Opening statement by Dr Keiji Fukuda, WHO's Assistant Director-General for Health Security

Joint press conference on the China-WHO Joint Mission on H7N9 Assessment

Beijing, China
24 April 2013

Good morning and thank you for your attendance today.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thank you.