Start of a New Pandemic?

It's China because in China human beings continue to live and work in close contact with chickens.
They need to work on their zoning.

Joe(we put all of our chicken in one basket, it's called Arkansas.)Nation

The New Bird Flu: How Dangerous Is Avian Flu H7N9?
(Melanie Haiken, Forbes.com, April 6, 2013)

Until a few days ago, most of us had never heard of influenza A (H7N9), the new bird flu virus that’s suddenly killing people in China. Then on April 1st the death reports started to come in, and all of a sudden health experts began to sound awfully nervous.

That’s because although the virus has infected a very small number of people, it’s killed or critically sickened a high proportion of them.

The toll is rising daily, with new cases and deaths reported on the World Health Organization’s Disease Outbreak News site. As of yesterday, just 16 cases were laboratory confirmed, but of those infected, six have died and three are in critical condition.

I don’t have to tell you that a flu that kills or critically sickens almost two thirds of those who contract it must be taken very seriously.

The virulence of the H7N9 virus is not the only reason health officials around the world are scurrying to figure out the scope of the danger it poses. Genetic evaluation of the H7N9 virus shows it has the ability to mutate readily. Here’s how the World Health Organization (WHO) put it in a statement released yesterday: “analysis of the genes of these viruses suggests that although they have evolved from avian (bird) viruses, they show signs of adaptation to growth in mammalian species.”

Should We Worry About Catching the H7N9 Avian Flu Here in the U.S.?

Right now, you’d be borrowing trouble. All the cases have been in China, either in Shanghai or the nearby provinces of Jiangsu and Anhui. And so far, H7N9 has not been found to be transmissable from human to human. All those who’ve contracted it have had contact with poultry. Both pigeons and chickens have tested positive for the virus.

As Forbes.com’s Russell Flannery reported yesterday, all poultry markets in Shanghai were closed yesterday as Chinese officials try to stop the spread of infection. Poultry dealers also began killing chickens from markets where birds had tested positive for the virus.

However, that could change. According to the CDC, however, this type of virus has “the potential to become a pandemic if it changed to become easily and sustainably spread from person to person.” Yesterday the CDC issued an official public health advisory on H7N9 under the auspices of emergency preparedness and response.

The CDC advises clinicians to be on the lookout for H7N9 in “patients with respiratory illness and an appropriate travel or exposure history.” In other words, if you come down with severe flu symptoms and you’ve recently been to China, let your doctor know right away.

There’s also the issue of the virus travelling with people who are already infected. Yesterday, six possible cases of H7N9 were reported in Taiwan. All were tested; four were found not to be H7N9 and two have yet to be confirmed.

Know the Signs of Avian (Bird) Flu H7N9

Most of the people identified with the new bird flu have had symptoms of severe pneumonia such as chest congestion, difficulty breathing, fever, and severe cough. However the case reports are so recent that experts don’t believe they have a full picture of all possible symptoms.

Yesterday the CDC began issuing guidance to public health clinics and hospitals in the U.S. on how to test for the H7N9 virus. In a teleconference yesterday afternoon, CDC officials said they have already developed a diagnostic test that’s available for use on “travelers with suspicious illnesses.”

How is Bird Flu H7N9 Treated?

The good news is that like other influenza A viruses, H7N9 appears to respond to the antiviral drugs Tamiflu (oseltamivir), made by Genentech (Roche), and GlaxoSmithKline‘s Relenza (zanamivir). Both Tamiflu and Relenza have been used to combat past bird flu outbreaks. However, there has also been concern that widespread use of Tamiflu could spur the development of drug-resistant viral strains.

Forget the Flu Shot

It’s great if you had one, but it won’t help you in this case. There is no vaccine for H7N9 right now. Health officials will begin developing one, but that will take time.

Is It Safe to Travel?

Yes, to anywhere other than southern China. As regards that area, use your own discretion. But practically speaking, around there world there are no airport closures, inspections, or controls in place.

The primary concern is the H7N9 flu getting out of China. Therefore, passengers leaving China and arriving in other countries are being asked to report flu or flu-like symptoms. In Japan, signs have gone up in airports asking passengers disembarking from China to seek medical attention if they have suspicious symptoms. On flights in and out of Hong Kong, announcements asked passengers who were feeling sick to notify airport personnel or flight attendants.

What About Eating Chicken?

