Random Analytica

Charts, Infographics & Analysis without the spin

Tag: Flu

QuikStats: Avian Influenza A(H7N9) Autumn 2013

H7N9 in China “is still present and there is still a great deal not yet understood about this H7N9 virus. Other influenza viruses that circulate in poultry often decrease dramatically during the summer months, only to reappear later in the year during cold season. Also, many low pathogenic influenza viruses in poultry have transformed into highly pathogenic viruses.” (Hiroyuki Konuma, FAO regional representative for Asia and the Pacific, 18th September 2013)

1 - H7N9_Infographic_131203_Final

***** Please note that this infographic of the Avian Influenza A(H7N9) was updated with public source information to 1200hrs 3 December 2013 EST. There will be no more infographic updates for this post *****

After 80-days in the wilderness and with the world’s pandemic attention more focussed on the Middle East the H7N9 virus has popped up again.

When H7N9 was daily news the eye of the storm was concentrated on the provinces of Zhejiang and Jiangsu and the municipality of Shanghai. As the daily case numbers declined after April the movement of the virus seemed to deploy outward at a snail’s pace. In fact the previous four case onsets to this one were Jiangxi (East China), Beijing (North China), Hebei (North China) and in Huizhou, Guangdong (South Central China) barely a 100-kilometres from Hong Kong.

After two cases were reported in the middle of summer H7N9 has backtracked returning to more familiar hunting grounds in Zhejiang half-way through the northern hemisphere autumn striking down a relatively young man, aged just 35 (according to my data the average age prior to this case was 57).

Cause like all good mysteries just as we think H7N9 is gone, it pops up again.

As my calendar permits I’ll keep the infographic updated as new information comes to hand through the autumn months. Here is a look at the first infographic I produced with the 137th case presenting in Zhejiang on the 8th October 2013.

2 - H7N9_Infographic_131015_Orig

Acknowledgements: Data for this infographic was sourced largely from CIDRAP, H5N1, FluTrackers and the WHO. Background reading supplied mainly via Pandemic Information News, Ian at Virology Down Under and Helen Branswell.

Updates

Random Analytics: H7N9 (August 2013)

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***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 13 August 2013 CET/EST *****

Infographic Details

The recent confirmation of a H7N9 case in Huizhou, Guangdong Province was the inspiration for this month’s infographic.

During the month of July there were two confirmed cases of H7N9. The first case, with a 10 July onset occurred in Langfang with a dispersed population of around 3.9-million located just 60-kilometres from the heart of Beijing and its 20.7-million residents. The more recent case with onset 27 July was in Huizhou, with its 4.6-million citizens and just 100-kilometres from Hong Kong (population 7.1-million).

After a brief sojourn this variant has decided to randomly strike at two locations within a relatively easy drive to two extremely connected and globally linked population centres. Just these four cities alone are more than 50% more populated than the entire land mass of Australia and 1.8-million more than Canada.

The other point that I wanted to make was to highlight the temporal pattern which now has six-months of data confirmed. Since April, where 70.6% of the current onsets were recorded, only four cases (two in May, none in June and two in July) have occurred.

The Northern hemisphere summer has not killed of H7N9 although it is quiet.

The fact that H7N9 has cropped up again near global cities is pure downside risk. The fact that it is occurring during the Northern hemisphere summer is additional risk. The fact that we only have a half year of temporal data available for this emerging disease means we don’t yet have a full picture of what risk we face as we commence the colder seasons.

Autumn is upon us and Winter is Coming.

Cases by Region (including Taiwan)

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There have been 135-cases reported in China, 44 of which have resulted in death. Although transported by commercial aeroplane from Jiangsu there is one case reported in Taiwan who has subsequently recovered. For the record my case numbers include the single asymptomatic cases from Beijing. The most recent onset confirmation occurred 27 July in Guangdong, the first known case from that province. The last fatality confirmation via Xinhua was reported on the 12th August.

