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 China Announces 4 New Bird Flu Cases H7N9 
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Post China Announces 4 New Bird Flu Cases H7N9
By DAVID BARBOZA
Published: April 2, 2013

SHANGHAI — China said Tuesday that four more people in the coastal part of the country had been infected with a new strain of bird flu, which is believed to have killed two Shanghai residents last month and left one person in critical condition.

The four new patients, ages 32 to 83, are hospitalized and critically ill, according to a government Web site that cited the authorities in the city of Nanjing, in Jiangsu Province northwest of Shanghai. The officials said laboratory tests had confirmed that all four were infected with a strain of bird flu identified as H7N9, which was not found in humans before the Shanghai cases.

The cases are troubling because there is no vaccine for the H7N9 strain and because another strain of bird flu, identified as H5N1, killed hundreds of people in Asia beginning in 2003.

The World Health Organization says that most H5N1 cases had involved contact with infected poultry. One of the four people in Nanjing infected with the H7N9 virus is a poultry butcher. Health authorities had previously reported that H7N9 could not easily be contracted by humans, and officials said that no one who had contact with the four infected patients had developed symptoms.

The government said Monday in Shanghai that no link had been found between the bird flu virus and the 15,000 dead pigs found recently in the Huangpu River. :roll

http://www.nytimes.com/2013/04/03/world/asia/china-announces-new-flu-cases.html?_r=0

Call me paranoid but this sooooo reminds me of SARS and the very early days of Avian Influenza. :shock:

Edited to change title from H5N1 (oops) to H7N9 - the correct strain. BB

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Tue Apr 02, 2013 6:36 pm
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Post Re: China Announces 4 New Bird Flu Cases H5N1
Definitely something to keep an eye on. Do you know if any of the old BF sites are still operating? I'll take a look too.

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Tue Apr 02, 2013 8:00 pm
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Post Re: China Announces 4 New Bird Flu Cases H5N1
Answering my own question: Avian Flu Talk, Flutrackers, Plan for Pandemic, PFI Forum (Monotreme). Wow, this brings back memories. What am I missing, Blue? Oh yes, Niman - Recombinomics. If this gets more serious, I'll post links, but it's easy enough to google the titles.

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Tue Apr 02, 2013 8:09 pm
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Post Re: China Announces 4 New Bird Flu Cases H5N1
Here are links to some of the sites I used to read religiously:

Avian Flu Diary:

http://afludiary.blogspot.com/2013/04/statement-from-jiangsu-province-health.html

Crof's Blog:

http://crofsblogs.typepad.com/h5n1/2013/04/who-h7n9-avian-influenza-human-infections-in-china.html

And my old home is still there - Flu Wiki: :mrgreen:

http://www.newfluwiki2.com/

Edited to add Recombonics (Niman):

http://www.recombinomics.com/whats_new.html

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Wed Apr 03, 2013 4:49 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
China reports 2 more H7N9 bird flu cases
English.news.cn 2013-04-03 18:35:15

HANGZHOU, April 3 (Xinhua) -- Two infections of H7N9 bird flu, involving one death, have been reported in east China's Zhejiang Province, bringing the total number of infected people in the country to nine, local authorities said on Wednesday.

One of the infected has already died, said a statement issued by the provincial health department.

According to the statement, a 38-year-old chef surnamed Hong died on March 27. The man, who worked in Jiangsu Province, where four other cases of H7N9 bird flu have been identified, became ill on March 7 and returned to his home in Jiande, Zhejiang, where he was admitted to a hospital on March 18.

The provincial and national disease control centers confirmed on Monday and Wednesday, respectively, that he was infected with H7N9 avian influenza.

The other patient, a retired Hangzhou man surnamed Yang, was admitted to a hospital on March 25 with a cough and fever. He was transferred to another hospital for better treatment and remains hospitalized, according to the statement.

Provincial and national health authorities confirmed on Tuesday and Wednesday, respectively, that he is infected with the H7N9 avian influenza virus, the statement said.

No epidemiological connection between the two cases has been found so far.

A total of 183 people who came into contact with the two men have so far shown no symptoms of fever or respiratory illness, the statement added.

Zhejiang has initiated an emergency response for epidemics based on regulations of the Ministry of Health, and relevant departments have been asked to take precautionary actions toward disease control.

Seven other H7N9 bird flu cases had been reported previously, two in Shanghai, one in Anhui and four in Jiangsu. The two in Shanghai died and the other five are in critical conditions under treatment in Nanjing, capital of Jiangsu.

