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Is H7N9 Spreading from Human to Human in China?

Re: Is H7N9 Spreading from Human to Human in China?

In the meantime, H5N1 hits Bangladesh again xhttp://bdnews24.com/health/2013/04/07/first-bird-flu-death-in-5-years
 
Re: Is H7N9 Spreading from Human to Human in China?

Migration season is generally September to March each year on the East Asian Flyway. I imagine even in birds that dont migrate, they relocate within a region as conditions drastically change during the year.

Its not generally popular to implicate wild animals in disease spread but that doesn't change the reality that it plays a role. Avian influenzas are also devastating to many wild/endangered species.
 
Re: Is H7N9 Spreading from Human to Human in China?

so, now it's the lacking infects in healthcare workers.
All the years with H5N1 the message was: keep watching for infected
HCWs, that would ring the alarm bells
 
Re: Is H7N9 Spreading from Human to Human in China?

This report suggests the latest case in Anhui has resulted in some HCWs being placed under observation (see last sentance in bold), although I cannot determine the validity/ authority of this site as it appears to be an automatic machine translation and the ultimate source of the information is unclear, although all articles on this site relate to China. It would be useful if we can get some verification or a second report.

Anhui membership dye H7N9 patients still in the rescue any time of danger
April 7, Nanjing, Jiangsu Health Department announced March 20 female patients go to Nanjing treatment of a 35-year-old human infection with the H7N9 avian influenza by Chuzhou City, Anhui Province Mr. Han is still Zhongda Hospital of Southeast University for treatment, the condition is still very critical, life-threatening at any time.

Patients admitted to hospital, his condition is very critical condition. Zhongda Hospital treatment group established for this purpose, in the famous Chinese intensive medical experts, Critical Care Medicine Branch of the Chinese Medical Association chairman, the Zhongda Hospital Director of Critical Care Medicine, under the leadership of Professor Qiu Haibo, actively carry out treatment work early in the given invasive mechanical ventilation, the lung recruitment conventional treatment is still difficult to maintain oxygen saturation treatment group adopts the international advanced extracorporeal membrane oxygenation (referred to as ECMO, commonly known as artificial lung) respiratory alternative treatment, the patient's oxygen saturation and oxygen supply is maintained, and damage lung rest and protection at the same time, to give a positive anti-virus, phlegm, immune-enhancing, nutritional support and other organ support and maintenance treatment. go to Nanjing patients with pulmonary infection and injury is extremely serious, and septic shock and liver injury, given rehydration supplement effective circulating blood volume and use of vasoactive drugs to maintain blood pressure and tissue perfusion in patients with lung injury and improved shock and acute renal failure. taking into account the patients with severe infection has led to multiple organ damage, Zhongshan University Hospital for treatment group for the first time patients hemofiltration. course of the disease, due to the severe lung injury and combined with high cardiac output, treatment group also uses high-frequency oscillatory ventilation and prone position ventilation in the treatment, which is today's severe acute respiratory distress syndrome, the most effective means of treatment.

...

The hospital strictly take all of isolated protection and management of infection prevention and control work, 13 health care workers early contact with the patient under medical observation, abnormalities were found. [sic]

http://www.newshome.us/news-42...
 
Re: Is H7N9 Spreading from Human to Human in China?

There have been hundreds perhaps thousandths of workers and family in close contact with these cases. Were it in its most prevalent form generally capable of routine human to human infection and covered up till now the conspiracy would be vast indeed. Too vast to even worry about probably.

I was reading a story yesterday of a wife that cared for and had close contact with a sick husband for weeks with no signs of infection which I think is a rather common narrative in this.
 
Re: Is H7N9 Spreading from Human to Human in China?

Bottom line is that one can not use inductive reasoning - using questionable and incomplete data from China - to begin to say anything at all about this outbreak. Thats a waste of time.

The only interesting part of the story, from a scientific standpoint, is the sequence data.
 
Re: Is H7N9 Spreading from Human to Human in China?

Ok, let's say there are not widespread H2H mild cases that are being overlooked or that the government is not supressing information. Then, we are faced with a virus that has recently jumped to humans simultaneously (within weeks of one another) in multiple locations separated by tens or hundreds of kilometers. How likely is this scenario? How does this compare with the emergence of H5N1 in humans? If all the cases were clustered near a single avian or swine host, it would make more sense. But, how did a mammalian adapted avian virus acquire the ability to infect humans suddenly over such a wide area?

I suppose one possibility is that there have been sporadic human cases over the past year or so that went undetected or were assumed to be pH1N1, H5N1, or some other strain and were never subtyped or sequenced.

There have been hundreds perhaps thousandths of workers and family in close contact with these cases. Were it in its most prevalent form generally capable of routine human to human infection and covered up till now the conspiracy would be vast indeed. Too vast to even worry about probably.

I was reading a story yesterday of a wife that cared for and had close contact with a sick husband for weeks with no signs of infection which I think is a rather common narrative in this.
 
Re: Is H7N9 Spreading from Human to Human in China?

