CDC joins bird flu fight

Published : Thursday, 25 Apr 2013, 7:26 PM EDT

• Erika Edwards (NBC News)

(NBC NEWS) - The H7N9 influenza virus circulating in China has public health officials on edge.

It's the most lethal form of the virus they've seen in years, with one out of five infected patients dying from the illness.

Lab workers at the Centers for Disease Control's headquarters in Atlanta are working nonstop trying to develop a vaccine for H7N9.

So far those in China affected by the virus have had direct contact with infected but healthy-looking birds and there's no evidence the virus is spreading between humans, but the strain could mutate into a form that makes it contagious.

"If it develops the capacity to spread from one person to another, then it could cause very severe disease both in China and neighboring countries and around the world, including in the US," warns CDC Director Dr. Thomas Frieden.

It could take a year or more to develop a vaccine, and once it is available patients will likely need two shots to build immunity.

In the meantime, the CDC is alerting doctors to be on the lookout for cases among travelers so patients who test positive can be isolated immediately.

"There have already been two dozen travelers from China with severe illness in the US, we've tested them at CDC, all negative for this strain of flu," Dr. Frieden says.

Unlike past strains of bird flu H7N9 is not making birds sick, so it is hard to tell where the virus is spreading and which type of bird is infected.

If the virus does not mutate experts say H7N9 will likely not cause a pandemic.

Temporarily closing poultry markets, isolating infected patients and an active surveillance system could prevents its spread. http://www.wwlp.com/dpp/news/national/cdc-joins-bird-flu-fight

Ministry of Agriculture and the World Organization for Animal Health (OIE) joint mission animal H7N9 avian flu prevention and control work

　On April 25, the Ministry of Agriculture and the World Organization for Animal Health (OIE) animal H7N9 avian influenza prevention and control of the joint study group, Shanghai, Zhejiang, National Avian Influenza Reference Laboratory and other places will be a week-long visits. Expedition veterinary epidemiologist at home and abroad , the new poultry disease prevention and control policy experts.

　　Examine kick-off meeting, the Ministry of Agriculture, the National Health and Family Planning Commission, State Forestry Administration, animals, wild birds, the H7N9 avian influenza prevention and control work. OIE that the joint mission is the concrete practice of the "One Health" concept, timely information on the basis of the epidemic invited OIE experts to visit China to further reflect the epidemic management open, transparent, not only conducive to the international community to understand the Chinese animal H7N9 avian influenza prevention and control, but also conducive to China to deepen cooperation with international organizations.  http://www.zgqxcg.com/news/show.php?itemid=7487

H7N9 changed weekly has been questioned

2013-04-26 02:26:00

Core Tip: the mainland yesterday least three new confirmed cases of avian influenza, the National Health and Family Planning Commission decided earlier avian flu communications from daily to weekly, daily new confirmed number is not known, Legislative Council members questioned the practice of the mainland attempted to play down the epidemic.

　　【Reporters Johnnie report the Mainland yesterday least three new confirmed cases of avian influenza, the National Health and Family Planning Commission decided earlier avian flu communications from daily to weekly, daily new confirmed number not and know, Legislative Council members questioned the practice of the mainland attempted to play down the epidemic. Looming epidemic, the Government today from a three-day "Clean Campaign, more than the Secretaries opt off the area of ​​street washing.

　　Found in Jiangxi, the first case of human infection of H7N9 avian influenza suspected cases, are waiting for the Chinese Center for Disease Control for review. Henan surnamed Zheng (56 years old) men, and Zhejiang Province Wang (60 years old) and farmer surnamed Yu (50 years old) diagnosed with H7N9 avian influenza infection in a critical condition. Wei Planning Commission changed weekly epidemic, Legislative Council members of the Civic Party the ki and worried public vigilance will be reduced, increasing the chance of an outbreak of SARS in Hong Kong, sought to maintain published daily in the "V." golden weeks ago .

　　University of Hong Kong Joint Zhejiang University team published a new study in the Journal of International Medical authority "needles" (The Lancet) found that chickens found in four cases and live poultry markets in Zhejiang highly homologous H7N9 virus identified live poultry markets It is the source of the virus. http://www.singpao.com/xw/gat/201304/t20130426_431690.html

Patients admitted to hospital before the seven-day history of fever

2013-04-26 02:38

Yesterday, the Provincial Health Department to inform the media, the province introduced new case of human infection with H7N9 avian influenza.