Authorities in Chinese regions have ordered health institutions to step up monitoring.

snip

Read more here: http://news.xinhuanet.com/english/china/2013-04/03/c_132282994.htm

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Wed Apr 03, 2013 11:50 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
H7N9 Flu Virus May Have Adapted To Mammals
By Helen Branswell, The Canadian Press

Posted: 04/02/2013 8:57 pm EDT | Updated: 04/03/2013 9:42 am EDT

snip
Genetic sequences of viruses isolated from the first three cases have already been mapped and deposited in databanks accessible to influenza scientists. And as they study the viral blueprints, some clues to where to look for the virus are starting to emerge.

Webby said the H7N9 viruses are showing changes that are hallmarks of adaptation to mammals, the same types of mutations that have been seen when other flu viruses — which all have their origins in water birds like ducks — learn to infect mammalian species.

One of the changes is in what's know as the receptor binding site. Bird viruses use a different receptor to latch on and trigger infection than flu viruses that have adapted to infect humans and other mammals. And the genetic sequences of the H7N9 viruses show they have started to make that change, Webby said.

As well there are a couple of other mutations seen in these H7N9 sequences that are known to be indicators of viruses that have switched to mammalian hosts from avian hosts, he said.

"There's clear evidence of mammalian adaptation. So the big question to me is where is that mammalian adaptation occurring? Is it in the human cases we've seen or is it perhaps in a mammalian animal reservoir?"

These changes suggest looking for the virus in poultry would not be the most productive approach, suggested Michael Osterholm, director of the Centre for Infectious Diseases Research and Policy at the University of Minnesota.

Concerns have already been raised about whether pigs are playing a role in the spread of this virus. That's because of late, thousands of dead pigs have been found floating in the Huangpu River near Shanghai. At least two of the human cases of H7N9 have been in residents of Shanghai.

Some have suggested the pigs were killed in an outbreak of circoviruses, another pathogen which infects swine. Others have said farmers are dumping pigs they can no longer sell to slaughterhouses after authorities moved to block dead pigs from entering the food chain.

But others worry the pigs are part of the H7N9 story.

Webby thinks pigs may be playing a role, but he's not convinced the dead animals were killed by the H7N9 virus. While pigs are highly susceptible to influenza viruses — and often serve as intermediary for bird viruses to become mammalian viruses — influenza doesn't generally kill pigs, he said.

Even H5N1 viruses, which are so deadly to poultry and to people, don't cause severe illness in swine, said Webby. "It would be very, very surprising to see that amount of death (in pigs) with a flu virus. Even H5N1, pigs kind laugh at that virus."

snip

Read more here: http://www.huffingtonpost.ca/2013/04/02/h7n9-chinese-avian-flu-mammal-adaptation_n_3002804.html

And, yet, another name from the old bird flu days - Helen Branswell. :mrgreen:

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Wed Apr 03, 2013 11:57 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Chinese authorities kill 20K birds as avian flu toll rises to 6
By Jethro Mullen, CNN
updated 7:59 AM EDT, Fri April 5, 2013

Hong Kong (CNN) -- Chinese authorities have killed more than 20,000 birds from a live-poultry trading zone in Shanghai after an unusual strain of bird flu that has so far killed six people in the country was found in pigeons on sale in the city, state-run media outlet Xinhua reported Friday.

Details of the slaughter of chickens, ducks, geese and pigeons come as the city prepares to temporarily close all its live poultry markets. It wasn't clear how long the market closures -- announced Friday on the Shanghai Municipal Government's microblog account -- would last.

By Friday morning, authorities in Shanghai had already closed the Huhai agricultural market, where the H7N9 avian flu virus had been found in pigeons, Xinhua reported. The virus had not previously been found in humans until a series of cases were reported in China this week.

The cull at the Shanghai poultry trading zone came as researchers in the United States said they had started work on developing a vaccine for H7N9.

The Chinese Minister of Agriculture said Thursday an analysis showed a strong genetic overlap between the strain found in the Huhai market pigeons and the one detected in infected humans.

At the Huhai market, Shanghai authorities were disinfecting the area and objects that came into contact with the birds, Xinhau reported.
Officials are trying to track where the infected pigeons came from.

A growing number of cases
A 64-year-old man died Thursday night in Huzhou, Zhejiang province, the provincial health bureau said Friday. He died hours after doctors had confirmed he had been infected with the H7N9 virus, it said.

He is one of the 14 human cases of H7N9 reported so far -- all of them in the coastal area of eastern China. Authorities there began reporting the first cases on Sunday. Four of the deaths happened in Shanghai, the two others in Zhejiang.

The ages of those infected have ranged from a 4-year-old child, who was reported to be recovering, to an 83-year-old man.

