested positive. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication. Situation update Animals . 11 August: MoA published its national H7N9 monitoring results for the first part of August: 9,305 serum samples and 7,079 virological samples were collected in 448 locations in 10 provinces. Five chicken serum samples (3 from layer farms and 2 from breeder farms) collected in Shandong province tested positive for H7 [reference]. . 4 August: MoA published its national H7N9 monitoring results for the third part of July: 13,856 serum samples and 5,526 virological samples were collected in 794 locations in 18 provinces. Nine serum samples from LBMs in Guangdong province tested positive for H7 [reference]. . 22 July: MoA published its national H7N9 monitoring results for the second part of July: 355 serum samples and 150 virological samples were collected in 23 locations in 3 provinces. No positive sample was found [reference]. . Following the release of the National Poultry H7N9 Influenza Eradication Plan by MoA on 24 June 2014 and the request for provinces to report implementation plans to the Veterinary Bureau before the end of July 2014, provinces started to release their Poultry H7N9 Influenza Eradication Plans, including Shandong [reference], Hubei [reference], Guizhou [reference] and Shanghai City [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 12 August 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: No new human case was reported. For detailed information on human cases please refer to WHO's Disease Outbreak News. Graphs (Sources: WHO, National and Provincial Government websites) Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and June 2014

Publication . Microbiology and Immunology published ahead of print a study comparing the ability of 21 influenza rapid tests (IRDTs) to detect human influenza isolates, including three different H7N9 strains. All 21 IRDTs tested effectively detected these viruses, but their detection sensitivities differed from 4log10 to 6log10 TCID50/100 μL [reference].

Intensity* of swab sampling (mainly poultry, few wild birds, mammals and environmental samples) in each province under the MoA national H7N9 monitoring over the past 12 months (August 2013 - July 2014) *Intensity of sampling is defined as the total number of swab samples collected divided by the total poultry population

Page 3 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 12 August 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Viro-prevalence* observed in each province under the MoA national H7N9 monitoring over the past 12 months (August 2013 - July 2014) *Viroprevalence is defined as the number of swab samples positive for H7N9 divided by the total number of swab samples collected

Page 4 of 4; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 12 August 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO Animal Health Service / EMPRES 26 August 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 452 confirmed; 170 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui and Xinjiang Uyghur Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples. Positive virological samples are mainly reported in live bird markets and vendors; with only one positive farm. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update

Animals . 21 August: MoA published its national H7N9 monitoring results for the second part of August: 1,891 serum samples were collected in 89 locations in 2 provinces (Jiangsu and Hunan). All tested negative for H7. No virological samples were collected [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 26 August 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: . Since Tuesday 12 August, one new human case was reported in Xinjiang Uyghur Autonomous Region. Prior to symptoms the patient had been exposed to live chickens bought in a market. . For detailed information on human cases, please refer to WHO's Disease Outbreak News. Graphs: Information sources for human cases are WHO, national and provincial government websites.

Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and August 2014

Publications: . Underlying medical conditions may play an important role in the severity of the disease caused by H7N9 in humans according to a pathogenic study conducted in cynomolgus macaques. [reference]. . Chinese perception of H7N9 risks may be low according to a recent survey. Only 30 percent of respondents supported the permanent closure of markets as a control measure [reference].

FAO actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$5 million USAID, US$1.9 million TCPs).

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 26 August 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION **

Human cases and positive findings in birds and from markets or restaurants Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 26 August 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO Animal Health Service / EMPRES 09 September 2014, 1700 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 453 confirmed; 171 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui and Xinjiang Uyghur Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples. Positive virological samples are mainly reported in live bird markets, vendors and farms. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update

Animals . 2 September: MoA published its national H7N9 monitoring results for the third part of August: 21,425 serum samples and 6,282 virological samples were collected in 872 locations in 20 provinces. Five chicken serum samples originating from three different breeding farms in Guangdong Province tested positive for H7 [reference]. . 3 September: Hong Kong SAR resumed live poultry imports from mainland China. Imports will be tested at Man Kam To control point for H5 and H7 viruses by PCR and serology [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Humans: . Since Tuesday 26 August, one new human case was reported in Xinjiang Uyghur Autonomous Region. For detailed information on human cases, please refer to WHO's Disease Outbreak News. Graphs: ( human case information from WHO and Chinese authorities.

Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and August 2014

Publications: . Ferrets inoculated with an inactivated whole H7N9 virus were subsequently challenged with wild-type A/Anhui/1/2013 (H7N9). All vaccinated ferrets had lower virus loads in their lungs as compared to controls. Ferrets vaccinated with 50 μg of vaccine showed no illness and shed significantly less virus than controls [reference]. . According to a study, closure of LBMs reduced the mean daily number of human infections: in Shanghai by 99% (95% credibility interval 93–100%); in Hangzhou by 99% (92–100%); in Huzhou by 97% (68–100%); and in Nanjing by 97% (81–100%). Mean incubation period was assessed as 3.3 days (1.4–5.7) [reference]. . A serological survey was performed on 1,310 pigs in Jiangsu, Zhejiang, Guangdong and Fujian Provinces. No samples were found to be positive for H7 [reference]. . Novel H7N2 virus was isolated in backyard poultry during trace-back from the human H7N9 case in Jilin. Genetic analysis revealed the virus to be reassortant. Six out of eight genes were derived from H7N9, while the NA and NS genes were derived from a local H9N2 strain [reference].

