Re: H7N9 discussion thread: recent increase in cases, January 24, 2014+
Re: H7N9 discussion thread: recent increase in cases, January 24, 2014+
Deleted original post - found article referred to. I have patched in the whole thing as there is some important data in here. The 11% was the lower level of mortality in Guangzhou region, and it also talks about mild cases found through screening/contact tracing. Could we usefully reverse extrapolate this data to the wider China region?
Zhong Nanshan: H7N9 bird flu need to guard against "limited human to human transmission"
At 09:31 on January 24 2014 Source: Dayang - Guangzhou Daily
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Limited cases of human to human transmission is the occasional occurrence of relatives
Zhong Nanshan also said two possibilities of interpersonal communication does not appear
2014 New Year's Day has been less than in January, H7N9 human infection in Guangdong new bird flu cases, 20 cases, 3 deaths occurred. Yesterday, the provincial people infected with H7N9 bird flu prevention and control team leader academician Zhong Nanshan, director of the provincial CDC Zhang Yonghui, chief expert of the provincial disease control and prevention and control of infectious diseases Jianfeng, director, Institute in Guangzhou call interview. They say, H7N9 controllable and curable in Guangdong can prevent, on the "person to person" issue, Zhong Nanshan said, according to the Guangdong cases, the virus strains showed genetic variation, group two cases of the phenomenon does not exist, and therefore does not appear human to human transmission, but be wary of limited human to human transmission.
Talk therapy: 7 to 10 days longer treatment stopped
The presence of the virus in critically ill patient than the general guidelines when it comes time to be long, the longest presence of the virus 30 days.
"We treated the four cases of severe patients, one patient died, and the rest are currently (condition) stable, one case has been extubated," Zhong Nanshan estimated that two cases are expected to discharge before the Spring Festival.
The sooner the better with the effects of Tamiflu
Admitted from the current clinical situation, Zhong Nanshan that treatment is still the right direction is to early intervention neuraminidase inhibitors, "such as Tamiflu use sooner the better, to develop into the more severe the less" . He suggested that, regardless of the city or the countryside, once the live bird markets or been associated with chickens, flu-like symptoms, medication right away, except for the more expensive drug with no apparent side effects, the treatment effect is very clear, positive obvious effect.
Longer on medication, medication should be extended Zhong Nanshan pointed out, do not be like the past seven to 10 days on the disabled.
Because not only discovered the extent of critically ill patients have a great relationship with the viral load, the higher the viral copy number, the heavier the disease; and an important new finding is that the presence of the virus in critically ill patient than the general guidelines when it comes to the time of longer, the presence of the virus up to 30 days.
Drug peramivir treatment effect is not obvious
In addition to Duffy, the other a new drug peramivir effects are much outside attention. In this regard, Zhong Nanshan said that at present the drug has only been used in two critically ill patients, but did not see a significant effect, which may be related to disease progression in patients with fast, simple anti-virus does not work, oseltamivir , Zhalamiwei same everywhere. "Prepare to develop programs with the relevant departments, but how accurate comparison of other issues yet to answer," Zhong Nanshan considers it necessary to continue to observe from an academic perspective.
In addition, he reminded, H7N9 critically ill patients need to have the strength of the general hospital for emergency treatment, because more involved in multi-organ failure, such as heart, lung, liver, kidney and other organ systems circulation, even the blood system, and some also require comprehensive rescue with plasmapheresis to cross the border.
Tan epidemic: Guangdong H7N9 infection mortality by 11%
26 cases of close contacts of cases in 1076 in Guangdong, all their medical observation, now 780 people have been lifted medical isolation, more than 200 people are still observed, has not found someone occasion infection.
Jianfeng reminder, ended Jan. 22, 26 cases were reported in Guangdong,
mild cases of five cases (discovered by the province's influenza surveillance system active monitoring),
seven patients were cured, and death for the three cases, the overall mortality was 11% lower than the national (country overall mortality was approximately 30% of cases). "Guangdong is still in the local sporadic cases, and each case reported to the public."
Why are there before the Spring Festival peak of the epidemic? Jianfeng explained that the bird flu virus has obvious characteristics of cold-span, Guangdong is located in subtropical regions, humid climate, suitable for the survival and reproduction of the virus; addition, around the Spring Festival live poultry market trading is more active, increasing the exposure of live poultry market opportunities.
Chicken trading at vulnerable transit
Zhong Nanshan pointed out, more and more evidence that, where there are chickens trade, transit places most prone to cross-infection.
Monitor displays information from the agricultural sector, the province of all breeding farms are not detected H7N9 avian influenza virus, Jianfeng, due to the virus originated in East China, East China and supply of poultry farms, mainly in Guangdong, "so experts speculate, virus is mainly spread and diffusion through the market route. "
Be wary of limited human to human transmission
At present four cases of H7N9 infection were reported in Guangzhou, two cases of father and daughter, has the disease, whether the person signs successor exists?
