China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Diane Morin · Apr 14, 2013

hat tip Crof

April 14, 2013

H7N9: Another case in Beijing?

This is why I don't like computer translations. The Beijing Municipal Health Bureau just posted a story on its website: Active screening for the monitoring found one case of human infection with H7N9 avian flu virus. Here's a translated excerpt:

/.../

If I understand this report, a family living across the street from the Yao family has a four-year-old boy who has tested positive for H7N9 but is showing no clinical symptoms. He was tested with a lot of other poultry dealers' family members. If he's asymptomatic, that's probably a bigger story than if he's sick.

http://crofsblogs.typepad.com/h5n1/2013/04/h7n9-another-case-in-beijing.html

sharon sanders · Apr 14, 2013

Re: H7N9: Another case in Beijing?

Re: H7N9: Another case in Beijing?

Diane Morin said:
April 14, 2013

H7N9: Another case in Beijing?

This is why I don't like computer translations. The Beijing Municipal Health Bureau just posted a story on its website: Active screening for the monitoring found one case of human infection with H7N9 avian flu virus. Here's a translated excerpt:

/.../

If I understand this report, a family living across the street from the Yao family has a four-year-old boy who has tested positive for H7N9 but is showing no clinical symptoms. He was tested with a lot of other poultry dealers' family members. If he's asymptomatic, that's probably a bigger story than if he's sick.

http://crofsblogs.typepad.com/h5n1/2013/04/h7n9-another-case-in-beijing.html

Here is the government of Beijing translation. It appears a small child who is asymptomatic has tested positive for H7N9. Apparently his parents work in the poultry industry and may be a neighbor of the 7 year old who is in a Beijing hospital improving:

Active screening monitoring found one case of human infection with the H7N9 avian flu virus carriers
Time :2013 -04-15 Source: Beijing Municipal Health Bureau Views: 42
30 points, on April 14, 2013, the Beijing Municipal Health Bureau received a the Beijing CDC report found a father first case of human infection of H7N9 avian influenza confirmed cases of trafficking poultry populations Active screening monitoring 4-year-old bamboo surname boys H7N9 avian influenza virus nucleic acid positive. The boy is currently no clinical symptoms. Clinical expert in Beijing, according to its clinical manifestations, epidemiological investigation and laboratory test results, the overall judgment of the boy man infected with the H7N9 avian flu virus carriers. Out of concern for the health of the children, the Ministry of Health goalkeeper sent to the Ditan hospital for close medical observation.
The active screening monitoring implementation by the Chaoyang District CDC, milk range including Chaoyang District, Cuigezhuang is the East Village poultry farmers a total of 24 people, the way of collecting a throat swab specimens were sent to the Beijing CDC for testing. The boys' parents engaged in the sale of poultry fish, its across the street neighbor bought the family of the first confirmed cases of trafficking chicken.
The discovery carriers, Beijing extends from the passive "syndromic surveillance" to carry out the initiative pathogen monitoring of high-risk groups "to further improve the prevention and control work initiative, the forward-looking results achieved. Expert analysis, monitoring the active screening results with some reference to judge the virulence of the H7N9 avian flu virus and susceptible populations.

http://www.bjhb.gov.cn/wsxw/201304/t20130415_59472.htm

Giuseppe · Apr 14, 2013

Re: H7N9: Another case in Beijing?

Re: H7N9: Another case in Beijing?

[Source: Beijing Municipal Health Bureau, full text: (LINK). Automatic translation from Chinese.]

H7N9, Beijing: One possible additional birdflu case

Time :2013-04-15 article Source: Beijing Municipal Health Bureau Views: 44

April 14, 2011 20, 2013 30 pm, the Beijing Municipal Health Bureau received a the Beijing CDC report, in the first case of human infection of H7N9 avian influenza confirmed cases father trafficking monitoring of the poultry population active screening and found a 4-year-old bamboo boy surnamed H7N9 avian influenza virus nucleic acid positive. The boy is currently no clinical symptoms.

Beijing clinical expert groups according to their clinical manifestations, epidemiological investigation and laboratory test results, the overall judgment that the boy's human infection of H7N9 avian influenza virus carriers.

