Timeline

September 12: Approximately 17,000 + cases of 2018 H7N9 virus infection have been identified in the U.S. and worldwide, with early cases in the U.S. during August linked to travelers who returned from China or Tibet.

September 9: HHS approves CDC’s recommendation to activate Flu on Call ® on Thursday, September 13th.

September 8: The ACIP reviewed the available safety and immunogenicity data for the stockpiled 2017 H7N9 vaccines from the National Institutes of Health (NIH)/ National Institute of Allergy and Infectious Diseases (NIAID) phase two studies in adults. Pediatric clinical trials of 2017 H7N9 vaccine have been accelerated, but data are not available. Data from safety and immunogenicity studies of stockpiled 2013 H7N9 vaccines were reviewed.

September 6: WHO declares an influenza pandemic: 2018 H7N9 Pandemic. 20 countries have reported a total of 8625 lab-confirmed H7N9 cases to WHO (Americas (2332), Europe (860), Eastern Mediterranean (352), South-East Asia (294) and the Western Pacific (4787)) from five of six WHO regions. Many additional cases are suspected. In the U.S., some parents in communities with confirmed H7N9 cases where schools are in session are electing to keep their children out of school, leading to absenteeism and disruptions in operations for some companies and school districts. The first lot of 400 new CDC H7N9 rRT-PCR Reagent Kits is available for distribution to public health laboratories in the United States and internationally.

August 28: CDC staff and EIS officers are deployed on field investigations in multiple states of H7N9 virus transmission in households in three communities and on one cruise ship. CDC publishes article in NEJM on the early epidemiology of 2018 H7N9 in the U.S.

August 22: CDC Influenza Division has developed two pandemic H7N9 candidate vaccine viruses (CVVs) for prioritization, and has initiated the required testing that must be completed before the CVVs can be distributed to the Food and Drug Administration (FDA), other WHO Influenza Reference Centers, and two vaccine manufacturers for planned use as adjuvanted monovalent vaccine in clinical trials.

August 19: The HHS Secretary declares a Public Health Emergency. Personal protective equipment (PPE) manufacturers, the International Safety Equipment Association (ISEA), and the Health Industry Distributors Association (HIDA) all report significant surges in orders of respiratory protection devices (RPDs) from medical facilities and the general public.

August 12: China reports 42 H7N9 cases to WHO from Tibet, Beijing, Shanghai, and Guangzhou. WHO issues a Public Health Event of International Concern (PHEIC) and also declares a Pandemic Alert based on H7N9 cases confirmed, including human-to-human transmission in five countries (U.S., China, Thailand, U.K., Australia).

August 11: CDC confirms additional H7N9 cases in hospitalized patients in Ohio, Texas, and California. China CDC publishes an article in the New England Journal of Medicine (NEJM) describing the clinical features and A(H7N9) virus characteristics of 10 cases in Beijing. August 10: MMWR article is published on the Houston family cluster of H7N9 cases.

August 9: CDC EOC is Fully Activated to Level 1. Through multiple communication channels, CDC alerts the general public and state, local, and territorial public health officials about the 2017 Community Mitigation Guidelines regarding the non-pharmaceutical interventions (NPI) that may be recommended in the event of a severe pandemic.

August 8: CDC EOC is activated to Level 3.

August 7: H7N9 virus infection is identified by the Influenza Division, CDC The hospitalized Houston (M/52) patient’s specimen is sent to CDC Atlanta and is received late AM. Influenza A(H7N9) virus is identified by real-time RT-PCR at the Influenza Division in the late afternoon. This is the first human case of influenza A(H7N9) virus infection identified in the U.S.

August 6: The Houston Health Department notifies the Influenza Division, CDC, by email of an influenza A positive, non-subtypeable result in a hospitalized patient that arrived from China on 1 August. The patient now has severe pneumonia.

August 5: The China CDC reports five H7N9 cases with severe pneumonia in Beijing and Tibet to the World Health Organization (WHO). The CDC Influenza Division assignee in Beijing is briefed on details of the field investigations and epidemiological findings. Characterization of influenza A(H7N9) viruses from patients is in-progress at the China CDC NIC.

August 4: China CDC NIC identifies influenza A(H7N9) virus by RT-PCR in respiratory specimens from three hospitalized patients with severe pneumonia from two different Beijing hospitals. The China CDC NIC also identified A(H7N9) virus by partial sequencing of RNA extracted from the specimens collected from two patients hospitalized at Tibet People’s Hospital with pneumonia in Lhasa. Field epidemiological investigations among close contacts of the H7N9 patients are initiated by the China CDC along with local CDC colleagues in Lhasa and Beijing. CDC requests full sequences from China Collaborating Center.

August 2: Results of testing at the China CDC National Influenza Center (NIC) conducted on nasal and throat specimens collected from two patients hospitalized recently at Tibet People’s Hospital with pneumonia (specimens were received at the China CDC NIC on August 1st): both patients’ specimens tested positive for influenza A, and negative for H1 and H3 by RT-PCR.

August 1: There are reports of increases in respiratory illness at emergency departments and outpatient clinics in the Lhasa area and in nearby Tibetan districts since mid-July.

July 31-Aug 1: 35 become ill in China with non-severe acute respiratory illness, depart the Lhasa airport to other cities in China to fly back to their respective countries.

July 24-31: 35 tourists from the U.S. and other countries become sick with fever and respiratory symptoms while on eight-day “Gateways to Lhasa” group tours in China during 24 July to 31 July.

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