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

WHO warns of H7N9 pandemic

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Albert View Drop Down
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    Posted: March 29 2017 at 5:01am
This came out a few months ago, but is still relevant for a couple of reasons.  First, is that there are probably several mild cases, although it has now mutated a bit and has become quite a bit more virulent and infectious.  Second, is that since the article, it has in fact mutated to HPAI and began killing poultry.   Chan claims H7N9 could be a pandemic flu strain, and the virus appears to be changing rather quickly as the WHO has warned.  When you read the article, it's amazing all of the rapid changes that have taken place over the last 90 days with this one.  Not a good pattern.
 

WHO warns of H7N9 pandemic
Dec 15, 2016

World Health Organization director- general Margaret Chan Fung Fu-chun warns bird flu H7N9 is particularly worrying as it could be a flu pandemic strain.

This is because H7N9 is unique as it does not make chickens sick but is deadly in humans. Sick birds could usually provide early warning for imminent outbreaks, Chan told The Standard.

This comes as Macau reported its first human case of H7N9 yesterday.

"The biggest challenge for the world is the next influenza pandemic," Chan said.

The last flu pandemic was the human swine flu H1N1 which originated in Mexico in 2009, but was considered milder than most pandemics.

Chan, who was the first to notify the WHO of a new bird flu H5N1 when she was Hong Kong's director of health in 1997, said that of the various bird flu viruses, she has paid attention the most to H7N9.

"H7N9 is unique as compared to H5N1. Why? Because when it affects the poultry population, it does not kill the bird. So we lost one early warning signal. We only see human morbidity and mortality," she said.

"In other words this is not causing disease in birds, it is only causing disease when it jumps to humans. So we need to watch it. We have been blindsided (by H7N9) as we don't have early warning signs in animals as we do in H5N1."

Chan said the world could not get complacent with flu as the viruses are "highly unpredictable and always full of surprises, starting from H5N1, H1N1 to H7N9, H5N6."

The H7N9 victim, a 58-year-old stall owner at Sociedade do Mercado Abastecedor de Macau Nam Yue, a wholesale poultry market in Macau, has not shown symptoms but has been quarantined along with his wife at Centro Hospitalar Conde de Sao Januario.

Macau has culled 10,000 live poultry and the wholesale market has been closed for sterilization. A three- day ban was imposed on live poultry trade.

This followed the discovery of H7N9 in the batch of 500 samples taken from imported silky fowls from the mainland on Tuesday.

Investigation by the Health Bureau of Macao said the man handled the cages containing the infected chickens.

He was sent to hospital and his test results came back positive for H7N9 at night.

The male truck driver who delivered the batch of chicken had returned to the mainland and Macau health officials said they have notified mainland counterparts.

"At this point in time, we see a wide spread of these viruses in both northern and southern countries in different continents," Chan said. "They are still primarily affecting the bird population.

"It has not gained sustained human- to-human transmission. We still see sporadic human cases due to close contact with poultry," Chan said.

On Tuesday, Hong Kong's Centre for Health Protection said five men in the mainland were in serious condition from H7N9.

One man, 59, is from Fujian while the four others are from Jiangsu, aged 32 to 64. All have poultry market exposure.

A spokesman for the center said bird flu virus activity increases in winter in the mainland.

"The public should avoid contact with poultry, birds and their droppings and should not visit live poultry markets and farms to prevent avian influenza, particularly during travel in the Christmas and New Year holidays," the spokesman said.

Mainland health authorities have reported 783 human cases of H7N9 since 2013

http://www.thestandard.com.hk/section-news.php?id=177527





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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2017 at 8:12am
At least it's showing symptoms in birds now, but that's a double edged sword because it means it's capable of significant mutation.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2017 at 9:02am
I agree JD, and that's the moral of the story on this.  It's capable of mutating and evolving fairly fast, as it is currently toing in Asia, and how rapidly it mutates to HPAI here.   The different lineage claims don't mean a lot to me personally.  It's the same strain, but with a different lineage, is splitting hairs.  Plus, China doesn't even share their sample so who knows how many different variants they're dealing with, but to say this strain didn't arrive from Asia, and this is a complete novel strain that randomly popped is laughable, bordering on insulting.    

