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Online Discussion: Tracking new emerging diseases and the next pandemic.

‘Largest pandemic in 100 years’ threatens Chin

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arirish View Drop Down
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    Posted: February 18 2017 at 4:40pm
‘Largest pandemic in 100 years’ threatens China as bird flu spreads

China could be facing the worst bout of bird flu to hit the country in a century, with Avian Influenza A(H7N9) accounting for the deaths of 79 people in January from the 192 human cases reported so far.

The outbreak has been described as the “worst season since the virus first appeared in the country in 2013,” by members of the Chinese Center for Disease Control and Prevention.

Guan Yi, an expert in emerging viral diseases at the University of Hong Kong in China, said the surge in human cases is a cause for grave concern. "We are facing the largest pandemic threat in the last 100 years," he told Science.

Between December 20, 2016 and January 16, 2017, a total of 918 laboratory-confirmed cases of human infections as well as 359 deaths from H7N9 worldwide have been reported to the World Health Organization (WHO).

Until it was detected in China in March 2013, the virus hadn’t been seen in people or animals, apart from birds. Although it “does not appear to transmit easily from person to person,” the disease is raising concern because “most patients have become severely ill,” the WHO says.

As a rule, infection with the A(H7N9) virus is marked by fever, cough, respiratory problems and rapidly progressing pneumonia. “Severe illness and fatal outcome have been more frequently observed in pregnant women, in older persons and those with underlying chronic conditions,” according to research published by the WHO last week.

At this stage, it’s thought that most of the cases of human infection can be traced to “recent exposure to live poultry or potentially contaminated environments,” with poultry markets of particular concern. To date, A(H7N9) virus has not been reported in poultry populations outside China, according to the WHO.

Four previous epidemics have been observed in China between February 2013 and September 2016, with this outbreak now officially classed as the fifth.

Among the possible reasons for the sudden increase of H7N9 cases is “increased environmental contamination by the H7N9 virus,” while Ni Daxin, deputy director of emergency response for the Chinese Center for Disease Control and Prevention, said on Wednesday that weather conditions and "the local habits of buying live or freshly slaughtered chickens,” have also helped spread the virus.

The closing of live poultry markets has helped to slow down the spread of the virus, however, according to Ni. "If the public buys only frozen poultry, control of the epidemic will be much easier. The nutritional value is equal to that of freshly slaughtered poultry, but it involves far fewer health risks.”
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EdwinSm, View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: February 18 2017 at 10:18pm
Originally posted by arirish arirish wrote:

it “does not appear to transmit easily from person to person,”


Is this the reason why, given the numbers in China, we are not seeing it spread elsewhere in the world?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: February 19 2017 at 7:01am
I've lost track a little with h7n9 over the last few years, but we all used to track it early on.  One thing that has got my attention is the 918 cases with 359 deaths.  The fatality rate has significantly increased over the years and was never near 40%.  No doubt h7n9 is changing more than all the others.    Plus a large number of cases are not related to poultry these days.  There may very well be an h7n9 pandemic down the road.    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: February 19 2017 at 9:57am
I'm starting to become concerned about H7N9 in a way that I haven't since H5N1, and that nasty little bug was the reason I began prepping in the first place. With H7N9's recent emergence meaning we've had no chance to acquire immunity to it as a species, it's disturbing that it seems to be developing a taste for humans at a pretty brisk pace.

Early reports of clusters quite rightly elicited concern, if not panic. Now they're reported almost in passing, with little importance attached to them because they still dead end quickly. It might not be a chain, but a cluster of two is still a virus that can jump between humans under the right conditions, and it is significant when it's happened on a number of occasions. Don't let the notoriously short attention span of the media be your compass on this one, because the next pandemic has no date on it yet. The ability of a virus to jump to a third, fourth or hundredth case won't be heralded by an announcement - it happens without warning, and that is why preemptive preparations are so important. None of us has a crystal ball, and we have no way of knowing if this will amount to anything, but disease outbreaks like this should be a wake up call for all of us. Prepping is nothing more than an insurance policy, after all.

