H7N9

[dothedd]

June 27, 2013

Scientists Warn of Possible H7N9 Rebound

The H7N9 strain of bird flu appeared in China in February, claiming its first casualties in March. So far, there have been 130 recorded infections and 37 deaths. While anxiety over the spread of the virus is easing after recent evidence has shown its dissipation, scientists are cautioning against complacency, as H7N9 could reemerge after the summer months. From Reuters:

A new and deadly strain of bird flu that emerged in China in February but seems to have petered out in recent months could reappear later this year when the warm season comes to an end – and could spread internationally, scientists said on Monday.

[...]“The warm season has now begun in China, and only one new laboratory-confirmed case of H7N9 in human beings has been identified since May 8, 2013,” the researchers wrote in a study published in The Lancet medical journal.

But they added: “If H7N9 follows a similar pattern to H5N1, the epidemic could reappear in the autumn.”

[...]The team urged health officials and doctors not to be lulled into a false sense of security by the sharp drop off in H7N9 cases in recent weeks.

“Continued vigilance and sustained intensive control efforts against the virus are need to minimize risk of human infection, which is greater than previously recognized,” they said. [Source]

The research cited in recent media reports on H7N9 comes from two studies published in The Lancet medical journal: “Comparative Epidemiology of Human Infections With Avian Influenza A H7N9 and H5N1 Viruses in China,” and “Human Infection With Avian Influenza A H7N9 Virus: An Assessment of Clinical Severity.” The former study looks at data on the H5N1 bird flu that spread internationally after emerging in China in 2003 to determine that the new strain is less severe in terms of fatality. While some headlines are stressing this finding, the South China Morning post looks to data in the study regarding the H1N1 “swine flu” pandemic of 2003 to reiterate a cautionary message:

The rate of fatality in hospitalised H7N9 patients was 36 per cent, compared to 5 per cent to 20 per cent in swine flu patients and 65 per cent in H5N1 patients in China.

“One-third hospital fatality is not a small figure. Killing of chickens and market closures may still be needed when the epidemic reappears. I believe these measures should not be relaxed,” said Professor Gabriel Leung, director of the university’s Public Health Research Centre who announced the findings on Monday.

They warned watchdogs not to take comfort from a lull in new infections, as the virus may reappear in the autumn.

[dothedd]

4:05 am - July 10, 2013 — Updated: 4:06 am - July 10, 2013

Fort Smith Tyson Plant Breaks Production Record

Times Record

Tyson Foods’ Fort Smith poultry plant, which employs more than 100 people, set a record June 3 for the largest single-day total. The plant on Midland Boulevard produced 1.2 million pounds.

This work also helped the plant reach a new weekly production record for the week ending June 8, Springdale-based Tyson Foods Director of Public Relations Gary Mickelson wrote in response to an inquiry.

“The records were achieved through improvements in the plant’s production process over the past couple of years and the hard work of our employees,” Mickelson stated.

The production record was set more than a week before a Tyson Foods breeder stock farm at Boles in Scott County tested positive for the low pathogenic H7N7 bird flu virus. Scott County also has a Tyson Foods poultry plant.

Arkansas Livestock and Poultry Commission received confirmation on June 18 that 18 chickens from a Boles farm tested positive for the H7N7 virus. Those birds and 9,000 others were euthanized. A 6.2-mile quarantine was established, and a testing on June 25 showed no new instances of the virus, according to Preston Scroggin, director of the Arkansas Livestock and Poultry Commission.

Chicken processed at the Fort Smith plant is primarily exported to customers in other countries, Mickelson wrote. Following the tornado at Moore, Okla., on May 20 much of Tyson Foods’ meat also went to feed survivors and rescue workers. Tyson’s disaster relief teams served more than 80,000 meals in the aftermath of the tornado.

More than 70 Tyson employees from 18 company locations were involved in the relief efforts at Moore. They volunteered an estimated 3,000 man hours, and served three meals a day.

“Anything from breakfast burritos, omelets, chicken sandwiches, pork loin, hot dogs, hamburgers, and even steak,” Mickelson wrote.

[dothedd]

China confirms 132 H7N9 cases, 43 deaths
Xinhua, July 10, 2013

A total of 132 H7N9 avian flu cases have been reported on the Chinese mainland, including 43 that have ended in death, according to an update released Wednesday by health authorities.

Of the total, 85 H7N9 patients have been discharged from hospitals after receiving treatment. The other patients are being treated in hospitals, according to the National Health and Family Planning Commission.

The H7N9 infections cover 40 cities in 10 provincial regions, the commission said in a statement.

There was one H7N9 case reported in east China's Jiangsu Province last month and the patient has recovered, it added.

[dothedd]

H7N9 prompts fresh look at H7 pandemic potential

David M. Morensa,
Jeffery K. Taubenbergerb,
Anthony S. Faucia

+ Author Affiliations

Office of the Directora


Viral Pathogenesis and Evolution Section,b Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA

Address correspondence to David M. Morens, [e-mail].

Editor Arturo Casadevall, Albert Einstein College of Medicine 

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ABSTRACT

The ongoing H7N9 influenza epizootic in China once again presents us questions about the origin of pandemics and how to recognize them in early stages of development. Over the past ~135 years, H7 influenza viruses have neither caused pandemics nor been recognized as having undergone human adaptation. Yet several unusual properties of these viruses, including their poultry epizootic potential, mammalian adaptation, and atypical clinical syndromes in rarely infected humans, suggest that they may be different from other avian influenza viruses, thus questioning any assurance that the likelihood of human adaptation is low. At the same time, the H7N9 epizootic provides an opportunity to learn more about the mammalian/human adaptational capabilities of avian influenza viruses and challenges us to integrate virologic and public health research and surveillance at the animal-human interface.


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Introduction

The ongoing epizootic of H7N9 influenza in Eastern China (1), associated with 132 confirmed human infections and 39 related deaths (as of 18 June 2013), once again presents us questions about the origins of influenza pandemics, the risk to humans of avian influenza viruses (AIVs), and their potential to infect large numbers of humans via poultry epizootics (2–4). The new virus in question has a subtype 7 hemagglutinin (HA), which heightens concern because other HA subtype 7 (H7) viruses not only have caused large-scale poultry epizootics but also have become enzootically established in or have otherwise infected mammals, including humans. In attempting to assess the possible risk of an H7N9 pandemic, it is important to consider not only AIVs in general but also specific H7 influenza outbreaks that may give us clues about what to expect from H7N9. In this regard, the evidence as a whole is complex and the implications of past outbreaks for predicting the future course of the current H7N9 epizootic are uncertain.

All influenza A viruses are derived from a large global pool of AIVs circulating in, and moving geographically between, hundreds of species of migratory and nonmigratory wild birds (5, 6). AIVs appear to be stably adapted to these wild avian hosts, and their HA and neuraminidase (NA) genes seem to be under little or no immune selection pressure within each subtype (7). However, our concept of the stability of AIVs in wild birds may be erroneous. Wild birds are often infected simultaneously with multiple influenza viruses (7); this leads to constant/ongoing genetic reassortment that creates endless variations of new gene constellations. Such gene constellations may not exist as stable viruses until such time as they leave the wild-bird avian host to infect such “nonnative” hosts as galliform poultry or mammals.

