H7N9

[dothedd]

China poultry markets closure helps curtail bird flu spread

October 31, 2013 - 12:19 AMT

PanARMENIAN.Net - Closing live poultry markets in China dramatically curtailed the spread of a novel strain of bird flu this year, an analysis says.

According to BBC News, the report, published in the Lancet, showed shutting the markets cut the number of new cases of H7N9 bird flu by 97%. It said the future of the markets, a millennia-old culture in China, needed to be reassessed.

Experts said the markets can become a reservoir of viruses.
There have been 137 cases of H7N9 bird flu and 45 deaths, according to the World Health Organization. However, most were in the months immediately after the virus was found to be moving from infecting animals to people.

Live poultry markets rapidly became linked with the outbreak. Nearly 800 markets were then shut across Shanghai, Hangzhou, Huzhou, and Nanjing. It allowed scientists to analyze the role of the markets in the spread of the virus.

Dr Benjamin Cowling, one of the researchers at the University of Hong Kong, said: "Our findings confirm that live poultry market closure is a highly effective intervention to prevent human disease and protect public health.

"Without this robust evidence, policymakers would struggle to justify further closures of live poultry markets because of the millennia-old culture of trading live birds and the potential huge economic loss on the poultry industry in China."

The Lancet report said the markets should be "rapidly" closed in areas where the bird flu emerged and that discussions on the role of the markets "should be renewed".

Guillaume Fournie and Dirk Pfeiffer, of the Royal Veterinary College in the UK, said: "If birds spend a sufficient amount of time in live poultry markets to become infected and transmit the virus to other susceptible birds, sustained virus circulation in the live poultry markets can occur. Live poultry markets can then become a permanent source of infection for poultry flocks and for people who are in loose contact with infected poultry."

Two cases of H7N9 bird flu have been reported in October.
Dr Cowling said: "These are the first laboratory-confirmed cases of H7N9 this autumn, five months after the outbreak earlier in 2013. This is of great concern because it reveals that the H7N9 virus has continued to circulate and now has the potential to re-emerge in a new outbreak of human disease this winter."

[dothedd]

Japan ends ban on Wisconsin poultry products Merced Sun-Star

MADISON, Wis. — Japan has lifted a ban on Wisconsin poultry products that was instituted after birds in Jefferson County showed signs of exposure to avian flu.



Wisconsin Ag News Headlines


Japan to Remove Ban Against Wisconsin Poultry Products
Wisconsin Ag Connection - 10/31/2013

Japan has lifted its Low-pathogen Avian Influenza ban on poultry products in two U.S. states, including Wisconsin this week. The move comes four months after a routine inspection at a Jefferson county poultry farm determined that some birds had developed antibodies to the disease indicating possible exposure.

"All initial and follow-up test results were declared negative in early August after an extensive investigation, but it takes time to work through the proper channels to get an international ban lifted," said Wisconsin State Veterinarian Dr. Paul McGraw. He says product from birds slaughtered or eggs laid on or after October 30, 2013 is now eligible for trade to Japan. Any product produced between June 3 and October 30 remains ineligible.

State animal health exports began extensive testing during the early weeks of July after the antibody discovery. DATCP veterinarians and inspectors, utilizing livestock premises registration and poultry sales records, tested 111 flocks within a seven mile radius of the initial property. Follow-up test samples were collected from the same birds two weeks later.

"There was never any risk to public health or food safety and the test results showed no signs of the virus itself," Dr. McGraw said.

China and Russia have also ordered a ban on Wisconsin poultry as a result of the investigation.

A ban on Arkansas poultry products has also been removed this week by Japan and Russia.

[dothedd]

Bird flu outbreak: UAE bans Australia imports

Published Saturday, November 02, 2013

The UAE has slapped a temporary ban on importation of all kinds of tamed, wild and ornamental living birds, their products and offal from Australia due to the appearance of infectious cases of bird flu.

The decision, issued by Dr Rashid Ahmed bin Fahad, Minister of Environment and Water, followed reports received from the International Organisation of Animal Health (OIE) on the appearance of infected cases of highly pathogenic avian influenza virus (H7N2).

The decision exempts heat-treated birds as per ministerial resolution No (9 of 2012) regarding conditions for importing red meat and heat-treated chicken meat.

The ban was imposed as part of the ministry's strategic objectives to keep safe man and animal health in the country from epidemic diseases.

[dothedd]

H7N9: New infection confirmed... 3rd in a month. 


