China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

[Giuseppe]

[Source: Ifeng, full text: (LINK). Automatic translation from Chinese.]

H7N9, Guangzhou: Poultry vendor died after an unexplained illness

The Guangzhou one that sold doves, female stall owners unexplained sudden Death


Apr 15, 2013 02:33 Source: Express Author: Wang Lu Bin Lisi Lu Chen Haisheng

The deceased Recently do not have symptoms such as fever, municipal disease control department is yet to receive reports of cases of avian influenza

Express News reporter Wang Lu Bin Lisi Lu Chen Haisheng reported 1 o'clock yesterday afternoon, a middle-aged women engaged in more than a decade pigeons run in the Baiyun District baixing three birds wholesale market stall owners, sudden unexplained death in the home.

According to their families, after the female file the main body in good condition, no flu-like symptoms, are currently awaiting the coroner's investigation report.

The disease control department of Guangzhou City, as of 17:00 yesterday, did not receive any report on avian influenza.

The day before had dinner with family and friends - This female stall owners, surnamed Li, 47 years old, Hunan, operating in the Baiyun District baixing three birds wholesale market dove more than ten years.

According to Mr. Wong, his son, Lee's physical condition has been very good, normal appetite has been good, but recently there is no cold, fever, cough, influenza-related symptoms.

Lee's home is not far away from the wholesale market, last night's home to a few friends and relatives, and everyone ate some home cooking, dinner, and did not drink. Mr Wong said that zero o'clock yesterday, Lee busy to go out to the friends and relatives to buy water, that there is no strange.

Later, Lee first go to bed, but 1 am yesterday, but found her husband lying in bed, Lee is not right, how to call on him did not respond, so call the 120 emergency phone. A few minutes later, the near East Ren Hospital medical staff rushed to the scene, but after some rescue still powerless. Health care workers involved in the rescue, confirmed that Lee died at the scene after they handed over to the police chief.

Therefore, Lee's specific cause of death has yet to be further investigation.

Mr Wong said that the day before the dinner we eat, and no one else an exception occurs, you can exclude the possibility of food poisoning. Lee's body stored in a funeral home, family, hope as soon as possible for an autopsy to find the specific cause of death.

The normal operation of the market did not cause panic - Yesterday afternoon, the Express reporter came to baixing three birds wholesale market visited various stalls are still operating normally, most of the stall owners, security, customers and even stallholders children, personal protective measures are not taken, only a few The stall owners to wear disposable masks.

Many stall owners said that, although the market as a whole know that Lee was killed, but the birds to enter the market have inspection and quarantine certificate, Lee's death may avian influenza. Therefore, within the market is not very panic, coupled with the poultry business is bad, the stall owners must be up business, in order to wait for more customers.

In response to this incident, the Guangzhou Municipal Center for Disease Control main Renwang Ming pointed out that in the case, Lee only history of contact with poultry flu-like symptoms, can not be considered "suspected cases". As of 17:00 yesterday, the Guangzhou Municipal Center for Disease Control has not received the report of the avian influenza.

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[AlaskaDenise]

1918's influenza hit its typical victim suddenly, and some went from seemingly good health to death in a matter of hours. Others lingered for days or weeks.

http://www.history.navy.mil/photos/e...8/influenz.htm

Was it a particular mutation or the health status of the patient that make the 1918 virus take such a sudden outcome?

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[AlaskaDenise]

Determinants of mortality in naval units during the 1918?19 influenza pandemic

Summary


In 1918, two waves of epidemic influenza arose with very different clinical phenotypes. During the first wave, infection rates were high but mortality was low. During the second wave, high numbers of deaths occurred and mortality differed 30?100 times among seemingly similar groups of affected adults, but the reason for this variation is unclear. In 1918, the crews of most warships and some island populations were affected by influenza during both waves of infection and had no or very few deaths during the second wave. However, some warships and island populations were not affected during the first wave of infection and had high mortality during the second wave. These findings suggest that infection during the first wave protected against death, but not infection, during the second wave. If so, the two waves of infection were probably caused by antigenically distinct influenza viruses?not by one virus that suddenly increased in pathogenicity between the first and second waves. These findings are relevant to modern concerns that the 2009 influenza A H1N1 virus could suddenly increase in lethality......