FAO actions . 25–26 August FAO-USAID meeting in Bangkok reviewed H7N9 preparedness in the Greater Mekong Subregion. Animal and public health representatives from China, Viet Nam, Lao People’s Democratic Republic and Myanmar: i) shared surveillance, preparedness and response results; ii) reported on operational challenges encountered; and iii) identified measures for improvement and next steps. . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance:www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$5 million USAID, US$1.9 million TCPs).

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 2 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 09 September 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Important links . Ministry of Agriculture of the People’s Republic of China: www.moa.gov.cn/zwllm/yjgl/yqfb/ . FAO FAQ: http://www.fao.org/ag/againfo/programmes/en/empres/H7N9/Faq.html . FAO/EMPRES Animal Health News: www.fao.org/ag/againfo/programmes/en/empres/news.htm . OFFLU updated laboratory protocols: http://www.offlu.net/index.php?id=267 . FAO EMPRES-i Global Animal Disease Information System: empres-i.fao.org . WHO disease outbreak news: www.who.int/csr/don/archive/year/2013/en/index.html . World Animal Health Information Database:www.oie.int/wahis_2/public/wahid.php . Centers for Disease Control and Prevention:http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 09 September 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** H7N9 bi-weekly situation update FAO Animal Health Service / EMPRES 23 September 2014, 1645 hours; Rome Overview Situation: Influenza A (H7N9) virus with pandemic potential Country: China, human case originating from Guangdong (China) detected in Malaysia Number of human cases: 453 confirmed; 171 deaths Provinces/municipalities*: Beijing and Shanghai; Anhui; Fujian; Guangdong; Hebei; Henan; Hunan; Jiangsu; Jiangxi; Shandong; Zhejiang; Guangxi; Guizhou; Jilin; Hong Kong SAR; Macao SAR, Ningxia Hui and Xinjiang Uyghur Autonomous Region, and Taiwan Province of China; Sabah State of Malaysia. Findings: H7N9 confirmed in chickens, pigeons, ducks, a tree sparrow and environmental samples. Positive virological samples are mainly reported in live bird markets, vendors and farms. FAO actions: liaise with China and partners, monitor situation, explore and assess virus characteristics, conduct market chain analysis, risk assessment, surveillance guidance and communication.

Situation update

Animals . 16 September: MoA published its national H7N9 monitoring results for the first part of September: 4,283 serum samples and 1,563 virological samples were collected in 214 locations in 10 provinces. All samples tested negative [reference]. . 23 September: MoA published its national H7N9 monitoring results for the second part of September: 12,214 serum samples and 1,959 virological samples were collected in 616 locations in 6 provinces. Four chicken serum samples from 2 LBMs in Urumqi City, Xinjiang Province tested positive [reference].

Positive virological samples from birds or the environment, by province* and time period

Positive virological samples of known origin, from birds or the environment

Sample origin could not be determined for additional 64 samples (35 in wave 1, 29 in wave 2), From non-governmental sources, additional 349 virologically positive samples were reported in peer-reviewed articles (1, 2, 3, 4, 5, 7, 8, 9) and 346 in press releases (1).

*Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in a different geographic area.

Page 1 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 09 September 2014 cannot guarantee accuracy of information from reported sources. ** NOT FOR GENERAL DISTRIBUTION ** Humans: . Since Tuesday 26 August, no new human case was reported. For detailed information on human cases, please refer to WHO's Disease Outbreak News. Graphs: human case information from WHO and Chinese authorities.

Officially reported human cases, by province* and time period

Officially reported human cases, by week (onset date), between February 2013 and August 2014

Publications: . A virological surveillance program was conducted in Guangzhou, Guangdong Province from 15 April 2013 until 14 February 2014. The study included 36 retail LBMs, 6 wholesale LBMs and 8 poultry farms. Results: 131 of the 8,900 samples (1.5%) collected from live poultry or the environment were positive for H7N9; 44.4% (16/36) of retail markets, 50.0% (3/6) of wholesale markets and none of the farms were found to be contaminated. Nineteen of the 316 poultry workers (1.6%) associated with the contaminated markets had antibodies against H7N9 [reference]. . A survey in Jiangsu Province investigated the prevalence and genetic diversity of H7N9 in poultry. Frequent occurrence of H7N9/H9N2 co-infection in chickens was found. Molecular clock phylogenetic analysis confirmed this and demonstrated that the H7N9 outbreak lineage is confounded by ongoing reassortment between these two viruses [reference]. . Laboratory mice were inoculated with a H7N9 chicken isolate. Clinical signs, pulmonary viral loads, cytokine/chemokine profiles and histopathological changes suggest that H7N9 viruses isolated from poultry can cause lethal pulmonary infection in mammals without prior trans-species adaptation. It was also shown that co-administration of a non-steroidal anti-inflammatory drug in combination with the antiviral zamivir could ameliorate pulmonary inflammation and improve survival [reference].

FAO actions . FAO continues supporting at-risk countries with surveillance and preparedness for H7N9 incursion. . FAO is providing surveillance and sampling guidance for South and Southeast Asia. . FAO guidance: www.fao.org/h7n9. . Funding to date: US$6.9 million mobilized (US$5 million USAID, US$1.9 million TCPs).

* Provinces have been listed according to the order used in the Chinese Official Veterinary Bulletin

Page 3 of 3; FAO/EMPRES H7N9 update Disclaimer: Information provided herein is current as of the date of issue. FAO 09 September 2014 cannot guarantee accuracy of information from reported sources.