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Discussion - Chinese researchers speculate that Influenza A(H7N9) could cause a severe pandemic
--->@MarionKoopmans --->@Crof A yesterday chinese paper doi: 10.1007/s11434-013-5880-5
suggested high degree of panic among readers.What's your op?
@MarionKoopmans ---> @ironorehopper --->@Crof
''i do not see new info in the paper, prediction is speculation. The severity score is quite crude and influenced by CFR ''
09:06 AM - 30 Apr 13
Individuals who die from this infections are hospitalized between 2 and 31 days before dying, with an average hospital stay of 9 days before death. Beside the few mild and one asymptomatic case, recovered patients are hospitalized for long periods too, from 6 to 25 days. That suggests this is a severe disease to me. The concern should be on whether or not this virus becomes transmissible.
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I understand but look at who wrote this paper: The Ministry of Agriculture of China. A very interesting development.
This piece of paper is not the holy bible of pandemic risk assessment.
It is bad written, without evidences and proof and it is hardly all but a statement.
Furthermore, the Authors said that human cases detected so far are the 'tip of an iceberg'. How can they calculate actual cfr when the iceberg size is not determined?
And if there are so many cases, why does the overall situation not point toward a widespread workpalces abseenteism or school closures, mass burials?
Because if the cfr is really 20% and the iceberg is growing, than we must have mass burials or cremations...
Re: Discussion - Chinese researchers speculate that Influenza A(H7N9) could cause a severe pandemic
Vincent Racaniello:
"For the most part we do not know the significance of any of the amino acid changes for viral replication and virulence in humans.
I believe that these H7N9 viruses might take one of two pathways. If they are widespread in birds, they could spread globally and cause sporadic zoonotic infections, as does avian influenza H5N1 virus. Alternatively, the H7N9 viruses could cause a pandemic. Influenza H7N9 virus infections have not occurred before in humans, so nearly everyone on the planet is likely susceptible to infection. Global spread of the virus would require human to human transmission, which has not been observed so far. Some human to human transmission of avian H7N7 influenza viruses was observed during an outbreak in 2003 in the Netherlands, but those viruses were different from the ones isolated recently in China. Whether or not these viruses will acquire the ability to transmit among humans by aerosol is unknown and cannot be predicted. If a variant of H7N9 virus that can spread among humans arises during replication in birds or humans, it might not have a chance encounter with a human, or if it did, it might not have the fitness to spread extensively.
"Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear." -Nelson Mandela
Re: Discussion - Chinese researchers speculate that Influenza A(H7N9) could cause a severe pandemic
when people don't want to predict, they say it can't be predicted.
Or "noone can predict it" or "noone can predict it with any certainety"
And then come the people who _do_ predict, lol.
Everyone can predict. Predicting is easy. What it's worth
and what predictions we should trust how much - well, that's another question.
But any prediction is better than no prediction.
Re: Discussion - Chinese researchers speculate that Influenza A(H7N9) could cause a severe pandemic
I agree with Giuseppe that the paper is lacking scientifically and despite the qualifications of the authors, this is all highly speculative given what we know so far. However, even if their methods are not sound, that doesn't mean that they haven't speculated correctly. As I've stated elsewhere, the CFR calculated based on the reported cases is a gross overestimate, IMO. There most certainly appear to be many more mild cases circulating, which is hinted at based on the asymptomatic case in Bejing and the reduction of the calculated CFR as more cases are confirmed.
However, the sequences reveal that this virus has already adapted when comparing the bird sequences with human. Nobody can predict the rate or direction of future mutations, but we have a somewhat aggressive, adaptable virus that has a potential host pool of over 6 billion individual who have little or no immulogical protection. It makes sense that it will adapt to exploit this. Although it's still too early to really compare it to H5N1, there are some prominent differences:
1) Reported cases show a pattern from an origin (Shanghai) outward that has not abated.
2) The animal host has not been identified, whereas infected domestic poultry has been closely associated with human H5N1 cases.
3) There is clearer evidence of H2H spread than with H5N1.
4) Research has shown that H7 viruses can infect mammals other than humans and swine without much mutational change, such as mice. Based on the papers I've reviewed, it appears that H7 viruses can do this more readily than H5N1.
Personally, I think we could see a Pandemic as early as this fall in the northern hemisphere.
"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta
Isolation and characterization of H7N9 viruses from live poultry markets?Implication of the source of current H7N9 infection in humans
The novel features that the new H7N9 viruses possess, including: previously unidentified HA and NA composition wide prevalence in avian hosts and the environment; an exceptional adaptive ability in humans; and the potential to acquire multiple basic amino acids at the HA cleavage site and evolve into a highly pathogenic form, are a major cause for concern with respect to public health worldwide.
Re: Discussion - Chinese researchers speculate that Influenza A(H7N9) could cause a severe pandemic
There are no mass burials because transmission between humans is not sustained. We have had limited h2h transmissions but they stopped at one or two persons. We have some hints that health care providers have also been infected. Again, the number of subsequently infected were extremely low. The key here is if the virus can be limited in its ability infect any humans. That is why the Chinese closed the wet markets. Every human infection invites polymorphisms which affect the viruses ability to replicate in humans. Natural selection will favor those polymorphisms. Will we see these polymorphisms? I don't know. But I do agree with the authors of this paper that limiting human infection is key. Closing the wet markets may have been responsible for the lower number of cases in China over the last few days. But, despite the best efforts of the Chinese we still do not know what infected those who never had any contact with poultry or wet markets. Until we know the vector we are going to see additional cases. Given the unalterable fact that there have been at least 129 human cases in a few months whatever is responsible has to be over a very wide area and has to be able to infect at least some humans casually. Either that or it is so ubiquitous in the area that many thousands of people have been exposed and only a tiny fraction have become ill. Neither scenario is good.
Please do not ask me for medical advice, I am not a medical doctor.
Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
Thank you,
Shannon Bennett
. . . Given the unalterable fact that there have been at least 129 human cases in a few months whatever is responsible has to be over a very wide area and has to be able to infect at least some humans casually. Either that or it is so ubiquitous in the area that many thousands of people have been exposed and only a tiny fraction have become ill. Neither scenario is good.
Shannon has framed the issue we should all be concerned about. Even if it is ubiquitous in China, at some point it may start infecting people on other continents, where it is mostly certainly not ubiquitous now.
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