Influenza host-switching events that result may follow either of two different viral evolutionary pathways. One such pathway begins with AIV host switching and adaptation to galliform poultry, such as chickens, turkeys, or quail. Another entirely different pathway begins with host switching and adaptation to a mammal, such as a horse, a pig, or a human. Because AIV host switches are associated with viral mutations that reflect adaptation to the new host, they seem generally to lead the virus away from an ability to back-adapt to wild birds. Evidence also suggests that poultry and mammalian adaptation may independently increase the evolutionary distance between diverging viruses (i.e., between viruses adapting in galliform poultry and viruses adapting in mammals). If this were the case, the distinctive genetic specializations resulting from viral replication and accumulating mutations that occur during host adaptation may arguably make poultry-adapted viruses less likely to cross-adapt to mammalian species (8, 9). This possibility has important implications for the emergence of influenza pandemics.

Were it not for several highly unusual aspects of H7 viruses, such information about AIV evolution, coupled with the fact that since at least 1918, no poultry-adapted influenza virus has ever stably infected humans, let alone caused a pandemic (10, 11), might be reassuring. However, such aspects of H7 viruses challenge any sense of assurance, including (i) the repeated involvement of H7 avian viruses in large-scale poultry epizootics, (ii) their capacity to spontaneously develop mutations leading to high pathogenicity in poultry, (iii) the association of poultry-adapted viruses with human spillover infections and epidemiological features at times reminiscent of highly pathogenic avian influenza (HPAI) H5N1 (4, 10), (iv) a propensity for ocular replication and transmission, and (v) the ability of H7 viruses to infect several other mammals (e.g., seals and swine), including an H7N7 lineage that achieved long-term stable mammalian adaptation in horses, challenge any sense of assurance.


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EPIZOOTIC BEHAVIOR OF H7 VIRUSES

The current H7N9 epizootic is not the first time that H7 viruses have exhibited unexpected and unusual epizootic and epidemiologic behaviors. Over recent decades, both HPAI and low-pathogenicity avian influenza (LPAI) H7 viruses have caused numerous explosive poultry outbreaks, notably massive 1999 H7N1 HPAI and 2003 H7N3 LPAI outbreaks in Italy (12, 13), a 2003 H7N7 HPAI outbreak in the Netherlands (14, 15), 2004 and 2007 HPAI H7N3 outbreaks in Western Canada (16), a 2012 HPAI H7N3 outbreak in Mexico (17), and ongoing enzootic circulation of H7N2 viruses in bird markets in New York (18). Each of these epizootics has been associated with the independent emergence and adaptation to galliform poultry of a novel virus from the wild-bird AIV pool. Moreover, with the exception of the 1999 H7N1 outbreak, each has caused spillover human cases; one of them, the 2003 Netherlands outbreak, led to an estimated 450 human cases, one death, and three secondary cases that may have arisen from person-to-person transmission (14, 15). Human infections have also resulted from other poultry epizootics caused by various H7N2, H7N3, and H7N7 viruses (19–22). Another unusual epizootic feature is that the Chinese H7N9 virus contains a cassette of internal genes acquired from an avian H9N2 virus (1). In recent decades, H9N2 viruses have spread panzootically in poultry and have also caused swine infections and widespread but mostly asymptomatic human infections (23, 24).


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POULTRY PATHOGENICITY

Similar to H5 viruses, but unlike viruses with any other HA, H7 viruses sometimes acquire polybasic HA cleavage site insertional mutations that render them highly pathogenic to poultry. Indeed, in some of the H7 poultry epizootics noted above, mutations from LPAI to HPAI were documented during the epizootics (12, 16). The Chinese H7N9 virus has remained a low-pathogenicity virus to date; however, it is conceivable that if it spreads further in poultry, it may undergo a similar spontaneous mutational change to HPAI. Although HPAI viruses do not as a rule infect humans or cause severe human disease (10), large-scale culling of diseased poultry during HPAI outbreaks can create intense exposure situations for large numbers of people, potentially leading to human infections and even deaths in persons who may have specific but uncommon and as-yet-uncharacterized susceptibilities (4, 10, 14, 25).


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THE H7N9 EPIZOOTIC SHARES EPIDEMIOLOGICAL SIMILARITIES WITH THE HPAI H5N1 EPIZOOTIC

Unlike the H5N1 virus, which has caused widespread fatal poultry outbreaks, the current LPAI H7N9 virus spreads silently in poultry. Moreover, to date, H7N9 seems to have been confined to live-bird markets and circumscribed poultry foci, compared to H5N1, which has spread panzootically in poultry and wild-bird populations. Nevertheless, the two avian viruses share a number of epidemiological features, as follows (4): both viruses have produced a characteristic clinical picture in humans that includes bilateral pneumonia, acute respiratory distress syndrome, and multiorgan failure (1, 26); human cases have been rare but unusually severe and often fatal; large numbers of humans have apparently been exposed to both viruses without immunologically detectable or clinically apparent infection; person-to-person transmission has rarely if ever occurred; and although uncommon, case clusters seem to indicate common source exposures in persons who are genetically related. As appears to be the case for H5N1 (10, 25), H7N9 may be exhibiting features of a poorly adapted avian influenza virus that is now and may remain unable to infect humans easily but which is at the same time capable of causing severe disease in rare persons with as-yet-uncharacterized genetic susceptibilities (4, 10, 26).


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TROPISM OF H7 VIRUSES FOR CONJUNCTIVAL CELLS

Another unique aspect of some H7 viruses is a predilection for infecting human conjunctival cells, a property of potential importance for prevention and clinical management. Although most influenza viruses can infect multiple epithelial cell types of the nasopharyngeal and respiratory tracts (including conjunctival cells), human infections caused by some but not all H7 viruses have featured unusually prominent conjunctival signs and symptoms—often without traditional respiratory signs and symptoms—as well as possible conjunctival-associated person-to-person spread. In the 2003 Netherlands H7N7 outbreak, the majority of infected humans had conjunctivitis alone (91 percent of 86 virologically confirmed primary cases) (14, 15). Recent work has linked conjunctival tropism to different H7 viral lineages, to host responses, and to host receptor binding affinity (27–29), although the underlying mechanisms of enhanced conjunctival cell tropism with certain H7 viruses remain unclear. The clinical implications of a human influenza virus that causes high-viral-titer conjunctival infection and is associated with conjunctival spread are speculative. Various other viruses (e.g., some adenoviruses and some enteroviruses) have been associated with conjunctivitis and conjunctival spread (30), and two unrelated enteroviruses, EV70 and coxsackievirus A24 variant, emerged in 1969 and 1970, respectively, to cause explosive pandemic conjunctivitis (31). At the very least, analogous human conjunctival adaptation of an influenza virus would have important implications for patient treatment and public health prevention given the possibility of conjunctival-associated transmission.