To date 32.4% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

The World Health Organisation confirmed that to 11 August there were 87 patient discharges (the National Health and Family Planning Commission has been doing monthly updates on the 10th of each month but the August press release is still pending). This equates to a Case Recovery Rate of 64% (with every chance for a slight improvement as there are still four patients receiving treatment). Asymptomatic cases remain at one (0.7%).

Cases by Job Title

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As a Workforce Planner I am always fascinated by how disease interacts with our employment or our daily activities. This is potentially relevant in understanding how H7N9 transfers as only one case can be scientifically linked to a person-to-person transfer, although there is strong evidence to suggest at least three family clusters.

With 42.2% of cases in the 65+ cohort the greatest job title is that of retirement. Of the 106 confirmed occupations 37-cases (34.9%) are attributed to retirees who are more likely to visit traditional bird markets and potentially are more involved in food preparation at home, both with greater associated risks. I make a small point that food preparation is traditionally more likely to be done by women and there are only seven females (just 18.9%) who are ‘retired’ in my data, thus exposure to bird markets might be a greater factor in exposure.

Farmers account for 27-cases (25.5%). Given that most Chinese agriculture is still small cropping with additional poultry (chicken, ducks, geese etc.) and other livestock the high proportion is not that surprising given that it is an avian influenza.

From there the break-downs by employment don’t offer much in terms of vector assistance, outside those such as market vendors or poultry transporters that have daily exposure to feather and fowl.

It still seems that although your employment might marginally increase your exposure to H7N9 your just as likely to catch the disease by preparing a chook for the table or living within proximity of a bird market.

Recent Health Analytics Blogs: Random Analytics: Hendra! & Random Analytics: Ebola (2013)!

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Acknowledgements: Thanks first and foremost to FluTrackers and the great work you do. For good journalism on this topic I follow Helen Branswell and CIDRAP. If you are interested in getting a daily feed on H7N9 (and other related topics) then I would recommend Crawford Killian’s H5N1 site. If you like more detailed analysis of H7N9 (and other viruses) then I would point you to my fellow Queenslander Dr Ian M Mackay and his recently revamped Virology Down Under blog.

Lastly, thanks to George R.R Martin and his wonderful ‘A Song of Fire and Ice’ epic for the borrowed line (books only, I don’t do ‘A Game of Thrones’ HBO series).

 

Update (14/08/2013)

  • Updated the main infographic and Cases by Region after a Hebei fatality was confirmed. Some minor tweaking of article after a review of the published material confirmed a further 5 patient releases. Added Helen Branswell & CIDRAP to my acknowledgements and can’t say why I didn’t do this in the first case.

Random Analytics: H7N9 Infographics (to 22 Jul 2013)

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

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Infographic Details

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

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

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

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Cases by Region (including Taiwan)

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

Note: This infographic was created using Tableau Public.

Thoughts by Crawford Kilian

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

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

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

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

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

Final Thoughts

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

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

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

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

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

Update (28/05/2013)

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

Update (29/05/2013)

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

Update (15/06/2013)

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

Update (21/07/2013)

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

Update (22/07/2013)

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

Random Analytics: H7N9 Infographics (to 15 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 16 May 2013 CET/EST *****

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Infographic Details

Between 12 – 16 May there have been no new reported cases of H7N9 and a drip feed of case and fatality details. To date the totals for China are 131-cases including 36-deaths and Taiwan 1-case without loss of life. Two deaths were confirmed on 13 May without details and the first confirmed fatality from Hunan was reported on 15 May. Note that all totals include asymptomatic cases.

To date 27.3% of all known cases have been fatal, or more than one in every four afflicted by H7N9. For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health and Chinese media confirmed that to 15 May there have been 61 patient discharges (46.2%). Asymptomatic cases remain at one (0.8%).

The most recent fatality (with details) reported by the Chinese media was on the 15th May 2013 via Xinhua.