The chicken you buy at the grocery store is safe to eat. The normal rules apply, of course: always wash your hands thoroughly after handling, thoroughly clean and disinfect all handling surfaces, and cook meat all the way through. But would I go to a high-volume commercial poultry farm right now? Probably not. If you’re lucky enough to have your own backyard chickens, there’s no need to worry about them.

Intense farming blamed for latest bout of bird flu
(Agence France-Presse, April 7, 2013)

A STATE-BACKED Chinese newspaper has blamed"intense" farming methods for heightening the risk of deadly diseases such as H7N9 birdflu crossing from animals to humans.

China has confirmed 18 cases - including six deaths - of the new strain of avian influenza, so far confined to its developed east coast, since announcing a week ago that the virus had been discovered in humans for the first time.

"Normally, diseases are likely to break out in poor areas. Why is it the other way around in China?" the Global Times editorial asks.

"In China's southern and eastern coastal areas, agriculture, especially animal husbandry, has become more intense and populations more dense," says the English-language edition of the paper, known for its pro-China stance. "There is greater chance of contact between humans and animals, and subsequent diseases. Local authorities have to develop disease prevention and control methods to match this situation, but this is a weak spot in the country's overall development."

Shanghai, which reported two new cases on Saturday to bring the city's total to eight, with four deaths, has slaughtered birds, banned live poultry trading and shut markets in an effort to prevent spread of the disease. Nanjing followed Shanghai by shutting markets selling live poultry to its more than eight million residents, while Hangzhou culled birds after discovering infected quail.

Chinese authorities maintain there is no evidence of human-to-human transmission for the H7N9 cases.

Chinese officials urge calm as seventh bird flu victim dies
(By Barbara Demick, The Los Angeles Times, April 8, 2013)

The toll from China’s new strain of bird flu climbed to seven on Monday with the death of a 64-year-old retiree in Shanghai and the number of cases spread to 24, but officials expressed confidence the outbreak could be contained.

The World Health Organization's representative for China, Michael O’Leary, said the flu known as H7N9 did not appear to be transmitted between humans, which should limit its spread.

"The recent reports from China are the first cases of human infection with H7N9 viruses. Although we do not yet know the source of infection, at this time there is no evidence of sustained human-to-human transmission," O’Leary said at a joint press conference with Chinese health officials.

The international agency also offered to send a team of researchers to help the Chinese.

The cases so far have all come from Shanghai and four surrounding provinces. Most have involved people who had direct contact with infected poultry. However, there might be milder cases of the illness that have gone undetected, acknowledged Liang Wannian, director of the Chinese health agency's H7N9 flu prevention and control office.

What has frightened researchers is the speed with which the confirmed victims sickened and died. The 64-year-old man who was the latest victim sought medical treatment for a pneumonia-like illness on Wednesday, was admitted to the hospital on Sunday and died a few hours later. However, a 4-year-old boy from Shanghai was reported to have made a full recovery.

Shanghai residents appeared to be avoiding chicken restaurants. Even the ever-popular Kentucky Fried Chicken outlets were emptier than usual. A panic broke out Saturday when passengers on one Shanghai subway line discovered a live chicken left behind in a bag.

As of Saturday night, nearly 100,000 birds had been killed and their bodies cremated to prevent the spread of the illness, according to the state media.

All live poultry markets have been closed and sales of live birds banned. Poultry sales have been banned as well in nearby Nanjing and other cities. Aviaries at zoos have been temporarily closed.

Zhong Nanshan, a Guangzhou-based expert on respiratory diseases, also called for screening of wild birds that could be carrying the disease.

"Analysis shows that the H7N9 virus comes from fowl, including poultry, wild fowl, migrating birds and pigeons," Zhong said on state television on Sunday. “

The Chinese public remains wary of government disease response measures after scandals involving government cover-ups during the SARS outbreak in 2002-03. This time around, there was a delay of several weeks, but government officials say that was because of uncertainty of the diagnosis.

The H7N9 strain was previously recognized, but infected only birds.

Last month, thousands of dead pigs were found washed up along the banks of Shanghai’s main waterway, a phenomenon that has yet to be fully explained. Government assurances that the flu is not related to the pigs have been received with skepticism.

China's new bird flu sickens 38, kills 10
(Elizabeth Weise, USA TODAY, April 11, 2013)

After China reported 38 cases of a new, highly virulent flu strain that has killed 10 people, U.S. health agencies are moving into high gear to combat it.

