China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

it is believed that the virus can not be transmitted person to person

This is very bad public health communication and can lead to injury and death.

It has to be assumed at ALL H5N1 clades can be transmitted between humans.

People need to exercise infectious disease precautions.

FAO - How to Protect Yourself - Poultry, Hunters, Birds - pdf

http://www.fao.org/docs/eims/upload//207623/FAO_HPAI_messages.pdf

 

[alert]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Hat-tip Monotreme. I hope this isn't a reference to H275Y, or some other mutation that would give the virus Tamiflu resistance.

http://www.881903.com/Page/ZH-TW/newsdetail.aspx?ItemId=467345

Shenzhen man died of bird flu virus, experts say the normal gene 01.01.2012 23:12 01.01.2012 23:12

Shenzhen confirmed a human infection of highly pathogenic H5N1 avian flu, Shenzhen Center for Disease Control issued a press release said the evening, and our experts found that the CHP gene mutation in the virus, it is believed that the virus can not be transmitted person to person, the public need not panic.

Center also allege that the man infected with the virus highly pathogenic humans, and similar virus found in birds, resistant to some drugs, it is estimated the incident transmitted to humans by birds.

Experts say the bird flu virus to humans is generally not easy, because the different human and animal cells, and the virus mutates is normal, as long as the person to person not yet reached the point where people do not need to worry too much.

 

[Giuseppe]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

For this issue, readers may read the Journal of General Virology (http://jgv.sgmjournals.org/content/91/4/949.short ) about naturally occurred H5N1 neuraminidase inhibitors resistance among viral isolates in Laos.

Excerpt:

Prior to 2008, all H5N1 isolates in Lao PDR were from clade 2.3.4; however, clade 2.3.2 was introduced in September 2008. Of greatest concern was the circulation of three isolates that showed reduced sensitivity to the neuraminidase (NA) inhibitor oseltamivir in an enzyme inhibition assay, each with different NA mutations – V116A, I222L and K150N, and a previously unreported S246N mutation. In addition, six isolates had an S31N mutation in the M2 protein, which conferred resistance to amantadine not previously reported in clade 2.3.4 viruses.

Such viruses could be resistant to the antiviral drug oseltamivir or have a diminished susceptibility to zanamivir and peramivir in addition to the old adamantanes compounds (S31N aa substitution in the M2 protein) (IOH).

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Hat-tip Monotreme. I hope this isn't a reference to H275Y, or some other mutation that would give the virus Tamiflu resistance.

http://www.881903.com/Page/ZH-TW/newsdetail.aspx?ItemId=467345

Shenzhen man died of bird flu virus, experts say the normal gene 01.01.2012 23:12 01.01.2012 23:12

Shenzhen confirmed a human infection of highly pathogenic H5N1 avian flu, Shenzhen Center for Disease Control issued a press release said the evening, and our experts found that the CHP gene mutation in the virus, it is believed that the virus can not be transmitted person to person, the public need not panic.

Center also allege that the man infected with the virus highly pathogenic humans, and similar virus found in birds, resistant to some drugs, it is estimated the incident transmitted to humans by birds.

Experts say the bird flu virus to humans is generally not easy, because the different human and animal cells, and the virus mutates is normal, as long as the person to person not yet reached the point where people do not need to worry too much.

There are many media quoting the Shenzhen CDC press release and each version is a bit different.

However, there is nothing about this event on their government site. Unless I am missing something...??

http://www.szcdc.net/bornwcms/Html/szcdc/index.html

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Mike Coston has this link for the Guangdong Department of Health:

http://www.gdwst.gov.cn/

 

[Giuseppe]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Concerning the possible altered affinity of the surface glycoprotein hemagglutinin for upper respiratory tract in humans of H5N1 (switch from alpha2,3-linked sialic acids (bird like virus affinity) to alpha2,6-linked sialic acids (human like virus affinity), see in the same paper:

