Be Flu Smart: H7N9

As we are to begin the Chinese New Year festivities and witness the greatest annual migration of humanity during a single period, this is not only an occasion for celebration with family, exchanging pleasantries, gifts and Hong Baos, but also an occasion to exercise vigilance.

I would like to talk about the current Avian Influenza A (H7N9) Virus and on how to be “Flu Smart.”

What is H7N9?

H7N9 was first reported in humans in March 2013. Symptoms include fever, cough, and shortness of breath. Infection with the new virus has resulted in severe respiratory illness and, in some cases, death. Available evidence suggests that most people have been infected with the virus after having contact with infected poultry or contaminated environments.

Influenza A (H7N9) is one of a subgroup of influenza viruses that normally circulated among birds. Until recently, this virus had not been seen in people. However, human infections have now been detected. 
So far, there is limited information about the scope of the disease the virus causes and about the source of exposure. Why be concerned about the disease? Most H7N9 patients have been severely ill. There is no indication thus far that it can be transmitted between people, but both animal-to-human and human-to-human routes of transmission are being actively investigated.

Most of these infections are believed to result from exposure to infected poultry or contaminated environments, as H7N9 viruses have also been found in poultry in China. While some mild illnesses in human H7N9 cases have been seen, most patients have had severe respiratory illness, with about one-third resulting in death. No evidence of sustained person-to-person spread of H7N9 has been found, though some evidence points to limited person-to-person spread in rare circumstances.

The point of most concern is the pandemic potential of this virus, although perhaps not in the current season. Influenza viruses constantly change, and it’s possible that this virus could gain the ability to spread easily and sustainably among people, triggering a global outbreak of disease (pandemic).The World Health Organization (WHO) is activity collaborating with the Centers for Disease Control (CDC) and other organizations to assess a need for a vaccine once a predominant strain is identified and whether to include it in the next seasonal flu vaccine.

Background

According to WHO, there have been 192 confirmed human cases of avian influenza A (H7N9) with 57 deaths reported from China since April 2013. Most of these cases were reported during the spring of 2013, with very few over the summer months. More new cases have been recently reported, likely coinciding with the return of colder weather in China. Cases have been reported in the following provinces and municipalities: Anhui, Beijing, Fujian, Guangdong, Hebei, Henan, Hunan, Jiangsu, Jiangxi, Shandong, Shanghai, and Zhejiang. A case in Taiwan and two cases in Hong Kong also have been reported in people who have traveled to an area of China where other H7N9 cases have been reported.

The decrease in H7N9 cases over the summer likely resulted from a combination of control measures taken by Chinese authorities – like closing live bird markets – and the change in weather. Studies indicate that avian influenza viruses, like seasonal influenza viruses, have a seasonal pattern: they circulate at higher levels in cold weather and at lower levels in warm weather.

Current Situation

A total of ten human H7N9 bird flu cases were newly reported in China on Friday, January 24, 2014, including one in Beijing, one in Guangdong province, one in Fujian province and seven in Zhejiang province, forcing cities in Zhejiang to close their live poultry markets. In the first case reported in Beijing in 2014, a man in Beijing was confirmed to have contracted H7N9 on Thursday night (January 23, 2014), according to the Chinese capital’s disease control and prevention center. He is receiving treatment at Ditan Hospital. The center said the patient had bought pigeons and ate them before being admitted to the hospital.

Protection

There is no vaccine currently available to prevent H7N9 infections; therefore the best available option is prevention.

Get your current seasonal flu vaccine as soon as possible if you have previously not done so, practice common sense and follow good hand hygiene and food safety practices.

Precautionary measures:

-Avoid live bird or poultry markets.

-Avoid other markets or farms with animals (wet markets).

-Eat meat and poultry that is fully cooked (not pink) and served hot.

-Eat hard-cooked eggs (not runny).

-Don’t eat or drink dishes that include blood from any animal.

Practice hygiene and cleanliness:

–Wash your hands often.

-If soap and water aren’t available, clean your hands with hand sanitizer containing at least 60% alcohol.

-Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.

-Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

-Try to avoid close contact, such as kissing, hugging, or sharing eating utensils orcups, with people who are sick.