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Cases by Region (including Taiwan)

Along with a decline in cases there has been a drip-feed of case details that have flowed through during the week. Note: I have two confirmed deaths that I cannot add as the province has not been disclosed.

The last confirmed onset that I could see has moved from Fujian to Jiangxi and it’s more than a week old in the regional extremities of the outbreak. Shanghai, the region which hosted the outbreak in mid-April announced during the week that it had not had a confirmed case in more than 20-days and was in the process of dismantling its emergency level response to H7N9.

Note: I have created this infographic using Tableau Public software which can be viewed here.

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Cases by Job-Title

Here is another look at the cases by employment.

Given that more than 44% of cases were in patients over the age of 65 it’s no surprise that 35 (28.8%) of job titles are ‘Retired’.

To tenuously back the avian link the next largest job title was ‘Farmer’ with 26 confirmed at 19.7% of all cases. If you include those job-titles with linkages to farming, poultry production and food preparation that number would increase to 38 making it the most dominant employment type at 28.8%.

Of the 31 unknown job titles, 12 (9.1%) are represented by people over the age of 65, thus would predominately fall into the ‘Retired’ or ‘Farming’ employment types depending on whether they are rural or urban based.

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 8 May 2013)

Updates (13/05/2013)

  • Confirmed two additional job titles (1x Builder and Farmer) so updated both the infographic and Cases by Job-Title.

Updates (14/05/2013)

  • Updated the main infographic after a further 2 fatalities and 15 recoveries were confirmed via Xinhua.

Updates (16/05/2013)

  • Updated the main infographic and Cases by Region map after a fatality was confirmed via Xinhua and a further four recoveries were announced via CCTV News. The most recent Xinhua announced fatality link was also updated.

Random Analytics: H7N9 Infographics (to 8 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 9 May 2013 CET/EST *****

1 - H7N9_Infographic_130508

Infographic Details

In the past 48-hours of reporting there has been one new case of H7N9 and one retrospective fatality. This brings the total for China to 131-cases including 32-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 24.2% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health also confirmed that to 6 May there were 42 discharges. That keeps the recovered total to 42 (31.8%) and asymptomatic cases at one (0.8%).

The most recent fatality (with details) reported by the Chinese media was on the 3rd May 2013 via Xinhua.

Economic Impacts of H7N9: Direct Costs and The Poultry Industry

According to the World Bank, China’s Gross Domestic Product hit $7.318-trillion USD in 2011, making it the second largest economy on the globe. Back in 1982 China had a GDP of $203-million, a mere 1/36th of its current size, thus an economy that has doubled in size more than six times.

Last year China’s economy grew by 7.9%, the weakest result since 1999 and below expectations.

The first quarter of this year was expected to see growth rates return to 8% or greater. This would be driven by internal consumer consumption over exports. However the first quarter of 2013 disappointed with GDP growing by 7.7%, again under expectations.

Although the avian influenza A(H7N9) virus is not the reason the Chinese economy has been soft it is a contributing factor. Some considerations when considering direct costs:

  • Effecting flu controls on the human and fowl populations such as the additional ¥303M ($48.6M USD) which was put up by the Chinese Ministry of Finance in late April;
  • Subsidizing the poultry industry as it struggles with the outbreak, like the ¥90M ($14.6M) from the Beijing Municipal Bureau of Agriculture again in late April;
  • Additional medical costs and insurance for regional populations costed to the Ministry of Finance, and;
  • One of the biggest direct costs of the H7N9 outbreak is the loss suffered by the poultry industry. By mid-April that agriculture component stated that it has lost approximately ¥10Bn ($1.6Bn USD) as chicken consumption halved and chicken/egg prices collapsed.

If the figures are not overstated then the impact to the first and second quarter GDP figures would be at a cost of between 0.1 and 0.15% with a work-in-progress cost to the economy of between 0.2 – 0.3% over the calendar year. Although future poultry losses would not be of that magnitude (as the poultry industry ramps down production and concentrates on protecting its breeding stocks) that number will still likely increase to some degree over the coming months. The standalone poultry industry losses to mid-April alone could account for the 0.3% minimum underperformance of the Chinese economy.