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H7 VIRUSES HAVE INFECTED OTHER MAMMALS

From the 1940s, if not earlier (32), until the 1970s, a well-adapted H7N7 virus was widely enzootic in horses and seems also to have caused uncommon and mild spillover infections in humans (33). The origins of this virus lineage are incompletely understood, making it difficult to predict the length of time it had been adapted to horses, but it was generally believed at the time of its initial isolation in 1956 to have circulated for decades beforehand (32, 34). Equine influenza-like epizootics had been exceedingly common for centuries but began to disappear as horses were replaced by automobiles and farm machinery, around the time of World War I (35). Since the 1970s, the equine H7N7 virus has become extinct or at least virtually undetectable by surveillance. Nevertheless, the ability of an H7 virus to adapt stably to a mammal over several decades raises the possibility that another H7 virus, such as H7N9, may adapt to a mammal in an analogous manner or even to humans. LPAI H7N7 viruses have also caused fatal outbreaks in seals without stable adaptation and have been associated with spillover seal-to-human infections (36). In addition, H7 viruses have infected pigs (37), a species that seems to be permissive for many influenza viruses and which is considered to be a “mixing vessel” that allows dynamic reassortments of the kind that led to the 2009 H1N1 pandemic. The novel H7N9 virus infects pigs experimentally (38) but has not so far been detected in swine populations.

What does the H7 viral track record reviewed here tell us about the potential for the current H7N9 epizootic to evolve into a human pandemic and about the consequences if such a pandemic occurs? On the one hand, in 94 years of virologic surveillance, we have never seen a poultry-adapted influenza virus cause widespread human transmission (10, 35), and archaeserologic evidence from the 1950s and later, including subjects born as early as the 1880s, makes it doubtful that H7 viruses have circulated in humans at any time since then (39). On the other hand, H7N9 is only the latest of a series of H7 subtype viruses that have exhibited unusual behaviors not only in poultry but also in mammals, including adapting to epizootic/enzootic transmission in at least one mammalian species, the horse. H7 viruses have also repeatedly infected humans, sometimes causing atypical clinical features, such as conjunctivitis. It is concerning that the recent H7N9 virus contains an internal gene cassette from an H9N2 virus, representing a lineage that has caused widespread human infection, although there is no evidence that the specific subtype strains of internal genes of the Chinese H7N9 virus have themselves infected humans as components of an H9N2 virus. Nevertheless, given the ubiquity of H9N2 viruses and their capacity to evolve dynamically and to infect and move rapidly between numerous avian and mammalian hosts (24), H7N9 might arguably be more likely than other avian viruses to become human adapted (4).

The history of H7 viruses constitutes a set of complex observations that may or may not be relevant to the emergence of an H7N9 pandemic, and we thus find it challenging to fit them into calculations of potential human risk. If it was not obvious before, the emergence of H7N9 makes a strong argument supporting the need for much more basic and applied research on the mechanisms of evolution of human and particularly avian and mammalian influenza viruses as well as better integration of influenza virology within human and veterinary public health. Threats like those posed by H7N9 also reflect natural experiments from which we can gain important fundamental knowledge about the characteristics and behavior of influenza viruses. Looked at from the combined points of view of epidemiology, epizootiology, and virology, there may be no more complex infectious disease problem than that posed by influenza. Regardless of whether the current H7N9 outbreak dies out or proceeds to pandemic spread, we have a unique opportunity to learn more of influenza’s many secrets and thereby enhance our ability to prevent and control an important disease that seems destined to appear again and again, in multiple guises, far into the foreseeable future.

[dothedd]

China's Bird Flu's Drug Resistance Worries Experts

Current tests don't detect strains that won't respond to antiviral medication, study says

July 16, 2013

TUESDAY, July 16 (HealthDay News) -- Some strains of the new H7N9 bird flu virus that appeared in China this year are resistant to antiviral drugs, and tests can fail to identify that resistance, which could help accelerate their spread, a new study finds.


"We'd better get some vaccine seed stocks up and ready. The antiviral option for controlling H7N9 isn't too good," said study corresponding author Robert Webster, of St. Jude Children's Research Hospital in Memphis, Tenn.

Researchers analyzed viruses taken from the first person known to have H7N9 infection and found that 35 percent of them were resistant to Tamiflu (oseltamivir) and Relenza (zanamivir), which are antiviral drugs used to treat H7N9 infections.

However, lab testing of the viruses failed to detect the strains that were resistant, so using lab tests to monitor the development of resistance in H7N9 would be useless, according to the authors of the study, published July 16 in the online journal mBio.

Resistant strains of H7N9 can flourish in patients treated with oseltamivir or zanamivir, inadvertently leading to the spread of resistant infections, explained Webster.

"If H7N9 does acquire human-to-human transmissibility, what do we have to treat it with until we have a vaccine? Oseltamivir. We would be in big trouble," he said in a journal news release.

H7N9 first appeared in China in early 2013, in some cases infecting people who had been in contact with poultry or had been in places where poultry are housed. The virus has since been detected in poultry at live markets near where human infections have been reported. As of July 12, the number of H7N9 infections was 132 and the number of deaths 43.

[dothedd]

H7N9 Bird Flu May Be Developing Drug Resistance

By Rachael Rettner, Senior Writer | July 16, 2013 07:56am ET 

Some strains of the H7N9 bird flu in China are becoming resistant to the only antiviral drugs doctors have left to treat the infection, a new study suggests.

The study, which examined the viruses in a single person infected with H7N9, found that a portion of the H7N9 viruses lurking inside the person were resistant to the antiviral drugsoseltamivir (marketed as Tamiflu) and zanamivir (Relenza). About 35 percent of the viruses were resistant to these drugs, while 65 percent were sensitive, the researchers said.

Treating such "mixed populations" of flu viruses within a single patient can be problematic — giving the patient oseltamivir or zanamivir may increase resistance to those drugs.

www.livescience.com/38197-h7n9-bird-flu-antiviral-resistance.html

[dothedd]

China H7N9 bird flu survivor gives birth
Published July 19, 2013

BEIJING (AFP) – A Chinese woman who spent five weeks in intensive care with H7N9 bird flu has given birth to a girl in what was described as a "miracle" first, according to state media.

Qiu Yan, 25, was five months pregnant when she was diagnosed with the virus in April, early in China's human outbreak of the disease. She was in a "very serious condition" and underwent antibiotic, antiviral and hormone treatments, along with daily X-rays, during her therapy, the Global Times cited doctors as saying.

Qiu, from Zhenjiang in the eastern province of Jiangsu, is the world's first H7N9 survivor to give birth, the paper said.

"Her lung was severely infected and she needed a respirator to breathe because she was suffering from respiratory failure," it quoted Qiu's doctor Sun Lizhou as saying.

Qiu was discharged from intensive care in May but stayed in hospital until she delivered the baby -- a 3.3-kilogram (7.3-pound), 50-centimetre (1.6-feet) girl -- on Wednesday.

"It was a miracle," Sun said according to the paper.

The first human cases of the H7N9 virus were reported in late March and it had infected 132 people in mainland China, killing 43 by the end of June, according to official data.

Experts fear the possibility of the virus mutating into a form easily transmissible between humans, with the potential to trigger a pandemic.

Both Qiu and her baby were in stable condition but the child will have to be checked regularly for any possible effects of the virus, Sun added, according to the report.

[dothedd]

• Hebei infected with H7N9 patient's condition did not change a life-threatening
 2013-07-24 17:19

Reporters learned from the Beijing Chaoyang Hospital, Hebei to Beijing for treatment of H7N9 bird flu disease compared with yesterday, the condition did not change significantly, still critical, life-threatening.

Hong Beijing July 24 news reporter learned from the Beijing Chaoyang Hospital, Hebei to Beijing for treatment of H7N9 bird flu disease compared with yesterday, the condition did not change significantly, still critical, life-threatening.