Adaptation of H5N1 avian influenza viruses in humans
likely requires a switch in receptor-binding specificity of
the viral HA glycoprotein from avian a2,3-linked sialic
acids to human a2,6-linked sialic acids, but the mutations
(or their combination) in the H5N1 HA glycoprotein
causing this change are unknown. We did not observe a
preference for SAa2,6Gal with 189R; however, an arginine
at position 189 is reported to influence adaptation of avian
H5N1 influenza viruses to human receptors when Q222L
and G224S HA substitutions occur (Q226L and G228S, H3
numbering) (Stevens et al., 2008). The loss of glycosylation
at position 154, which is near the RBD and more common
in isolates from clade 2.2, is reported to increase the affinity
of H5 viruses for a2,6 residues (Stevens et al., 2008). In the
Lao H5N1 isolate A/chicken/Laos/17/08, the loss of
glycosylation at position 154 reduced the receptor affinity
for SAa2,3Gal and there was no switch to SAa2,6Gal. The
additional HA mutation H179R may cause the reduced
affinity for SAa2,3Gal. The H179 residue is conserved
among influenza viruses and interacts with sialic acid
residues and stabilizes the receptor-binding pocket (Iwata
et al., 2008). The effect of the 179R mutation on affinity
and specificity requires further investigation. Most importantly,
we did not observe a switch to a2,6 linkages in
individual HA mutations. Although previous studies have
utilized this assay to characterize receptor binding
(Auewarakul et al., 2007; Yamada et al., 2006), it utilizes
only two glycans. Due to the multiple interactions of the
HA molecules on the virus particle, a glycan array is
necessary to further characterize receptor specificity and
affinity and may give alternative binding patterns.

Also in:

Emergence of H5N1 avian influenza viruses with reduced sensitivity to neuraminidase inhibitors and novel reassortants in Lao People's Democratic Republic

David A. Boltz, Bounlom Douangngeun, Phouvong Phommachanh, Settha Sinthasak, Ricarda Mondry, Caroline Obert, Patrick Seiler, Rachael Keating, Yasuo Suzuki, Hiroaki Hiramatsu, Elena A. Govorkova and Robert G. Webster

Journal of General Virology, http://jgv.sgmjournals.org/content/91/4/949.short

(IOH)

-
-----

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

深圳市宝安区, 感染高致病性禽流感, 防病知识链接 (Highly Pathogenic Avian Influenza Prevention Information)

http://www.flutrackers.com/forum/showthread.php?p=434204#post434204

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Universal Declaration of Human Rights:

Article 3.

Everyone has the right to life, liberty and security of person.


Security of person includes threats to our health.

We are entitled to know about public health threats.

The World is Watching.

 

[alert]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Hat-tip Hellbindi.

http://www.scmp.com/portal/site/SCM...360a0a0aRCRD&vgnextfmt=teaser&ss=China&s=News

Guangdong official back-pedals on bird-flu death
Stephen Chen and Joyce Ng
Jan 02, 2012

Guangdong authorities said yesterday they were unsure whether the death of a bird flu victim in Shenzhen was related to migratory birds, changing their tone a day after they described a wetland park visited by the victim as "highly suspicious".

Media reports last night, meanwhile, said the Shenzhen Centre for Disease Control and Prevention had found genetic mutations in the virus that infected the victim. But the mutated virus was not transmissible between humans. Hong Kong's government information service could not confirm the reports.

He Jianfeng , from the Centre for Disease Control and Prevention in Guangdong, told Xinhua he was not yet able to determine how the 39-year-old bus driver, only identified as Chen, contracted the H5N1 bird flu virus, although Chen went for regular morning jogs at the wetland park, Waterlands Resort.

"There are two channels for humans to be infected with bird flu: through poultry and migratory birds. At the moment there is no solid evidence to prove Chen had contact with poultry or birds," He said.

more at above link...

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

"There are two channels for humans to be infected with bird flu: through poultry and migratory birds. At the moment there is no solid evidence to prove Chen had contact with poultry or birds," He said.

There are more than 2 channels.

Possible human to human transmission should also be considered.

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Also, everyone, please post links back to original sources and please post only the newest data contained in an article. Many repeat, over and over, the same background facts that we have already established on this thread.

Thanks!

 

[tetano]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Virus leading to bird flu death identified

Health authorities in south Guangdong province have identified the type of the virus that led to the death of a bus driver, but the cause of the bird flu remains unclear, a local disease control center confirmed Monday.

The receptor of the virus, a highly pathogenic H5N1, is poultry, according to a statement released by the Shenzhen Disease Control Center.

Though it is highly pathogenic to human beings, the virus can not spread among people, the center said in the statement, adding that there is no need for Shenzhen citizens to panic.

Genetic analysis also indicated that the virus was spread directly from poultry to human, according to the statement.

A 39-year-old man surnamed Chen in Bao'an district of Shenzhen was hospitalized for fever on Dec. 21 and tested positive for the H5N1 avian influenza virus. Chen died of multiple organ failure Saturday afternoon.

Health authorities are trying to figure out where Chen acquired the virus.

The Guangdong Department of Agriculture announced Saturday that no epidemic of bird flu among poultry had been reported in the province.

http://en.ce.cn/National/Local/201201/02/t20120102_22969917.shtml

 

[Vibrant62]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

If the more obvious 'sources' of infection are indeterminate or appear unlikely, they should look to the less obvious e.g. pigs, cats. H5N1 infections in both of these (and other animals) have been detected before in Indonesia and Egypt, and either of these could be a transmission vector if infections are occuring in these potential host populations.