Which is the city's second case of human infection of H7N9 avian influenza.

Choi patients, aged 56, who lives in the Central Plains District of Zhengzhou City, is currently in critical condition, in treatment of Zheng sophomore Affiliated Hospital isolation.

According to the Zheng sophomore Affiliated Hospital Respiratory experts, provincial members of the Group Xia Xi Zheng said, is significantly different from other cases, Choi had no significant history of poultry exposure.

Patients who lives in the Central Plains area, before admission, the highest temperature reached 39.7 ° C Choi, who lives in the Central Plains road workers in a community, readme fever symptoms on April 17 had reached 39.7 ° C, the maximum temperature.April 18, 19, he went to the city center hospitals and the forest cottage community health service centers for treatment, no significant improvement in symptoms.April 20 cough, sputum, throat itching and other symptoms, April 22 Zheng sophomore Affiliated Hospital for treatment.

By CT imaging, it is found that the lungs infection, bilateral pleural thickening; mycoplasma, chlamydia test is negative.

The hospital initially diagnosed as severe pneumonia, and check in the treatment of the hospital respiratory intensive care unit. City CDC initially specimens test results are negative, and subsequently sent to the provincial CDC detected again, the final test report positive, identified as infected with the H7N9 avian influenza virus.

B

Have high blood pressure, coronary heart disease and other diseases, very difficult to treatment

After diagnosis, the hospital set up a leading group of treatment, medical treatment group, drawn from the respiratory department and intensive care unit experienced medical staff involved in treatment, the hospital itself, including myself, Director of Respiratory and ICU director three provincial-level members of the Group. "

Choi 8-year history of hypertension, cerebral infarction and coronary heart disease history, the 30-year history of smoking and drinking, the basic situation is very bad, which brought a great deal of difficulty to the treatment.

C

No significant history of poultry exposure, but their place of residence in the corridor often hanging bird cage

Zhengzhou Municipal Health Bureau data show that patients living conditions for urban residential building homes, floor the first floor of two buildings, and the only channel - Public corridors, corridors in addition to channel the rest is closed.

Family often hanging at the top of the corridor 78 Birdcage (including pigeons and birds), one week before the onset of the hospital two backyard poultry (chicken), after Community Board ordered the slaughter.

The basic patients once a day to a nearby vegetable market to buy food, the vegetable market currently no live poultry around the residence Jan. dead migratory birds and wildfowl.

Xia Xi Zheng said, according to patients and their families , before the onset of no significant history of poultry exposure and found H7N9 epidemic, but also in domestic, Choi special attention in this regard and to keep their distance, with poultry and poultry products.

Implementation of the disinfection of disease control department of the patient's living environment and the contaminated area

The reporter was informed that the disease control department to carry out epidemiological survey of patients, close contacts have been taken under medical observation measures. Health Watch contact medical staff in the patient treatment process. The patient's living environment and the contaminated area to carry out disinfection measures.

Guidance of the Central Plains area, Jinshui disease control departments of close contacts within the jurisdiction of the follow-up investigation, the implementation of the close contacts under medical observation measures and temperature measurement reporting on the forest cottage community health service centers cases treatment area and the Second Affiliated Hospital of Zhengzhou University cases treatment area terminal disinfection.

http://www.kaixian.tv/R1/n2092656c20.shtml

Some Asian govts tighten airport controls on bird flu fears

Thu Apr 25, 2013 6:51am EDT

* Thailand warns new bird flu could spread

* Taiwan airlines shares fall on flu fears

* Airlines: no change in bookings to China

* Govts crack down on poultry from China

By Sui-Lee Wee

BEIJING, April 25 (Reuters) - Several governments in Asia have ordered tougher screening of air travelers from China in an effort to contain a possible spread of a new strain of bird flu that has killed 23 people in the mainland and infected one visitor from Taiwan.

The H7N9 virus has infected 109 people in China since it was first detected in March. The Geneva-based World Health Organization said it has no evidence so far of sustained transmission between people but added that this strain was more easily transmitted than an earlier, more deadly H5N1 strain that has killed hundreds around the world since 2003.