Looking at this from a different angle there is also currently an unrealised loss in terms of the overall chicken population value.

In brief, the Chinese chicken population in 2009 was 4,680,000,000. Here’s a great infographic via The Economist:

2 - CountingChickens_110727

Prior to the outbreak becoming known in China the national average broiler price (chickens raised purely for meat production) was ¥9.37 (source: Beijing Shennong Kexin Agribusiness Consulting). At publication date the average price of broilers across Liaoning, Shandong, Henan, Hebei and Jiangsu was just ¥4.07 (source: www.chinafarming.com), effectively a 56% reduction. Eggs have had a similar price decline and broiler chicks around 75% as agribusiness pends new stock purchasing and waits out the virus .

Now I know that not all chickens are broilers (being an owner of nine-chickens and a rooster myself) but with a huge appetite for chicken which is on-hold and an approximate 10-week lifespan of broilers the short-term price impacts of such a decline are a huge drag on first and second quarter Chinese GDP growth numbers.

Another consideration: Taking the 2009 chicken population number of 4,680,000,000 as a base, the bulk of chickens across the country would now be worth, on average, ¥5 less. Thus the national stock, minus protected and virus free breeders could be worth as much as ¥23.4Bn (approx. $3.74Bn USD) less than it was two months ago. If not for other inputs (such as an increase in vegetable prices against the gains in chicken import prices) then the possible impact on GDP could be doubled or even tripled.

In summary, the impacts of the current H7N9 outbreak on the economy are still short-term. Prices always recover when there is a market but by the time the virus passes and confidence returns to the poultry industry the national stock will have decreased, poultry producers have gone out of business and outside of imports the industry will take at least 3-months to re-stock. This will drive up prices in the short-term and those direct impacts will flow through the economy.

Much like the medical unknowns still in play the economic impacts can only be forecast.

Unlike the medical impacts which are tracked on a daily basis and could disappear overnight the negative economic impacts of the virus could be sustained for many months.

 

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 6 May 2013)

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Update: (30/07/2013)

  • World Poultry published an article on 29 Jul 2013 stating that:

“The total losses of poultry-related companies all over the country up until the end of June exceeded 600 billion yuan ($92.2 billion) since the first case of H7N9 virus was discovered by the authorities at the end of March, according to the latest statistics from the National Poultry Industry Association.”

In my article I envisaged that the loss for the first and second quarters of Chinese GDP would be between 0.1 and 0.15%. The National Poultry Industry Association total would equal 1.26%. Industry bodies tend to overstate the loss in a crisis so I am still confident in my original forecast but happy that the first numbers to be discussed fell well within a reasonable range of error.

Random Analytics: H7N9 Infographics (to 6 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 7 May 2013 CET/EST *****

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Infographic Details

In the past 24-hours of reporting there has been one new (retrospective) case of H7N9 and confirmation via the Chinese Ministry of Health 4 additional fatalities. This brings the total for China to 130-cases including 31-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 23.7% of all known cases have been fatal (an increase of 2.9% from yesterday’s data). For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health also confirmed that to 6 May there were 42 discharges. With that update the recovered total now moves to 42 (32.1%). Asymptomatic cases remain at one (0.8%).

The most recent fatality reported by Chinese media was on the 3rd May 2013 via Xinhua.

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Cases by Region (including Taiwan) to 6 May 2013

I usually don’t repeat the second infographic from one night to the next, however some data came in via the Chinese Ministry of Health which included four new deaths confirmed by province (although not down to case level at this stage). Two additional fatalities were reported in Jiangsu and one each in Zhejiang and Anhui.

Although recoveries have been revised upwards I cannot confirm to case level the details of 14-cases and 5-cases cannot be confirmed to province or municipality level.