GUANGZHOU, Nov. 5 (Xinhua) -- A three-year-old boy was confirmed to have contracted H7N9 bird flu in south China's Guangdong Province on Tuesday.

The child, a native of Sichuan Province living in a village in Guangdong's Dongguan City, tested positive for the virus by the provincial disease prevention and control center, said a statement issued by the center.

The boy is receiving treatment at the People's Hospital of Dongguan City, and is in stable condition, the statement said.

This is the third H7N9 case reported in autumn in China, following two cases in Zhejiang Province on Oct. 15 and 23.

[dothedd]

Audio:Sep11 Sep19 Oct 17 MAP RSS Feed twitter News Now                      


Another H7N9 Dongguan Case Raises Concerns
Recombinomics Commentary 15:00

November 5, 2013

Patient is an approximately 3 years, 5 months boy, Sichuan Suining people living in Changping Town, Dongguan. Patients currently treated in isolation, Dongguan City People's Hospital, he had no fever, symptoms of mild, stable condition.

The above translation describes the most recent confirmed H7N9 case (3M) in China. He is the third confirmed H7N9 bird flu case this season, but he is near an August case, which was also in Dongguan City in Guangdong Province (see map). The two earlier cases this season were in Zhejiang province, near Shanghai in northern China (see map).

Full sequences have been released from patients in each geographic region. The earlier sequence from Dongguan, A/Guangdong/1/2013, had H7 and N9 sequences similar to the vast majority of cases from the spring (most of which were from northern China in and around Shanghai). However, the sequences for four of the internal gene segments (PB2, PB1, NP, NS) match H9N2 avian sequences from southern China (in and around Hong Kong), in contrast to the cases from northern China, which match H9N2 avian sequences from northern China (in and around Shanghai) as seen in A/Zhejiang/22/2013 and A/Zhejiang/DTID-ZJU10/2013 from the same case (35M).

Thus, the reporting of a second case in Dongguan since August, 2013 raises concerns that two distinct H7N9 lineages are circulating in China at the present time. Moreover, the detection (via routine surveillance) of the most recent case in a child who did not have a fever and had mild symptoms, raises concerns that the number of H7N9 cases, especially in children may be much higher than the reported cases. Moreover, initial reports have not cited a poultry link for the latest case.

More information on poultry exposure and the sequences from this case would be useful.

     
Third H7N9 Zhejiang Case Raises Concerns
Recombinomics Commentary 18:30
November 5, 2013

WHO ‏@who 1h
China has notified WHO of 2 new laboratory-confirmed #H7N9 cases in Guangdong and Zhejiang #influenza

Gregory Härtl‏@haertlg
Two #H7N9 cases in different parts of China on the same day. Winter is starting.

The above tweets from WHO and Gregory Hartl, WHO head of social media / public relations, indicate two new H7N9 bird flu infections have been reported today by China. The case from Guangdong Province (3M) has been widely reported in the media, but an update on a case in Zhejiang Province (see map) has been lacking.

However, two earlier cases in Zhejiang Province were reported by WHO (67M on Oct 24 and 35M on Oct 16), which followed reports of a case in Guangdong province (51F on Aug 11). Sequences from each region indicated two distinct H7N9 sub-clades were circulating, with differences in four internal gene segments (PB2, PB1, NP, NS).

The latest report increases concerns that both sub-clades are emerging again and levels will likely be higher in the winter than the spring of 2013.

More information on the latest case in Zhejiang, as well as detail on poultry exposure for the case in Guangdong Province (which has not been cited thus far) would be useful.

[dothedd]

Technicians on the mainland test for H7N9 bird flu. Photo: Reuters file photo.
Hong Kong has confirmed its first human case of the deadly H7N9 bird flu


December 2, 2013

The deadly H7N9 bird flu virus has arrived in Hong Kong, it was confirmed last night.

The city activated its flu contingency plan after an Indonesian domestic worker who recently travelled to Shenzhen was found to have contracted the deadly new strain, the first case in the city.

The 36-year-old patient is in a critical condition in Queen Mary Hospital, Pok #$%$ Lam, with severe pneumonia and breathing with the help of an artificial lung.

The live-in helper works for a couple with two children, and all four were said to have minor flu symptoms and were under observation in quarantine at Princess Margaret Hospital.

Secretary of the Food and Health Bureau Dr Ko Wing-man said: "Since the helper had travelled to Shenzhen, where she had killed and cooked a live chicken, we believe it is a case imported [from the mainland]."

