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Online Discussion: Tracking new emerging diseases and the next pandemic

Warning: H7N9 P2P Epidemic Threshold Is Now!

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jdljr1 View Drop Down
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    Posted: October 24 2013 at 3:11pm
 
October 24, 2013

New China H7N9 Bird Flu Cases 'Signal Potential Winter Epidemic'

By REUTERS

LONDON — Fresh human cases in eastern China of a deadly new strain of bird flu signal the potential for "a new epidemic wave" of the disease in coming winter months, scientists said on Thursday.

The strain, known as H7N9, emerged for the first time in humans earlier this year and killed around 45 of the some 135 people it infected before appearing to peter out in China During the summer.

But a new case in October in a 35-year-old man from China's eastern Zhejiang province shows that the virus "has re-emerged in winter 2013" and "indicates a possible risk of a larger outbreak of H7N9 this winter," according to Chinese researchers writing in the online journal Euro surveillance.

Flu experts around the world have been warning that despite the marked drop off in cases during the summer months, the threat posed by H7N9 bird flu has not passed.

Ab Osterhaus, a leading virologist based at the Erasmus Medical Centre in the Netherlands who has been tracking the virus, told Reuters earlier this month: "We're bracing for what's going to happen next."

The first scientific analysis of probable transmission of the new flu from person to person, published in the British Medical Journal in August, gave the strongest proof yet that it can jump between people and so could potentially cause a human pandemic.

And another study published in August identified several other H7 flu viruses circulating in birds that "may pose threats beyond the current outbreak".

In a detailed analysis of the 35-year-old man's case, scientists from the Zhejiang Provincial Centre for Disease Control and Prevention said it differed from previous ones in that it was a severe case in a younger patient "with no obvious underlying diseases and no obvious recent direct contact with live poultry".

Most laboratory-confirmed cases in the past had been people over the age of 60, many of whom said they'd had recent exposure to poultry, generally at live bird markets.

The case of the 35-year-old man, plus another H7N9 infection confirmed just a day ago, suggest the virus "has apparently continued to circulate in an animal reservoir during the summer", the researchers said.

The second October case is a 67-year-old man with no underlying disease whose work included transporting and selling poultry.

The researchers said that based on China's experience in the spring, when there were 30 cases in March and 88 in April, the best approach now would be to maintain enhanced and expanded surveillance in human and animal populations to make sure any new cases of H7N9 are picked up and diagnosed swiftly.

"In particular, enhanced surveillance in poultry would be helpful if it can identify the H7N9 virus and inform early control measures before human infections occur," the Chinese scientists said.

"Hygiene campaigns and closure of live poultry markets can reduce the risk of severe cases and deaths."

(Editing by Philip Barbara

John L
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2013 at 5:03pm
Second wave looming? And now that researchers are looking for it in poultry, other H7 viruses have been found silently spreading alongside, including an H7N7 strain that has been shown to be infectious to mammals.
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"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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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2013 at 7:43pm
On the contrary Jacksdad my friend, this would be wave one.  We've all been warning of this for months here on AFT.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cobber Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 1:43am
I maybe loosing my MERS vs H7N9 bet. 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 4:54am
I can assure you that there are more than a couple cases at the moment.  The Chinese are masters at suppressing information. Similar to last spring when Chinese officials began arresting internet posters for reporting cases, and how they managed to hide the initial SARS outbreak in 2003, this will be no different.  The Lancet reported there were an estimated 1,500 - 27,000 possible cases last spring, and the Chinese never budged off their 135 cases. 

It also doesn't appear that h7n9 needs another mutation to become a potential global event this winter.  Let's hope that it remains only efficiently transmitted via limited human to human transmission and this will be a slow mover.  Either way, we're probably about to see a rather large spike in cases.

I understand that I'm a little harsh when it comes to criticizing the WHO and China in this matter, but both have a very poor track record in their handling/reporting of initial outbreaks - and times have changed.   


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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 5:01am
Originally posted by Albert Albert wrote:

We've all been warning of this for months here on AFT.

Oh hell, I don't pay attention to all that crazy prepper stuff - I just come here to spar with TG

You're right, A. It never became a pandemic, or even an epidemic, so technically it hasn't had any "waves" yet. What I should have asked is are we looking at a new virus compared to the one that was spreading inefficiently earlier this year, or is it H5N1 all over again, having good years and bad years while we post about the coming doomsday? Has this virus spent the summer picking up the genetic material necessary (maybe in Guangdong/Hong Kong) to go H2H this time around, or is it just more of the same? If it hasn't had it's first wave yet, let's hope that when it does it's relatively mild but enough of a kick in the pants to wake us up to it's potential before the second (historically always the worst) takes us down as hard as we know it can.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote KiwiMum Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 11:50am
Why is the second wave the worst? I've seen that mentioned on here before but don't know why it would be more deadly than the first or third. Can anyone explain please?