No cases of human-to-human transmission of the H7N9 virus have been confirmed so far.

A person in Shanghai who developed flu symptoms after coming into close contact with a patient who died of the virus tested negative for H7N9, city authorities said.

snip

Read more here: http://www.cnn.com/2013/04/05/world/asia/china-bird-flu/index.html?hpt=hp_t2

All well and good but where is the mammalian reservoir?

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Fri Apr 05, 2013 5:53 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Don't panic over new bird flu outbreak, CDC cautions
By JoNel Aleccia, Senior Writer, NBC News

A deadly outbreak of a new kind of bird flu has now sickened 16 people in China and killed six, but U.S. health officials on Friday cautioned that there’s no cause for widespread alarm.

The new influenza A H7N9 virus has not been seen before in humans, but it doesn’t appear to be transmitted easily among people, and there have been no cases detected in the United States, Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention said.

“There are no specific steps people in this country can take. People can go about their daily lives,” he said. Wonderful! That makes me feel soooo much better!
Still, he said CDC officials are in close contact with Chinese authorities as they track the spread of the novel virus, which has been found in people from four Chinese provinces.

Victims have included 15 adults and a 4-year-old child, all of whom appeared to have clear ties to live poultry markets. They all became ill between Feb. 19 and March 31. Two of the 16 had other people in their families fall ill, but whether it was related is still being assessed.

“At this point, there are several things that give us confidence that this is not spreading widely from person to person,” Frieden said.

For example, Chinese authorities have tracked 100 close contacts of people who got sick, and none of them became ill. With typical influenza, perhaps 20 percent to 30 percent of family members could be expected to develop the flu.

CDC is working with vaccine manufacturers to develop a seed strain to produce a vaccine to protect against the H7N9 virus, but that would only occur if there appeared to be widespread transmission. If that were necessary, it would not disrupt production of the seasonal vaccine, CDC officials said.

The agency issued a health alert for U.S. clinicians urging them to be alert for recent travelers from China who could show signs of the novel flu. CDC is also developing a diagnostic test that could quickly detect the virus.

No travel advisories have been issued, but CDC officials are reminding U.S. tourists in China to stay away from poultry markets. That's the same advice the agency has issued for about a decade, since outbreaks of SARS and H5N1 flu. The World Health Organization said it was not advising screening at points of entry or any trade restrictions in connection with the outbreak.

China's neighboring countries are closely monitoring people for signs of flu. A 7-year-old girl in Hong Kong was being tested Friday in a local hospital for signs of the virus, according to the official Chinese news outlet Xinhua. Tougher surveillance also has started in Laos, Cambodia, Thailand and Taiwan, CDC officials said.

Though no source of the outbreak has been identified, Chinese officials have detected the virus in chickens and in pigeons and are now culling flocks to prevent further spread of the virus.

snip

Read more here: http://vitals.nbcnews.com/_news/2013/04/05/17618253-dont-panic-over-new-bird-flu-outbreak-cdc-cautions?lite

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Fri Apr 05, 2013 3:09 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
China closes poultry sale in third city after bird flu outbreak
By Lateef Mungin and Michael Martinez, CNN
updated 12:05 PM EDT, Sat April 6, 2013

(CNN) -- Nanjing became the third city in China to suspend live poultry trading in the wake of an unusual strain of bird flu that has so far killed six people in the country, state-run media outlet Xinhua reported Saturday.

Jiangsu's provincial capital of Nanjing joined Shanghai and Zhejiang's provincial capital of Hangzhou in shuttering the markets, Xinhua said.

Four deaths occurred in Shanghai and two in Zhejiang, the agency said.

Chinese authorities have killed more than 20,000 birds from a live-poultry trading zone in Shanghai in an effort to deal with the issue.

snip

As of Saturday evening, China had confirmed 18 human infections of the H7N9 avian flu virus, Xinhua reported. The World Health Organization confirmed 16.

snip

Read more here: http://www.cnn.com/2013/04/06/world/asia/china-bird-flu/index.html?hpt=hp_t2

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Sat Apr 06, 2013 9:30 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Commentary
H7N9 Minghang Cluster Raises Pandemic Concerns
Recombinomics Commentary 17:00
April 6, 2013

Quote:
Wu Demao was bewildered when he heard that his son-in-law, Wu Liangliang, who died on March 10 at Shanghai No 5 People's Hospital, was a victim of H7N9 bird flu.

The hospital paid the family 130,000 yuan (HK$161,000) in compensation on March 26, saying it was for humanitarian reasons and for its minor responsibility in Wu Liangliang's treatment, without elaborating.