Two other changes with this infographic. The first is a colour scale to reflect the number of cases in each region. Secondly, I have created this infographic using the excellent Tableau Public software which can be viewed here. (Note: I have no commercial or personal relationship with Tableau).

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 5 May 2013)

Random Analytics: H7N9 Infographic (to 5 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 6 May 2013 CET/EST *****

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Infographic Details

In the past 48-hours of reporting there has been one new case of H7N9 with no new fatalities. This brings the total for China to 129-cases including 27-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 20.8% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were 2 discharges over the past 24-hours, both from Shanghai. With the additional two discharges the recovered total now moves to 38 (29.2%). Asymptomatic cases remain at one (0.8%).

The most recent fatality reported by Chinese media was on the 3rd May 2013 via Xinhua.

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Cases by Region (including Taiwan) to 5 May 2013

Here is a look at the Cases by Region data which closes out Week 11 of the avian influenza A(H7N9).

Zhejiang continues to have the most cases (46) with 19 recovered and six deaths.

With 33-cases and 13-deaths Shanghai has the most deaths and the highest Work-In-Progress Case Fatality Rate, currently 39.4%. That municipality also had the first case.

Beijing still has the only confirmed asymptomatic case.

Taiwan has the only non-mainland China case, that of a man who was working in Jiangsu and flew home before displaying any symptoms.

Fujian had the most recent confirmed case.

Lastly, for the first time since the H7N9 became a known issue there are now more case outcomes than there are patients being treated. Of note is that positive outcomes outweigh negative outcomes.

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 3 May 2013)

Random Analytics: H7N9 Infographic (to 3 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 4 May 2013 CET/EST *****

1 - H7N9_Infographic_130504

Infographic Details

In the past 24-hours of reporting there have been no new cases of H7N9 and no new fatalities, although the 27th fatality (without specifics) was reported by Xinhua. This brings the total for China to 128-cases including 27-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 20.9% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were 10 discharges over the past 24-hours, all from Zhejiang and just 17-hours after I discussed the lack of detail from that province. Although Xinhua detailed the case of Cao it didn’t provide any detail of the 9 other outpatients discharged today. With ten H7N9 cases cleared that would bring the total recovered to 36 (27.9%). Asymptomatic cases remain at one (0.8%).

The most recent fatality reported by Chinese media was on the 3rd May 2013 via Xinhua.

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Zhejiang: 17-hours later

Yesterday I looked at cumulative cases for Zhejiang, the most impacted to date by H7N9.

At that time there were 46-cases with 6-deaths and 6-recoveries and no new reported cases in 14-days.

How 17-hours can make a difference.

There have been only two Xinhua H7N9 stories released in the past 24-hours. The first confirmed the 27th fatality but did not provide details of the two most recent victims. The second story detailed the recovery of Cao who had recovered from the severest of symptoms thus far.

It also stated:

Nine other H7N9 patients were also discharged on Friday from the First Affiliated Hospital of Zhejiang University.

I have updated yesterday’s chart with the data input provided. I’d advise that this is a look at the cases, fatalities, recoveries and Work-In-Progress (WIP) Case Fatality Rate (CFR) for Zhejiang only and might be useful. Given the percentile of known H7N9 cases for Zhejiang are very low and those still receiving treatment remains above 50% the CFR should be seen as a useful guide only. Also of note is that Zhejiang has had no reported asymptomatic cases and as shown in the daily infographic we still have a ‘Fog of Flu’ or a lack of data around three-deaths and 12-recoveries which may impact this chart.

No data points jump out at me, but…

A long time ago I was a soldier, a communicator and a Cold War warrior who trained up against the best the Soviets were still pumping out in 1989/90.

I always remember my first ‘operational active’ exercise where I watch the Vladivostok fishing vessels trailing our combined fleet and being told that though most of this peace time force would be going through the motions, my efforts were real.