On another note, one human infection (or panic) and the collapse of our poultry industry would be imminent.  We are now dependent on chicken and eggs as our primary food source in this great country, and shifting to cheese burgers and pizza for people would be no problem, lol.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2017 at 3:20pm

Another H7N9 epidemic, with possible HPAI isolates

​CDC developing new vaccine but says public health risk low

By Greg Cima

Posted March 29, 2017

China is enduring its fifth epidemic in four years of an avian influenza strain that has killed hundreds of people, according to the World Health Organization.

Recent isolates of the influenza A H7N9 virus, found in humans and environmental samples, have genetic sequences characteristic of highly pathogenic avian influenza viruses, which cause disease in birds. While viruses with those changes could cause severe disease in birds, WHO officials reported in March that they had no evidence the changes affect pathogenicity or transmissibility in humans.

The current epidemic is the largest of five, with 460 reported human infections since Oct. 1, 2016, according to a March 3 report from the U.S. Centers for Disease Control and Prevention. Most infections in humans have been connected with exposure to poultry, especially on farms, in live bird markets, and at slaughter locations.

CDC officials are developing a vaccine against the H7N9 virus and working with counterparts in China in response to the latest epidemic.

The virus is transmitted from birds to humans, and the risk of sustained human-to-human transmission is low, according to the WHO. But the organization’s report notes that constant change is the nature of influenza viruses.

In a recording from a March 1 WHO press briefing in Switzerland, Jacqueline Katz, PhD, deputy director of the CDC’s influenza division and director of a CDC collaborating center with the WHO, said sporadic infections can occur in humans while avian influenza viruses circulate in poultry. Avian influenza viruses can acquire genetic changes that would let the viruses infect people more easily or spread person to person, which could lead to a pandemic, she said.



​A negative-stained transmission electron microscopic image of the A H7N9 avian influenza virus. (Courtesy of Cynthia S. Goldsmith and Thomas Rowe/CDC)

The CDC report—an early release from the Morbidity and Mortality Weekly Report—indicates 453 of the 460 laboratory-confirmed human infections since October 2016 occurred in mainland China. Four others were associated with travel from the mainland to Hong Kong, one each involved travel to Macao and Taiwan, and one involved an asymptomatic poultry worker in Macao.

Of the 800 known human infections from the prior four outbreaks, 88 percent of victims developed pneumonia, and 41 percent died, the CDC reported.

The CDC Influenza Risk Assessment Tool, which is used to assess the pandemic risk of influenza A viruses not circulating in people, lists the low-pathogenic H7N9 avian influenza virus as having the highest risk of emergence and highest potential impact among 12 influenza viruses that are public health concerns. It also has the highest listed pandemic risk: moderate to high.

But the MMWR article notes the public health threat remains low.

A. Danielle Iuliano, PhD, an epidemiologist in the CDC’s influenza division and one of the MMWR article authors, said the general risk of a person becoming infected with the H7N9 virus is low, and she noted that most of the H7N9 infections in humans have followed exposure to poultry in specific areas of China. The assessment of a virus’s pandemic potential considers factors such as epidemiologic characteristics, virus characteristics, and clinical presentation, and the findings from that assessment become more important if the virus becomes transmissible among humans.

“Right now, we think the general risk to the public is low because it’s not transmissible person to person,” she said. “But we’re monitoring things very closely because of the anticipated pandemic risk.”

The virus is circulating among poultry populations and is endemic in some areas. 



Source: The World Health Organization

(click to enlarge)

As for the avian influenza isolates with characteristics of highly pathogenic viruses, Dr. Iuliano noted that clinical signs—including die-offs—among birds infected with highly pathogenic avian influenza viruses can help alert people that the virus is present before anyone becomes infected. Identifying the presence of low-pathogenic avian influenza often involves looking for the sources of infections in humans, she said. She was not aware of any bird die-offs reported in connection with the H7N9 epidemics.