The above comments describe a payment to the family of the second H7N9 case (27M) who lived in the Minghang District and died at the Shanghai Number Five People’s Hospital in Minhang. The first confirmed case (87M) was also treated on the same floor of the hospital. In addition, his two sons (69M and 55M) were also treated at the hospital, so the family of the second victim claimed that their relative had been infected at the hospital by one of the three family members being treated at the hospital.

The three family members had been described earlier (in March 7 media reports) and prior to the announcement of confirmation of H7N9 in the father this week, their cluster had been a mystery. The media reports noted that all three had developed pneumonia and two had died (87M and 55M). Microblogers has suggested that deaths were due to the novel coronavirus (nCoV), which had been circulating in the Middle east, but transported to the UK via an index case on a commercial airline. However, the cases in Shanghai tested negative for nCoV.

Micobloggers then claimed that the deaths were due to influenza, which was denied. Deaths were said to be due to pneumonia caused by changing weather. The micoblogger was then arrested and fined for spreading false rumors. However, the father was H7N9 confirmed, confirming the influenza “rumor”.

Controversy did not end with the H7N9 confirmation of the father because the sons tested negative and recently WHO said no additional samples were available. Thus, the number of confirmed cases at the hospital remains at two and human to human transmission is denied.

The hospital payment suggests that the younger victim may have been infected while being treated at the hospital, and additional media reports cited additional cases at the hospital who had been H7N9 confirmed, including three deaths outside of the family cluster, as well as two cases discharged.

Sequences from the two confirmed cases were made public by the WHO Chinese Influenza Research Center. Although the sequences from the first case, A/Shanghai/1/2013, and the second case, A/Shanghai/2/2013 were related (both had PB2 E627K, a 5 amino acid deletion in N9, and H9N2 internal genes, the sequences were distinct and did not support infection of the second case by the first case. However, the presence of the other cases at the hospital may have been the source of the infection in the second case, which would involve human to human transmission (H2H) in the family cluster.

In that cluster the confirmed case had not been outside of his residence in the two weeks prior to disease onset, which was five days after one or both of his sons were hospitalized. Thus, the gap in the disease onset dates, coupled with the same symptoms and the lack of exposure by the index case strong supports H2H transmission within the family. The above payment also suggests H2H transmission may have been the cause of the infection in the second confirmed case.

Moreover, the cluster of cases at the hospital beyond the two confirmed cases and contacts suggest that the Minghang District may have been the epicenter for the outbreak. H7N9 has been detected in birds at three wet markets in the area, including one that is less than 2000 feet from the hospital (see map). Although the avian sequences are closely related to the human sequences, it is unclear of the human adaptation changes such as PB2 E627K, H7 Q226L or L226I are in the bird sequences. The genetic changes have much in common with H5N1 bird flu transmission studies.

However, the concentration of confirmed, probable, and suspect cases at the Minghang hospital suggest that considerable human transmission is occurring in the area, but only a small subset of cases are being reported. Although there are 18 confirmed cases, including 6 deaths reported to date, none of the confirmed cases have been discharged, which gives a case fatality rate of 100%.

This rate is due to a gross under-reporting / testing of milder cases, which provide evidence for sustained H2H transmission, WHO and CDC denials notwithstanding.

http://www.recombinomics.com/News/04061302/H7N9_Minghang_Cluster.html

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Sat Apr 06, 2013 9:43 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
No evidence of human transmission of bird flu as China cases rise
By Paul Armstrong, CNN
updated 9:58 AM EDT, Mon April 8, 2013

Hong Kong (CNN) -- On the day when China announced the number of cases of bird flu had increased, the World Health Organization (WHO) said Monday that it has no evidence of human-to-human transmission of the virus.

According to the state-run Xinhua news agency, another case of the H7N9 strain of bird flu was confirmed in the country's eastern Anhui province, taking the total number of infections to 21
.
Six people have died so far, four in Shanghai and two in Zhejiang, in eastern China, Xinhua said.

Chinese authorities have killed more than 20,000 birds from a live-poultry trading zone in Shanghai in an effort to deal with the issue, while a number of other cities across the country have also announced trading suspensions.

In a joint press conference with China's health ministry in Beijing early Monday, the WHO admitted the source of the current outbreak has yet to be pinpointed but that they have not seen any cases of the virus passing between humans.

"The recent reports from China are the first cases of human infection with H7N9 viruses. Although we do not yet know the source of infection, at this time there is no evidence of sustained human-to-human transmission," said the WHO's Michael O'Leary.

"We know at this point that, in the human cases we know, the disease is very serious and a large percentage of cases have died -- or a substantial percentage have died and others are critically ill.