This week, the Centers for Disease Control and Prevention activated its Emergency Operations Center at Level II, the second-highest level of alert. The last time that happened was during the Fukushima nuclear disaster after the Japanese tsunami in 2011.

CDC staffers working on the outbreak who aren't in laboratories moved to the operations center for efficiency.

"It's to ensure that we don't have any loose ends," CDC director Thomas Frieden said.

There have been no cases of the new flu reported outside China.

The CDC expected to receive a culture of the virus from China on Thursday afternoon. That would allow scientists to begin developing a rapid test for the new strain, called H7N9. They hope to have it within a week, Frieden said.

Three things make the strain less of a threat, he said.

"First, there's been no sustained person-to-person spread," he said. Almost all the cases have come from people exposed to infected poultry.

Asia's vast wild and captive flocks of birds are a known reservoir of various types of bird influenza. That puts people who come into contact with the birds at risk, but the larger danger for any flu strain comes if it can be passed easily between people, as the annual flu is each year. This strain doesn't seem to be able to do that. Because few people spend time around live chickens, it is unlikely to develop into a full-blown pandemic.

Second, Frieden said, is the excellent cooperation among health workers and governments worldwide to quickly share information and expertise. Finally, he said, since the H5N1 world flu pandemic of 2009, "we have a system in place that's more prepared than ever to respond to emergencies."

China Confirms 63 H7N9 Cases, 14 Deaths
(Xinhua News Agency, April 15, 2013)

During the 24-hour period ending at 6 p.m. on Monday, China confirmed three new cases of H7N9 avian influenza, with one more death reported in Jiangsu Province.

The National Health and Family Planning Commission said in its daily update on H7N9 cases that a total of 63 H7N9 cases have been reported in China, including 14 cases that have ended in death.

The three new infections were confirmed in patients from Anhui, Zhejiang and Jiangsu provinces.

A total of 24 cases, including nine ending in death, have been reported in Shanghai. Seventeen cases, including two deaths, have been reported in Jiangsu Province, and 16 cases, including two deaths, in Zhejiang Province. Anhui Province has reported three cases, with one death. Beijing has reported one case and two have been reported in Henan Province.

China officially confirmed the occurrence of humans infected with the H7N9 virus late last month.

Those who have had close contact with people infected by H7N9 have been placed under medical observation and have exhibited no abnormal symptoms, the commission said.

According to the commission, China's confirmed H7N9 cases are isolated and there has been no sign of human-to-human transmission.

The commission said it will set up a joint inspection group with the World Health Organization to launch a week-long investigation and analyze the development of the virus.

Investigators Look Beyond Birds for Origin of H7N9 Flu Strain
(By JANE PERLEZ, The New York Times, April 18, 2013)

China is investigating four possible cases of human-to-human transmission of a deadly bird flu that has killed 17 people, but so far there was “no sustained” evidence of transmission between people, the World Health Organization said on Thursday.

Three families in Shanghai and two young boys in Beijing who may have infected each other were being examined as possible examples of human-to-human transmission, Gregory Hartl, the spokesman for W.H.O. in Geneva, said in a telephone interview.

“Even if two family members are positive, it is not necessarily the case they got it from each other. They may have gotten it from the same bird,” Mr. Hartl said.

As investigators looked at the possibility of human transmission, there was mounting concern that the new virus, known as H7N9, may not originate in birds but in other animals and in environmental sources, the W.H.O. spokesman said.

To that end, a team of international influenza experts from the agency’s headquarters in Geneva and a regional office in Manila and scientists from the United States Centers for Disease Control who were invited by China to help investigate the virus, arrived in Beijing Thursday. The experts would be looking at possible sources for the virus other than birds, Mr. Hartl said.

A Chinese expert on the disease, Feng Zijian, the director of the health emergency center at the Chinese Center for Disease Control and Prevention, said on Wednesday that an estimated 40 percent of people infected with the virus said they never had contact with poultry.

Mr. Hartl concurred with Mr. Feng about the surprisingly low incidence of infected people who had no contact with birds. “It is not clear all cases so far have had contact with poultry,” Mr. Hartl said.

Because it seemed possible that the virus originated in animals other than birds, or from some environmental source, the international investigating team would be casting a wide net for possible sources, Mr. Hartl said.

Seventeen people have died since China told the World Health Organization on March 3 of the bird flu outbreak, according to China’s state-run news agency, Xinhua. There were 83 cases of infection, the news agency said.