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[sharon sanders]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

I moved this out of the H7N9 forum because the health authorities specifically state that this woman is not a suspected H7N9 case.

However, we are watching this case and will include her in our suspected/confirmed list when the test results are in.

[AlaskaDenise]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou,City, Guangdong province (Ifeng, April 15 2013)

A more recent (very good) study comparing 1918 flu to 2009/H1N1:

(snipped)

In summary, we hypothesize that mortality risk after infection with the 1918 pandemic influenza A (H1N1) strain depended on the number, nature, and diversity of prior infections with influenza virus and respiratory bacteria. Specifically, mortality rates during the lethal second wave were highest among persons with prior exposures to heterosubtypic influenza strains that enhanced immunopathogenic effects when a person was infected with the 1918 pandemic strain and had limited exposures to other respiratory infectious agents. In such persons, infection with the pandemic strain caused high viral loads, dysregulated and pathogenic cell mediated immune responses, and transient increases in susceptibility to invasive bacterial infections. If such influenza virus?infected hosts were subsequently exposed to bacterial strains to which they had no protective antibodies, they were at high risk of acquiring life-threatening secondary bacterial pneumonia.

The unique circumstances that enabled the unprecedented mortality rates of the 1918 pandemic no longer exist on a global scale. For example, in modern times, even the most isolated communities (e.g., Pacific islanders, indigenous populations of North America, Australia, and New Zealand) are interconnected through myriad commercial and sociopolitical activities. As a result, most populations are exposed to annual seasonal influenza viruses, and most young adults are exposed to numerous viral and bacterial respiratory pathogens. Thus, compared with the situation in 1918, adults in modern communities have more diversified immune repertoires against influenza strains and bacterial respiratory pathogens. The hypotheses presented may explain at least in part the relatively low mortality rate associated with pandemic (H1N1) 2009 virus. During the 2009 pandemic, many persons who died had underlying medical conditions, including obesity, asthma, cardiovascular diseases, diabetes, and pregnancy; histopathologic changes consistent with diffuse alveolar damage; and evidence of bacterial co-infections (40).

Finally, the findings of this report are relevant to the research and development of a universal influenza vaccine. Candidate vaccines that contain antigens that are highly conserved across influenza A strains and strongly immunogenic must be closely monitored to ensure that T-cell?mediated immune responses to future seasonal and pandemic strains are protective but not pathogenic.

http://wwwnc.cdc.gov/eid/article/18/...42_article.htm

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[NS1]

Re: H7N9, Guangzhou: Poultry vendor died after an unexplained illness (Ifeng, April 15 2013)

1918's influenza hit its typical victim suddenly, and some went from seemingly good health to death in a matter of hours. Others lingered for days or weeks.

http://www.history.navy.mil/photos/e...8/influenz.htm

Was it a particular mutation or the health status of the patient that make the 1918 virus take such a sudden outcome?

.

Strangely enough, the 1918 virus isolates on file are strikingly stable and homologous. As individuals from all ages and walks of life were fatal, the virus gene constellation must be the strongest determinant. We do not know with precision the average Ab makeup of humans during that time, but we do know that 1918 was a novel event. The steps leading to the 1918 background may never be known. The 1918 virus, as we know it, was not a confused virus that was seeking stasis; it was already stabilised.

We do not know yet if the emergent H7N9 fits that stability category; however, significant signals demonstrate that host-species transition is ongoing. Whether emergent H7N9 moves toward a 1918 clinical profile remains under study with very limited data.

Our continuing characterisation of the pH1N1 emergence and development has shown that these types of disease always leave tracks, even to the distant past (more than a decade). But finding the genetic tracks for 1918 would require samples that have long since been lost to time. The best we can hope is to evaluate very closely each emergence from avian to human for signals that will form an emergence pattern.