Health officials are looking for a second person who accompanied the helper to Shenzhen on November 17.

The helper developed flu symptoms four days later. She was first treated at Tuen Mun Hospital, but was transferred to Queen Mary last Wednesday.

Ko said two earlier tests for the virus came back negative, but a third test last night confirmed she had contracted H7N9.

[dothedd]

H7N9 Influenza: The Emerging Infectious Disease

Abstract
Influenza virus infection is a common respiratory pathogen. Emerging of new atypical influenza is usually a big public health threat. H7N9 bird flu is the newest atypical influenza virus infection that has just been reported since early 2013. The emerging of this new disease occurred in China and becomes the present focus for possible worldwide pandemic. In this specific article, the author will discus and describe on epidemiology, symptomatology, pathology, diagnosis, treatment, and prevention of this new bird flu. The literature researching by PubMed and Google is used for data gathering in this collective review.

Keywords: Bird, Emerging, H7N9, Influenza
Go to:
Introduction
Influenza virus infection is a common respiratory pathogen. In fact, there are several groups of influenza viruses, which are proved to be the causes of respiratory tract infections in human beings as well as in other animals. In human beings, the influenza virus infection can be seen worldwide with a wide range of epidemic areas. Each year, million illnesses are reported. As a virus, the possible mutation can be expected, and any sense mutation can result in new problematic virus. The new atypical influenza virus can be the cause of new disease that can cause the worldwide pandemic.[1,2]

There are many historical outbreaks due to emerging of new atypical influenza viruses. Within the past decade, there are several new epidemics due to new atypical respiratory viruses such as H5N1 bird flu[3] and H1N1 swine flu.[4] Emerging of new atypical influenza is usually a big public health threat. H7N9 bird flu is the newest atypical influenza virus infection that has just been reported since early 2013. Indeed, there is a previous big outbreak of bird flu due to H5N1 influenza virus.[3] At that time, the H5N1 influenza became the great concern in global public health.

Due to the nature of a new emerging infection, there are limited data on the natural history of H7N9 influenza infection. Hence, diagnosis and treatment are difficult. The first case was an 87-years-old male from Shanghai, China, with 19 February 2013 onset, and the confirmation on this new emerging infection by Chinese CDC was on 29 March 2013. In this specific article, the author discusses on the new H7N9 influenza infection, which has just been described since early 2013.[5,6]

Go to:
The First Report on New H7N9 Bird Flu in China
Bird flu is not a new thing. Bird flu usually means the influenza infection in avian. However, the case that human beings get the avian type influenza virus infection is usually problematic, and the atypical influenza virus infection can be the result. In early 2013, there are emerging cases of atypical infections in China presenting with the signs and symptoms of acute respiratory tract infection.[5,6] The clinical presentation of this new infection is classified into the respiratory disease. However, some atypical clinical manifestations can be seen. At first, the exact pathogenic cause of this new disease was unknown. Nevertheless, due to the modern technology, the pathogenic agent was finally determined as a kind of influenza virus, H7N9.[7]

Indeed, H7N9 influenza is a kind of virus that is primarily seen in avian.[8,9] Existence as a human pathogen is considered an actual new emerging infection.[10] The new outbreak occurred in China and the clinical scientists finally succeeded in genetic analysis of the novel H7N9 influenza virus.[7] The new virus is considered to the result from the genetic mutated classical avian H7N9 influenza virus and has high potential to cause mammal infection.[7] The sequence of this new pathogen has never been reported elsewhere; hence, the new problematic virus is accepted as a new H7N9 influenza virus. It is proved that there are at least four origins contributing to the sequence of the new N7N9 influenza virus.[11]

Briefly, the HA gene is derived from duck origin, and the NA gene from migratory birds infected with avian influenza viruses.[11]

The first report of swine flu is from Shanghai, China. The first indexed case was in February 2013. China became the present epidemic focus of this new emerging disease. Several infected cases have been continuously reported. Also, there were some death cases. However, after the primary emerging in the primary site in mainland of China, the disease finally spread to the new setting in Taiwan Island bringing more concern on the possibility of worldwide pandemic.[6,12]

Go to:
Epidemiology of New H7N9 Influenza Infection
The new H7N9 influenza infection can be seen in any age groups.[6] Both males and females can be infected.[6] However, in the outbreak in China, most patients are adult.[13] Li et al. analyzed the clinical epidemiology of 82 Chinese infected patients and found that “the median age was 63 years (range, 2 to 89), 73% were male, and 84% were urban residents.[14]” The significant higher incidence in the elderly than other groups is the question that needs further studies to explain.[15]