Taiwan, which reported the first H7N9 case outside of mainland China on Wednesday, said it would test air travelers for bird flu if they displayed suspicious symptoms. The island's first victim, a 53-year-old man who had returned from a visit to China's eastern city of Suzhou days before, was being treated in hospital. He said he had not had any contact with poultry.

Vietnam began screening temperatures of all visitors at its airports, officials said on Thursday, while Japan said it will allow airports and seaports to make "thermographic inspections" of travelers from China starting in May.

Thai Health Minister Pradit Sintawanarong said the country must step up precautions, adding that the health ministry will soon submit a plan to the prime minister to address the problem.

"From our assessment of the situation, there is a chance that the H7N9 virus may spread to Thailand," Sintawanarong said.

The moves came a day after a WHO expert said the H7N9 strain is "one of the most lethal" of its kind. An international team of scientists led by the WHO and the Chinese government said on Wednesday they were no closer to determining whether the virus might become transmissible between people after a five-day investigation in China.

Singapore's health ministry said its healthcare institutions "remain on heightened alert".

TAIWAN AIRLINES TANK

Shares in Taiwan's airlines fell sharply on Thursday after news of the island's first bird flu victim sparked worries that the outbreak could spread and hurt travel.

China Airlines shares shed 2.2 percent, the stock's worst daily loss since April 8. Eva Airways fell 2.4 percent to close at its lowest in about two weeks. Both underperformed the main TAIEX index, which finished flat on Thursday.

However, most Asian airlines said they had not experienced a noticeable change in bookings to China.

Raj Tanta-Nanta, a vice-president for investor relations at Thai Airways International, said the number of passengers to destinations in China had declined slightly but the national carrier had not canceled flights to China.

Thai AirAsia also said it is not trimming flights.

"We're not cancelling flights and that may be because we fly to Yunnan, which has not faced bird flu disease," Chief Executive Tassapon Bijleveld told Reuters.

Still, the current spate of cases has sparked reminders of the impact on travel from SARS, or severe acute respiratory syndrome, which killed 774 people, mostly in China and Hong Kong in 2003.

Japan's Sharp Corp. urged its employees to "take extra precaution" when visiting China, telling them on Monday to avoid contact with birds, wash their hands and wear a mask if they develop cold or flu symptoms.

Many companies across Asia that have operations in China, including India's Tech Mahindra Ltd, said they were evaluating the situation but had not yet placed any restrictions on employees there.

POULTRY IMPORTS BANNED

Some countries tightened screening of poultry imports from China, where some bird samples had tested positive for H7N9.

Vietnam banned poultry imports from China in early April, its agriculture ministry said. The Philippines, which has banned poultry imports from China since 2004, is tightening quarantine measures on all poultry products, said Davinio Catbagan, assistant secretary for livestock at the agriculture department.

Manila has also strengthened measures to prevent the entry of smuggled poultry and other poultry products such as pigeons, Peking ducks and chicken, especially those coming from China, Catbagan said.

"The department had been notified that there are businessmen in the Philippines who illegally imports these products, which may have been contaminated by the highly pathogenic H7N9 virus and are now openly served in five-star hotels and well-known Chinese restaurants in the country," Catbagan said

http://www.reuters.com/article/2013/04/25/health-birdflu-travel-idUSL3N0DC3D520130425

A total of 112 diagnosed with the H7N9 avian influenza which 22 people died

on April 25 (25 days), Zhejiang new cases of human infection of H7N9 avian influenza confirmed cases, one new confirmed cases in Henan.

Zhejiang Provincial Health Department Bulletin, April 25, Zhejiang Province, add two cases of human infection with the H7N9 avian flu cases as of April 25 at 15:00.

Patients Wang, female, 60 years old, farmers, Huzhou onset on April 17, Hangzhou, a hospital for treatment. The patient Shumou, female, aged 50, the farmers, Shaoxing, onset on April 18, now a hospital for treatment.

By the provincial CDC testing, specimens of 2 patients are infected with the H7N9 avian influenza virus nucleic acid positive. Organized by the Office of Zhejiang Provincial Health Department experts on the patient's clinical manifestations, epidemiological data and laboratory test results are discussed, and diagnosis of human infection of H7N9 avian influenza confirmed cases.Currently, two patients were seriously ill, the hospital is under active treatment.

Henan Province Health Department reported today, April 25, Zhengzhou City, Henan new case of human infection of H7N9 avian influenza confirmed cases.

