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Confirmation of Avian Influenza H7N2 Infection in Wales
Can you qualify "bad"? For instance, I would consider any novel virus that spreads easily H2H as "bad" regardless of mortality rate.
A reassortant with an increased H2H efficiency would be H7, so it is not clear that such a virus would be virulent, because an H7 may not fit in with H5 internal genes, and therefore the cases may be even milder and less infectious than H7N2. This was seen in reassortant tests with H5N1 done by the CDC with human flu genes.
A reassortant with an increased H2H efficiency would be H7, so it is not clear that such a virus would be virulent, because an H7 may not fit in with H5 internal genes, and therefore the cases may be even milder and less infectious than H7N2. This was seen in reassortant tests with H5N1 done by the CDC with human flu genes.
Why is the M230I in the UK cases spreading more quickly than the M230I in Al Gharbaya? Are there other genes in the RBD that are different in these two cases?
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"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
Why is the M230I in the UK cases spreading more quickly than the M230I in Al Gharbaya? Are there other genes in the RBD that are different in these two cases?
Re: Confirmation of Avian Influenza H7N2 Infection
Avian flu contacts 'identified' Health officials say they have identified all the people who came into close contact with an outbreak of avian flu at a smallholding in north Wales.
The number of people who may have had contact with the disease rose over the weekend to 142.
The disease, which is the H7N2 strain of bird flu, not the more virulent H5N1, was first found last week among chickens at a farm near Corwen, Conwy.
Children at a Denbighshire school are being offered anti-viral medication.
A year five pupil at Ysgol Henllan suspected of contracting the virus has been linked to the smallholding.
A dozen children aged nine and 10 and two teachers at the school are being given tamiflu treatments as a precaution. School meeting
The National Public Health Service of Wales has said a total of 142 people have had either direct or indirect contact with the smallholding.
Four people have tested positive for bird flu and 12 have flu-like symptoms, but no-one is seriously ill.
Of the 142 to come into contact with the virus, 47 came into contact "in the household setting," 14 in the school and 81 in "the workplace setting".
Health officials held a meeting for concerned parents at the school on Monday evening, in which it was stressed the risk of anyone contracting the virus is very small.
Another meeting for those who could not attend is planned for Tuesday evening.
Hugh Pennington, a microbiologist and bird flu expert from Aberdeen University, said there was no risk of the virus being spread from person to person.
Professor Pennington said: "You have to be in quite close contact with infected birds to get infected.
"It doesn't spread from one infected person to another.
"It's still a bird virus - someone infected isn't going to cause any more human cases."
Professor Pennington added that distribution of tamiflu was a sensible precaution. Birds slaughtered
The first confirmed case involved a smallholding at Llanfihangel Glyn Myfyr, Conwy.
Owners Tony Williams and Barbara Cowling, who have tested negative for the virus, called in a vet after their Rhode Island Red chickens began to die.
They bought the chickens at Chelford Market at Macclesfield, Cheshire, some 70 miles (112 km) away, on 7 May.
A total of 30 chickens from the smallholding have now been slaughtered after 15 birds died.
Officials have stressed that the disease found at the Conwy farm was the H7N2 strain of bird flu, not the more virulent H5N1.
The second possible case emerged on Saturday about 35 miles (56 km) away, at a farm on the outskirts of Efailnewydd, near Pwllheli. It has also been linked to the market.
Would someone mind please posting the URL to the government statement that gives the details of the 2 positives from N-W England? Thanks
Here's the text on the four positives
"Four of the test results were positive - two of these were from Wales and two were from north west England.The remaining five test results came back as negative. However because these five cases were associated with the birds and had a compatible illness, they are being treated as a precaution"
So why aren't the Egyptian cases spreading as quickly as the UK cases, since they both have M230I?
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"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
Re: Confirmation of Avian Influenza H7N2 Infection
Here is more text, clearly stating that the four patients were positive for avian influenza (bold added)
The Health Protection Agency is providing expert support and advice to the National Public Health Service for Wales after an H7N2 avian influenza infection was found in birds on a small farm in north Wales. The Agency has carried out tests on specimens from nine people associated with the incident; seven are from Wales and two were from north west England. Four of the test results were positive - two of these were from Wales and two were from north west England.The remaining five test results came back as negative. However because these five cases were associated with the birds and had a compatible illness, they are being treated as a precaution.
H7N2 is a low pathogenic strain of avian flu. It is different to the highly pathogenic H5N1 strain currently circulating in South East Asia, and in Europe last year. In almost all human cases to date, H7N2 infection has generally been associated with a mild disease. The risk to the general public is considered to be very low.