 

[Shiloh]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Source: http://rthk.hk/rthk/news/englishnews/20120102/news_20120102_56_808951.htm

Bird flu similar to strain found in HK

02-01-2012
The Centre for Health Protection has said that the strain of bird flu virus which led to the death of a man in Shenzhen at the weekend was very similar to that recently found in wild birds in Hong Kong.

Genetic analysis also found that the virus can be treated by amantadine, a common antiviral drug.

The man, a 39-year-old bus driver, who lived in Shenzhen, died from multi-organ failure on Saturday, a week after being admitted to hospital with a fever brought on by the virus. Meanwhile, the Shenzhen Centre for Disease Prevention and Control stressed that the virus could not be transmitted between humans, and urged people not to panic.

"The virus found in the patient was 90 percent similar to H5N1 viruses previously isolated in ducks in China, which suggested that the man was very likely to have been infected through direct contact with a bird," the centre said in a statement.

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

On December 30 people in Shenzhen with respiratory disease were advised by an expert to wear masks when outside due to air pollution.

machine translation -

Respiratory patients to wear masks out
At 05:23 on December 30, 2011 Source: Shenzhen Economic Daily Author: Zhang Yan

[Shenzhen Economic Daily News] (Reporter correspondent Linshao Xia Zhang Yan) yesterday, City People's Hospital Director of Respiratory Medicine, Fu Ying-yun said, would have been easier in winter dry climate caused by the high incidence of respiratory diseases, with days of the haze, it will lead to asthma, chronic recurrence in patients with obstructive pneumonia, these patients should avoid outdoor activities, such as wearing face masks out.

FU Ying-yun told reporters, because the haze just started two days, breathing no significant increase in medical outpatients. "But if this weather continues, the number of patients would be expected to surge in coming days."

Experts say the real component of haze over the city's numerous long-term suspension of black carbon, dust and other particles. Because of the recent weather conditions are not conducive to the city spread of pollutants, thus resulting in a haze appears. Small dust particles can not be the same as being blocked nose, will be the direct inhalation of respiratory tract and lungs. Particles larger than 5 microns can cause rhinitis, pharyngitis, bronchitis, asthma, less than half of 0.1 micron particles will be deposited in the lungs, damage cells in the lungs, causing pulmonary sclerosis.

Fu Ying-yun said, into the autumn and winter, outpatient asthma, COPD patients significantly increased their usual symptoms are cough, sputum and shortness of breath and so on. Polluted air in the fall and winter season, the tiny particles can cause respiratory infections, is the main reason for these patients relapse.

Experts remind that the haze occurs, the elderly, children and people with respiratory disease should avoid outdoor activities. Otherwise, the more movement of particles inhaled more toxic. If you go out, it is best to wear masks, avoid direct contact with dirty air

Zhttp://news.hexun.com/2011-12-30/136818827.html

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

hat tip Michael Coston -

Bolding and color mine (s.)

MONDAY, JANUARY 02, 2012

China Seeks To Reassure On Bird Flu






Guilty as charged? Photo Credit – FAO



# 6047



The news wires this morning are filled with reports on the investigation into the death of a Shenzhen bus driver late last week from the H5N1 virus (see Shenzhen Bird Flu Suspect Dies).



The substance of most of these reports appear to be based on the details released in a Xinhua News Service report overnight.
Xinhua is the official news service (some would say press agency) of the Chinese government.


The gist of the report (linked below) is that health officials have reportedly identified the H5N1 strain, and have determined through genetic analysis that while pathogenic in humans, it is `not transmissible’.



First the Xinhua report (emphasis mine), then I’ll return with a little more.



Authorities identify virus leading to Guangdong bird flu death
Source: Xinhua | 2012-1-2 HEALTH authorities in south Guangdong province have identified the type of the virus that led to the death of a bus driver, but the cause of the bird flu remains unclear, a local disease control center confirmed today.

The receptor of the virus, a highly pathogenic H5N1, is poultry, according to a statement released by the Shenzhen Disease Control Center.

Though it is highly pathogenic to human beings, the virus can not spread among people, the center said in the statement, adding that there is no need for Shenzhen citizens to panic.

Genetic analysis also indicated that the virus was spread directly from poultry to human, according to the statement.

A 39-year-old man surnamed Chen in Bao'an district of Shenzhen was hospitalized for fever on December. 21 and tested positive for the H5N1 avian influenza virus. Chen died of multiple organ failure Saturday afternoon.

Health authorities are trying to figure out where Chen acquired the virus.