Apparently there are not thousands of recent, unexplained/pneumonia/ILI deaths mentioned in any newspapers.

This is about the only thing I can say with some reasonable certainty.

To what degree, or willingness, does the government of China have to cover up deaths? And if they have this willingness, at what point does this become unmanageable? Probably in the thousands?

So can we assume that H7N9 is not killing thousands of Chinese?
 
Re: Is H7N9 Spreading from Human to Human in China?

We cannot say it.

But people are moving, and moved in the recent past, so that H7N9 would be likely behind other severe or mild cases around the world, if it is readily h2h.

If the cluster of cases would have emerged in a remote Kalimantan village, then we might speculate some attempt to coverup.

It is less likely when we are talking of regions such as Shanghai or Guangdong, with hundreds of millions of inhabitants and highly connected hubs.

Really, if h2h this virus is already everywehere.
 
Re: Is H7N9 Spreading from Human to Human in China?

Well I dont know whole story and I love considering all options to the point of probably being annoying - I just am not ready to take up broad conspiracy without overwhelming evidence, that opens everything too much to wide swings in applicable theories and undermines progressive reasoning.

I think too many assumptions are being made comparing this to seasonal influenza, H1N1 or H5N1 as well when in fact it may be very, very different in the way it spreads. Even between infected animals. I think we need to look more closely how these types of viruses are spread.
 
Re: Is H7N9 Spreading from Human to Human in China?

Because seasonal influenza viruses could play a role in this event, reducing heterotypic immunity in some adult patients, as suggested by D. danuta skowronski in a recent paper on emerging influenza viruses.
 
Re: Is H7N9 Spreading from Human to Human in China?

This report suggests the latest case in Anhui has resulted in some HCWs being placed under observation (see last sentance in bold), although I cannot determine the validity/ authority of this site as it appears to be an automatic machine translation and the ultimate source of the information is unclear, although all articles on this site relate to China. It would be useful if we can get some verification or a second report.
:tiphat:Lu Hongzhou: From the information available, all contact with the patient's doctors and nurses, as well as hundreds of people in close contact with the patient, by tracking survey, no infections:tiphat:http://www.bjd.com.cn/jryw/201304/07/t20130407_3622964.html
 
Re: Is H7N9 Spreading from Human to Human in China?

the decisive reassortment was probably ~1 year ago.
Since then it spreads in poultry. Even with some further reassortment(s).
So it's already quite widespread in poultry.
The human cases are also distant enough from each other that
they not came from the same recent source.
At least Shanghai/1 was different, Shanghai/2 and Anhui/1 were similar.
These reassortments unlikely happened in humans, you would
need a double infection with new H7N9 and poultry-H9N2 for that.
But subsequent reassortments are quite normal for chickens.
 
Re: Is H7N9 Spreading from Human to Human in China?

I also would like to point out that this is a discussion thread and our related news forums on this subject are here:


English -

http://www.flutrackers.com/forum/forumdisplay.php?f=1610


Français -

http://www.flutrackers.com/forum/forumdisplay.php?f=2928


Italiano -

http://www.flutrackers.com/forum/forumdisplay.php?f=2619


Nederlands -

http://www.flutrackers.com/forum/forumdisplay.php?f=2754


Espanol -

http://www.flutrackers.com/forum/forumdisplay.php?f=2732
 
Re: Is H7N9 Spreading from Human to Human in China?

Influenza HA Subtypes Demonstrate Divergent Phenotypes for Cleavage Activation and pH of Fusion: Implications for Host Range and Adaptation - February 14, 2013[ http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.1003151 ]

Our findings show that the cleavability of the HAs vary considerably between subtypes and depending on the protease. Additionally, analysis of the pH of fusion for each subtype showed that HA stability varied significantly among the subtypes, as well as within subtypes from viruses isolated from different species. Overall, these data have implications for host range, potential for adaptation, and persistence in natural environments.
 
Re: Is H7N9 Spreading from Human to Human in China?

My two cents.

While I do not believe this is a conspiracy I do have serious reservations about Chinese transparency. They have always been reluctant to allow complete openness in what is going on inside their borders when it comes to disease. Whether this is

political, cultural or for perceived home security reasons, they are slow to open a dialogue. Perhaps they think this time there isn't time to try to limit the damage by covering this up. And, I have to agree with them. This disease is not sustained

at this point. But, we do know it does have mammalian markers and we do know it does infect humans. We have no absolute knowledge of how and where some of the victims are being infected, I don't believe the Chinese know either. What they

did see is what our gene sequencers saw, this flu is already at or near creating a pandemic. Hence the immediate release of the sequences. We have at most a few months I believe for this to become a nightmare. At some point sooner or later we

are going to have an individual who is infected with some flu already present in the human population. When H7N9 does cross fertilize with a seasonal flu we are going to open the door for gene swapping that does allow for easy human transition.

When that happens, and I really don't think we are quite there yet, we will see the number of cases explode.
 
Re: Is H7N9 Spreading from Human to Human in China?

it may happen, it happened with mx=H1N1v although it took 11 years.
It did not happen with H5N1 yet nor H3N2v
 
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