Pat Troop, Chief Executive of the Health Protection Agency said:-
?As a routine precaution, we have tested those who were associated with the infected or dead birds and reported flu-like symptoms. We tested samples from nine people in our laboratories and confirmed infection in four. ?These test results confirm that human infection with the avian flu virus has occurred. The cases so far have been associated with the infected birds. ?It is important to remember that H7N2 avian flu remains largely a disease of birds.
Re: Confirmation of Avian Influenza H7N2 Infection
Mild bird flu in Britain has pandemic potential, experts say
The Associated PressPublished: May 29, 2007
The four presumed human H7N2 bird flu cases identified in Britain last week are a reminder that the next flu pandemic could be sparked by a virus other than the feared H5N1 strain, experts say.
While the global health community's attention in recent years has targeted the H5N1 virus, which has killed at least 186 people worldwide since 2003, some experts worry that attention is being diverted from seemingly less dangerous bird flu subtypes like H7.
"There may be a bit of complacency when it comes to recognizing the pandemic potential of H7 viruses," World Health Organization bird flu expert Dr. Michael Perdue said Monday.
Last week, British authorities confirmed that four people apparently tested positive for H7N2, a mild strain of bird flu, after 15 chickens at a small farm in Wales died. Health officials are currently investigating 36 people who may also be infected, of whom 11 have symptoms of flu or conjunctivitis.
Having so many human cases at once is a potential concern. In Asia, where H5N1 has circulated most widely, millions of people have been exposed to millions of infected birds, resulting in about one new infection per week.
"Here, we're talking about a small number of birds and yet we still have four cases," Perdue said. "Unless there's something unusual about the contact with birds, that suggests the virus is finding new ways of getting into humans."
The H7 subtype has previously sparked human outbreaks. In a large outbreak in the Netherlands in 2003, 89 human cases were reported, mostly of conjunctivitis, as well as one death. There were also at least three likely instances of human-to-human transmission involving family members of poultry workers. In the case of the single fatality, officials noticed that particular virus had about 10 mutations.
British officials have been quick to reassure the public that the "low pathogenic" H7N2 virus ? in comparison to the "highly pathogenic" H5N1 virus ? poses little risk to the population. Indeed, H7N2 appears to cause only mild symptoms such as eye infections.
But low pathogenic viruses can quickly morph into highly pathogenic ones, sometimes within weeks. Too little is known about flu viruses to predict with any certainty which ones are most lethal for humans.
"The pandemic risk from low pathogenic avian viruses is almost as bad as that from highly pathogenic avian viruses," said Dr. Angus Nicoll, an influenza expert at the European Centre of Disease Prevention and Control.
"When people say low pathogenic or highly pathogenic, that only refers to how unpleasant the disease is for birds," Nicoll explained. "That's almost irrelevant for humans."
Like all flu viruses, low pathogenic viruses mutate rapidly, and could theoretically transform into a pandemic strain without the warning signals of a more virulent strain, which would leave many dead chickens ? and perhaps humans ? in its wake. Experts also worry about the possibility of a bird flu virus mixing with a human flu virus to create a new pandemic strain.
"If you have an H7 virus causing mild symptoms, that might give the virus the chance to reassort into a more dangerous virus before anybody notices," Perdue said. And for health officials hoping to quash a pandemic in its emerging stages, it might be too late to contain a global outbreak without an early warning.
Most experts believe that the preoccupation with H5N1 as the most likely pandemic candidate is justified.
"The situation with H5N1 is very intense," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United States. "We know that H7 can cause outbreaks in chickens and that it can occasionally jump the species barrier, but it has not done it nearly to the extent of the H5N1 virus."
Unlike many other bird flu subtypes, which disappear off the radar after a short period, H5N1 has remained entrenched in the environment, and continues to spread to new areas.
Still, while no bird flu virus can be ruled out when it comes to igniting the next pandemic, some clues may exist. Though H5N1 has several worrying characteristics, other flu subtypes are also in the running for the pandemic title.
"The last two flu pandemics were the result of a human flu virus recombining with low pathogenic avian viruses," said Perdue. The H7N2 recently detected in Britain would fall into that category. "Given that historical context, perhaps we should concentrate our efforts a little more in that direction."
That is incorrect. Both H5 and H7 can convert by adding or changing amino acids at the cleavage site.
There is no evidence that an H5/H7 reassortant would be bad.
