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CDC - H7N9 Important Information on H7N9 April 19 2013

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  • CDC - H7N9 Important Information on H7N9 April 19 2013

    H7N9 Flu and You

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    A new strain of H7N9 bird flu has been found in birds and people in China. No ongoing person-to-person spread of this virus has been found at this time. Here are some common questions and answers about this new virus.

    What is H7N9?

    “H7N9” is the designation for one subtype of influenza viruses that is sometimes found in birds, but that does not normally infect humans. Like all influenza A viruses, there also are different strains of H7N9. Beginning at the end of March 2013, China reported human and bird (poultry) infections with a new strain of H7N9 that is very different from previously seen H7N9 viruses.

    Is this new strain of H7N9 infecting humans?

    Yes. While H7N9 viruses had never before been detected in people, in the first two weeks of April, China reported more than 70 cases of human infection with this new H7N9 virus.

    How are people getting infected?

    This virus has been found in birds (poultry) in China in some of the same areas where human infections have happened. Since this virus does not normally spread in people, the working assumption is that people have been infected with the virus after having contact with infected poultry.

    How do people get infected with bird flu viruses?

    Human infections with bird flu viruses are rare, but have happened in the past, usually after close contact with infected birds (both live and dead) or environments contaminated with bird flu virus.
    Infected birds can shed a lot of flu virus, for example, in their droppings or their mucus. If someone touches an infected bird or an environment contaminated with virus and then touches their eyes, nose or mouth, they may be infected with bird flu virus. There is some evidence that infection may also occur if the flu virus becomes airborne somehow, such as when an infected bird flaps it wings. If someone were to breathe in airborne virus, it’s possible they could get infected.

    Is infection with this virus serious?

    Most of the reported cases of human infection with this virus have had very serious illness. There also are reports of some milder illness and one possible report of a person who tested positive for the virus who did not have any symptoms.

    What are the symptoms of illness with this virus?

    Symptoms have started with high fever and cough. A lot of the cases have progressed to very serious illness, including severe pneumonia, acute respiratory distress syndrome (ARDS), septic shock and multi-organ failure leading to death.

    Is this virus spreading from person-to-person?

    Chinese health authorities are investigating this situation very carefully. They are following up on close contacts of infected people to find out if they have gotten infected. This is important to find out whether there has been person-to-person spread of this virus. So far, hundreds of close contacts have been checked and there has not been any evidence of ongoing spread of this virus from person-to-person.

    Is it possible that this virus will spread from person-to-person?

    Yes. Based on what we know about human infections with other bird flu viruses, it’s possible and even likely that there will be some limited person-to-person spread with this virus. The important factor will be to determine whether this virus gains the ability to spread easily from one person to another. Sustainable human to human spread is needed for a pandemic to start. Health officials are watching the situation closely for this.

    Is there a vaccine to protect against this new H7N9 virus?

    No, right now there is no vaccine to protect against this virus. CDC and others are working to develop a vaccine candidate virus that could be used to make a vaccine if it is needed.

    Are there medicines to treat illness associated with this virus?

    CDC has received one H7N9 virus sample from China. Laboratory testing at CDC indicates that this virus would be sensitive (susceptible) to the two influenza antiviral drugs that are used to treat seasonal flu. These drugs (oseltamivir/Tamiflu® and zanamivir/Relenza&#174 work best when given early in the course of illness. However, influenza viruses can be, or can become, resistant to these drugs, so these medications may not always work. As new virus isolates are received, CDC will conduct ongoing testing to determine the susceptibility of other H7N9 viruses to existing antiviral drugs. Right now, CDC recommends oseltamivir/Tamiflu® and zanamivir/Relenza® for treatment of H7N9.

    What is the risk from this virus in the United States right now?

    No cases of human or bird infection with this H7N9 virus have been detected in the United States. At this time, the risk to people in the United States is considered to be low.

    Is it possible that human cases of H7N9 flu will be found in the United States?

    Yes. The most likely scenario for this right now would be H7N9 infection in a traveler from China. Many people travel between China and the United States. CDC issued a health alert for public health officials and clinicians in the United States to be on the look-out for flu symptoms in travelers who are returning from countries with bird flu. CDC has issued guidance for isolating, testing, and treating such patients. However, since this virus does not seem to be spreading easily from person-to-person, a few cases in the United States with travel links to China would not change the risk of infection for the general public in the United States.

    Does CDC recommend that people delay or cancel trips to China because of H7N9 flu?

    Since H7N9 is not spreading easily from person-to-person at this time, CDC does not recommend that people delay or cancel trips to China. The World Health Organization also is watching this situation closely and does not recommend any travel restrictions.

    What advice does CDC have for people traveling to China?

    CDC advises travelers to China to take some common sense precautions, like not touching birds or other animals and washing hands often. Poultry and poultry products should be fully cooked. CDC will update its advice for travelers if the situation in China changes. This guidance is available at Avian Flu (H7N9) in China.

    Should travelers to China get a prescription for antivirals before their trip?

    At this time, CDC does not recommend prescribing antiviral drugs for prevention or self-treatment of H7N9 flu. CDC recommends that travelers to China follow common sense precautions to protect themselves and monitor their health during and after their trip. Anyone with fever, coughing, or shortness of breath within 10 days of traveling to China should see a doctor and tell the doctor about the recent travel to China.

    What does CDC advise for people in the United States with regard to H7N9?

    CDC does not have any new or special recommendations for the U.S. public at this time regarding H7N9.

    Is CDC worried that an H7N9 pandemic will start?

    This is a serious public health situation and it’s possible that a pandemic could start if this virus were to change to spread easily between people. CDC is preparing for that possibility.

    What is CDC doing in response to H7N9?

    CDC is following this situation closely and coordinating with domestic and international partners, including China CDC and the World Health Organization. On April 8, 2013 CDC activated the Emergency Operation Center (EOC) at Level 2 (limited activation) to support the management of the emerging H7N9 situation in China. CDC also is sending a team to China to support the domestic outbreak response.
    In addition, CDC is taking routine preparedness measures, including:
    • Developing a candidate vaccine virus that could be used to make vaccine if it becomes necessary.
    • Creating a test kit to detect this virus that could be used by other public health laboratories.
    • Conducting studies on blood samples to see whether there is any existing immunity to this virus in the population.
    • Conducting ongoing testing to determine H7N9 susceptibility to the licensed influenza antiviral drugs, oseltamivir (commercially known as Tamiflu&#174 and zanamivir (Relenza&#174 as well as investigational antiviral drugs.
    • CDC also is gathering more information to make a more thorough public health risk assessment. This is an evolving situation and there is still much to learn.

    • Page last reviewed: April 19, 2013
    • Page last updated: April 19, 2013