Overnight, unexplained and rapid death was frequently associated with pH1N1 and we believe is a clinical feature of most intermediate / host-species transitional viral backgrounds.

[Giuseppe]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

H1N1 had NS1 C-terminus but H7N9 not.

NS1 C-terminus has been suggested as tissue tropism and pathogenicity marker for human infections, because it permitted the H1 flu virus to infect multiple organs other than lungs, ie brain.

H7N9 has an entire genetic constellation distinct from previous human flu viruses, so any parallelism may be futile at this stage.

[AlaskaDenise]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

H1N1 had NS1 C-terminus but H7N9 not.

NS1 C-terminus has been suggested as tissue tropism and pathogenicity marker for human infections, because it permitted the H1 flu virus to infect multiple organs other than lungs, ie brain.

H7N9 has an entire genetic constellation distinct from previous human flu viruses, so any parallelism may be futile at this stage.

This ability is also under the influence of the NS1 CPSF30 binding, which in H7N9 contains the non-concensus values. Changes in those values from H5N1/97 to H5N1/2003 had considerable influence on virulence. I wonder if non-concensus values always convert to concensus?

see (among several studies about CPSF30): http://jvi.asm.org/content/87/5/2430.full

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[Treyfish]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

Guangzhou pigeons file female boss early morning sudden death2013 04 15, 2011 03:582013 04 15, 2011 03:58

Southern News reporter Liu Jun Wang Daobin early yesterday morning, the Guangzhou Baixing three birds wholesale market in the sudden death of a dove file female boss, causing a burst of panic within the line. The family of the deceased and experts said, should be independent of and H7N9.

Witnesses said the corpses away at 6:00 in the morning yesterday, the police far stood "not close". The inner line of the message a few minutes, spread, many people tried to get to the market stall owners call message. "Brain haemorrhage death, the results are out. Assured that is definitely not the avian flu." Worried that their business affected everyone's answer seems resolutely simply and unified.

Named Li and month of the dead, 48-year-old, Huaihua, Hunan Mayang County. The memories of her husband Huang, more than 11:00 last night, when the wife to get up on the toilet, and also told him to go to bed early to stop the beating of mahjong, no abnormalities were found. 0:00, Huang found his wife shortness of breath, unable to speak by phone light to find wife face right, and quickly began to do artificial respiration. After a child is not improved, Huang quickly hit 120. The ambulance arrived seven minutes later. But his wife is still away at 1:00 yesterday.

Huang said that the body has been a good wife, before no fever, no cold, no illness, and certainly not the avian flu. Recent sluggishness, his wife the day before head dyed red hair back. 120 VMOs stated in the coroner's column: "cardiopulmonary arrest." Guangzhou CDC has not yet received the report, people die so suddenly like H 7N 9 due. Currently forensic corpse dissected diagnostic results are not yet out. http://news.ifeng.com/mainland/speci...?_from_ralated

[NS1]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

H1N1 had NS1 C-terminus but H7N9 not.

NS1 C-terminus has been suggested as tissue tropism and pathogenicity marker for human infections, because it permitted the H1 flu virus to infect multiple organs other than lungs, ie brain.

H7N9 has an entire genetic constellation distinct from previous human flu viruses, so any parallelism may be futile at this stage.

The appearance of a futile state does not always end in disorder. At inflection points, determinants are often shadowed.

Futility is found where facts are forgotten.

A thoughtful consideration of the present Hemagglutinin demonstrates homology at critical areas to human Influenza of both currently circulating Influenza A serotypes.

Evaluation of factual parallels, wherever those parallels are found, leads to correlation. Correlation often leads to causality.

We will continue to search for inclusionary and exclusionary facts like Denise has presented.