The Guangdong Department of Agriculture announced Saturday that no epidemic of bird flu among poultry had been reported in the province.


This reassuring missive – complete with the standard admonishment `not to panic’ – is unfortunately both contradictory, and lacking in detail.



We are told in two places that the route of infection is unclear, and in another that genetic analysis shows it was from direct contact with infected poultry.



But at the same time we are assured by the Agriculture Department that no outbreaks of H5N1 have been reported in poultry anywhere in the Province.


The `receptor’ of the virus – by that I assume they mean the RBD (Receptor Binding Domain) – is stated as being `poultry’.



I’m assuming they mean avian in nature (an affinity for alpha 2,3 receptor cells).


A virus’s ability to bind to specific cells is controlled by its RBD or Receptor Binding Domain; an area of its genetic code that allows it to attach to, and infect, specific types of host cells.





(A Very Simplified Illustration of RBDs)

Like a key into a padlock, the RBD must `fit’ in order to open the cell to infection.



Humans, unlike birds, have mostly alpha 2,6 receptor cells in their upper respiratory tract, making it difficult for avian viruses to attach. Humans do have some a2,3 receptor cells deep in the lungs and in their gastrointestinal tract.



The declaration that the `virus can not spread among people’ would therefore seem a bit strong, as we’ve seen limited transmission of avian-adapted viruses among humans in the past.



That this virus is not yet well adapted to human physiology - and therefore unlikely to be spread from one human to another - is probably a more reasonable assessment.



The lack of additional cases thus far in the province is obviously a good sign, and if that trend continues, would lend credence to the government’s claim that this is not an easily transmissible strain.



But a lack of scientific detail - along with an overly reassuring tone and China’s chequered history on the reporting of previous disease outbreaks - makes it difficult to come away from this report completely assuaged.

Posted by Michael Coston at 8:34 AM

 

[sharon sanders]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

Genetic analysis also found that the virus can be treated by amantadine, a common antiviral drug.

I hope this is not a media manipulation and is, indeed, true as stated. I believe the responsiveness of other H5N1 strains that have infected humans in Egypt and Indonesia is unclear.

 

[Giuseppe]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

I hope this is not a media manipulation and is, indeed, true as stated. I believe the responsiveness of other H5N1 strains that have infected humans in Egypt and Indonesia is unclear.

As I pointed out in the posts http://www.flutrackers.com/forum/showpost.php?p=434400&postcount=63 and http://www.flutrackers.com/forum/showpost.php?p=434403&postcount=66

sometimes H5N1 detected in southern Asian regions carry an aminoacid substitution in the M gene segment (M2, S31N) that makes the virus resistant to the old antiviral drugs amantadine/rimantadine (see also: http://jid.oxfordjournals.org/content/193/12/1626.full.pdf+html )

The frequency of these detection varies according the time and place and the clade the virus belongs.

As these drugs are widely considered to be not an option for the treatment of sesonal (H3) and the former pandemic A(H1N1)pdm09 viruses (both possess the M2 mutation), it is also true for the A(H5N1).

Much more important is to know whether the virus is susceptible to NAI drugs (oseltamivir, zanamivir, peramivir, laninamivir) or has a decreased sensitivity due to multiple mutations in the surface protein neuraminidase.

(IOH)

 

[Vibrant62]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

According to this report, that question is still under investigation

Shenzhen Center for Disease Control said the bird flu is not transmitted person to person without panic

Posted on January 1st, 2012
http://www.3abc.net/?p=28506

Exerpt (machine translation)
Shenzhen CDC experts also resistant to the virus were analyzed, the results show that virus is adamantane class of drugs are more sensitive (including rimantadine, amantadine song, King Kong bromide, the United States King Kong, etc.), but resistance to Tamiflu, the role of drugs still under study.

 

[Giuseppe]

Re: China - Human case of H5N1 Dies in Shenzhen, Guangdong province (December 30 2011)

According to this report, that question is still under investigation

Shenzhen Center for Disease Control said the bird flu is not transmitted person to person without panic

Posted on January 1st, 2012
http://www.3abc.net/?p=28506

Exerpt (machine translation)
Shenzhen CDC experts also resistant to the virus were analyzed, the results show that virus is adamantane class of drugs are more sensitive (including rimantadine, amantadine song, King Kong bromide, the United States King Kong, etc.), but resistance to Tamiflu, the role of drugs still under study.

Anyway, since influenza A viruses tend to become rapidly resistant to amantadine even during treatment of an individual case, a monoterapy is not a good choice I suspect. Because of this limitation, amantadine should be seen as second-line drug or part of a combined therapy with other drugs such as oseltamivir, zanamivir, peramivir or ribavirin. (IOH)