This morning (July 24) to Beijing Chaoyang Hospital, Tong Zhaohui, vice president, head of the Institute for the expert consultation comments, compared with yesterday, no significant change in the patient's condition, is still critical, life-threatening. Continue to monitor the circulation, gastrointestinal and other important organs, to maintain the current plasma support, thymosin enhance immunity, protect the gastric mucosa therapy, nutritional support, strict isolation, attention to good health care protection.

It is understood that Moumou, female, 61 years old, mainly "5 days fever, cough, dyspnea two days" on at 18:00 on July 18, 2013 Revenue Beijing Chaoyang Hospital respiratory intensive care unit. Now seven days of hospitalization, living RICU first seven days, endotracheal intubation first seven days. Patients currently live in the ward for the respiratory intensive care ward of negative pressure isolation ward.

Current diagnosis: human infection with H7N9 avian influenza virus pneumonia (severe cases), acute respiratory distress syndrome, septic shock, acute renal failure, disseminated intravascular coagulation, hypoalbuminemia, cholecystectomy.

[dothedd]

H7N9 Avian Flu Outbreak Eases; Could Return In The Fall With Human-to-Human Spread Possible

Tuesday , July 23,2013

There’s good news and bad news out of China about the H7N9 avian flu strain that has caused more than 130 human infections and nearly 40 deaths so far this year. In the near term, it appears that the virus has been fairly successfully contained by control measures implemented in live poultry markets, with reports of new infections having eased substantially in recent months.

However, it’s not quite time to uncork the champagne yet. A new report published last week in the journal Science warns that “the character of the virus, including its pandemic potential, remains largely unknown,” that “one virus isolated from humans was highly transmissible in ferrets by respiratory droplets,” and concludes: “Our findings indicate nothing to reduce the concern that these viruses can transmit between humans.”

“H7N9 Influenza Viruses Are Transmissible in Ferrets by Respiratory Droplet” (Science DOI: 10.1126/science.1240532), was conducted and co-written by teams of scientists led by Dr. Hualan Chen, corresponding author, at the Harbin Veterinary Research Institute’s State Key Laboratory of Veterinary Biotechnology at Harbin and the College of Veterinary Medicine, at Gansu Agricultural University in Lanzhou, China.

According to the Centers for Disease Control, an outbreak of human infections with the new avian influenza A (H7N9) virus was first reported in China by the World Health Organization on April 1, 2013, and was detected in poultry in China as well. The vast majority of infections were reported during the month of April, and many of the people infected reported contact with poultry. The working assumption is that human infections occurred after exposure to infected poultry or contaminated environments, and while some mild illness in human cases was seen, most patients had severe respiratory illness and 43 people died. Close contacts of confirmed H7N9 patients were followed to determine whether any human-to-human spread of H7N9 was occurring. No evidence of sustained person-to-person spread of the H7N9 virus was found. No cases of H7N9 outside of China have been reported and the new H7N9 virus has not been detected in people or birds in the United States.

The CDC also notes that the number of new cases detected after April fell abruptly, possibly resulting from containment measures taken by Chinese authorities such as closing live bird markets, or from the change in seasons, or a combination of both factors. Since avian influenza viruses have a seasonal pattern to them, the CDC warns that the incidence of H7N9 infections – in birds and people – may ramp up again when the weather turns cooler in China, and since limited person-to-person spread of bird flu is thought to have occurred rarely in the past, most notably with avian influenza A (H5N1), based on that previous experience, some limited human-to-human spread of this H7N9 virus would not be unlikely should the virus reemerge in the fall.

The major concern with H7N9 is its pandemic potential, the CDC warns, noting that influenza viruses constantly mutate, and it’s possible that this virus could become able to easily and sustainably spread among people, triggering a global outbreak of disease (pandemic).

Senior author of the Chinese ferret study published in Science, Dr. Hualan Chen, PhD, told CIDRAP News that there was no significant difference in transmission among four of the five viruses they tested in aerosol transmission testing, and observed that “The transmission of AH/1 to all three ferrets suggests that the H7N9 virus has great pandemic potential,” with only a few changes needed to make the H7N9 virus highly transmissible among mammals, and that “Moreover, these changes can occur easily during replication in humans.” Overall, the Harbin/Lanzaou team said their tests found that the H7N9 viruses from poultry and humans can bind to human airway receptors, and can replicate efficiently in ferrets, and that one human isolate can transmit efficiently among ferrets by aerosol droplets. Dr. Chen further commented that she was “surprised that all of the viruses tested are able to bind to humanlike receptors and that the PB2 gene of the virus so easily gains mutations during replication in humans that boost its virulence and transmissibility,” and warns ominously that “This study suggests that the H7N9 virus is likely to transmit in humans, and immediate action, not only in China, is needed to prevent a possible pandemic caused by such a virus.”

drhualanchenDr. Hualan Chen is an animal virologist and a Professor at Harbin Veterinary Research Institute. She obtained her PhD from the Chinese Academy of Agricultural Sciences in 1997, and did post-doctoral research at the U.S. Centers for Disease Control from 1999 till 2002, when she began working as researcher and PhD supervisor at Harbin Veterinary Research Institute of Chinese Academy of Agricultural Sciences, and also was the director of the National Bird Flu Research Laboratory. Since 1994, Dr. Chan has focused on basic and applied research on the avian influenza virus and its prevention and control, has published more than 30 avian flu-related research papers in major international academic journals and has developed various avian flu vaccines, 50 billion doses of which have been sold in China and overseas.

A Springer open access journal Chinese Science Bulletin posted online as an Open Access article (June 2013, Volume 58, Issue 16, pp 1857-1863) says that to investigate the possible origins of the H7N9 viruses causing last spring’s human infections, a team of researchers led by Dr. Chen collected 970 samples, including drinking water, soil, and cloacal and tracheal swabs of poultry, from live poultry markets and poultry farms in Shanghai and Anhui Province. Twenty samples were positive for the H7N9 influenza virus, and notably, all 20 viruses were isolated from samples collected from live poultry markets in Shanghai.

Phylogenetic analyses showed that the six internal genes of these novel human H7N9 viruses were derived from avian H9N2 viruses, but the ancestor of their HA and NA genes is uncertain. However, when the researchers examined the phylogenetic relationship between the H7N9 isolates from live poultry markets and the viruses that caused the human infections, they found that the samples shared high homology across all eight gene segments. They thus identified the direct avian origin of the H7N9 influenza viruses that caused the human infections, and importantly observed that the H7N9 viruses isolated from humans had acquired critical mutations that made them more “human-like”. Consequently, they conclude that It is “imperative to take strong measures to control the spread of H7N9 viruses in birds and humans to prevent further threats to human health,” and that “additionally, it is also imperative to evaluate the pathogenicity and transmissibility of these H7N9 viruses, and to develop effective vaccines and antiviral drugs so as to reduce their adverse effects upon human health.”

Complicating the H7N9 issue further, the Avian Flu Diary Blog’s Michael Coston cites a recent study (see mBio: Antiviral Resistance In H7N9) suggesting that antiviral resistance may form quickly in patients infected with H7N9, with early reports out of China indicating a small but worrisome number of oseltamivir (Tamiflu) resistant strains detected among those infected during the first wave (see The Lancet: Antiviral Resistance In Two H7N9 Patients). Coston observes that these are all qualities that could help make the H7N9 virus a formidable foe should it return in the fall.