Whether it will become a human strain is the big question, but even if it were to follow historical norms and trade off some of it's virulence for transmissibility in people, it's still possible that H7N9 could be far deadlier than anything we've seen in a century or more. Albert mentioned H7N9's current cumulative CFR of 40%. We still don't know if there are significant numbers of mild or unreported infections, but the mortality rate in confirmed cases has recently increased to almost 50%. To put that in perspective, many historians estimate Spanish Flu's CFR to be about 2.5%. Even if there are milder infections we haven't seen yet, and H7N9 loses half of it's ability to kill us as it mutates to an efficient H2H strain, that still leaves us with the possibility of a virus - one that spreads as easily as influenza with a CFR potentially in double digits - that could decimate society in a matter of months with little warning.

This is the one to watch right now, although H1N1 is also worthy of attention given the very real possibility that it might have undergone significant mutations. And don't forget that these viruses like to swap spit and reassort - two significant viral strains circulating at the same time only stacks the odds against us even more.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: February 19 2017 at 1:21pm

Bird flu strain taking a toll on humans

By Dennis Normile

SHANGHAI, CHINA—An avian influenza virus that emerged in 2013 is suddenly spreading widely in China, causing a sharp spike in human infections and deaths. Last month alone it sickened 192 people, killing 79, according to an announcement this week by China's National Health and Family Planning Commission in Beijing.

The surge in human cases is cause for alarm, says Guan Yi, an expert in emerging viral diseases at the University of Hong Kong in China. "We are facing the largest pandemic threat in the last 100 years," he says.

As of 16 January, the cumulative toll from H7N9 was 918 laboratory-confirmed human infections and 359 deaths, according to the World Health Organization (WHO). Despite its high mortality rate, H7N9 had gotten less attention of late than two other new strains—H5N8 and H5N6—that have spread swiftly, killing or forcing authorities to cull millions of poultry. But so far, H5N8 has apparently not infected people; H5N6 has caused 14 human infections and six deaths.

All human H7N9 cases have been traced to exposure to the virus in mainland China, primarily at live poultry markets. The strain likely resulted from a reshuffling of several avian influenza viruses circulating in domestic ducks and chickens, Guan's group reported in 2013. Studies in ferrets and pigs have shown that H7N9 more easily infects mammals than H5N1, a strain that sparked pandemic fears a decade ago. There have been several clusters of H7N9 cases in which human-to-human transmission "cannot be ruled out," but there is "no evidence of sustained human-to-human transmission," according to an analysis of recent developments that WHO  last week. WHO’s analyses of viral samples so far "do not show evidence of any changes in known genetic markers of virulence or mammalian adaptation," WHO's China Representative Office in Beijing wrote in an email to Science.

Still, there are worrisome riddles. One is that H7N9 causes severe disease in people but only mild or even no symptoms in poultry. The only previous example of that pattern, Guan says, is the H1N1 strain responsible for the 1918 flu pandemic, which killed 50 million to 100 million people.

A menace again

After two quiet years, human cases of the H7N9 bird flu virus in mainland China spiked sharply at the end of last year, provoking renewed fears of an influenza pandemic. 

G. Grullón/Science

Because poultry infected with H7N9 show few symptoms, the virus has spread stealthily, coming to the attention of authorities only after human victims appeared. Determining where the virus is circulating requires testing chickens and collecting environmental samples from live poultry markets.

Human infections have followed a consistent pattern, dropping to zero during summer, picking up in the fall, and peaking in January. During the fifth wave of H7N9 that began last fall, authorities noticed an early and sudden uptick in cases, with 114 human infections from September to December 2016, compared with 16 cases during the same months in 2015 and 31 in 2014, according to a surveillance report. The report notes that the virus has spread geographically, with 23 counties in seven eastern Chinese provinces reporting their first human cases last fall.

"It is too late to contain the virus in poultry," Guan says. He predicts that the virus will continue to spread in China's farms, possibly evolving into a strain that would be pathogenic for poultry. Authorities have culled more than 175,000 birds this winter to stamp out local outbreaks of H7N9 and other avian flu strains. Further spread of H7N9 "will naturally increase human infection cases," Guan says. 

H7N9 may also spread beyond China's borders, either through the poultry trade or through migratory birds. The virus has not been reported in poultry outside China. However, warns WHO's Beijing office, "continued vigilance is needed." 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: February 19 2017 at 1:25pm
the thing that sets h7n9 apart is the fact that it does not affect birds,

but kills humans,there is  no warning signs that there is a virus about
12 monkeys!!!!!
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