Patients Choi, male, 56 years old, Zhongyuan District, Zhengzhou City, members of the public. April 25, the provincial-level expert group, according to the results of laboratory tests and clinical manifestations and epidemiological investigation, the overall judgment that the human infection in patients with confirmed cases of the H7N9 avian influenza. Currently, patients in critical condition, receiving treatment in a hospital in the city of Zhengzhou. Close contacts of the cases of 7, have been taken under medical observation measures and found no abnormalities.

In addition, the Taiwan health authorities for Disease Control informed in the evening of the 24th, Taiwan is the first case of human infection with the H7N9 avian influenza confirmed cases, the patients have been sent to a special hospital for treatment.

As of April 25 at 17, confirmed a total of 112 H7N9 avian influenza, which killed 22 people, cases were distributed in Beijing (1) Shanghai (33 cases, 12 patients died), Jiangsu (24 patients, 3 patients died ), Zhejiang (44 cases, 5 cases died), Anhui (4 cases, 1 death), Henan (4 cases), Shandong (1), Taiwan (1). Cases in the dissemination of state, have not yet found evidence of human-to-human transmission.

http://news.qq.com/a/20130425/001012.htm

108 cases, 23 deaths,news released weekly

WASHINGTON] H7N9 avian flu although no new cases today, but the number of deaths increased 1 person, but also to China's cumulative H7N9 cases to 108 cases, 23 deaths.In addition, China announced that from today, for avian flu will be released week released instead. 　According to the official website of the Health and Family Planning Commission statistics from today 16, 23, 16, no new cases of human infection with the H7N9 avian flu, Jiangsu new deaths, the death toll climbed to 23 people, and rehabilitation 14 people. 　Total 108 cases, 23 deaths, located in Beijing (1) Shanghai (33 cases, 12 patients died), Jiangsu (24 patients, 4 patients died), Zhejiang (42 cases, 6 died), Anhui (n = 4 1 died), Shandong (1) the Henan (3) 7 provinces and cities. 　Health and Family Planning Commission of China in Beijing and the World Health Organization (WHO) held a press conference, pointed out that the uncertain family clusters of cases, patients are exposed to the source of the virus, or the phenomenon of human-to-human transmission. H7N9 human-to-human transmission capacity, they said "can not completely exclude the development of human-to-human transmission may". http://iservice.libertytimes.com.tw/liveNews/news.php?no=797867&type=%E8%B2%A1%E7%B6%93

First H7N9 case contacts pass the upper respiratory tract symptoms

2013 04 24, 19:10  

Today the startling news of the first case of H7N9 confirmed cases, the patient is returned to Taiwan from China Suzhou Taiwan of 139 contacts, the Central News Agency reported, three hospital staff contact patients for medical treatment of upper respiratory tract symptoms are tube track. Reported that patients who have a total of 139 people, including close contacts, general contact 26 people, more than 7 days incubation period, 110 hospital staff. , Hospital staff has more than 4 incubation period, and asymptomatic, only three people not wearing appropriate protective track has average daily asymptomatic, be traced to April 27; another in the implementation of the care work, appropriate protective 3 of upper respiratory tract symptoms in hospital staff. http://www.appledaily.com.tw/realtimenews/article/life/20130424/176693//H7N9%E9%A6%96%E7%97%85%E4%BE%8B3%E6%8E%A5%E8%A7%B8%E8%80%85%E3%80%80%E5%82%B3%E6%9C%89%E4%B8%8A%E5%91%BC%E5%90%B8%E9%81%93%E7%97%87%E7%8B%80

Taiwan patient timeline

Time	Status
3/28-4/9	Go to Suzhou.
4/9	Returned to Taiwan from Shanghai.
4/12	Fever, night sweats, fatigue symptoms.
4/16	High fever to the clinic, the doctor recommended referral and use Tamiflu.
4/18	Chest X-ray the right lower lobe interstitial infiltrates.
4/19	Night deterioration
4/20	Transferred to a medical center, respiratory failure intubation into the intensive care unit negative pressure isolation.
4/24	The present H7N9 positive sputum inspection by RT-PCR, 4/24 evening by the National Influenza Center confirmed gene sequencing.

http://iservice.libertytimes.com.tw/liveNews/news.php?no=797671&type=%E7%94%9F%E6%B4%BB&Slots=Live

The Taiwan H7N9 patients diagnosed with contacts of upper respiratory tract symptoms

http://news.sina.com   2013 04 24 at 05:20

BEIJING, Taipei, April 24 (Reporter Dong Huifeng) Taiwan Epidemic Command Center today (24) confirmed the first case of H7N9 confirmed cases, three hospital staff contact patients for medical treatment of upper respiratory tract symptoms, in the track of the tube.

