Media digest: Scientists’ advances on H7N9

Last update: 1 October 2014

Since the first avian influenza H7N9 outbreak, scientists’ understanding of the epidemiology and virology has made considerable progress, but many burning questions still need to be addressed:

9th May 2013

The achievements are :

The avian origin (chickens or pigeons) very probable of human cases, although the exposure to poultry of some of them is uncertain (we lack of detailed information).

The unanswered questions are :

What is the level of traffic among this LP virus in farms, yet proven by the few published investigations to date, the severity of human infection (greater than SARS case-fatality rate), and positive response to early treatment with neuraminidase inhibitors (the outstanding issue is the ability of the virus to subclinical circulate among humans)?
What is the geographic expansion of human cases? It may reflect a previous presence of the virus in living birds raised locally and/or transportation pathways of living bird trade. 
Has H7N9 entered the entrance of this virus into the Chinese pork industry? If this were possible, closing poultry markets wouldn’t be enough anymore.

1. Maps of reported Human Cases

Several maps have been designed to illustrate the H7N9 outbreaks:

  • Google Map
    This map was created by the South China Morning Post. You can click on each balloon for more information on individual patients infected: blue, patients infected with the H7N9 virus under treatment; red, those infected with H7N9 who have died; yellow, those who have fully recovered; and pink, those infected other types of the Influenza A virus, including H1N1.
  • Shanghai Daily website
    It offers a clear picture of human cases and is often updated.
  • The New England Journal of Medecine
    HealthMap and NEJM have partnered to produce an interactive map with data to date on H7N9 cases and deaths. The data come from official sources (WHO, U.N. Food and Agriculture Organization, World Organization for Animal Health, Chinese Ministry of Health) and informal sources, including news and social media reports. Also included are reports to the Chinese microblogging service, Weibo, as translated by native Chinese speakers.

2. Risk mapping

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3. General understanding of the disease

Scientists from all over the world have published articles on their general understanding of the disease:

  • “Characterizing H7N9”
    Virologists and epidemiologists worldwide have sprung into action trying to understand and control the outbreak. Chinese researchers have posted the viral sequence in an open-access repository and are sending samples of the live virus to labs around the globe for study. April 26, 2013
  • While describing the beginning of the “long journey aimed at the elucidation of the epidemiology”, Chinese and German researchers insist on the need for an increased cooperation between animal and public Health:
    “The barriers between physicians and veterinarians should be removed, and gaps should be filled between government agencies responsible for animal health (Ministry of Agriculture) and public health (Ministry of Health). While a close watch on H7N9 is going on in China, we expect that at the same time, basic research and international collaboration will be supported and encouraged”. April 10, 2013
  • Is H7N9 more fatal than H5N1?
    Report of a fatal case caused by H7N9 AIV in the very early stage of this endemic: 
    Since the highly pathogenic H5N1 avian influenza virus (AIV) was first transmitted from birds to humans in Hong Kong in 1997, other pathogenic AIVs, including H7N2, H7N3, H7N7, and H9N2 have been reported in China and other parts of the world.1,2,3,4 However, no human infections with the novel H7N9 virus have been reported until now from China. Here we report a fatal case caused by H7N9 AIV in the very early stage of this endemic. April 10, 2013
  • The Novel H7N9 Influenza A Virus: Its Present Impact and Indeterminate Future
    “The world is being given a crash course in the importance of “One Health,” because it is primarily through research at the human–animal–environmental interface that this virus can be better understood and hopefully controlled. There are no existing vaccines for the H7N9 virus for any species, including humans.” An article from American scientists (Center of Excellence for Emerging and Zoonotic Animal Diseases (CEEZAD), Kansas University). April 30, 2013

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4. Clinical impacts

5. News about H7N9 in South-East Asia and China

In South-East Asia and particularly in China, newspapers have reported governments’ steps and measures to report cases of contaminated people, prevent the spread of the new H7N9 avian flu and be prepared to address its consequences.

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6. Other useful sources of information about H7N9 can be found through the following links:

Last update: 1 October 2014