A total of 374 H7N9 cases through February 27, 2014

The World Health Organization  (WHO) has not been providing cumulative case counts of H7N9 cases in their Disease Outbreak News reports. This may be due to incomplete and inconsistent case information that has been provided to WHO by the National Health and Family Planning Commission (NHFPC) of China.

Perhaps the most accurate enumeration of H7N9 cases is provided by the Centre for Health Protection (CHP), Department of Health, Hong Kong Special Administrative Region.They report

"As of yesterday (February 27, 2014), a total of 367 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (136 cases), Guangdong (81 cases), Jiangsu (42 cases), Shanghai (41 cases), Fujian (20 cases), Hunan (16 cases), Anhui (nine cases), Jiangxi (six cases), Beijing (four cases), Henan (four cases), Guangxi (three cases), Shandong (two cases), Guizhou (one case, imported from Zhejiang), Hebei (one case) and Jilin (one case).cases), Shandong (two cases), Guizhou (one case, imported from Zhejiang), Hebei (one case) and Jilin (one case)."

 link: http://www.chp.gov.hk/en/content/116/33679.html

The 367 cases are only those reported from the mainland of the People’s Republic of China (PRC). The two imported cases reported from Taiwan and the single imported case reported from Malaysia need to be added to this total. Surprisingly, the four H7N9 confirmed cases from Hong Kong are also not included in the CHP total. 

A review of the CHP cumulative totals by province with publicly available information suggests that there is a discrepancy of one case in the count for Zhejiang Province (possibly FluTrackers’ case #182 because WHO reported this as a Shanghai case).  Also, in several reports on the initial 2013 cases from Shanghai, there is conflicting information about which cases actually died and whether or not one or more cases were only suspected cases. Confusing the situation even further is that at least one asymptomatic child from Beijing in May of 2013 is not included in the official counts.

It would be beneficial if public health agencies and international health organizations would make their line list of cases publicly available for scrutiny. In any event, through February 27, 2014, a total of 374 H7N9 cases have been officially reported since March 2013.