"Some of the confirmed cases had contact with animals or with environments in which animals were located. The virus has been found in a pigeon in a market in Shanghai. These events gave possibility of animal-to-human transmission, for which investigations continue."

snip

Read more here: http://www.cnn.com/2013/04/08/world/asia/china-bird-flu-who/index.html?hpt=hp_t2

Note the use of the phrase "sustained human-to-human transmission."

Some of the bird flu forums are reporting on the possibility of human-to-human transmission at one hospital in China.

Interesting...

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Mon Apr 08, 2013 7:17 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
from ProMed Mail - note that all articles posted here are from various sources that have been submitted to ProMed Mail for publication. Often the source is Xinuah or China net or other media which have a desire to keep any news of H2H transmission out of news reports, so it is a case of caveat lector.

State media reported late on Monday afternoon [8 Apr 2013], 3 new cases of H7N9 avian influenza in eastern China, one of them fatal, bringing the total number of deaths in the country to 7.

Shanghai authorities confirmed that a 64-year-old retiree was killed by the H7N9 virus, bringing the total number of infection-related deaths in the city to 5.

snip

The new death in Shanghai and 2 new cases in Jiangsu bring the total number of H7N9 human infection cases in eastern China to 24.

In Hong Kong, 7 new suspected cases of bird flu were undergoing tests for confirmation. 2 earlier suspected cases tested negative for the virus which had previously not been known to infect humans.

The World Health Organisation said on Monday [8 Apr 2013] that there is currently no proof that the H7N9 bird flu virus is being transmitted between people in China.

****************

More than 530 close contacts of the confirmed cases are being closely monitored. In Jiangsu, investigation is ongoing into a contact of an earlier confirmed case who developed symptoms of illness. Retrospective testing of recently reported cases with severe respiratory infection may uncover additional cases that were previously unrecognized.

At this time there is no evidence of ongoing human-to-human transmission. (As Blue noted above, the key word here is "ongoing" or "sustained". They are not saying that there is no H2H (human to human) transmission.





http://www.promedmail.org/

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Tue Apr 09, 2013 7:55 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Okay Blue, maybe, just maybe, this is one we have to keep an eye on. Too early to say, but it bears watching. I've added a folder to my toolbar with BF sites; thanks for the links. I'm going to add a couple of others. What is the site that Siam was a mod on?

Edited to add:

Signs of the times! Niman is mentioning Tweets from China!! OMG!

OT (I don't like that OMG thing, too casual a use of the divinity, just put it here as another sign of the times. Soon kids won't even know what the letters stand for. Aargh.)

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Tue Apr 09, 2013 7:59 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
rutsuyasun wrote:

OT (I don't like that OMG thing, too casual a use of the divinity, just put it here as another sign of the times. Soon kids won't even know what the letters stand for. Aargh.)


Ah but OMG can have more secular meanings, such as Oh My Goodness!

BTW, I am trying to remain optomistic and not sink into gloomy fear-mongering. But I understand the possibility of this becoming a wider (hopefully not global) pandemic. Just because something can happen does not mean that it has to... :scared

Simon

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Tue Apr 09, 2013 12:26 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Report on 3 in China Who Died From Bird Flu Points to Severity of Strain
By DENISE GRADY
Published: April 11, 2013


A report on three of the first patients in China to contract a new strain of bird flu paints a grim portrait of severe pneumonia, septic shock and other complications that damaged the brain, kidney and other organs. All three died.

So far, the disease has killed 10 people in China and has sickened more than 20 others in the last two months, and new cases are reported every day. The illness is caused by a virus called H7N9 that patients contract from birds but that does not seem to spread from person to person.

The new report, by a team of researchers from China, was published Thursday in The New England Journal of Medicine along with a commentary from American health officials, who said the disease “raises many urgent questions and global public health concerns.”

During a telephone news briefing on Thursday, Nancy J. Cox, of the influenza division at the Centers for Disease Control and Prevention, said that several features of H7N9 were particularly troubling: it causes severe disease, it has genetic traits that help it infect mammals and humans probably have no resistance to it.

snip

Read more here: http://www.nytimes.com/2013/04/12/world/asia/report-published-on-3-who-died-from-h7n9-bird-flu.html?

What I find interesting is that there have been no reported cases in countries bordering China (yet).

But we saw this with H5N1 at first, too.

Bears watching anyway.

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Fri Apr 12, 2013 6:42 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
from "Nature":

Virologists know its name: H7N9. What they don't yet know is whether this novel avian influenza virus -- first reported in humans in China less than 2 weeks ago -- will rapidly fizzle out, become established in animal hosts to fuel future human outbreaks, or morph into a virus that can spread easily between people and spark a deadly pandemic.