Out of concern for the health of the children, the Ministry of Health goalkeeper sent to a the Ditan hospital for close medical observation.

The active screening monitoring implemented by the Chaoyang District Center for Disease Control, covering the Township in Chaoyang District Cui milk East Village poultry farmers a total of 24 people, is collected throat swab specimens were sent to the Beijing CDC for testing.

The parents of the boy engaged in poultry fish trafficking, its neighbor across the street bought the first confirmed cases of families selling chicken.

The discovery of the carriers, Beijing extends from the passive "syndromic surveillance" to high-risk groups to carry out the initiative pathogen monitoring, to further improve the prevention and control work initiative, the results achieved by the forward-looking.

Expert analysis, the active screening monitoring results with some reference to determine the virulence of H7N9 avian influenza virus and susceptible populations.

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------

Diane Morin · Apr 14, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Machine translation

2013 04 14, 2010 02:40 Beijing Times

　Children with their parents at home, isolation

/.../

It is understood that the children with a primary school student, before the onset of health, but do not go to school two weeks. The the Shunyi District Board of Education has comprehensive disinfection of patients where school classes, the to immediately monitor teachers and students have had close contact with the student, and the campus of the requirements of the region to strengthen the morning afternoon inspection. Up to now, it has not been found infected with the H7N9 suspected symptoms.

/.../

　Children can not go far away to play

　　Yaojia diagonally opposite Pengcheng cooked food franchise business as usual, but no longer sell chicken. The shop owner said that the original store to sell Texas braised chicken and VI and Square duck, but since the avian flu will not dare to sell enter arrival. I thought so far away from the bird flu, but he did not expect the first cases in Beijing in its own ramp door, afraid to pour out of the question, is to let the children away from the far point of live chickens, ducks and birds can not go far away to play. "

　　She said that the day before yesterday afternoon, armed immunization to the whole street spraying disinfectant. West Center Street, north side of the road a household housing some pigeons in the pigeon holes has been "no-fly."

http://news.sina.com.cn/c/2013-04-14/024026819105.shtml

Giuseppe · Apr 14, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

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

H7N9, Beijing: An asymptomatic boy infected with birdflu virus

Beijing case of human infection with H7N9 avian influenza virus carriers

2013 04 15, 2011 03:36 Source: Xinhua News Agency

Xinhua Viewpoint: Beijing case of human infection of H7N9 avian influenza virus carriers] reporters from the Beijing Municipal Health Bureau was informed that at 3:00 on the 15th, father in Beijing first case of human infection of H7N9 avian influenza confirmed cases of trafficking in the poultry population monitoring, found a 4-year-old boy with H7N9 avian influenza virus nucleic acid positive.

Beijing clinical expert group overall judgment that the boy's human infection of H7N9 avian influenza virus carriers without clinical symptoms.

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-----

Pathfinder · Apr 14, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Symptom-Free Bird Flu Case Suggests Wider H7N9 Spread

By Bloomberg News - Apr 14, 2013 8:05 PM 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, who is under medical observation, suggests that some H7N9 infections may be going unrecorded because of a lack of obvious symptoms. Almost all the 60 previous cases in eastern China were 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.?

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

Pathfinder · Apr 14, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

4/14/2013 @ 10:52PM

Four-Year-Old Boy Is Suspected To Be Beijing's Second H7N9 Bird Flu Case

Beijing?s Municipal Bureau of Health this morning reported the discovery of a suspected H7N9 bird flu carrier in the city, a four-year-old boy, according to a local reports.

The boy, who surname is Zhu, would be the city?s second case following the discovery of an ill 7-year-old girl that was reported on Saturday.

The boy?s neighbor purchased poultry from the family that was the first confirmed H7N9 case in Beijing, the official Xinhua news agency reported.

The transmission may be person-to-person, a report said. Previously, transmissions during the H7N9 outbreak have been believed to have been bird-to-person.

More...
http://www.forbes.com/sites/russell...ted-to-be-beijings-second-h7n9-bird-flu-case/

Pathfinder · Apr 14, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Beijing reports H7N9 flu virus carrier

BEIJING, April 15 (Xinhua) -- Beijing municipal health authorities said Monday that a four-year-old boy, who was tested positive for H7N9 flu virus, was determined to be a H7N9 flu virus carrier.