A HealthDay News report last week cites Dr. Chen noting that the discovery that H7N9 is highly transmissible between ferrets, could portend a time where the virus might become pandemic, and that “The situation raises many urgent questions and global public health concerns.”

On the other hand, Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, stressed to Healthday News that it isn’t known whether large-scale spread of H7N9 among humans will actually occur, commenting that “We already know H7N9 can spread human-to-human. So far, however, we are not seeing large outbreaks. That’s not an accident. You can see something in a test tube or in a ferret that doesn’t reproduce in real life.”

Nevertheless, Dr. Chen counters that replication in humans provides opportunities for the virus to acquire more mutations and become more virulent and transmissible in mammals, and is quoted explaining that “Our results suggest that the H7N9 virus is likely to transmit among humans, and immediate action is needed to prevent an influenza pandemic caused by this virus.”

josephbreseeThe article also cites Dr. Joseph Bresee, chief of the epidemiology and prevention branch in the CDC’s Influenza Division, and a captain in the U.S. Public Health Service, saying that one thing that gives us comfort so far is that the H7N9 virus doesn’t seem to be able to spread efficiently between humans, “and that’s what allows a flu virus to develop into a pandemic”, but it is still a matter of concern, since “It can cause severe disease and deaths in humans,” and “Anytime a new flu virus emerges, especially one that can cause severe disease in humans, it’s a virus we get very interested in.”

Dr. Bresee, a graduate of Houston’s Baylor College of Medicine, further noted to HealthDay News that within the United States, the CDC has informed state health departments on what to look for and how to test for H7N9, and that the agency is at work studying the virus, watching for mutations, trying to understand what medicines work against it, and developing a H7N9 flu vaccine — “just in case we need to use [It] at some point.”

bionews-tx.com/news/2013/07/23/h7n9-avian-flu-outbreak-eases-could-return-in-the-fall-with-human-to-human-spread-possible/

[dothedd]

H7N9: "An important pandemic threat"

The Lancet Respiratory Medicine: Tropism and innate host responses of a novel avian influenza A H7N9 virus: an analysis of ex-vivo and in-vitro cultures of the human respiratory tract. The summary:

Background

Since March, 2013, an avian-origin influenza A H7N9 virus has caused severe pneumonia in China. The aim of this study was to investigate the pathogenesis of this new virus in human beings.

Methods

We obtained ex-vivo cultures of the human bronchus, lung, nasopharynx, and tonsil and in-vitro cultures of primary human alveolar epithelial cells and peripheral blood monocyte-derived macrophages. We compared virus tropism and induction of proinflammatory cytokine responses of two human influenza A H7N9 virus isolates, A/Shanghai/1/2013 and A/Shanghai/2/2013; a highly pathogenic avian influenza H5N1 virus; the highly pathogenic avian influenza H7N7 virus that infected human beings in the Netherlands in 2003; the 2009 pandemic influenza H1N1 virus, and a low pathogenic duck H7N9 virus that was genetically different to the human disease causing A H7N9 viruses.

Findings

Both human H7N9 viruses replicated efficiently in human bronchus and lung ex-vivo cultures, whereas duck/H7N9 virus failed to replicate in either. Both human A H7N9 viruses infected both ciliated and non-ciliated human bronchial epithelial cells and replicated to higher titres than did H5N1

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BARDA Flu BAA - July 31, 2013 - H7N9

Note to Potential Offerors: Due to the urgency of ongoing preparedness activities for avian influenza A(H7N9) virus, available funding for awards under this solicitation may be limited. In addition, submissions that directly address H7N9 preparedness may be evaluated more favorably than those directed towards other influenza subtypes.

Offerors for Area of Interest #5 should propose activities for products that can currently be described as having a maturity level equal to or greater than Technology Readiness Level (TRL) 6 (e.g. as evidenced by release of a finalized report for a Phase 1 clinical study for the same indication as proposed activities). A product can be described as achieving a TRL if it has completed all activities identified in that TRL. The Technology Readiness Level ranking criteria can be found in Attachment 1C of this BAA.

Under this Area of Interest, BARDA is seeking technologies that will improve preparedness against influenza subtypes with pandemic potential. Successful offerors will provide evidence of vaccine approaches that show improvement in key vaccine attributes as compared to currently available products.

5.1 Advanced development of novel influenza vaccine candidates which have achieved TRL 6 or greater. Support for advanced development of novel influenza vaccine candidates with the potential to stimulate a broader and more effective immune response than currently available products. Data should be provided that demonstrates statistically-relevant improvements in immunogenicity/efficacy as compared to existing vaccines. Proposed activities should enable improvements to key vaccine attributes, including dose schedule, time to onset of protection, induction of improved immunogenicity, broader cross-protection across influenza A virus subtypes, and duration of protection. Use of approved or novel adjuvants to achieve enhanced or ....
CONTINUED:https://www.fbo.gov/index?s=opportunity&mode=form&tab=core&id=986a47da81c19a4de4dac9e07e5f7197&_cview=0

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6 August 2013 Last updated at 19:32 ET

Bird flu strain in China 'passed between humans'

Researchers have reported the first case of human-to-human transmission of the new strain of bird flu that has emerged in China.

The British Medical Journal said a 32-year-old woman was infected after caring for her father. Both later died.

Until now there had been no evidence of anyone catching the H7N9 virus other than after direct contact with birds.

But experts stressed it does not mean the virus has developed the ability to spread easily between humans.

By 30 June there had been 133 cases of H7N9 bird flu reported in eastern China and 43 deaths.

Most people had visited live poultry markets or had close contact with live poultry in the week or two before they became ill.

Intensive care
Yet researchers found that the 32-year-old woman had become infected in March after caring for her 60-year-old father in hospital.

Unlike her father - who had visited a poultry market in the week before falling ill - she had no known exposure to live poultry but fell ill six days after her last contact with him.

Both died in intensive care of multiple organ failure.

Tests on the virus taken from both patients showed the strains were almost genetically identical, which supports the theory that the daughter was infected directly from her father rather than another source.

Public health officials tested 43 close contacts of the patients but all tested negative for H7N9, suggesting the ability of the virus to spread was limited.

The researchers said that while there was no evidence to suggest the virus had gained the ability to spread from person to person efficiently, this was the first case of a "probable transmission" from human to human.

'Strong warning sign'
"Our findings reinforce that the novel virus possesses the potential for pandemic spread," they concluded.

Dr James Rudge, of the London School of Hygiene and Tropical Medicine, said that limited transmission between humans is not surprising and has been seen before in other bird flu viruses, such as H5N1.

He added: "It would be a worry if we start to see longer chains of transmission between people, when one person infects someone else, who in turn infects more people, and so on.

"And particularly if each infected case goes on to infect, on average, more than one other person, this would be a strong warning sign that we might be in the early stages of an epidemic."

An accompanying editorial in the BMJ, co-authored by Dr Rudge, concluded that while this study might not suggest that H7N9 is any closer to delivering the next pandemic, "it does provide a timely reminder of the need to remain extremely vigilant".

www.bbc.co.uk/news/health-23594392

[dothedd]

New case of H7N9 bird flu confirmed in China: officials

August 12, 2013 - Updated 618 PKT

BEIJING: A Chinese poultry worker was confirmed as having contracted the deadly H7N9 bird flu virus, health officials said, the first case in the southern Guangdong province.

The 51-year-old woman is in a critical condition after she was admitted to hospital on August 3 following signs of a fever, the Guangdong Provincial Health Department said on Saturday.