In a frantic effort to find answers, scientists are bearing down on H7N9 on multiple fronts. They are testing wild birds and thousands of domestic fowl; analysing the viruses they find; and trying to trace people who have been exposed to infected patients. Chinese health authorities say that they have 400 laboratories looking for genetic changes in the virus.

"We are going to be sitting with bated breath over the next month to find out what happens," says Michael Osterholm, who heads the University of Minnesota's Center for Infectious Disease Research and Policy in Minneapolis.

full article, interesting but somewhat technical, found here: http://www.nature.com/news/urgent-searc ... E-20130411

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Fri Apr 12, 2013 2:09 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
from "New Scientist"

China bird flu may be 2 mutations from a pandemic
---------------------------------------------------
In China, 9 people have died and more than 20 are seriously ill in the latest outbreak of bird flu, H7N9. And there are fears that the death toll could rise much higher because the virus already has 3 of the 5 mutations that we know could allow another bird flu, H5N1, to spread between mammals.

snip

The most lethal pandemic we know of, which spread across the world in 1918, was a pure bird flu that acquired mutations [http://www.newscientist.com/article/mg18825204.000-reconstruction-of-1918-flu-virus-prompts-warnings.html] that allowed it to spread in humans. Virologists fear H7N9 could be doing that.

H7N9 might be unusually severe: it carries a mutation thought to promote deep lung infection, which is also in H5N1, the 1918 flu, and severe cases of the 2009 pandemic [http://pesquisa.bvsalud.org/portal/resource/en/mdl-20844044]. But 2 known cases of H7N9 only show mild symptoms, so the Chinese authorities are trying to establish how often it makes people seriously ill, in order to estimate the number of unreported mild cases, and therefore the total number of human cases there have already been.

Full article here: http://www.newscientist.com/article/dn2 ... demic.html

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Fri Apr 12, 2013 2:14 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Beijing reports first case of new bird flu strain

(Reuters) - Chinese capital Beijing reported on Saturday its first case of a new strain of bird flu, state news agency Xinhua said, the first time it has been found in a human outside of eastern China.

The seven-year-old child is in a stable condition in a Beijing hospital, the report said.

Two people who have had close contact with the child have shown no signs of being infected so far, Xinhua added.

A total of 11 people have died of the H7N9 bird flu strain since it was confirmed in humans for the first time last month, with 44 infections in all having been reported to date.

snip

In a bid to calm public jitters over the virus, Chinese authorities have detained a dozen people for spreading rumors about the spread of bird flu.

Read more here: http://www.reuters.com/article/2013/04/13/us-birdflu-china-idUSBRE93B0QM20130413

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Fri Apr 12, 2013 7:49 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
H7N9 Bird Flu Cases Jump To 60 In China; Shanghai Reports Two New Deaths

Eleven new cases of the deadly bird flu H7N9 were found in China today, bringing the total in the country to 60, including 13 deaths, the state-run Xinhua news agency reported.

Two of today’s new cases are in Henan province, the first time that H7N9 has been discovered there. Two new deaths were reported in Shanghai, bringing the number of dead in the city to nine, more than any other city, according to Xinhua figures.

Beijing, China’s capital, announced yesterday that it would close markets that sell live poultry and ban live poultry trading in a move to try to halt the spread of the flu after the city’s first H7N9 case was discovered there on Saturday. A seven-year-old girl is Beijing’s first to fall ill; she is hospitalized and reportedly in stable condition.

With the disease spreading northward, a geographical spot between Beijing and Henan of note in the coming days may be Shandong province, an important supplier of chicken meat in the country.

The closure of live poultry markets in Beijing will put new pressure on a poultry industry that is struggling to handle chickens ready to be sold but have no buyers. China is the world’s No. 2 producer of chicken after the United States. Shanghai has up to 600,000 such chickens, and city processors have been deep freezing them.

Eastern Chinese cities where most H7N9 cases have been concentrated have also closed live poultry markets and are taking other precautions to limit the spread of the new virus. China was the epicenter of the SARS epidemic in 2003 which killed several hundred people worldwide.

snip

Read more here: http://www.forbes.com/sites/russellflannery/2013/04/14/h7n9-bird-flu-cases-jump-to-60-in-china-shanghai-reports-two-new-deaths/

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Sun Apr 14, 2013 9:17 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Symptom-Free Bird Flu Case Suggests Wider H7N9 Spread

By Bloomberg News - Apr 15, 2013 7:26 AM CT

Bird flu was found in a 4-year-old Beijing boy who has no symptoms of the infection, health authorities said, suggesting more people may be catching the H7N9 influenza virus than reported.