Comments on H5 vs H7 mechanism of transformation to HPAI are supported by the following paper. I wholly agree that there is no guarantee that an H7 virus would be bad, merely that it has the potential (like H5 viruses) to convert to HPAI variants, relatively readily. Therefore an H7 pandemic could be quite a serious matter, even if at present it only causes mild human disease; as human experience of H7 infections of a high path variant are (fortunately) very limited, no one can state with any certainty what the disease profile might be in humans. However, a high path human variant must be viewed as likely to be quite severe. This was a primary concern of WHO planners I worked with some years ago, when working on selection of annual vaccine strains. An H7 or an H5 human virus was often quoted as the 'nightmare scenario', and one we should hope would never happen as the world would be in deep trouble if it were to occur. It is the reason I have followed the H5N1 virus so closely for the last few years.
Lee CW, Lee YJ, Senne DA, Suarez DL. Pathogenic potential of North American H7N2 avian influenza virus: A mutagenesis study using reverse genetics. Virology. 2006 Jul 7; [Epub ahead of print]
submited by wanglh at Jul, 14, 2006 8:30 AM from Virology. 2006 Jul 7; [Epub ahead of print]
An H7N2 subtype avian influenza virus (AIV) first appeared in the live bird marketing system (LBMS) in the Northeastern United States in 1994. Since then this lineage of virus has become the predominant subtype of AIV isolated from the LBMS and has been linked to several costly commercial poultry outbreaks. Concern for this low pathogenicity isolate mutating to the highly pathogenic form has remained high because of the increasing number of basic amino acids at the hemagglutinin (HA) cleavage site, which is known to be associated with increased pathogenicity of AIV. To address the risk of low pathogenic LBMS-lineage H7N2 virus mutating to the highly pathogenic form of the virus, we generated a series of mutant viruses that have changes in the sequence at the HA cleavage site by using plasmid-based reverse genetics. We confirmed that a conserved proline at -5 position from the HA cleavage site could be changed to a basic amino acid, producing a virus with five basic amino acids in a row at the cleavage site, but with no increase in virulence. Increased virulence was only observed when additional basic amino acids were inserted. We also observed that the virus preferred the arginine instead of lysine at the -4 position from the cleavage site to manifest increased virulence both in vitro and in vivo. Using helper virus-based reverse genetics, where only one transcription plasmid expressing a mutated HA vRNA is used, we identified specific HA cleavage site sequences that were preferentially incorporated into the low pathogenic wild-type virus. The resultant reassortant viruses were highly pathogenic in chickens. This study provides additional evidence that H7 avian influenza viruses require an insertional event to become highly pathogenic, as compared to H5 viruses that can become highly pathogenic strictly by mutation or by insertions.
The concerns for an H5/H7 reassortant are based on the supposition that the virulence genes are spread across three seperate RNA strands, and therefore the odds of a reassortant virus acquiring increased virulence are reasonably high but by no means certain. Much depends how accurate the findings of the following paper are with regard to virulence distribution; additionally, I had not meant to imply that an H7 pandemic virus would certainly be bad, merely possible and with a high degree of risk that an HP variant would emerge if such a virus became widespread. If that was not the way in which my comment was read, please do accept my apologies.
See: Why is the world so poorly prepared for a pandemic of hypervirulent avian influenza?
Taylor & Francis publishes knowledge and specialty research spanning humanities, social sciences, science and technology, engineering, medicine and healthcare.
Authors: Olav Albert Christophersen; Anna Haug a
a Norwegian University of Life Sciences. Ås. Norway
DOI: 10.1080/08910600600866544
Publication Frequency: 3 issues per year
Published in: Microbial Ecology in Health and Disease, Volume 18, Issue 3 & 4 December 2006 , pages 113 - 132
Re: Confirmation of Avian Influenza H7N2 Infection
News: Avian Flu cases in North Wales
28 May 2007, National Public Health Service for Wales (NPHS)
Cases of the H7 flu virus have been identified following the discovery of avian flu at a smallholding near Corwen in North Wales.
Key messages
The illness people are experiencing is, for the most part, not serious. No one is seriously ill.
Preliminary investigations indicate that we cannot exclude person to person spread having occurred in this outbreak. Person to person spread would be very unusual but limited spread of this type has been seen elsewhere in the past in some cases of bird flu. There is no laboratory confirmation. As a precautionary measure the NPHS is continuing to offer people who have had contact with individuals with this illness antiviral medication to minimise the risk of spread.
Experience of this particular bird flu virus in humans is limited so we are actively managing the public health response.
The risk to the health of the general public is assessed to be low.
Avian flu cases and contacts in people
By 3pm yesterday, Sunday 27 May, 12 avian flu contacts had been identified who have or have had symptoms of a flu like illness or conjunctivitis. No one is seriously ill.