Original Research

• Ongoing Sequence Analysis - Open-Access, Full-Text
• GISAID Citation

[Pathfinder]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

Translation Google


Avian / Guangzhou pigeon trafficking sudden death authorities: no avian flu

http://www.cdnews.com.tw 2013-04-15 11:16:13

Li Hanyang / finishing 　mainland north of H7N9 avian flu positive development inland southern no cases so far. But three birds wholesale market in Guangzhou Baiyun District Baixing yesterday outgoing traders dove female shopkeeper sudden death at home, elicited a lot of suspicion; authorities has not received any reports avian flu. 　Due to the outbreak of severe acute respiratory syndrome (SARS), Guangzhou is considered the birthplace and heavy endemic areas, the Chinese mainland, the outbreak of H7N9 avian flu, the situation in Guangzhou so outside attention, but so far no outbreaks outgoing. 　Mainland Guangzhou New Express reported on the 15th, 1 o'clock yesterday afternoon, a wholesale market in Baiyun District Baixing three birds engaged in more than a decade pigeons operated by 47-year-old surnamed Li, female shopkeeper sold, unexplained sudden death in the home. 　Female shopkeeper's son, Mr Wong said the female shop owner in good physical condition, recently flu-like symptoms, also last night dinner with family and friends, no strange yesterday, is awaiting the coroner's investigation report. 　Guangzhou Center for Disease Control main Renwang Ming pointed out that, as of 17:00 yesterday, did not receive any reports of avian flu. 　Rosanna said shopkeeper surnamed Li only flu-like symptoms and history of exposure to poultry, can not be considered "suspected cases". 　The Guangdong CDC said At present, Guangdong has not received any unexplained pneumonia, report suspected cases of people infected with the H7N9 avian influenza; individual type A (H1N1) in patients with severe but has started to appear, which the Huadu last week on one cases a pregnant woman. 　Reported that the woman surnamed Li shopkeeper sudden death, did not cause too much panic, Baixing three birds wholesale market shops are normal business yesterday afternoon, most of the shopkeepers, security, customers, and even the owner of the children do not have to take personal protective measures , only a small number of shopkeepers wear disposable masks.

http://www.cdnews.com.tw/cdnews_site/docDetail.jsp?coluid=109&docid=102275052

[Giuseppe]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

This ability is also under the influence of the NS1 CPSF30 binding, which in H7N9 contains the non-concensus values. Changes in those values from H5N1/97 to H5N1/2003 had considerable influence on virulence. I wonder if non-concensus values always convert to concensus?

see (among several studies about CPSF30): http://jvi.asm.org/content/87/5/2430.full

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I would only say that the quest for discover the exact mechanism of pathogenicity of H1N1 spanish flu pandemic virus remains open and without a defnite answer. This is also true for H5N1 virus infection in human, never explained in full.

These viruses are really distinct in their evolutionary path and their natural hosts differ also.

Human hosts play a great role and the parallelism with H1 and H7 seems excessive at this stage.

H5N1 has never been able to readily infect humans with the frequency seen for H7N9 and its pathogenicy determinants are also difficult to elucidate.

It seems that the entire H5N1 machinery was not able to make it a good pandemic candidate overall.

Often the other part of the sky is taken apart: human hosts, its immunological response to flu viruses, the interference of other human seasonal flu antibody response, conserved antigenic trait in some of the viral sub-units, etc.

[AlaskaDenise]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

These viruses are really distinct in their evolutionary path and their natural hosts differ also.

I often wonder if mankind will ever be able to understand all the programming of these complex systems.

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[Giuseppe]

Re: China - Woman, 47, poultry worker unexplained sudden death - tests pending - Guangzhou City, Guangdong province (Ifeng, April 15 2013)

I often wonder if mankind will ever be able to understand all the programming of these complex systems.

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Yes, it is an Amazing quest. If one also think of the complexity of other viral pathogen such as Coronavirus (with a gene constellation much more convoluted than flu), it sounds as studying the hidden universe secrets.

But often it was said that no clue and no cure would be found for most of the mankind scourges and then - suddenly - the hard work of researchers and indefatigable curiousity of some paved the way to these sores heal.