Re: H7N9 bird flu and travel during the Chinese New Year
Translation Google
Expert: During the Spring Festival is not an outbreak of H7N9
January 28, 2014 07:28:49 Source: Beijing News
Yesterday, the National Health and Family Planning Commission meeting of people infected with H7N9 avian influenza interview meeting, the CDC, the National Influenza Center experts said, because there is no evidence of large-scale spread of H7N9 between man and man, does not predict the Spring Festival mobility causing the outbreak.
According to Xinhua News Agency statistics, January 1 to 26, the country has confirmed cases of human infection with H7N9 avian influenza 96 cases, three provinces of Zhejiang, Guangdong and Shanghai confirmed 83 cases, 20 deaths, including Zhejiang death in 12 cases, 4 deaths in Guangdong, Shanghai 4 deaths, including a medical staff.
Experts believe that the higher H7N9 fatality rate, and the current number is close to the onset of the peak levels of last year.
Cases have been close to the peak levels of last year
Yesterday, the State Planning Commission, David held on H7N9 avian influenza group interview. Chinese Feng Zijian, deputy director of the CDC, said although a lot of the upcoming Spring Festival will cause movement of persons, but does not increase the probability of infection of H7N9.
Shu Yuelong, director of the National Influenza Center also believes that, because there is no evidence of large-scale spread of H7N9 will be between people, that this virus does not have the biological basis of interpersonal widespread. Meanwhile, there is no variation in the virus itself, as long as the prevention and control measures in place, the risk will be lower and lower. "There are sporadic cases will now see the situation will continue, but in the entire large outbreaks during the Spring Festival, the situation will not happen quickly spread."
He said that at present the number of sporadic cases of H7N9 have been close to last year's peak levels. He believes that people all over the fowl of exposure measures, efforts to control the spread of the virus, the scope of the epidemic will determine the future direction.
Feng Zijian said, H7N9 is relatively high in the East China region, the presence of the virus spread between levels and consumption of poultry, poultry certain relationship, in addition, after the H5N1 avian influenza virus has a high incidence in winter and spring characteristics, H7N9 seems there are some seasonal touch.
He suggested that people try to avoid contact with live poultry, it is recommended to purchase, consume chicken, chilled, replace the live bird markets. Live poultry slaughter process, if unavoidable, wash your hands as soon as possible after exposure may also reduce the chances of infection. Older people with low immunity, with particular attention.
Mortality or below the H5N1 virus
According to Chinese Feng Zijian, deputy director of the CDC introduced since January 1, 2014, the country reported cases of human infection with H7N9 avian influenza 96 cases and 19 deaths. If you start to last year, the country has reported 240 cases, more than 60 cases of death.
"Fatality rate is relatively high." Said Feng Zijian. The number of cases and deaths in the current figures, H7N9 case fatality rate of 20% -30%.
According to Shu Yuelong introduced, this figure is lower than the H5N1 fatality rate, which reached 60%. He said that from the perspective of the characteristics of several viruses, H1N1 viruses belonging to interpersonal communication, and H3N2 is similar. This will cause a lot of people infected with the virus, but the mortality rate is very low.
But Feng Zijian pointed out that this is not a strict 20% -30% mortality scientific sense. First, there are still patients continued treatment; Also, the patient is currently found mainly severe, and some patients the presence of light, they may not visit, or visit the doctor did not suspect, disease picture is not known. "We see the molecules, but there is no accurate information on the denominator."
■ response
The CDC
"Doctors infection H7N9" only confirmed one case
Recently, the network continued rumors that there are doctors in different parts of the virus H7N9 infection and died. Yesterday, Feng Zijian clear response, "Dr. infection around the H7N9" is not true, the current emergency department Shanghai confirmed only one case of H7N9 infection surgeon.
However, the path of infection and cause of death for doctors in Shanghai, said Feng Zijian is still under investigation. He said that did not find its onset before contact with H7N9 patients, also found no direct contact with live birds and so on. However, because this doctor had died when diagnosed only by family, colleagues asked, still need further investigation.