"She was a poultry slaughtering worker at a local marketplace," the local health bureau said in a statement on its website.

A total of 134 cases have now been reported on the Chinese mainland, including the Guangdong case.

State news agency Xinhua said Saturday that 44 people had died of the disease -- which includes a recent fatality following the release of the latest official figures a month ago.

The virus was first reported in late March, with most cases confined to eastern China, and only one reported outside the mainland, in Taiwan.

Scientists reported last week the first likely case of direct person-to-person transmission of the H7N9.

However, they told people to "not panic" as the virus's transmissibility remained "limited and non-sustainable".

Local health authorities Saturday lifted medical observations on 54 of 96 people who were placed under monitoring after they had close contact with the Guangdong patient, Xinhua said.

The patient had worked in markets in Boluo, which is about 129 kilometres (80 miles) east of the provincial capital Guangzhou.

Many of those infected with the virus had direct contact with birds, commonly at poultry markets, which have been closed by officials across China to halt the spread of the disease.

Cases of H7N9 have dropped significantly in recent weeks.

In the southern Chinese city of Hong Kong, which borders Guangdong province, a government spokesman Sunday said the territory is closely monitoring the virus for any developments.
 
  

[dothedd]

H7N9 bird flu patient dies in Beijing

12/08/2013 | 06:34 PM | World News
تصغير الخطتكبير الخط

TOKYO, Aug 12 (KUNA) -- A man infected with the H7N9 avian influenza died of multiple organ failure on Monday, state-run Xinhua News Agency reported.

The 61-year-old patient was transferred from the city of Langfan in north China's Hebei Province to a hospital in Beijing for treatment on July 18, the report said.

He tested positive for the H7N9 bird flu virus on July 20. A single human infection of H7N9 was confirmed in south China's Guangdong Province on Friday, bringing the total number of infections on the Chinese mainland to 134 this year, Xinhua said, adding that 44 of the infections have resulted in death.

Authorities halted their emergency response to the H7N9 outbreak in late May. However, a spokesman for the National Health and Family Planning Commission said authorities have been monitoring the situation and are preparing for possible outbreaks in the coming fall and winter.

Earlier this month, researchers in east China's Jiangsu Province said the H7N9 virus may be capable of human-to-human transmission, but they added that such transmissions are limited and non-sustainable. (end) mk.sd KUNA 121834 Aug 13NNNN

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Bird flu strikes again in China

Chinese authorities have confirmed that another person has fallen ill with the deadly H7N9 strain of bird flu.

www.globalmeatnews.com/Industry-Markets/Bird-flu-strikes-again-in-China

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Yum! Brands Inc's same-store sales in China declined an estimated 13 percent year-on-year in July, with a 16 percent decrease at KFC and only 3 percent growth at Pizza Hut, Yum! Brands said on Monday. McDonald's Corp also saw a sales decrease in China.Provided to China Daily

africa.chinadaily.com.cn/business/2013-08/14/content_16891923.htm


AN EXCELLENT ARTICLE:
Thu, Aug 15, 2013
left corner
中文 CHINA US EUROPE ASIA PACIFIC
Partial to Africa
africa.chinadaily.com.cn/weekly/2013-08/09/content_16882422.htm

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H7N9 bird flu may be spread through human faeces, research suggests
Thursday, 15 August, 2013, 8:15am
South China Morning Post

"This has important implications on the infection control strategies for H7N9 virus infection, as the influenza virus in stools may contaminate the surrounding environment," Yuen and his team reported.

But the team also suggested that the fact the virus may be transmitted via faeces was the reason why, so far, few cases of human-to-human infection had been recorded, Yuen said.

HKU conducted the joint study with Zhejiang University's First Affiliated Hospital in Hangzhou and published the results in the Clinical Infectious Diseases journal on Tuesday. They tested 12 patients who were admitted to the intensive care unit between April 10 and 23. Half of them have died.

During post-mortem tests, stool samples collected from four of the six fatalities returned positive results for the H7N9 strain.

The rate - 67 per cent - was much higher compared with those found for human flu or H5N1 bird flu, which ranged from 5 per cent to 33 per cent, the report said.

None of the blood or urine samples from the six dead patients carried H7N9. Other tissue samples, from the lung, heart, liver, kidney and bone marrow, also tested negative.

Earlier this month, Chinese researchers said their findings indicated that the H7N9 bird flu "has not gained the ability for efficient sustained transmission from person to person", although a father infected with the deadly virus was believed to have passed it to his daughter in Wuxi , Jiangsu .

In 2003, Hong Kong dealt with the deadly Sars outbreak, after it had first appeared on the mainland in late 2002.

At the Amoy Gardens housing estate 329 people were infected with Sars, of whom 42 died. The cause was traced to the sewage system which, because of its design, released the virus into the air when toilets were flushed.

It is not known whether H7N9 bird flu can be transmitted in the same way, but Yuen believed it was "theoretically possible".

"The efficiency of human-to-human transmission is very poor up until now," he said.

He stressed that the faeces of sick birds were still suspected to be the most common means by which the bird flu virus spreads.

Human waste should be handled more carefully under infection control measures, Yuen said.

The H7N9 virus was first identified in eastern China, with the first known human case reported in March. Thus far there have been 135 confirmed cases and 45 deaths.

www.scmp.com/news/hong-kong/article/1296797/h7n9-bird-flu-may-be-spread-through-human-faeces-research-suggests 

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Woman with H7N9 bird flu dies in Beijing, bringing fatalities to 45

birdbeijing.jpg  


The fever clinic at Ditan Hospita in Beijing. The latest death of a woman from Hebei province was at Chaoyang Hospital. Photo: AP

A Chinese woman infected with the deadly H7N9 bird flu virus died of multiple organ failure, a Beijing hospital said, bringing the total fatalities from the disease to 45.

The 61-year-old tested positive for the virus on July 20 after she fell ill in Hebei province in northern China.

She was taken to Beijing’s Chaoyang Hospital for treatment and died on Sunday, the hospital said in a statement.

A total of 134 cases have now been confirmed on the Chinese mainland, including one in Guangdong, the first in the southern province, which was reported on Saturday.

State news agency Xinhua said then that 44 people had died of the disease.

The virus was first reported in late March, with most cases confined to eastern China, and only one reported outside the mainland, in Taiwan.

Scientists reported last week the first likely case of direct person-to-person transmission of the H7N9.

But they said there was no cause for panic as the virus’s transmissibility remained “limited and non-sustainable”.

Cases of H7N9 have dropped significantly in recent months.

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 IANS | Kathmandu August 15, 2013 Last Updated at 11:29 IST

Bird flu emergency declared in Nepal district

Nepal has declared a bird flu emergency in Bhaktapur, one of the three districts of the Kathmandu valley, an official said Thursday.

The decision was taken at a meeting between government officials and poultry farmers Wednesday, Narayan Ghimire, the government's spokesperson for the bird flu control campaign, told Xinhua.

"Bird flu could not be controlled even after several attempts including a ban on the chicken trade," Ghimire said.

In the emergency zone, around 500,000 fowl including chicken, duck and pigeon, will be culled along with their eggs, feed and excreta. Poultry farms will be cleaned and disinfected.

The emergency zone will remain active for at least three months. During this period, fowl cannot be transported and supplied to and from Bhaktapur. Sale of chicken and other fowl meat will also be banned.

