Media digest: Scientists’ advances on H7N9
Last update: 1 October 2014
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:
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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
- A map of avian influenza (H7N9) risk is also presented in Biomed Central’s open access journal Infectious Diseases of Poverty. The map is comprised of bird migration patterns, and adding in estimations of poultry production and consumption, which are used to infer future risk and to advise on ways to prevent infection. Please find the map on page 13, 14 and 15 of the following PDF document.
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“Human infection with a novel avian influenza virus, A (H7N9) – China”
Please find in the following PDF document ECDC’s updated risk assessment as of May 8, 2013. Some graphics and maps show the distribution of the disease in different Chinese provinces. -
At last, you can even find out risk mapping of H7N9 on Google Earth:
Risk maps developed for human infection by another, well-established avian flu virus — H5N1 — may help to target H7N9 surveillance and control efforts.
3. General understanding of the disease
Scientists from all over the world have published articles on their general understanding of the disease:
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“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
4. Clinical impacts
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“Emergence of Avian Influenza A(H7N9) Virus Causing Severe Human Illness — China, February–April 2013”
CDC’s Morbidity and Mortality Weekly report tell us about the Epidemiologic, laboratory and animal investigations. April 2013 -
“Clinical presentation and sequence analyses of HA and NA antigens of the novel H7N9 viruses”
Here is reported the case of a 64-year old man with possible history of chronic bronchitis who died from the H7N9 infection in Huzhou City, Zhejiang Province in Eastern China. The patient had been exposed to poultry before disease onset. May 1, 2013
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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In Thailand: “Ministry steps up bird flu measures”, Bangkok Post, April 28, 2013
“Health Minister Pradit Sintawanarong said yesterday Thailand is prepared to prevent any outbreak despite no cases of H7N9 so far reported here.” -
In Indonesia: “North Kalimantan Bans Ducks to Prevent Spread of H7N9 Bird Flu Strain”, Jakarta Globe, May 8, 2013
“North Kalimantan has prohibited ducks from other regions, particularly East Java, from entering the province in order to prevent the spread of the new H7N9 bird flu strain.” -
In Vietnam: “Viet-Nam culls swifts after bird flu hits”, Bangkok Post, April 25, 2013
“Authorities in central Vietnam culled nearly 10,000 swifts after samples of dead birds tested positive for the type A H5N1 influenza virus, news reports said on Thursday.” - In Vietnam, “Health Ministry proposes $115 million to fight H7N9 flu”, VietNamNet Bridge Tuesday, May 07, 2013 “The capital will be used to promote communication, anti-flu exercises, capacity building of laboratories, building isolated zones for flu patients, etc.”
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In China: “China reports four more bird flu deaths”, Bangkok Post, May 7, 2013
“The death toll from the H7N9 bird flu outbreak in China has risen to 31, according to official figures, with four more people dying of the virus in China's eastern provinces.” -
In Asia: "Some Asian governments tighten airport controls on bird flu fears", Reuters, April 25, 2013
"Several governments in Asia have ordered tougher screening of air travelers from China in an effort to contain a possible spread of a new strain of bird flu that has killed 23 people in the mainland and infected one visitor from Taiwan."
6. Other useful sources of information about H7N9 can be found through the following links:
- OIE – World Organization for Animal Health
- FAO – Food and Agriculture Organization of the United Nations
- OFFLU – OIE/FAO Network of expertise on animal influenza
- WHO – World Health Organization
- ECDC - European Center for Disease prevention and Control
- The new England Journal of Medecine
- News and resourceful websites
Last update: 1 October 2014