The National Public Health Service for Wales (NPHS) has identified 142 people who may have had contact with the avian flu:
47 in the household setting
14 in school
81 in the workplace setting
The list is constantly changing as possible contacts are added to or taken off the database. Contacts are added if contact was possible. They are taken off if detailed questioning shows that there was no contact.
The National Public Health Service (NPHS) is using the following definitions of cases and contacts:
A case is an individual with influenza-like illness (fever above 38? C, aches and pains, cough/head cold, sore throat or conjunctivitis) who has been in contact with affected premises or to known infected poultry (handling/within one metre) or close contact with another human case.
A contact is defined as an individual who has been in contact with affected premises or with known infected poultry (handling/within one meter) or has had close contact with another person with confirmed or presumptive avian influenza).
Investigations
The National Public Health Service for Wales (NPHS) has received microbiological test results from nine people in Wales so far. These are from swabs taken from the nose and throat and eyes. They have been tested for the Influenza A viruses, including the H7 subtype that has been isolated from the affected poultry. Two tests have been reported as positive for H7 subtype.
Definition of a case of avian flu relies as much on clinical symptoms with a history of contact with infected birds or another human case.
For this reason, the NPHS is contacting every individual who has been in close contact with the people who are cases. People identified as contacts are being offered medication to reduce the severity of any impact from the infection.
The NPHS is continuing to investigate and identify potential contacts today.
Dr Marion Lyons, Lead Consultant in Communicable Disease Control for the National Public Health Service for Wales, said: ?We are actively managing the outbreak. This involves taking every precaution in identifying possible contacts of the infected poultry or people who have been ill after contact with the infected poultry.
?We have identified contacts of a child in a school setting and a number of possible contacts in workplaces. Each of these is being followed up to establish whether they had symptoms or not.
?We are looking for people who have had flu like symptoms or conjunctivitis. It is the symptoms which are important to identify. It is reassuring that so few of the large number of contacts have had symptoms.?
?People who have had contact with someone who is well but who we have identified as a contact need not be worried.
?People can also be confident that, the more remote the contact with infected birds, the less likely that the symptoms that we have defined would really be H7 flu.?
Control Measures
People with symptoms of conjunctivitis and flu and meet the definition of a case have been given treatment. They have been advised to stay at home until they are better.
All well contacts are being given medication to reduce the severity of any impact from the infection.
Public Health Messages
Dr Marion Lyons, Lead Consultant in Communicable Disease Control for the National Public Health Service for Wales, said: ?We believe the risk to the health of the general public is low. Avian flu is primarily a disease of birds. H7N2 is different to and very mild compared with H5N1.
?Of the people with conjunctivitis or a flu-like illness, some did not have close contact with infected poultry.
?The illness people are experiencing is, for the most part, not serious. No one is seriously ill.
?Preliminary investigations indicate that we cannot exclude person to person spread having occurred in this outbreak. Person to person spread would be very unusual but limited spread of this type has been seen elsewhere in the past in some cases of bird flu. There is no laboratory confirmation. As a precautionary measure the NPHS is continuing to offer people who have had contact with individuals with this illness antiviral medication to minimise the risk of spread.
?Investigations also show that, when it spreads from person to person, the illness experienced becomes milder.
?Experience of this particular bird flu virus (H7N2) in humans is limited so we are actively managing the public health response.?
Communication
A Special Helpline available for general information about avian flu in people is open from 7am to 8pm daily. The number is 0845 600 3678.
Further information will be posted on this website as it becomes available.
An information sheet prepared by the NPHS for people who may have been exposed to Avian Flu is available from the link: Information for people who may have been exposed to avian flu
This information sheet is also available in Welsh from the link: Gwybodaeth i bobl a allai fod wedi cael eu hamlygu i ffliw adar
An updated Q&A information sheet for the public prepared by the NPHS is available to download from the link: Q&A Avian Influenza in North Wales (updated 26/05/2007)
This information sheet is also available in Welsh from the link: Gwybodaeth i?r Cyhoedd ar ffurf Cwestiynau ac Atebion am Ffliw Adar H7N2 yng Ngogledd Cymru
A map detailing the Avian Influenza Restricted Zone declared in accordance with Article 55 of the Avian Influenza and Influenza of Avian Origin in Mammals (Wales) (No.2) Order 2006 is also given on the Welsh Assembly website at: http://new.wales.gov.uk/topics/envir...ation/?lang=en
NHS Wales, Local Services, 111, Get Help, Staff Resources, Careers, National Programmes. The point of access for information on what the NHS in Wales does, how to access its services, available jobs and the careers we offer.
?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
Richard Horton, Editor-in-Chief The Lancet
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