　　According to Taiwan's "Central News Agency" reports, rumors that the 53-year-old patient is a medical center in Taipei negative pressure isolation ill treatment of H7N9, previously treated in private clinics, hospitals. Station command center of the outbreak is not the name of the public hospitals and medical personnel.

　　The epidemic survey shows that patients who have a total of 139 people, including close contacts, general contact, 26 people have been more than 7 days incubation period, as well as hospital staff of 110 people.

　　, Hospital staff has more than 4 incubation period and asymptomatic, only three did not wear the appropriate protective traced to a 24-day asymptomatic, be traced to the 27th, and the other in the implementation of the care work, with appropriate safeguards hospital 3 staff of upper respiratory tract symptoms.

　　The leader of the Taiwan authorities Ma Ying-jeou, through its spokesman, said on the evening of the 24th for H7N9 first case of imported cases, the first time informed of the message, to discuss the follow-up response as with the "Health Director", inviting the public to unnecessary panic.

　　Ma Ying-jeou and requested the Taiwan health authorities must strengthen epidemic prevention, but also make information transparent.  http://dailynews.sina.com/bg/chn/chnpolitics/phoenixtv/20130424/05204479938.html

National Health and Family Planning Bulletin H7N9 infection information to be released weekly

Mainland 24 did not report new cases of H7N9 epidemic information thereafter changed from day to week released

2013-04-25 05:03

According to Xinhua News Agency, Beijing, April 24 - National Health and Family Planning Bulletin, the 24th at 4:00 p.m. on the the 23rd at 16:00 on the 24th, China had not reported new human infection with the H7N9 avian flu cases.

　　Informed Up to now, China had reported a total of 108 confirmed cases, of which 23 people died, rehabilitation 14. Accordance with the relevant provisions of public health emergencies of information, starting from April 24, human infection with the H7N9 avian influenza outbreak information released by day week released instead.　　According to Xinhua News Agency, the ministry of Agriculture Information Office news release, the National Avian Influenza Reference Laboratory report in Henan collected 553 samples in the detected environmental samples were positive for the H7N9 avian influenza. The same day, animal disease prevention and control center in Zhejiang Province censorship suspected positive samples for review by the National Avian Influenza Reference Laboratory were positive for H7N9 avian influenza.

http://www.kaixian.tv/R1/n2071451c6.shtml

The two following medical institutions shall not be treated in patients with fever of unknown origin

　City Evening News yesterday, Changchun Municipal Health Bureau issued a "Notice on Further Improving the human infection with the H7N9 avian influenza medical treatment, the city's two medical institutions shall not be treated in patients with respiratory symptoms or fever of unknown origin.

　　Upon request, the Changchun City medical institutions to pay close attention to the unexplained severe pneumonia, strict implementation of the first patient responsibility and accountability, good consultation and treatment of pneumonia of unknown causes.

　　The city's two medical institutions shall not be treated in patients with respiratory symptoms or fever of unknown origin. Primary health care sector has been found in patients with fever should be promptly referred to the area secondary and higher medical facility for diagnosis and treatment of various medical institutions of human infection of H7N9 avian influenza suspected cases should be immediately referred to the designated hospitals for treatment.

http://news.gmw.cn/newspaper/2013-04/25/content_1277071.htm

Birds suspected of death "hit the floor" yet to be determined related to avian influenza

 8:00 yesterday, more than the front of Wangjing Futong East Avenue, sweet angel Children's Hospital, the process is more than ten birds fell dead. This scene is a crossing on the microblogging users exposed, immediately aroused everyone's concern and hot, many have speculated that it is related to avian influenza. In this regard, the hospital said that the birds died or mistakenly hit the glass, bird carcasses for inspection.

Reporters rushed to the incident, the bird carcasses has been the quarantine department staff away for inspection. Morning sudden bird deaths, the hospital explained that, as early as 8:40 or so, we found ten birdies down the hospital side door on the ground, most of which have died, and the remaining few are still struggling , thump. The discovery of this situation, the hospital closed the side door, and the local isolation, to prevent passers-by near the Chaoyang District Center for Disease Control and Beijing Animal Health Authority subsequently informed.

