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Evidence For Sustained H7N9 Human Transmission |
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tango
Valued Member Joined: April 25 2013 Location: malaysia Status: Offline Points: 15 |
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Posted: May 01 2013 at 9:28pm |
Albert
Admin Joined: April 24 2006 Status: Offline Points: 47746 |
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Here's the story:
Evidence For Sustained H7N9 Human
Transmission The recently released avian sequences had Q226L, which had not been reported previously in H7 (or H5). However, Q226L has become common in avian H9N2 sequences and the close relationship of the six H7N9 internal genes to H9N2 sequences suggests these internal genes were compatible with Q226L in avian hosts. However, the PB2 changes (E627K and D701N) have not been identified in any of the recent H7N9 sequences from live markets in and around Shanghai, and some have speculated that these mammalian adaptations happened in the human cases. However, the presence of E627K in six of the seven human cases, and the absence in any of the avian cases does not support the repeated acquisition E627K in each human case. The presence of L226I, another mammalian adaptation, in the two sequences from the earlier case (who has been described as 39M, 38M, and 37M) raises serious questions about a recent avian source, since this adaptation has not been reported in any of the avian sequences. Moreover, the recently released H7 sequence from a Jiangsu case (45M), A/Jiangsu/01/2013, also has L226I, and the H7 sequence is identical to A/Hangzhou/1/2013 and A/Zhejiang/1/2013. Although the PB2 sequence from A/Jiangsu/01/2013 has not been released, N9 and MP sequences are public and both sequences exactly match A/Hangzhou/1/2013. The H7 and N9 sequences have synonymous changes (A1215C and T409C, respectively), which are also not present in other human or avian sequences, strongly supporting clonal expansion. However, there is no reported contact between the two cases. The earlier case is a chef who lived in Jiande, Hangzhou, but worked in Taicang, Jiangsu, while the second case was from the Jiangning District of Nanjing, Jiangsu, which is not near Taicang (see map). The identity in the three sequences from cases without contact with each other strongly supports sustained human to human transmission, which is also supported by the presence of PB2 E627K in 6 of the 7 human cases (and absence in all five if the avian PB2 sequences). This sustained transmission contradicts WHO statements, which rely on testing of upper respiratory tract samples, which have produced frequent false negatives. In contrast to the negative data cited by WHO, the exact matches in the two cases above provides clear evidence for sustained human transmission. Release of a full set of sequences from the Jiangsu case would be useful (and quite doable since the sequences from the first three gene segments were from an egg isolate). The WHO claims of no evidence of H2H transmission, and the failure to address the identities in the human H7N9, continue to raise serious pandemic concerns. |
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MelodyAtHome
Valued Member Joined: May 16 2006 Location: United States Status: Offline Points: 2018 |
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Albert, so what does this mean for us? What do you think? Who do you believe? I'm with FluMom what she said in another post...about when to Sit In Place.
I'm thinking after we hear about our first case in the states? or 1st case in our state? What are you doing? Thanks. |
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Melody
Emergency Preparedness 911 http://emergencypreparedness911.blogspot.com/ |
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1NiceGuy
V.I.P. Member Joined: October 14 2008 Location: Nevada Status: Offline Points: 163 |
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Influenza is a virus, not an chemical weapon. what I mean is that it's not as lethal as say a nerve agent.
Wash your hands often, don't touch your face, even wear a N95 mask. Avoid crowds and confined spaces... elevators, vehicles.... and use common sense. If you respect the H7N9 virus you won't need to fear it. |
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"Chance favors the prepared mind."
Louis Pasteur -- Louis Pasteur |
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Albert
Admin Joined: April 24 2006 Status: Offline Points: 47746 |
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Hi Melody, I don't believe we have "sustained" h2h at the moment, so I wouldn't base much off dr. niman's commentary regarding that claim. However, we do have a lot of limited h2h happening and the virus is close to achieving sustained h2h. So for the time being, all is good and we're still in a holding pattern - watch and see mode.
If it does reach the U.S. and achieve efficient transmission, then we will prepare big time - and fast. I'll let you know my suggestions when/if the time comes, but for right now, we're okay. |
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MelodyAtHome
Valued Member Joined: May 16 2006 Location: United States Status: Offline Points: 2018 |
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Thank you Albert, I'll be here watching :)
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Melody
Emergency Preparedness 911 http://emergencypreparedness911.blogspot.com/ |
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cyndi26
Valued Member Joined: April 14 2013 Status: Offline Points: 55 |
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Albert, thank so much for keeping us all updated will keep a watch and wait to c whats next Thx again
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cynmentzer26
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jacksdad
Executive Admin Joined: September 08 2007 Location: San Diego Status: Offline Points: 47251 |
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I'm not seeing sustained H2H either. The clusters so far are small indicating that it's developed only limited human transmissibility at best at this point, and I think if Niman's suggesting otherwise he's being premature. It appears to be dead ending in the clusters we're seeing.
People seem to be ready to lock the doors as soon as it leaves Asia. Don't be too quick to SIP as most people's resources wouldn't last much more than one wave, and the first one is not usually the one to worry about. You might burn through your preps while it's still finding it's feet, and then be no better off than the non-preppers if it comes back as a fully H2H virus, maybe in the fall. It's getting used to us right now, and while it does seem to be mutating faster than other influenzas it's still not a fully human virus. Yet. Don't SIP until you have good reason to - timing is key to make it through with what you've put aside. |
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"Buy it cheap. Stack it deep"
"Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary. |
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I agree to wait and see about SIP but that is why I am here on this site. When we all pretty much agree it is time to SIP I will do so. My son may hate me but oh well!
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Albert
Admin Joined: April 24 2006 Status: Offline Points: 47746 |
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You got it Cyndi, my pleasure. We'll all watch this thing together and get it figured out.
Best, Albert |
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