■ Focus
1
What is a limited non-sustained person to person?
Experts said the man found only a few cases of human transmission, not sustained transmission
National Planning Commission, the day before the release of Wei 2014 edition H7N9 treatment program that specific route of transmission of H7N9 avian influenza virus can spread through the respiratory tract or close contact with infected poultry infected secretions or excretions obtained; or through contact with virus-contaminated environments to propagate people; do not rule out limited non-sustained person to person.
H7N9 spread of only 0.09 basis the number of
Chinese Feng Zijian, deputy director of the CDC, said, "limited human to human transmission" is a relatively continuous and effective person to person, the occasional occurrence of secondary cases, the vast majority of patients occurs only two generations, three generations occur rarely or almost never more patient. And sustained human to human to human transmission is effectively the same meaning, that there is more on behalf of patients, such as three generations of four generations, resulting in multiple cases of infection in a community. It more professional point of Medicine will be limited measure, called a continuing basis the number of indicators spread. When active person to person, the foundation will spread more than a few, that is, a patient as a source of infection, can infect an average of more than 1 person. The index is less than 1, it will not continue to spread.
Feng Zijian said, according to the H7N9 research, epidemiological investigation, mathematical model count is the number of basis spread was 0.09. At present, very few cases of H7N9 found in the second generation, and only a few cases, no one is three generations.
"There is no need to over-interpret secondary cases."
Shu Yuelong, director of the National Influenza Center said there was no need to read too much into secondary cases. Currently, patients in close contact with a chicken infected with H7N9 virus or contaminated environment, is a generation of cases; close contact with a patient, a second-generation cases. But from the perspective of Virology, there is no difference.
2
What is the difficulty to deal with H7N9?
Experts say the virus prevalence among asymptomatic poultry, harder than H5N1 prevention
Shu Yuelong said, and compared with H5N1, H7N9 is more likely to infect humans, highly pathogenic, but it is popular among poultry are asymptomatic, do not see any symptoms, it is relatively harder to guard against H5N1.
Hospitals generally weak ability to detect H7N9
People's Hospital, director of respiratory medicine accounted for a high that birds appear healthy but for people with a highly pathogenic virus, this is a big challenge. Only patients with very early symptoms of fever, clinicians make the diagnosis very difficult.
He said the doctor for questioning to strengthen epidemiological history, such as live bird markets have not been to, the availability of live poultry trade, with or without contact with live poultry populations transactions, ask the doctor to improve awareness. In addition, enhancements to the screening and identification of clinical symptoms, thus strengthening the joint between medical institutions and the prevention and control of disease control agency, timely submission of samples to the CDC. Previously, the disease is often severe pneumonia talent submission for mild colds less censorship.
For H7N9, medical institutions generally weak detection capabilities.
Because it requires a very high condition, such as to have a molecular biology laboratory, have the appropriate level of protection to handle specimens. Also detects, to avoid contamination, the instrument is also more expensive and can not be clinically charges. Therefore, free testing is difficult. These issues need further discussion.
Doctors said it is difficult to achieve 100% detection rate
Ditan Hospital, director of infectious disease treatment center Li Xingwang said, according to 2013, 2014, treatment programs, medical institutions qualified to be detected, there are no conditions to stay specimens. Like Tamiflu and other antiviral drugs effective against the virus, but the premise is the sooner the better. For flu-like symptoms, especially fever, cough and other lower respiratory tract symptoms, even though tested negative, also advocated giving antiviral therapy. However, each patient to achieve 100% detection rate, difficult. Even if detected, there are a variety of reasons could cause results to be negative.
Why no history of exposure to infected poultry?
Resulting in the death of an individual patient can not determine whether contact with live poultry
Feng Zijian introduction, 70% of patients had a history of exposure found in poultry. Most cases are not family autotrophic contact with infected birds, but to the town, the town's bazaars contacting live poultry. For each case found in the CDC, have made serious epidemiological investigations, but there is a problem that I am asking the patient survey is the most reliable.
