Intended for healthcare professionals


Human to human transmission of H7N9

BMJ 2013; 347 doi: (Published 06 August 2013) Cite this as: BMJ 2013;347:f4730
  1. James W Rudge, lecturer1,
  2. Richard Coker, professor12
  1. 1Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
  2. 2Saw Swee Hock School of Public Health, National University of Singapore, Singapore
  1. james.rudge{at}

Limited transmission between humans is not surprising

Since the new avian influenza virus, H7N9, first emerged in China, a primary concern has been whether it might spread between humans. The vast majority of the 133 confirmed cases reported so far seem to be epidemiologically unconnected, with many patients reporting a recent history of exposure to live poultry, which are suspected to be a main reservoir for the virus. Although an earlier study did report two family clusters of H7N9 cases, it was unclear whether these clusters resulted from person to person transmission or simply from exposure to a common animal source of infection.1

In the linked paper (doi:10.1136/bmj.f4752) by Qi and colleagues, a detailed investigation into one of these clusters provides the strongest evidence yet of H7N9 transmission between humans.2 The index case, a 60 year old man, was likely to have been infected at a nearby live poultry market, and subsequently developed …

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