Before they arrive, we send employees to the top-level view, and found no other bird deaths, but a residual Torike see the glass wall of the hospital appearance, and later transferred surveillance video and found that the group of small birds suddenly falling from the hospital two-story exterior wall of reflective glass, so we conclude the bird mistakenly hit hospital reflective glass and fall, death. "Dean Lee said.

"Later, the Animal Health Authority personnel to the scene to view, explained that the death of the small birds warbler, commonly known as 'Liu string of children', in Beijing recently there have been similar phenomenon, but this bird. Analysis of the main reason may be birds during spring migration on the way due to fatigue or starvation and other reasons, mistakenly hit the building and drop dead. "Reporters on the scene also noted that the external walls of the hospital by the reflective glass, a reflective effect.

After the matter was exposed by the users, causing a lot of friends concern, some people can not help but speculate whether this is related to avian influenza. Yesterday afternoon, the reporter learned from the Chaoyang District Headquarters Office learned that prevention and control of major animal diseases, bird carcasses have been censorship, two or three days before the test results to determine the specific cause of death. The staff said, "before the test results came out, the bird real cause of death can not be determined, but Beijing has not yet appeared in wild birds carrying avian influenza virus. http://news.qq.com/a/20130425/000042.htm

Mutant Bird Flu Virus Evolves to Show Pandemic Characteristics

By Makiko Kitamura - Apr 24, 2013 1:00 PM ET

A mutant version of a bird flu virus created by scientists last year to show its ability to spread between humans evolved to show characteristics of previous pandemic viruses, a study found.

A genetic component of the mutant H5N1 virus developed a 200-fold preference for binding with human over avian receptors, according to a study led by researchers at the MRC National Institute for Medical Research in London. Their paper was published today in the scientific journal Nature.

The study builds on work led by Yoshihiro Kawaoka at the University of Wisconsin-Madisonthat showed how H5N1 could become highly transmissible if its hemagglutinin gene is mutated and mixed with those of the H1N1 virus that sparked the 2009 swine flu pandemic. As a follow-up, the MRC-led team plans to study the same binding properties of the current H7N9 virus reported in China, John Skehel, one of the study authors in London, said in a phone interview.

“The preference of the transmissible mutant for binding to human versus avian receptors, and the structural manner by which it binds them, are highly characteristic of pandemic viruses,” the researchers said in the published paper.

The hemagglutinin gene produces the protein that the virus uses to stick itself to host cells. By measuring the binding properties of the mutated gene in the H5N1 virus, the scientists found that its affinity for human receptors increased slightly, while its preference for avian receptors declined significantly, they said.

Binding Properties

Research published last year in the journal Science led by Ron Fouchier at Erasmus Medical Center in the Netherlands also found that five genetic tweaks made a strain of H5N1 spread more easily.

The new virus has genetic features of those that are known to jump easily from birds to mammals and a mutation that may help it attach to cells in the respiratory tract, Fouchier said earlier this month after reviewing a gene sequencing of H7N9.

As of April 23, 108 laboratory-confirmed cases of human infection with H7N9, including 22 deaths, have been reported by Chinese authorities, the World Health Organization said in a statement yesterday. So far, there is no evidence of ongoing human-to-human transmission, it said. http://www.bloomberg.com/news/2013-04-24/mutant-bird-flu-virus-evolves-to-show-pandemic-characteristics.html?

cdc-Updated: Avian Influenza A (H7N9) Virus

Avian Influenza A (H7N9) Virus

http://www.cdc.gov/flu/avianflu/h7n9-virus.htmHuman infections with a new avian influenza A (H7N9) virus continue to be reported in China. The virus has been detected in poultry in China as well. While mild illness in human cases has been seen, most patients have had severe respiratory illness and some people have died. No cases of H7N9 outside of China have been reported.?? The new H7N9 virus has not been detected in people or birds in the United States.

An investigation by Chinese authorities is ongoing. Many of the people infected with H7N9 are reported to have had contact with poultry. However some cases reportedly have not had such contact. Close contacts of confirmed H7N9 patients are being followed to determine whether any human-to-human spread of H7N9 is occurring. No sustained person-to-person spread of the H7N9 virus has been found at this time.