Feng Zijian said, but some patients when the diagnosis has been in critical condition, the individual who has died can not investigate himself, and therefore can only investigate relatives and colleagues. But difficult for outsiders to fully restore all of the patient's own life experiences. Thus, 30% of patients did not find the presence of live poultry contact history, exposure history, this is a very important reason. In addition, some patients live birds I can not recall memories of history. This is the common scenario epidemiological investigation.
4
H7N9 vaccine developed any progress?
Not yet developed, pre-clinical studies have been completed some companies
Shu Yuelong said that in vaccine research and development in this area, some companies have completed preclinical studies, to be carried out to apply to declare. Vaccine development is very important, in order to develop a vaccine to respond to crises that may arise. Our current H7N9 virus is not very understanding, such a vaccine may produce side effects such experiments should be carried out strictly.
Shu Yuelong said the problem of resistance against the virus, the current monitoring point of view, H7N9 Tamiflu and other antiviral drugs also are sensitive. Encourage doctors to reduce mortality and timely use of antiviral drugs. For flu-like illness, especially high-risk groups, the elderly, pregnant women, there are flu-like symptoms have anti-viral therapy.
As to whether the use of antiviral drugs can lead to drug-resistant viral longevity issues, Shu Yuelong said, you do not have anti-viral treatment, as the global epidemic of the virus, the virus also appear resistant.
5
Whether the H7N9 virus mutation?
Experts say the virus mutation was not found no difference with last virus
Shu Yuelong said, according to the epidemic analysis, the basic conclusion is that the current pandemic virus and April of last year is the same, that there was no public health significance of variation, no significant difference. From the perspective of viral sequence analysis, we did not change the risk assessment, appeal, spread of power, such as drug-resistant viruses have not found changes. Prevention and control program in accordance with the new version, stressed the importance of virus monitoring, the purpose is to monitor changes in the virus, timely monitoring of how it will change in the end, highly concerned about the possibility of variation in trends and, if the first time be able to see, is our greatest success.
Shu Yuelong said relatively H5N1, H7N9 more susceptible to a number of people. In accordance with existing knowledge, can not make accurate predictions about the trend of variation of a virus, only closely monitored.
6
Prevention and control programs in place to adjust the new version?
Areas close contact management, information reporting to adjust
Feng Zijian said, the new treatment programs, prevention programs have been revised, did not make a big adjustment. Prevention and control program adjustments where there are few, some measures were emphasized, such as close contacts management, information reporting, the timely provision of strains, such as viral sequences submitted.
Feng Zijian said some places for H7N9 prevention and control has taken various measures. We also evaluate the effectiveness of different control measures. Like other departments such as the Department of Agriculture, is also actively studying longer-term, more fundamental measures.
Feng Zijian said, we have already put forward proposals to change consumption patterns, try not to make a habit of live poultry consumption, purchasing chicken, chilled and so on. In addition, poultry farming model, but also upgrading.
■ news
AQSIQ
Temperature over 38 ℃ and contacts are required sampling and testing of poultry recommended to postpone travel
Yesterday, this AQSIQ issued an urgent notice requiring the port inspection and quarantine people infected with H7N9 should bird flu prevention and control, temperature over 38 ℃, and a history of close contact with poultry within seven days and must be sampled pathogen detection to prevent cross-border spread of the epidemic.
AQSIQ emphasized that discovered or reported fever, cough, difficulty breathing and other flu-like symptoms exit personnel, timely epidemiological investigation and medical investigation. Focus on strengthening the monitoring of outgoing personnel, particularly personnel from the H7N9 cases occurred exit area.
Among them, the temperature over 38 ℃, and seven days a history of close contact with poultry, must be sampled pathogen detection, it is recommended to postpone their travel, transfer the designated hospital for treatment. Refusing to postpone the trip, may be required to give reasons in writing, inform the precautions required to wear N95 masks provide and to inform transport operators to take protective measures.
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