In this regard, Jianfeng response, after the onset of detailed, close contact, such as epidemiology, there is currently no evidence of human to human transmission of the existence of these two cases, there is exposure to live poultry markets, "the father of the stalls in a dish market, but children and the grandmother went to another market to buy food every day, we can not distinguish between what is human to human transmission, or the role of the market. "
"We are also very concerned about the signs of human to human transmission, but to achieve interpersonal communication, it is necessary to have a gene mutation in interpersonal communication, and second, there will be groups of cases," Zhong Nanshan said that at present none of these two possibilities to achieve, including before the emergence Doctors in Shanghai died after infection, and later found that the hospital where he was surrounded by live bird markets, drove a motorcycle to work, there is a certain history of contact with live poultry markets, and people in close contact with patients are not infected.
Zhong Nanshan reminded to be very wary of limited human to human transmission. For example, Jiangsu daughter's case, her personal care after his father got sick, was not to emphasize her daughter live poultry market, but clothes, **** urinated all her care; Guangzhou father and daughter cases also diagnosed six days after his father, daughter mild infection. Therefore, he suggested: "Patients not diagnosed before, but there is history of exposure to poultry and flu-like symptoms, were not in close contact with their families too."
"Limited human to human transmission, is the occasional, relatives, kinship which occurred a few." Jianfeng explained.
Most people infected with H7N9 is not easy
"Guangdong isolated 15 people infected with H7N9 avian influenza virus strains, the provincial disease control do sequencing, sequencing also sent to Beijing Influenza Center, are not mutation." Zhang Yonghui introduction.
Jianfeng said that epidemiological studies recognized, H7N9 is not susceptible to most people, "nearly a year, the number of cases nationwide just over 200 cases"; from virological analysis also found no public health significance of mutations, including the ability to communicate, virulence, drug resistance, there is no resistance found.
Tan Prevention: centralized slaughtering of live poultry chilled listed
It is understood that the Guangdong annual capacity of 1.1 billion poultry slaughter, meat consumption habits to use of live poultry, hence the chance of exposure in live bird markets.
Spring Festival is approaching, how do H7N9 prevention and control? Zhong Nanshan said it is still an urgent need to change eating habits, to strengthen the government's industrial upgrading of the live bird markets, standardized management. In the reported cases, more than 80% of patients had a clear history of contact with live poultry markets, and from the current monitoring perspective, focus on keeping the virus has not been found, the problem still lies in the backyard and markets do best centralized slaughter, slaughter-place, chilled market.
Be sure to wash your hands after touching buy chicken chicken
Similarly shopped in live bird markets, why some people infected with the disease, but some people right? Zhong Nanshan, explained that this is a lot of misunderstanding and questions of human existence, or not infected with the human body may also be susceptible genes, "in my opinion, is not one to be infected by the market, but we must have been to this place after advocate, Be sure to wash your hands. " He explained that in addition to hand washing, once the symptoms should seek immediate medical attention and inform if there is live bird markets exposure history.
Jianfeng said, you can buy chicken chicken, as long as the masses of the people to eat cooked cooked birds, chickens and ducks are no problem, but be sure to wash your hands immediately after contact with live birds.
Chopping raw and cooked separately recommended home
Jianfeng strongly recommend chopping separate raw and cooked at home, cut off the fresh chickens and ducks, not to chop cooked poached; cut off the meat, the best scalded with boiling water, may very well prevent transmission of the virus or infection.
In addition, experts reminded the public, but also to differentiate better between colds and coughs and flu-like symptoms, the flu in addition to colds and coughs, but also fever, body pain and other symptoms, if there would be further vigilant.
Bulletin: Shenzhen, Guangzhou, Foshan, add one case each one cases were cured
Another hearing yesterday informed the Guangdong Provincial Health and Family Planning Commission of Shenzhen 1 new confirmed cases of human infection with H7N9 avian influenza, there are two cases cured.
Patients Zhang, female, 34 years old, currently residing in Baoan, Shenzhen, January 23 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition in Shenzhen designated hospital admission. In addition, Guangzhou City on January 18 confirmed cases Panmou, Foshan City, January 10, Liu confirmed cases were cured and discharged on January 22. So far, the province's total of seven cases of human infection with H7N9 avian flu cured.
Since August 2013 the first reported case in Huizhou since, as of January 23, 2014, the province reported a total of 27 cases of patients have been cured in 7 cases, 3 deaths (residence were in Dongguan, Yangjiang, Guangzhou), there are still 17 patients admitted to hospital in point. By patient place of residence, Guangzhou four cases, 8 cases in Shenzhen, Foshan eight cases, one case of Huizhou, Dongguan three cases, Yangjiang 3 cases.