I was told that everything communicated was tracked, analysed and would be brought up in future operations. There were no ‘co-incidences’ in data…

Zhejiang had no new data for 2-weeks as of yesterday. It has some today.

Coincidence?

I’ll not leave it on a semi-pseudo conspiracy theory. I had a fantastic 3-tweet conversation with Crawford Kilian today. He stated that I was more literate but I would counter that he has a unique ability to be a superbly interesting chap on Twitter.

3 - @Crof

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 2 May 2013)

Random Analytics: H7N9 Infographic (to 2 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 3 May 2013 CET/EST *****

1 - H7N9_Infographic_130503

Infographic Details

In the past 24-hours of reporting there have been no new cases of H7N9 and as many as two fatalities, although only one death was fully reported via Xinhua. This brings the total for China to 128-cases including 26-deaths and Taiwan to 1-case without loss of life. Note that this includes asymptomatic cases.

There have been a number of reports, supported by organisations such as CIDRAP and FluTrackers.com which put the number of fatalities at 27. Given that only one fatality was identified on the 2nd May and the numbers seem to be including that person on top of the 26 announced via  Xinhua in a weekly update I am going to keep my number at 26 until further information can be verified.

To date 20.2% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

Although there were no new announcements on discharges today a weekly report stated that 26 people had recovered from the disease. That would increase the recovery number to 26 (20.2%) and asymptomatic cases at one (0.7%).

The most recent fatality reported by Chinese media was on the 2nd May 2013 via Xinhua.

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Cumulative Cases (Zhejiang)

Yesterday I looked at cumulative cases (just cases and deaths) across the entire H7N9 dataset.

Today I thought a look at the cases, fatalities, recoveries and Work-In-Progress (WIP) Case Fatality Rate (CFR) for Zhejiang only might be useful. Given the percentile of known H7N9 cases are very low and those still receiving treatment remains just below 70% the CFR should be seen as a useful guide only. Also of note is that Zhejiang has had no reported asymptomatic cases and as shown in the daily infographic we still have a ‘Fog of Flu’ or a lack of data around two deaths and three recoveries which may impact on this chart.

Two data-points jump out at me.

Firstly, would be the lower WIP CFR of 13%, much lower than the entire disease average which stands at (20.2%) today.

The second and more interesting data-point is that after a sharp rise in cases between 2 April and 18 April (where new cases reported averaged 2.3 per day) there have been no cases reported now for 14-days.

I have always thought that data that is 100% correct or 100% absent is unusual and worth looking into further.

The fact that there has been no data from Zhejiang for two weeks is ‘unusual’.

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 1 May 2013)

Updates (3/05/2013)

  • Updated Infographic section with note about 27th fatality.

Random Analytics: H7N9 Infographic (to 1 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 1 May 2013 CET/EST *****

1 - H7N9_Infographic_130502

Infographic Details

In the past 24-hours of reporting there has been one new case, reported from Hunan Province and for the second consecutive day, no new fatalities. This brings the total for China to 128-cases including 24-deaths and Taiwan to 1-case without loss of life. Note that this includes asymptomatic cases.

To date 18.6% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were no new announcements on discharges today. With no new data the current count of recoveries remains at 25 (19.4%) and asymptomatic cases at one (0.8%).

The most recent fatality reported by Chinese media was on the 29th April 2013 via Xinhua.

2 - CumulativeCases_130502

Cumulative Cases

Here is a look at the cumulative cases, fatalities and current Case Fatality Rate (CFR). Given the percentile of known H7N9 cases are still receiving treatment remains above 60% the CFR should be seen as a useful guide only.

Two interesting data-points from this chart. The first is that the cumulative cases have only increased by 10 over the past five days, averaging just 2 a day over a territory larger than South Africa and a population of more than half a billion.

The second item is that since mid-April the Case Fatality percentile has remained steady between the ranges of 18.3% – 22.2%.

What will tomorrow bring?

Note: My previous post on this can be found at Random Analytics: H7N9 Infographic (to 30 Apr 2013)