U.S. Department of Agriculture officials also announced March 7 that a highly pathogenic H7N9 avian influenza virus found in a Tennessee chicken breeding flock was different from the H7N9 virus in China. On March 5, officials with the USDA Animal and Plant Health Inspection Service said the farm had the first commercial flock of 2017 with confirmed infections with a highly pathogenic avian influenza virus, then an unknown variety of H7 influenza.

The farm had 73,500 chickens. Birds on the property were depopulated and buried, APHIS information states.


12 monkeys!!!!!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2017 at 10:38pm
...them chickens are gonna be the death of me yet!  Cry

I'm waiting to see if we get another reassortment with swine....the last major pandemic, H1N1 2009, had an interesting genome with portions of avian, human and swine virus components.  (see my followup post below)

Folks who know this stuff better than I do keep insisting that we need a swine flu reassortment event to get efficient mammalian transmission, and I'm inclined to believe them. 

I'm keeping my eyes & ears open....
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2017 at 10:41pm
Regarding the 2009 H1N1 "Swine" virus pandemic, this article explains how far viruses have to reassert in order to efficiently transmit from human to human:

Pandemic (H1N1) 2009 virus consists of multiple reassorted virus genes from different origins. Of its 8 segmented genomic RNAs, 2 polymerase genes, PB2 and PA, were from the avian virus of North American lineage and were introduced into swine populations around 1998. The other polymerase gene, PB1, also evolved recently from a human seasonal influenza (H3N2) virus around the same year. 

This particular H3N2 PB1 gene is known to have originated from an avian virus that entered humans in 1968. However, hemagglutinin (HA), nucleoprotein (NP), and nonstructural (NS) protein genes of pandemic (H1N1) 2009 virus descended directly from the classic swine influenza A virus of North American lineage, which can be traced back to the 1918 virus. 

Originating from the Eurasian swine virus, the remaining 2 genes, neuraminidase (NA) and matrix (M), were introduced from birds around 1979 (2,3). Limited information is available as to how this unique combination of gene segments evolved from 1998 until it was identified in April 2009 or on the molecular transitions or evolutionary path of this virus before it was transmitted among humans.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: March 30 2017 at 2:46am
Yes I agree,a swine reasortment ,


will be where it comes from ,I go back to
all the dead pigs in the river about the same time as h7n9 appeared,probably killed them outright ,but now has had time to reasort a few million times ,it only takes the right combo ,and woosh we gone ....lol
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: March 30 2017 at 6:58am
Good thing there aren't too many pigs in China... Ermm

http://modernfarmer.com/2014/03/tail-curling-facts-chinese-pork/



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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: March 30 2017 at 1:32pm
Originally posted by jacksdad jacksdad wrote:

Good thing there aren't too many pigs in China... Ermm

http://modernfarmer.com/2014/03/tail-curling-facts-chinese-pork/


Thanks, JD, fascinating! 

China never did offer an explanation for this event: 


The way that the PRC operates, this could be a regular occurrence and we wouldn't know!  The fact that this happened in a river running through Shanghai, one of their most prosperous cities with many foreign corporations, blew the cover off the situation. 


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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: March 30 2017 at 3:24pm
 lots of piggies ,lots of chucks, (aussie for chickens) 

LOTS of mixed up viruses......

LOTS of potential................
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: April 02 2017 at 4:30am
12 monkeys!!!!!
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: April 03 2017 at 6:33am
A little off topic here, but these new types of masks could offer a good line of defense should the crud hit the fan, as they say.


We of course have no affiliation with that company or any others.  Was just something I came across.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: April 03 2017 at 6:33pm
thanks for that info Albert
QUITE useful

along related lines
the best mask in the world won't protect you if you are not wearing it properly
various videos are available on YOuTube instructing you on how to properly fit a mask
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