The boy, surnamed Zhu, was tested positive for H7N9 flu virus by the Beijing Center for Disease Control and Prevention Sunday evening.

Zhu has so far shown no flu symptoms and is receiving medical observation in Beijing Ditan Hospital.
...
http://news.xinhuanet.com/english/health/2013-04/15/c_132309518.htm

AlaskaDenise · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

[Genetic predisposition to latent influenza A virus in children with blood type B(III) as a possible cause of new epidemiologic strains in the countries of South-Eastern Asia].

Sominina AA, Tsubalova LM, Karpova LS, Lipina NV, Nikanorov IIu, Semilutskaia IB, Bekhtereva TA, Popova TL, Konovalova NI, Grinbaum EB, et al.

Abstract

Regular clinical and epidemiological surveys of two groups of healthy 14-16-year-old boys were carried out for 3 years from September 1989 to May 1992 to investigate the latent circulation of influenza A viruses in the human population. Once or twice a quarter clinical materials were laboratorily studied to detect virus antigens, virus-specific NA-sequences and to determine changes in humoral immunity. The latent circulation of influenza A viruses might be identified in 10-20% of cases long before (2-4 months) the onset of epidemic development. The incidence of epidemic isolations was found to reach 33-36%, gradually decreasing from 29 to 9 or 3.5% in the postepidemic period. The long-term persistence (for 5 months) of virus antigens was reported among healthy children who had chiefly blood group B(III). The new hypothesis that the genetic predisposition of children with blood group B(III) to latent persistence of influenza A viruses may be a possible cause of the emergence of new epidemic strains in the South-East Asian countries has been forwarded.

.

AlaskaDenise · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Viral Carrier Status is Instilled by Viral Regulatory Particles

Summary

Human viral carriers are important agents in the periodic resurgence of many pathogens. Instillation of virus in human carriers explains several of the unusual epidemiological features of viral epidemics, such as where viruses linger between epidemics and how epidemics can arise without an apparent source. By inactivating itself, a virus can easily reside in a host for months or years without being noticed by the immune system, enabling the virus to be dispersed inconspicuously in the future and into new regions. When this silent activity of human carriers is appreciated, it is easier to understand the dynamics of viral epidemics, such as the explosive appearance of influenza epidemics.

(long article.....)

.

Giuseppe · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

It is not surprisingly discovery of a subclinical infection with this new H7N9 virus in a child, since in his residential area some people seem involved in poultry trade.

Children play often with chickens and other domesticated birds or other animals and have likely frequent contact with ground and soil possibly contaminated with birds' faeces.

It is also possible that children immune system reacts different comparing older people, immunocompetent.

The 'activation' of the immune system may result in a paradoxical hyperinflammatory response, as seen for other infectious diseases, leading to severe lung injury and multi-organ failures.

It is too early to tell about the implication of this discovery but it could also demonstrate the scope of environmental dispersion of the virus and the subsequent risk for further instances of infections in humans.

Catbird · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

This article specifies that testing included X-rays and blood work, which were apparently normal.

"H7N9 confirmed cases rose to 63 cases of viral genetic changes or human-to-human transmission

2013-04-15

...This station reporters Monday call the Beijing Center for Disease Control, and the other said that the reason for judgment as carriers of the virus rather than the suspected or confirmed cases because the boy did not show clinical symptoms.

"If you are suspected cases, he must have some clinical performance. Addition, he still has some of the example, blood (changes), some chest, chest X-ray, take X-rays, and he will have some changes this child is currently no any symptoms, so he can only say our laboratory tests he was carrying out of this thing (virus), but he did not have any clinical symptoms, so he can not be declared as suspected cases or cases."..."

xhttp://www.rfa.org/mandarin/yataibaodao/huanjing/yf2-04152013134951.html

Catbird · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Machine translation:

"China CDC: H7N9 detection range not blindly expand

2013-04-16

...Deputy Secretary of the Beijing Municipal Health Bureau spokesman Zhongdong Bo

Beijing News (Reporter Wei Ming words) "can not determine the potential virus H7N9 infection in the 4-year-old boy." Yesterday, the director of Ping Zijian China CDC Emergency Management Office, said the boy may be a potential infection may only is mechanical carryover of long-term exposure in the environment of live poultry. If it is the latter, not enough to prompt our need to change the existing prevention and control strategies for H7N9.

