The Avian Influenza A(H7N9) continues its steady attrition. According to CIDRAP there have been 277-cases of H7N9 with the fatality count standing unofficially at 61 (a Case Fatality Rate of 22%).
Earlier in the week I posted some analytics looking at the case list employment data. Subsequently I’ve been involved in a rolling tweet-up with Ian Mackay, A biologist and Potrblog.com on some of those findings. Some of that discussion has caused me to further reflect on the data I presented.
Reflection then turned into action (and some updated/revised charts plus one new one!).
The first chart is very similar to the H7N9 incidences by Job Title previously released with the exception that I have updated a number of Job Titles to align with the Chinese data (i.e. amended Maid (Expat) to Domestic Helper) but also to better reflect actual real world situations. Thus School Age (5-17) has been split into both Primary and High School age groups.
The current chart reflects Job Title data in 204 of 277 cases (73.7% of all data inputs). The two predominant employment types continue to be either a Farmer (33.8%) or Retired (27.5%). Farming job titles are up slightly and Retired job titles are down slightly from data released earlier in the week.
Some further points of interest and conjecture:
- In Wave 1 (to case #136) Farmers represented 28 out of all 136 of all cases (20.6%). Currently in Wave 2 the following 141 cases had 41 Farmers (29.1%);
- The current average age of the H7N9 impacted farmer is 61.9-years. More than 5.1-years over the average age of all those impacted by the virus, which probably demonstrates an ageing issue for Chinese agriculture; and
- The average age of the H7N9 retiree is 71.3. How good is the Chinese economy, its medical system and its infrastructure compared to barely three decades ago?
Before I go on to my next three charts I want to discuss the importance of job titles. During my tweet discussions this week I brought up the issue of the differentials between a small cropping and a pig farmer. Everyone agreed with the issue but, by chance, I found a great example as I was completing my data updates today.
Via CIDRAP reported (29 Jan 2014). Seven new H7N9 cases, plus family cluster, reported. Detail:
The family cluster reported today involves three people from Zhejiang province, a 49-year-old man, his wife, and their 23-year-old daughter, according to a report from Xinhua, China’s state news agency. All three cases were previously reported. The man’s infection, which ultimately proved fatal, was confirmed on Jan 20. His daughter got sick 3 days after taking her father to the hospital, and she is in serious condition. The man’s wife’s infection was confirmed on Jan 27, and her illness is mild, according to Xinhua. Media reports in China yesterday, citing officials from China’s Center for Disease Control and Prevention, said the parents are from Xiaoshan and worked as vegetable dealers in a live-bird market before they got sick and that their daughter had worked at the market for a short time, the South China Morning Post, an English-language newspaper based in Hong Kong, reported today.
That detail might have made me change my job title for the parents to a Market Vendor, yet I suspect they are a small cropping family (who as first reported are ‘Farmers’) who also ran a small vegetable stall in a local poultry market (thus a secondary occupation of ‘Market Vendor’/’Vegetable Dealers’). Their daughter who also became ill was first reported as ‘Staff’ potentially equating to her role as running their market stall.
For all the conjecture that I put forward they might have caught H7N9 from wild birds at their vegetable farm, rather than the poultry market.
The second chart looks at employment by Job Family (see previous H7N9 employment related blog for methodology). Unlike the previous post about Job Families I thought it important to include the unknown data inputs which have been relatively unchanged since the commencement of the outbreak in February 2013. The largest groups are represented by Non-Participatory (27.4% comprising children, retirees, students and the unemployed), followed by unknown employments (26.4% or more than one in four) finally followed by Farming, Fishing & Forestry (25.6%). After those two groups Food Preparation & Serving (6.9% including catering, chef/cook, food sales, live poultry trade, market vendor) and Production, Factory & Food Processing (2.5% comprising butcher, factory worker, poultry abattoir, sheet-metal worker and stone processor). Those five groups equate to 88.8% of all cases.
The final chart asks the question. Has the recent spike in H7N9 cases been over represented by farmers?
Short answer is No.
The above chart displays acquisition by employment type (at onset) with four main groups represented: Farmer, Retired, All Other Known Employments and those that are currently unknown.
Two key months dominate. April 2013 and January 2014. By the end of April Farmers represented 19.7% of cases, currently they have increased by more than 5-points to 24.9% while Retired have reduced from 31.8% to 20.2%. Farmers moving from one in five to one in four H7N9 cases is still a reasonable movement but a trend has (not yet) been proven.
Let us give it one or two more months…
Stay safe, stay healthy and continue to make good choices.