The government will compensate the loss to poultry farmers, the spokesperson said.

Bhaktapur has witnessed more than 40 cases of bird flu in a month. The other two districts, Lalitpur and Kathmandu, have reported at least 10 cases.

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China: H7N9 flu Spreads at "Unprecedented Speeds"

Via the South China Morning Post, an August 20 report: H7N9 flu spreads faster than others. Excerpt:
The deadly H7N9 influenza spreads at unprecedented speeds, Hong Kong microbiologists say, faster than all known strains of the bird flu virus.

The bug - which infected 130 people on the mainland in March and April, killing more than 40 - may derive its speed from being more readily transmitted from birds to humans than other strains, including H5N1.
A study by University of Hong Kong Professor Yuen Kwok-yung and his team draws a comprehensive comparison between the two viruses, including their structure, mode of transmission and at-risk groups.
It emphasises that the new virus has proved more deadly and harder to control than H5N1, despite resembling it in many ways.

Stringent measures to control the poultry outbreak - such as culling birds and closing wet markets - should be put in place on the mainland to prevent a pandemic, the scientists warn.

The team says in an article in the latest The Lancet medical journal that the pace of H7N9's spread could be related to speedier transmission from poultry to humans or improved testing that detects it more quickly.

The two viruses have genetic markers showing adaptation to mammals and have improved both their binding to human-type receptors and their replication in mammals.

But H7N9 seems to be more readily transmitted from poultry to people.

[dothedd]

"...the development of poultry and human H7N9 vaccines is important '

"H7N9 flu harder to control and spreads faster than other strains
Tuesday, 20 August, 2013

Study says strain harder to control than H5N1 due to lack of warning before humans infected
The deadly H7N9 influenza spreads at unprecedented speeds, Hong Kong microbiologists say, faster than all known strains of the bird flu virus.

The bug - which infected 130 people on the mainland in March and April, killing more than 40 - may derive its speed from being more readily transmitted from birds to humans than other strains, including H5N1.

A study by University of Hong Kong Professor Yuen Kwok-yung and his team draws a comprehensive comparison between the two viruses, including their structure, mode of transmission and at-risk groups.

It emphasises that the new virus has proved more deadly and harder to control than H5N1, despite resembling it in many ways."

[dothedd]

Vietnam calls for war against
bird flu as outbreaks hit
Asia

Viet Nam News/ANN, Ho Chi Minh City | Health | Tue, August 20 2013, 11:32 AM

Vietnamese Minister of Agriculture and Rural Development Cao Duc Phat has instructed relevant authorities to strengthen oversight to prevent the spread of bird flu from across borders.

In an urgent dispatch, Phat said Chinese health authorities have confirmed that the H7N9 strain of the disease killed 45 people in that country.

According to Cambodian health authorities, two more people recently contracted H5N1 bird flu, raising the total number of infected people this year to 16, and 11 of them have died.

Outbreaks have occurred in several provinces along the border with Viet Nam, he said.

Besides, smuggling of poultry and poultry products into the country through borders is on the increase, causing a high risk of the disease spreading.

Under the circumstances, the ministry has ordered relevant agencies to take drastic measures to prevent the spread of the disease.

It has also urged local authorities to ban the slaughter, transport, and distribution of smuggled poultry products, and review and organise poultry vaccination, especially in high-risk provinces like those along borders and with a lot of poultry farming.

The ministry said more than 26,000 quails with bird flu were recently destroyed in Tien Giang Province near HCM City.

The Department of Animal Health has supplied one million doses of bird flu vaccine to the province to help contain the disease.

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Japan to begin producing vaccine for H7N9 bird flu

September 3, 2013

Jiji Press

A panel of experts at the Health, Labor and Welfare Ministry will start producing a vaccine for the H7N9 strain of avian influenza, following a number of reported cases of human infections in China.

The ministry will base the vaccine on a vaccine strain produced by the National Institute of Infectious Diseases, while seeking cooperation from vaccine makers. Production work will start within this month, at the earliest.

The ministry will first test the vaccine on animals and then decide whether to conduct clinical trials on humans after examining the results.

It remains unclear when production will be completed because it is difficult to make a vaccine that can provide immunity against H7 type flu viruses, according to officials at the ministry.

No human-to-human spread of the H7N9 flu has been confirmed so far, but experts warn that genetic mutations in the virus could increase transmissions between humans and could lead to a pandemic.

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Mexican Bird Flu x2 -- H7N9 Lung Lesions --



 

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Chinese scientists publish new findings on H7N9
Updated: 2013-09-07 21:58
( Xinhua)
 

BEIJING - Chinese scientists have discovered that a type of H7N9 can bind with a human receptor, which explains how the virus can infect human beings.

Research focused on how H7N9 infected human beings, examining the two earliest reported virus types, known as isolates. These were SH-H7N9 and AH-H7N9, discovered in Shanghai and Anhui province respectively.

Researchers evaluated the viral hemagglutinin receptor binding properties of the two isolates. A receptor is a protein molecule in a cell, or on a cell, to which a substance can bind. A virus has to combine with a receptor in order to infect the host.

Researchers found that SH-H7N9 (reported in Shanghai) preferentially binds the avian receptor analog, whereas the AH-H7N9 (reported in Anhui) binds both avian and human receptor analogs.

The research titled "Structures and receptor binding of hemagglutinins from human-infecting H7N9 influenza viruses", jointly authored by a team from the Chinese Academy of Sciences, was published online on September 5 by Science, a leading journal.

Shi Yi, researcher with the academy and lead author of the paper, said AH-H7N9 was prevalent during the outbreak, whereas SH-H7N9 was only isolated from one case.

Researchers warned the H7N9 virus must be closely monitored in case of mutation.

H7N9 bird flu has killed 45 people on the Chinese mainland since the first human infection was confirmed in late March. A total of 134 cases of H7N9 human infection have been confirmed, according to China's health authorities.

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UN Agriculture Agency Warns of Re-emergence of Bird Flu Viruses
Sep 16, 2013

Two strains of the bird flu virus continue to pose serious threats to human and animal health, especially in view of the upcoming flu season.

The warning has come from the UN Food and Agriculture Organization (FAO) about the threats of the H7N9 and H5N1 avian influenza viruses.

The agency continues to call for funds to bolster the global response to H7N9.

It urges countries to make key investments in improving markets and promoting healthy food systems to fight viruses affecting animals and people.

The FAO's Chief Veterinary Officer Juan Lubroth has said that the world is more prepared than ever to respond to bird flu viruses after a decade of work.

However, international experts have recommended vigilance and the promotion of targeted surveillance and market restructuring to fight H7N9, H5N1 and other threats.

[dothedd]

FAO Unveils Two H7N9 Emergency Response Plans

Bangkok, Thailand, 18 Sep 2013 -- Two emergency regional projects* aimed at containing avian influenza were launched today by the UN Food and Agriculture Organization’s (FAO) Regional Office for Asia and the Pacific at a three-day workshop. The meeting was attended by veterinary experts from countries in the sub-regions of Southeast and South Asia and from a number of international organizations and development partners.


Working in coordination with development partners such as the United States Agency for International Development (USAID), the World Organization for Animal Health (OIE) and the World Health Organization (WHO), these FAO projects will promote coordinated sub-regional preparedness, surveillance and response to A(H7N9) in poultry and other animal populations in Asian countries at risk. The projects will assist countries in the region to better detect, control and respond to the virus.


