Measures to combat H7N9 virus infection in China: live poultry purchasing habits, poultry handling, and living conditions increase the risk of exposure to contaminated environments.

From March 31 to May 31, 2013, 132 cases of humans were infected with the H7N9 avian influenza virus, 39 of which resulted in death in China, which sparked global concerns about public health. Fortunately, no new case was reported in China since May 8, which seems like to make it step into a stable stage, and the emergency response to the event launched by Shanghai, Jiangsu, Zhejiang, Anhui, Jiangxi, Shandong, and Hu'nan of China have been terminated currently. However, on July 20 and August 10, two new cases were reported from two provinces--Hebei and Guangdong--where no case was reported during the period of spring of 2013. The emerged two new cases rung an alarm bell, thus, the continued public health response cannot let down its guard. Based on our before studies, we found that live poultry purchasing habits, poultry handling, and living conditions increase the risk of exposure to H7N9 virus contaminated environments in China. Due to the difficulty in changing live poultry purchasing habits and in thoroughly removing or closing live poultry markets in China, we suggest that enhanced regulation of poultry markets would be a more feasible and effective strategy to fight against H7N9 virus infection in China. Moreover, in view of the fact that frequent and inevitable contact between rural residents and poultry where rural residents lived also exists due to poultry handling and living conditions, the enhanced regulations on environmental health are also needed for free-range poultry, especially in rural areas.