The first asymptomatic H7N9 case was discovered by health- care workers searching for possible cases, the Beijing Municipal Health Bureau said in a statement on its website today. The boy’s parents are poultry and fish sellers, and their neighbors across the street had bought chicken sold by the family of a 7- year-old girl whose H7N9 infection was reported two days ago.

The boy is under medical observation. The case suggests some H7N9 infections may be going unrecorded because of a lack of obvious symptoms. Almost all of the 64 people diagnosed with the virus so far have been extremely unwell, with complications extending to brain damage, multi-organ failure and muscle breakdown.

“With asymptomatic cases around, I think everything changes,” said Ian Mackay, an associate professor of clinical virology at the University of Queensland in Brisbane, in a telephone interview today.

“There has been a spike in pneumonia cases that have drawn the health officials’ attention, but the virus may have been going around as a normal cold.”

The boy’s infection was picked up as part of contact tracing -- a process whereby relatives, neighbors and others known to have been in contact with a confirmed case are screened for the virus. The boy was one of 24 people tested in connection with the 7-year-old girl’s infection.


“It’s great that the authorities are showing some evidence of prospective screening of contacts, not just asking people if they are sick or not,” Mackay said. “It’s essential that lab testing of contacts is carried out as soon as possible to give us some information about the denominator: how many cases are positive for this virus, whether they’re symptomatic or not.”

The parents of the 7-year-old patient live and sell poultry in the Shunyi district of northeast Beijing. Her case was the first in northern China, demonstrating that the virus is circulating across much of the country’s east.

snip

Read more here: http://www.bloomberg.com/news/2013-04-15/symptom-free-bird-flu-case-suggests-wider-h7n9-spread.html


Sooo I guess there will be no more talk of "limited" H to H transmission now, huh?

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Mon Apr 15, 2013 8:23 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Bump to test permissions. BB

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Wed Apr 17, 2013 2:34 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Investigators Look Beyond Birds for Origin of H7N9 Flu Strain
By JANE PERLEZ
Published: April 18, 2013

BEIJING — China is investigating four possible cases of human-to-human transmission of a deadly bird flu that has killed 17 people, but so far there has been “no sustained” evidence of transmission between people, the World Health Organization said Thursday.

Three families in Shanghai and two young children in Beijing each other were being examined as possible examples of human-to-human transmission, Gregory Hartl, the spokesman for W.H.O. in Geneva, said in a telephone interview.

“Even if two family members are positive, it is not necessarily the case they got it from each other,” Mr. Hartl said. “They may have gotten it from the same bird.”

As investigators looked at the possibility of human transmission, there was mounting concern that the new virus, known as H7N9, may not originate in birds but in other animals and in environmental sources, he said.

snip

A Chinese expert on the disease, Feng Zijian, the director of the health emergency center at the Chinese Center for Disease Control and Prevention, said on Wednesday that an estimated 40 percent of people infected with the virus said they never had contact with poultry.

Mr. Hartl concurred with Mr. Feng about the surprisingly low incidence of infected people who had no contact with birds. “It is not clear all cases so far have had contact with poultry,” Mr. Hartl said.

Because it seemed possible that the virus originated in animals other than birds, or from some environmental source, the international investigating team would be casting a wide net for possible sources, Mr. Hartl said.

Seventeen people have died since China told the World Health Organization on March 3 of the bird flu outbreak, according to China’s state-run news agency, Xinhua. There were 83 cases of infection, the news agency said.

snip

Read more here: [url]http://www.nytimes.com/2013/04/19/world/asia/china-finds-no-sustained-evidence-of-human-to-human-flu-link.html?_r=0#h[][/url]

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Thu Apr 18, 2013 10:50 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Some notes from ProMed Mail:

Now 82 cases and 17 deaths
Date: Wed 17 Apr 2013
Source: China Daily, Xinhua report [edited]

No poultry contact in some cases
Date: Wed 17 Apr 2013
Source: Fox News, Reuters report [edited]
http://www.foxnews.com/health/2013/04/1 ... -who-says/


The World Health Organization [WHO] said on Wednesday [17 Apr 2013] that a number of people who have tested positive for a new strain of bird flu in China have had no history of contact with poultry, adding to the mystery about the virus that has killed 16 people to date. WHO spokesman Gregory Hartl confirmed that "there are people who have no history of contact with poultry," after a top Chinese scientist was quoted as saying that about 40 percent of those with the H7N9 virus had had no contact with fowl. "This is one of the puzzles still (to) be solved and therefore argues for a wide investigation net," Hartl said in emailed comments, though he added he did not know the exact percentage.