Human infections with avian influenza (AI, or “bird flu”) are rare but do occur, most commonly after exposure to infected poultry (Bird-to-human spread). Limited person-to-person spread of bird flu is thought to have occurred rarely in the past, most notably with avian influenza A (H5N1). Based on this previous experience, some limited human-to-human spread of this H7N9 virus would not be surprising. Most important, however, is that this transmission not be sustained (ongoing).

Influenza viruses constantly change and it’s possible that this virus could become able to easily and sustainably spread between people, triggering a pandemic. CDC is following this situation closely and coordinating with domestic and international partners. CDC takes routine preparedness actions whenever a new virus with pandemic potential is identified, including developing a candidate vaccine virus to make a vaccine if it were to be needed. CDC also has issued guidance to clinicians and public health authorities in the United States, as well as provided information for people traveling to China. This is an evolving situation and there is still much to learn. CDC will provide updated information as it becomes available. Page last updated: April 23, 2013

http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

Bird flu transmission alarms health officials

MeatPoultry.com, April 24, 2013

BEIJING – The ease with which the H7N9 avian flu virus passes from birds to humans may 

make the new bird flu one of the most lethal viruses to emerge so far, according to officials with the World Health Organization.

China’s National Health and Family Planning Commission invited a team of experts from WHO to visit affected areas around Shanghai and Beijing in order to provide recommendations on prevention and control of the virus. WHO officials said the virus doesn't appear to be easily spread human-to-human. But public health authorities are concerned because the virus seems to spread through poultry flocks causing no visible signs of illness in the birds. So farmers or anyone handling live poultry may not be aware that their birds are infected.

Speaking to reporters at a media briefing, Dr. Keiji Fukuda said the outbreak is an evolving situation, and he suggested that only the most serious infections are being reported while a large number of infections are going unreported, according to the Associated Press. http://www.meatpoultry.com/News/News%20Home/Global/2013/4/Bird%20flu%20transmission%20alarms%20health%20officials.aspx?cck=1

Containment begins as H7N9 spreads to Taiwan

This is not very good news. More cases are immanent from there and will be your proof of some H2H.

April 25, 2013, 12:03 

Taiwan has its first confirmed case of H7N9 avian influenza, the Central Epidemic Command Center (CECC) announced yesterday.The patient is a 53-year-old male Taiwanese citizen who had worked in China's Jiangsu province.

The CECC said that the patient, who returned to Taiwan from Shanghai on April 9, is currently in serious condition and is being treated in a negative-pressure isolation room.

One hundred and thirty-nine people who have come into contact with the man have been contacted by the CECC for health checks and follow-up observations. Among them are three health care workers who developed symptoms of upper respiratory infection.

CECC Commander-in-Chief Chang Feng-yee (張峰義) said that the center has reported the case to the World Health Organization through the IHR Focal Point system as well as through its contact point in China, in accordance with the Cross-strait Cooperation Agreement on Medicine and Public Health Affairs.

“The CECC will not make the number of the flight that the patient took to return to Taiwan public because he did not show any signs of infection when he entered Taiwan, or on the two days following his arrival,” Chang said.

Health Minister Chiu Wen-ta (邱文達) said that special clinics for H7N9 and the negative-pressure isolation rooms in 22 hospitals listed as disease control centers will be opened in response to the possible outbreak of the strain in Taiwan.

According to the CECC, the patient is a hepatitis B carrier with a history of hypertension and had been traveling between Jiangsu province's Suzhou City and Taiwan before contracting the virus.

He was in Suzhou from March 28 to April 9 and had not been exposed to birds or poultry, or consumed undercooked poultry or eggs, the CECC said.

The patient developed a fever, began sweating profusely and suffering fatigue on April 12. He was hospitalized for a high fever on April 16. He was incubated due to respiratory failure and placed in the negative-pressure isolation room in the hospital's intensive care unit on April 20.

The CECC said that the National Influenza Center in Taiwan confirmed the strain of the disease and completed the genome sequencing of the virus yesterday morning.

Chang said that the CECC has continued to strengthen surveillance and fever screening of travelers arriving from China, especially from Shanghai, Jiangsu, Zhejiang, Anhui, Beijing, Henan and Shandong.