If it is to be, it is up to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 1:11pm
KiwiMum - the first wave happens as the virus is finding it's feet and learning about us, the second is the fully adapted H2H virus spreading efficiently with maximum killing power in a population of susceptible human hosts, and the third (if there is one) is mild because we've either developed immunity or died. There are numerous theories as to why the wave phenomenon happens, and while there are undoubtedly many factors like mutation of the virus and seasonal temperature changes, I tend to believe human behavior plays a big role - when large numbers get sick, people are more careful and use social distancing and infections begin to decline, and when that happens we drop our guard and infections rise again.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote FluMom Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 7:45pm
When we talk about waves does the virus need to be world wide? Or at least country wide?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 7:45pm
Because of air travel the times have changed, if it was sustained h2h, wave one would be a flunami.  h7n9 has not achieved sustained h2h, but it has achieved sustained "limited" h2h.  A slow moving pandemic, but one none the less.  I don't believe it will need sustained transmission to cause an enormous problem, and it will most likely get entrenched.  
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CStackDrPH Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 9:38pm
I'm concerned because this new case is younger than previous cases (35 years old).  Earlier, H7N9 mortalities were largely older people with underlying health conditions. 

I concur with JD, this - is - not - good.   Time to stock up, folks.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote claude Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2013 at 11:43pm
Originally posted by cobber cobber wrote:

I maybe loosing my MERS vs H7N9 bet. 



MERS is likely a bioweapon and ethno-specific to arab/asians. Israelis have had this capacity for decades. This fact would inherently limit the targets and keep it a regional epidemic. havent you noticed how- despite those sick with MERS travelling to EU and outside ME, it is not spreading among Europeans?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote KiwiMum Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 12:09am
Jacksdad, thanks for the explanation. Is there a recognised time frame for all this: ie, does the second wave of a flu virus strike, for example, 2 months later or is there no set time frame for this?

I'm asking because I want to know, if I lock my gates, how long do we have to hold out for?

And, if we stay isolated and the second wave passes us by but then we re-emerge, would we still get a lethal dose because we've not been exposed to it thus far, or would the virus have evolved to become a much milder disease by the third, and subsequent waves?
If it is to be, it is up to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Gina Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 12:32am
Obamacare allows mandatory house-to-searches with vaccinations. timing is just right for a pandemic huh?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 1:58am
Originally posted by Gina Gina wrote:

Obamacare allows mandatory house-to-searches with vaccinations. timing is just right for a pandemic huh?


http://www.snopes.com/politics/medical/homeinspections.asp
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 3:28am
You're welcome, KiwiMum.
As Albert mentioned, the problem with predicting time frames for modern pandemics is that conditions exist now - like air travel and population densities not seen in previous pandemics - that allow the faster spread of a virus and make predicting it's behavior really difficult. Throw widespread factory farming of poultry and pigs into the mix and the opportunities that affords an emerging virus, and it becomes doubly difficult to predict it's origins and spread. SARS showed how fast a bug can now move around the globe under the right conditions, while H1N1 swine flu didn't exhibit the clear cut waves that we've seen previously, so you have to wonder if the modern world hasn't changed everything to the point where we can't rely on historical data anymore, and therefore all bets are off.
Check out the math they threw at the problem in this 2006 article,

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040013
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 7:03am
What's a little concerning is that Chinese officials are probably making every effort to suppress the reporting of any new cases.  We might not get much of a head start on this if it takes off.   Of course it's important to know of any cases whatsoever so we can gauge what to expect.  

What's also a little concerning with this, unlike h5n1, this new flu is somewhat resistant to antivirals. 

http://www.cidrap.umn.edu/news-perspective/2013/07/study-outlines-h7n9-antiviral-resistance-testing-problems
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Post Options Post Options   Thanks (0) Thanks(0)   Quote NatQ Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 8:25am
Snopes is nothing but an average husband and wife team who got money from Soros for whatever reason. they have ZERO special training, expertise or contacts- in anything- to qualify as "debunkers or even mediocre fact checkers. in fact they have long been discredited across the internet as an unreliable front with their own agenda / bias.  along the line of 'sorch faal'  (tho she too has been featured by the gullible on this site).

Obama care + Obama exec orders + CDC/WHO protocols WOULD allow home inspections, quarantines and mandatory vaccine. simple google of govt data bases will prove this true.
"Snopes" is an arbiter of NOTHING, on any subject whatsoever.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 9:57am
I did Google it, and it's debunked on many, many sites other than Snopes.
And it's off topic in this thread, and I find it interesting that you have the same IP address as "Gina", and you both use the same ISP. Yep - we get to see stuff like that... Ermm

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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2013 at 10:00am
Originally posted by Albert Albert wrote:

What's also a little concerning with this, unlike h5n1, this new flu is somewhat resistant to antivirals. 

http://www.cidrap.umn.edu/news-perspective/2013/07/study-outlines-h7n9-antiviral-resistance-testing-problems


So we'll have little or no warning, not enough antivirals, and the ones we have may not work anyway...Confused
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"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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