Bird Flu H7N9 Spreads Throughout China

Bird Flu H7N9 Spreads Throughout China, Evidence It May Pass Person-To-Person

New cases of H7N9 were reported over the weekend in Beijing and China‘s central Henan province, the first time the influenza A (H7N9) virus has spread through all regions of the country. If that weren’t worrying enough, officials announced (albeit quietly – they’re clearly concerned about public panic) that two of the cases are under investigation for being part of suspicious “family clusters.”

Translation: The H79N virus may now be transmitting from person to person.

The total number of flu cases reported so far is 60, with 13 dead. Almost all of the remaining cases are severe, says the World Health Organization (WHO). The details of all these cases are provided on the WHO’s Disease Outbreak News website.

Up to now, it was believed the only way to catch the novel influenza A (H7N9) virus was through contact with poultry or other birds. However, the Centers for Disease Control (CDC) and World Health Organization (WHO) both issued reports detailing the probability that the virus could mutate. It looks like that may be happening already.

The bad news: The WHO’s Risk Assessment of April 13 described two cases in which family members of people ill with H7N9 also have pneumonia-like symptoms. Says the report: “Two confirmed cases have been associated with possible family clusters, in which one and two additional family members, respectively, developed severe pneumonia.” In one case, 24 people associated with the 7-year-old Beijing girl are being tested for the virus.

The good news: People likely to contract the H7N9 flu, such as health care workers caring for ill patients, are not getting sick. (At least not so far.” Says the WHO: “Close contacts of confirmed cases and health care workers caring for cases have been monitored for infection. So far, among the contacts who have been tested by polymerase chain reaction, none has been shown to have infection.”

Unfortunately, the WHO’s latest risk assessment contains plenty of other scary tidbits. The report cites “gaps in critical information” including:
•how many types of animals (so-called “animal reservoirs”) are capable of carrying or transmitting the virus
•the main “exposures and routes of transmission” for how people are catching the virus and getting sick
•the current “scope of the spread of this virus among animal and human populations.”

And the genetic breakdown of the virus (just the first three cases) shows that the virus:
•Compared with other bird viruses, H7N9 “may have greater ability to infect mammalian species, including humans, than most other avian influenza viruses”
•the gene sequence variations that have been isolated “suggest there has been more than one introduction of this virus from animals into humans”
•the virus has “low pathogenicity” in birds – meaning birds carry the virus without showing signs of being sick

Last week, a team of experts from China published the details of this genetic analysis in The New England Journal of Medicine. As of today, the CDC’s “watch level” for travelers going to China is still at Level 1, or “practice usual precautions.” Other than normal hygeine advice, the CDC’s Traveler’s Advisory merely advises travelers to avoid contact with animals. Last week, a team of experts from China published the details of this genetic analysis in The New England Journal of Medicine.
•Do not touch animals whether they are alive or dead.
•Avoid live bird or poultry markets.
•Avoid other markets or farms with animals.

It will be interesting to see if the CDC changes its position if human-to-human transmission is detected.

Obviously, this is a fast-moving story. Please see the comments on my previous story for some very interesting insights from public health and medical experts. For more flu news, please follow me on Twitter, @MelanieHaiken and subscribe to my posts on Facebook.

http://www.forbes.com/sites/melaniehaiken/2013/04/15/alarming-bird-flu-news-h7n9-spreads-throughout-china-may-pass-person-to-person/