“Travelers visiting China should practice good personal hygiene, avoid visiting traditional markets with live poultry, and consume only well-cooked poultry and eggs,” Chang said.

According to the CECC, there are currently 108 confirmed H7N9 cases in China, including 22 deaths since the first case was reported on March 31.

Ban on Slaughters in Markets may be Brought Forward

Deputy Agriculture Minister Wang Cheng-teng (王政騰) said yesterday that if more local cases are found, new regulations prohibiting the slaughter of live fowl in traditional markets in Taiwan proper might take effect before the scheduled date of June 17.

Wang said that currently the Council of Agriculture (COA) plans to stick to the existing timetable for the launch of the new rules.

“Right now the COA will focus on doubling the number of random inspections in migratory birds, fowl and slaughterhouses before finally launching the new regulations,” said Wang. http://www.chinapost.com.tw/taiwan/national/national-news/2013/04/25/376959/Containment-begins.htm

China’s bird flu outbreak: 3 good signs, 3 bad signs and 3 very bad signs

Posted by Max Fisher on April 24, 2013 at 11:33 am

Since the new avian flu strain H7N9 began appearing in China earlier this year, it’s infected over 100 people, killed 22, spread to five provinces plus Beijing and Shanghai and, as of Wednesday, is confirmed to have spread abroad to Taiwan.

How worried should you be about this? How serious is the H7N9 outbreak? The simplest and most honest answer is that we don’t know what’s going to happen next, either with the virus, which may or may not mutate and become more transmittable, or with Chinese and international health-care authorities responsible for tamping it down. But there are some good signs, some bad signs and some very bad signs. Here are a few.

Three good signs

1. China is being unusually transparent so far. Ten years ago, as the deadly viral respiratory illness known as SARS first spread across China, the government did not respond well. It suppressed information about the outbreak, making it that much harder to contain and study the disease, ultimately costing lives. This time, though, Chinese authorities have been sharing information about the disease’s spread, and state media appear to be freely reporting on new cases. Chinese officials seem to take the disease seriously and want to combat its rise, even if it means overcoming more secretive instincts. All health care for H7N9 is now free in China, for example, to help encourage people to report cases.

2. The number of cases has largely flatlined in the last week. After weeks of rising cases, the number seems to have stayed stable at around 110 over the last week. Big caveats here that there might be cases we don’t know about, and the count could change at any moment.

3. Shanghai has found some success limiting new cases. A lot of the cases started around Shanghai, but the city was able to reduce the number of new infections after it closed poultry markets, according to Laurie Garrett, a senior fellow at the Council on Foreign Relations covering health-care policy. The Wall Street Journal found the same thing.

Three bad signs

1. It’s spreading. With cases recently reported in Shandong province and now in Taiwan, the virus seems to be moving outward.

2. No verified human-to-human transmissions, but it’s possible.Neither China nor the World Health Organization has documented human-to-human transmission, which would allow the virus to spread far more quickly and widely, but nor have they ruled it out. The Taiwanese case had no known exposure to poultry.

3. Tough to identify birds with the virus. World Health Organization officials saythe virus is more difficult to detect in sick poultry than were previous strains because the birds do not show symptoms that are as clearly identifiable. This makes it tougher to keep sick birds off the market.

Three very bad signs

1. It’s very deadly, with 18 percent mortality so far. For comparison, tuberculosis has a mortality rate of about 4 or 5 percent in China. Still, the avian flu virus that had its first outbreaks in China in 2006, known as H5N1, has a mortality rate of 60 percent and has killed hundreds of people on multiple continents. It’s way too early to tell H7N9′s mortality rate, given that many infected patients have not yet fully recovered, but it’s so far killed about 18 percent of patients.

2. “This is definitely one of the most lethal influenza viruses that we have seen so far.” That’s according to Keiji Fukuda, the World Health Organization’s assistant director general for health, security and the environment, who added, “This is an unusually dangerous virus for humans.” Fukuda said the WHO is still struggling to understand the disease, but he certainly seems to be sounding the alarm.

3. More easily transmitted than the 2006 avian flu outbreak. That’s also according to the WHO’s Fukuda, who says this new strain is more easily contracted than the H5N1 virus.

http://www.washingtonpost.com/blogs/worldviews/wp/2013/04/24/chinas-bird-flu-outbreak-3-good-signs-3-bad-signs-and-3-very-bad-signs/