Even as the international investigators would be seeking other sources of infection, China’s agricultural authorities were insisting the H7N9 virus was still confined to live poultry markets. As proof of this, the news agency said that 47,801 samples had been collected from 1,000 poultry markets, habitats and farms from across China.

From these samples, 39 tested positive for H7N9, the agricultural authorities said. But this number of birds that tested positive from such a large sample was actually quite low, Mr. Hartl said.

An early suspicion that pigs may be the carrier of the virus has not been confirmed, Mr. Hartl said. Pigs had been tested soon after the outbreak was announced, he said, and there were no positive results.

The Chinese authorities had informed the W.H.O. about three families in Shanghai where more than one person was infected with the virus, the spokesman said. In two of the families, two members were infected, he said. In another family, three people were infected. In that case, the 87-year-old father died, and one of his two sons, age 55, also died. Another son, 69, was sick but still alive, Mr. Hartl said.

In Beijing, two boys who were neighbors and often played together were infected, Mr. Hartl said. It was possible in this case, he said, that the boys may have picked up the virus from the same infected bird.

In a news conference Wednesday, Mr. Feng played down the possibility of “effective” human-to-human transmission.

“Effective human-to-human transmission is the case when a disease becomes a human flu virus, as seen in the case of H1N1, where groups of people would be infected at once, such as in schools and communities,” Mr. Feng said. “Effective human-to-human transmission means one patient could infect many and the virus continues to pass on to first, second and third patients. Effective human-to-human transmission has a clear chain of infection.”

The H1N1 virus was a new flu virus strain that caused a world wide pandemic in humans from June 2009 to August 2010.

There was “currently no evidence showing that H7N9 carries continuous infecting power,” Mr. Feng said.

Bird Flu Crosses Strait to Taiwan
(By KATIE MOISSE, ABC News, April 24, 2013)

A Taiwanese man has contracted a deadly strain of bird flu once confined to mainland China, health officials said today.

The man, 53, is thought to have imported the H7N9 virus to his native Taiwan after travelling to China's Jiangsu Province, where bird flu has sickened at least 24 people and killed three, according to the Chinese Center for Disease Control and Prevention. He is said to be in "severe condition."

The latest case has lifted the tally of virus victims to 109, 22 of whom have died, according to the World Health Organization. It has also flamed fears that the deadly virus could spread beyond East Asia.

"Given the extent of global travel, I expect that we will see cases in the United States," ABC News chief health and medical editor Dr. Richard Besser said. "It's so important that people who become ill tell their doctors if they have been traveling."

The Taiwanese man developed flu symptoms April 12, three days after returning to Taiwan from Shanghai, health officials said. He was hospitalized four days later. But initial tests for H7N9 were negative, with official confirmation from Taiwan's National Influenza Center coming more than two weeks after his trip April 24.

"Physicians are once again reminded to report suspected cases to the health authority within 24 hours of detection according to the relevant regulation," the Taiwanese CDC said in a statement, noting that suspected cases with severe respiratory infections should be hospitalized in isolation.

The H7N9 virus is thought to pass from birds to humans. But many of its victims, including the Taiwanese man, reported no contact with birds, and few birds are testing positive for the disease.

"There are so many unanswered questions about this disease," Besser said. "Could there be another route of transmission? Are some people becoming infected from exposure to infected people?"

Taiwan's Central Epidemic Command Center has obtained a list of 139 people who came into contact with the Taiwanese man, including 110 health care workers. Three health care workers who developed symptoms of an upper respiratory infection are being closely monitored, health officials said.

WHO spokesman Gregory Hartl last week said there was no evidence of "sustained human-to-human transmission," adding that "the only instances where there might have been human-to-human transmission are between two close family members."

"The main thing now is to figure out how this virus spreads and where it lives," Hartl said. "Until then, we're shooting in the dark."

In the meantime, Taiwanese health officials are urging travelers to mainland China to avoid direct contact with birds or their droppings, consume only thoroughly cooked poultry and eggs, wash their hands often and wear a protective mask.

U.S. health officials are also bracing for bird flu by preparing a vaccine, a process expected to take six months. In the meantime, they, too, are urging travelers to China to steer clear of birds, practice good hygiene and report any and all flu-like symptoms to a doctor upon return.

"The CDC has developed a diagnostic test for H7N9 flu so that travelers who develop symptoms can be tested," Dr. Besser said.

U.S. doctors are urged to promptly report suspected bird flu cases to their state health departments.