The emergence of A(H7N9) influenza in China raises the possibility that the virus could spread to a number of countries in the region which are members of the Association of Southeast Asian Nations (ASEAN) and South Asian Association for Regional Cooperation (SAARC). FAO said these initiatives will boost epidemiologic knowledge, surveillance and diagnostic capacity and risk management, including preparedness and response, risk communication, as well as coordination and collaboration among ASEAN and SAARC countries and between animal and human health authorities.

Countries in Asia need to guard against dangerous transformations of avian flu

Speaking at the workshop project launch, Hiroyuki Konuma, FAO Assistant Director-General and Regional Representative for Asia and the Pacific, warned the region that the “virus in China is still present and there is still a great deal not yet understood about this H7N9 virus. Other influenza viruses that circulate in poultry often decrease dramatically during the summer months, only to reappear later in the year during cold season. Also, many low pathogenic influenza viruses in poultry have transformed into highly pathogenic viruses.”


Konuma called on countries in the region to ensure that they are prepared should the H7N9 virus follow a similar path. “This means that all countries in Asia need to be vigilant– both for incursion and spread of the virus, and possible evolution to highly pathogenic type.”

Preparation needed in case there is a resurgence of the A(H7N9) virus

Konuma urged veterinary experts at the workshop to “discuss how to adjust surveillance and response mechanisms and to prepare for a possible resurgence of H7N9 suggesting that participants identify synergies of the human health, animal health and other sectors among the countries in the region and between the countries and the relevant international organizations.”

He added that the “sharing of information and the coordination that takes place at this meeting, and through the period of these projects, will lead to further improvements in infectious disease detection and response so that, as a global community, we will be better prepared for immediate action and early containment the next time a new disease emerges.”

*Emergency Assistance for Surveillance of Influenza A(H7N9) Virus in Poultry and Animal Populations in Southeast Asia - TCP/RAS/3406(E) and 3407(E)

[dothedd]

How lethal bird flu viruses evolved

September 19, 2013 - 4:31pm

Deadly H7N9 avian flu viruses infected people for the first time earlier this year in China, but little is known about how they evolved to become harmful to humans. In a study published by Cell Press on September 19 in Cell Host & Microbe, an in-depth evolutionary analysis of whole-genome sequences of different types of avian flu viruses has revealed that new H7N9 viruses emerged from distinct H9N2 viruses in a two-step process, first occurring in wild birds and then continuing in domestic birds.

"A deep understanding of how the novel H7N9 viruses were generated is of critical importance for formulating proper measures for surveillance and control of these viruses and other potential emerging influenza viruses," says senior study author Taijiao Jiang of the Chinese Academy of Sciences.

First detected in people in late March, H7N9 viruses have resulted in more than 130 human infections and at least 44 deaths. Most of these infections occurred after exposure to infected poultry or contaminated environments rather than person-to-person contact, but these viruses could evolve to become more readily transmissible among humans. This possible threat highlights the importance of understanding the evolutionary history of H7N9 viruses for developing appropriate strategies to monitor and control outbreaks.

To address this problem, Jiang teamed up with Daxin Peng of Yangzhou University and their collaborators to analyze whole-genome sequences of avian flu viruses from humans, poultry, and wild birds from China. They discovered that H7N9 viruses are genetically diverse, suggesting that complex genetic events were involved in their evolution.

Their analysis revealed that the new H7N9 viruses emerged through a two-step process involving the exchange of genetic material between distinct viruses. In the first step, which took place in wild birds, genetic material from H9N2 viruses and unspecified H7 and N9 viruses was mixed to create precursor H7N9 viruses. The second step, which occurred in domestic birds in eastern China early last year, involved the exchange of genetic material between the precursor H7N9 viruses and other H9N2 viruses to create new, genetically diverse H7N9 viruses.

"Our work not only re-enforces the important role of wild birds in the emergence of novel influenza viruses but also highlights the necessity of integrating data from infections in humans, poultry, and wild birds for effective influenza surveillance," Jiang says.
www.sciencecodex.com/how_lethal_bird_flu_viruses_evolved-119678

[dothedd]

H7N9 potentially highly transmissible, virulent
September 21, 2013

According to a new report in The American Journal of Pathology, researchers from Rotterdam, the Netherlands, found that the virus attaches easily to the epithelium of the upper and lower respiratory tracts, which is a trait not previously observed with avian influenza viruses.

“Abundant virus attachment to the human upper respiratory tract correlates with efficient transmissibility among humans,” Thijs Kuiken, DVM, PHD, of the department of viroscience at Erasmus University Medical Centre, said in a press release. “Virus attachment to Clara cells in the bronchioles and pneumocytes and macrophages in the alveoli correlates with high virulence.”


280 subject H7N9 trial results in august.. could be announced the 24th? below from Vancouver CA newspaper weeks ago..

According to Robin Robinson, director of the Biomedical Advanced Research and Development Authority division of the US Department of Health and Human Services, studies that are about to start should soon offer clues as to whether a usable vaccine against H7N9 avian influenza virus can be made, as reported by The Vancouver Sun.

Four influenza vaccine manufacturers have started or will soon start clinical trials on H7N9 vaccines, with four more expected to conduct trials in the late fall or early winter, says Robinson.

"We're just trying to get some indication that the vaccines are immunogenic and certainly well tolerated and that the adjuvants are providing some antigen-sparing effect," Robinson says, adding that preliminary results could be available in October or November.

Doses from 3.75 mcg to 30 mcg will be tested in a two-dose regimen. "If it takes more than 15 mcg per dose, then we certainly would rely on adjuvants and the antigen-sparing effects of adjuvants, and hopefully these newer ones will work," Robinson says.

Novavax, which does not currently produce a licensed seasonal influenza vaccine in the US, was the first to complete production of its H7N9 trial vaccine, Robinson says, adding that Sanofi Pasteur, Novartis and MedImmune have also made their vaccine batches and testing of their products will begin soon.

It's always good to be First...

Also, Dr. Robin Robinson was formerly Director of Vaccines at Novavax, and helped pioneer VLP technology. How sweet would it be for him if NVAX has the solution to H7N9?

[dothedd]

Researchers develop H7N9 flu vaccineUpdated:
2013-10-26 20:28 ( Xinhua)

HANGZHOU - Chinese researchers announced Saturday they had successfully developed the vaccine for the H7N9 bird flu virus, after the flu strain had left more than 130 people infected, with 45 fatalities reported.

Shu Yuelong, director of the Chinese National Influenza Center, said this is the first influenza vaccine ever developed by Chinese scientists.

The vaccine has provided important technical support to battle the new flu strain, making contribution to the H7N9 flu virus epidemic control all over the world, said Shu, also director of the WHO Collaborating Center for Reference and Research on Influenza.

The vaccine was jointly developed by the First Affiliated Hospital under the School of Medicine of the Zhejiang University, Hong Kong University, Chinese Center for Disease Control and Prevention, National Institute for Food and Drug Control, and the Chinese Academy of Medical Sciences.

China reported the world's first human case for H7N9 bird flu infection in March. As of Friday, a total of 136 people were confirmed to have been infected with the virus, according to the National Health and Family Planning Commission. Of the infected, 45 died, representing a fatality rate of 33.1 percent.