Boys serum analysis has been detected

Ping Zijian explained infected with a virus carrying the virus are two different concepts. Infected, the virus will enter its epithelial cell growth and reproduction; carriers, just long-term exposure to the virus activities, viral adhesion behavior of a mechanical in their respiratory tract. "If the machinery to carry two days and then take the child's throat swab (respiratory secretions) specimens may detect less than H7N9 traces Fengzai Jian said that the machinery to carry, to determine if the virus is able to recessive interpersonal spread of no value.

, Chinese Center for Disease virus laboratory has collected the boy's serum, to carry out further testing and analysis. "After two weeks, we will be collecting this boy's serum detected H7N9 antibodies, whether or not he incidence can be confirmed that indeed infected with this virus."

xhttp://news.qq.com/a/20130416/000087.htm

sharon sanders · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Catbird said:
Machine translation:

"China CDC: H7N9 detection range not blindly expand

2013-04-16

...Deputy Secretary of the Beijing Municipal Health Bureau spokesman Zhongdong Bo

Beijing News (Reporter Wei Ming words) "can not determine the potential virus H7N9 infection in the 4-year-old boy." Yesterday, the director of Ping Zijian China CDC Emergency Management Office, said the boy may be a potential infection may only is mechanical carryover of long-term exposure in the environment of live poultry. If it is the latter, not enough to prompt our need to change the existing prevention and control strategies for H7N9.

Boys serum analysis has been detected

Ping Zijian explained infected with a virus carrying the virus are two different concepts. Infected, the virus will enter its epithelial cell growth and reproduction; carriers, just long-term exposure to the virus activities, viral adhesion behavior of a mechanical in their respiratory tract. "If the machinery to carry two days and then take the child's throat swab (respiratory secretions) specimens may detect less than H7N9 traces Fengzai Jian said that the machinery to carry, to determine if the virus is able to recessive interpersonal spread of no value.

, Chinese Center for Disease virus laboratory has collected the boy's serum, to carry out further testing and analysis. "After two weeks, we will be collecting this boy's serum detected H7N9 antibodies, whether or not he incidence can be confirmed that indeed infected with this virus."

xhttp://news.qq.com/a/20130416/000087.htm

I can not find this announcement on the China CDC site.

Basically the China CDC is overriding the Beijing Health Department and saying there is no confirmation of the H7N9 virus in this child unless H7N9 antibodies are detected in his blood - a test to be performed in about 2 weeks.

It looks like the CDC is doing damage control over the Beijing Health Authorities news release yesterday. Asymptomatic human carriers of H7N9 present a real challenge to control and prevention of this disease. The international community has been very interested in this apparent development.

For now the 4 year old child is not in their official count of confirmed cases.

Earlier the CDC released their count which is 62 as of 5 pm Beijing time - which is 12 hours ago EST.

http://www.chinacdc.cn/zxdt/201304/t20130415_79926.htm

Laidback Al · Apr 15, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Information Containment Problem for China

If the child is a ?carrier? and doesn?t develop symptoms it would mean that the virus has been circulating in the neighborhood for quite a while, perhaps much longer then when China made the first announcements of human cases on March 31.

Also, if the boy doesn't become sick, it would support the claim that mild and asymptomatic cases can and are occurring.

However, it is probably too late for China to say that the lab results on the young boy are incorrect.
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Giuseppe · Apr 16, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

In the past some scattered reports about H5N1 positive samples in asymptomatic patients appeared into media stream.

The presence of RNA fragments detected by PCR does not correlate with infection, when virus particles replicate and are shed even in droplets with respiration.

It is quiet possible that this child has entered in contact with environmental contamination since the presence of poultry to sell but the 'infectious dose' has been not reached or the virus has not found a viable host (ie different cell receptor distribution).