As of 18 Apr 2013 (18:00 CET), the National Health and Family Planning Commission notified WHO of an additional 5 laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus from Jiangsu (1), Zhejiang (2), Henan (1) Provinces, and Shanghai Municipality (1). No additional death has been reported.

To date, there are a total of 87 laboratory confirmed human cases with avian influenza A(H7N9) virus including 17 fatalities in China reported from 4 Provinces: Anhui 3 (1), Henan 3 (0), Jiangsu 21 (3), and Zhejiang 27 (2) and 2 Municipalities, Beijing 1 (0) and Shanghai 32 (11).


Cluster unproven
Date: Thu 18 Apr 2013
Source: English news, Xinhua report [edited]
http://qz.com/75738/chinese-authorities ... nsmission/


The family-clustered H7N9 cases reported in Shanghai were unable to prove human-to-human transmission, an expert said Wednesday [17 Apr 2013] in an exclusive interview with Xinhua.

According to the National Health and Family Planning Commission, a man and one of his sons in Shanghai died from the bird flu, and his 2nd son was also infected but has since recovered. It has not been confirmed whether the 3 people contracted the virus from infected fowl or the contaminated environment or through human-to-human transmission, said Feng Zijian, an official with the Chinese Center for Disease Control and Prevention.

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Thu Apr 18, 2013 6:51 pm
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Post Re: China Announces 4 New Bird Flu Cases H7N9
Taiwan reports 1st case of H7N9 bird flu in man working in China
Man suffered from a high fever for three days
The Associated Press
Posted: Apr 24, 2013 2:51 PM ET

Taiwan has confirmed its first case of a new strain of bird flu.

Taiwan's Centers for Disease Control said Wednesday that a 53-year-old man became sick with the H7N9 bird flu virus after returning from working in the eastern Chinese province of Jiangsu on April 9.

It did not identify him or provide details on his condition, except to say that he had suffered from a high fever for three days.

China and Taiwan have close trade and economic ties. An estimated 1 million Taiwanese live on the mainland and some 6,000 Chinese tourists visit Taiwan every day.

The H7N9 bird flu virus emerged in China over the past month and has sickened more than 100 people there. More than 20 people have died.

http://www.cbc.ca/news/health/story/201 ... china.html


from ProMed Mail":

To date, a total of 108 laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in China, including 22 deaths, have been reported to WHO. Contacts of the confirmed cases are being closely monitored. National authorities continue to implement prevention and control measures.

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Thu Apr 25, 2013 6:58 am
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Post Re: China Announces 4 New Bird Flu Cases H7N9
More on Taiwan from Crof via Scott McPherson:

Taiwan: 3 hospital staff show symptoms after H7N9 contact
Via Focus Taiwan, a CNA report: 3 hospital staff show symptoms after H7N9 contact. Excerpt:

Three hospital personnel have developed respiratory symptoms after coming into contact with Taiwan's first confirmed case of H7N9 avian flu, the Central Epidemic Command Center said Wednesday.

All three had taken proper protective measures when providing medical care for the patient, a 53-year-old man who fell ill three days after returning from China's Jiangsu Province, one of the H7N9-affected areas, the center said.

A survey of the epidemic situation showed that 139 local people had come into contact with the man, a Taiwanese businessman based in Jiangsu's Suzhou area, the center said.

Three of them had close contact, 26 had contact more than seven days ago (putting them past the infectious period) and 110 are hospital personnel, the center said.

Con. http://crofsblogs.typepad.com/h5n1/2013 ... ntact.html

Scott commented on the testing in Taiwan:
Quote:
After two straight negative tests for H7N9, he finally tested positive.

"If at first you don't succeed, stop" seems to be the norm for avian influenza testing. In this case, the Taiwanese tested again (good for them), and successfully achieved a positive test.


I wonder how many people tested negative the first time around and were not tested again? Luckily so far the virus does not seem to go H2H readily, but time may be running out on that situation.

edited to add:

Quote:
As the Taiwan H7N9 patient reportedly had no contact with poultry while in the mainland, the case will likely raise new concerns about human transmission of the disease. Chinese state media has said repeatedly there is no evidence of human-to-human transmission. Michael O’Leary, the World Health Organization representative in China, said earlier this week, however, H7N9 ”is still an animal virus that occasionally infects humans.” Up to half of mainland victims have been reported to have had no contact with poultry.


http://www.forbes.com/sites/russellflan ... irst-case/

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Thu Apr 25, 2013 7:23 am
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