Situation Summary

September 13

CDC releases its first projected estimates of the 2018 Pandemic H7N9 burden in the United States up to this point.

  • Cases: CDC estimates that between 48,000 and 98,000 2018 H7N9p-related cases have occurred.
  • Hospitalizations: CDC estimates that between about 4,000 and 5,000 H7N9p-related hospitalizations have occurred.
  • Deaths: CDC estimates that between 300 and 425 H7N9p-related deaths have occurred.

These estimates represent a potentially catastrophic pandemic that is likely to cause significant stress on the health-care system and on schools, businesses and public services. It is also likely to significantly impact people’s daily lives and cause disruption in our communities and our nation. 2018 H7N9p is shaping up to be most comparable to the 1918 pandemic, which was the most severe influenza pandemic to date. Based on this information we must take aggressive actions now.

An H7N9 pandemic is declared

  • A novel influenza A(H7N9) virus of avian origin has adapted to infect and spread easily between people, sparking an influenza pandemic (worldwide flu outbreak). This virus is designated as “2018 H7N9 virus”.
  • The virus is highly contagious and is causing a lot of serious illness, including hospitalizations and deaths.
  • CDC’s Emergency Operations Center (EOC) was fully activated on August 9th

Vaccine is a tool for the future

  • Stockpiled H7N9 vaccines will be used as priming doses for persons at high risk of complications from influenza and critical workforce groups and an H7N9 vaccine that is specific to the 2018 H7N9 virus is in development.
  • Past flu pandemics have come in waves of activity. We are at the beginning of the first wave of activity now. Because of the high transmission rate of this virus, vaccines will have limited impact on the course of this pandemic during this first wave of disease.

Antivirals & nonpharmaceutical interventions are the first line of defense


Currently, early treatment with influenza antiviral drugs and non-pharmaceutical actions offer the best available options to fight against this new virus.

  • Pandemic H7N9 virus is susceptible to the antiviral medications called neuraminidase inhibitors, which means these drugs can be used to treat illness caused by 2018 H7N9 virus infection.
  • Recommended antiviral drugs can treat pandemic H7N9 infection and reduce serious outcomes. Treatment should be initiated as early as possible after symptoms develop as possible.
  • The priority for influenza antiviral drugs during this outbreak is early treatment of people with acute respiratory symptoms and suspected H7N9 infection. Treatment will be based on symptoms and not laboratory diagnosis.

Nonpharmaceutical interventions

  • Nonpharmaceutical Interventions are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like pandemic influenza (flu).
  • NPIs are also known as community mitigation strategies.
  • Everyone should take these everyday steps to protect their health and lessen the spread of this new virus:
    • Try to avoid close contact with sick people.
    • While sick, limit contact with others as much as possible to keep from infecting them. If you are sick with flu-like illness, CDC recommends you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone for 24 hours without the use of a fever-reducing medicine.
    • Cover your nose and mouth with a tissue when you cough or sneeze. After using a tissue, throw it in the trash and wash your hands.
    • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
    • Avoid touching your eyes, nose and mouth. Germs spread this way.
    • Clean and disinfect surfaces and objects that may be contaminated with germs like flu. Use an EPA-registered disinfectant. Read the label to make sure it states that EPA has approved the product for effectiveness against influenza A viruses.
    • Also, consider taking measures to reduce your potential exposure to the virus, like limiting social activities or large group gatherings.
    • Prepare for the possibility of staying home for an extended period of time and look for more guidance on this in the coming hours and days. CDC may recommend school closures, cancellation of mass gatherings and other measures to decrease community risk of transmission.

CDC Response

  • CDC continues to take aggressive action to respond to the 2018 H7N9 pandemic to support the public health response and to gather information about this virus and its characteristics. CDC’s response goals are to reduce the spread and severity of illness, and to provide information to help health care providers, public health officials and the public address the challenges posed by this new public health threat. CDC is issuing updated interim guidance daily in response to the rapidly evolving situation.

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