If the virus had not replicated, no infection and no transmission (and Abs production not initiated...)

gsgs · Apr 16, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

...and they succeeded to find that tiny amount of non-replicating
H7N9 viruses inside the huge body of the boy4 ?

while they failed to find H7N9 in the environment which would be contaminated by that theory

Pathfinder · Apr 16, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Translation Google

The incidence of children infected with H7N9 is not easy

United Daily News ╱ reporter Shi Jing - Ru / immediate reports]
2013.04.16 03:09 am

"Children infected with the H7N9 virus did not develop the disease, much like the SARS coronavirus." Li-Min Huang said the H7N9 virus transmission to children, there may be only mild symptoms or not develop the disease, the National Taiwan University Hospital, director of infection in children.

Ih-Jen Su, Director of the National Institutes of Health, Infectious Diseases and Vaccine Institute, said adults due to good immunity, virus attack tend to have a strong fever and other immune responses; child completely immune immature, before less symptoms emerging viruses such as SARS coronavirus .

[2013/04/16 the United News】

http://udn.com/NEWS/BREAKINGNEWS/BREAKINGNEWS1/7833120.shtml

Pathfinder · Apr 16, 2013

Re: China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Translation Google

The boy stained H7N9 in Beijing but asymptomatic, experts say to be isolated anti-virus mutation

Post reporter Yu Li Yan 2013-04-16 07:24

Father of the confirmed cases of trafficking poultry population active screening monitoring Beijing's first case of human infection with the H7N9 avian influenza, the H7N9 avian influenza virus nucleic acid found a 4-year-old bamboo surname boys.

Beijing Municipal Health Bureau received a the Beijing CDC report, on the evening of March 14 in Beijing's first case of human infection with the H7N9 avian influenza confirmed cases father trafficking poultry population active screening monitoring, the boy found a 4-year-old bamboo surname The H7N9 avian influenza virus nucleic acid positive.

The boy is currently no clinical symptoms. Clinical expert in Beijing, according to its clinical manifestations, epidemiological investigation and laboratory test results, the overall judgment of the boy man infected with the H7N9 avian flu virus carriers.

In this regard, the molecular microbiologist, Zhao Guoping, the Chinese Academy of Sciences, said yesterday, this deserves attention in the research. He pointed out that, after Shanghai, H7N9 virus infection in children showed symptoms are very light, but also take the initiative by the local CDC screening found.

"Discovered the first case of girls, together with the Beijing cases symptoms less severe phenomenon, similar to the case of H7N9 and SARS, infectivity and virulence children are relatively weak." Academician Zhao Guoping said that the SARS virus on children's infectious does not seem to lower virulence, specific performance is the incidence of children in rare cases, even if the disease, severe hardly.

However, Academician Zhao Guoping said, we need to let the data speak. Tamiflu H7N9 is very effective for SARS is no effect. Therefore, the need for more in-depth research in order to make a scientific judgment of the mechanism; This is the significance of the research work carried out in the new hair burst prevention and control of infectious diseases and the treatment process. Speculated that some rules from existing cases, based on previous studies and experience; from experience and speculated in real regularity mechanism, or by subsequent scientific research reveals.

Academician Zhao Guoping told reporters in early 2004, the infection in the second wave of SARS Community 4 conclusive evidence of more than 160 close contacts of the patients investigation found that the one with the second patient in the same floor of the same hotel work waiter asymptomatic carriers of the virus. By the time of the formation of antibodies judgment, ruled out the possibility of human-to-human transmission, determine the basic breeding of civet cats infected with floors.

Academician Zhao Guoping At present, we have no evidence that H7N9 human-to-human transmission, but can not guarantee that the virus does not occur further variation;, tested positive for the H7N9 avian influenza virus nucleic acid, but no cases of clinical symptoms, medical isolated for observation or necessary.

He also said that, for ordinary citizens cope with the H7N9 avian influenza virus, the first is not to blind panic, to maintain a healthy lifestyle and state of mind. Also, pay attention to avoid close contact with live poultry class to buy poultry food processing, timely wash your hands after handling heating cooked food. Of course, the most realistic, in the event of a flu-like fever symptoms seek immediate medical attention, so as not to miss the best treatment period.

http://www.dfdaily.com/html/21/2013/4/16/979393.shtml

China - Child, 4, 2nd H7N9 case in Beijing confirmed - asymptomatic

Diane Morin

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