Of most cases, the main clinical features are “fever and rapidly progressive pneumonia that did not respond to antibiotics.[16]“ Nevertheless, not all cases are severe, and not all cases require hospitalization.[14]

At present, the main question is on the relationship between the infection and poultry contact. Similar to the previous H5N11 bird flu, the avian contact can be identified in almost all patients.[14,16] According to the report by Li et al.,[14] only 77% have the history of avian contact. Therefore, the next question is which contribute to the infection in case with no history of avian contact. Adding to the cross species transmission, the great concern is on human-to-human transmission. Of interest, the genetic mutation contributing to human adaptation of virus is reported, and the human-to-human transmission is the topic to be followed up and further studied.[17] Nevertheless, according to the mathematical predictive model study, the chance for human-to-human transmission is still low at present.[18]

Go to:
Clinical Presentation of New H7N9 Influenza Infection
The signs and symptoms of swine flu are similar to those seen in other respiratory tract infections. The main clinical features of influenza, high fever, coughing, and myalgia can be seen.[5,6] In severe cases, the lung involvement is common.[5,6] Pneumonia is a common complication leading to tachypnia, hypoxemia, and respiratory difficulty.[5,6] In the worst case, respiratory distress and failure leading to death can be observed. Respiratory distress is the most common cause of death among the H7N9 bird flu cases, no regarding to existence of underlying personal illnesses.

In addition to the respiratory manifestation, the atypical clinical manifestations can be seen. Multiple organ involvement can be seen in severe cases. Heart failure, alteration of consciousness, alteration of thrombohemostasis, and renal impairment can be seen.[5,6] For the eye manifestation, conjunctivitis, which is common in H5N1 bird flu, is also common inn H7N9 bird flu.[5,6] Also, diarrhea is also reported as an atypical gastrointestinal manifestation in H7N9 bird flu.[5,6]

Pathology of New H7N9 Influenza Infection

The new H7N9 influenza virus mainly infects the respiratory tissue. However, there is no report on histopathological study of infected cases. Until present, no official autopsy reported is published. Nevertheless, there are some reports on clinical pathology assessment of the infected cases. The abnormalities of laboratory findings are reported. Leukopenia and lymphopenic, thrombocytopenia, impaired renal function and an increase in myocardial enzymes and aspartate aminotransferase are the main observations.[16,19] Increased serum cytokine or chemokine concentrations and disseminated intravascular coagulation are also observed along with disease progression.[16]

Diagnosis of New H7N9 Influenza Infection

Based on clinical feature, the influenza might be preliminary diagnosed. However, it is not possible to differentiate the type of influenza, and diagnosis of specific new H7N9 bird flu needs laboratory support.[20,21] At present, the definitive diagnosis required molecular diagnosis technique. A reverse-transcription PCR assay is required.[22] There is still no rapid test that can give the confirmation of H7N9 bird flu. The preparedness for good diagnostic tool for the new H7N9 bird flu is required.[23]

In clinical practice, it is recommended that any cases with high body temperature (more than 38.3 degree Celsius) and have the history of avian exposure or travel to the outbreak area should be primarily screened by influenza rapid test. If the result from screening is positive, starting the antiviral drug treatment is suggested, and further confirmation test for H7N9 bird flu should be done at the same time. It is observed that sputum is a better specimen than throat swab or viral detection.[16]

For diagnosis of complication of disease, chest radiography is useful for diagnosis of pneumonia. Normally, the chest radiography usually shows diffuse opacities and consolidation in complicated cases.[24] Those cases with severe progression of lung abnormalities usually end up with death.

CONTINUED: www.ncbi.nlm.nih.gov/pmc/articles/PMC3759064/
 

[dothedd]

17 people in isolation amid scare over Hong Kong's first H7N9 bird flu case 200 are under observation ... 200 are under observation after having contact with helper confirmed to be infected with H7N9 virus, but all tests so far have proved negative

Seventeen people are in isolation after coming into contact with an Indonesian domestic helper who is the first person in Hong Kong to be infected with the deadly H7N9 strain of bird flu.

They are among more than 200 people who have been placed under observation as a precaution, the Centre for Health Protection said yesterday.

Those in isolation either lived in the same Tuen Mun flat as the patient or were in the same cubicle as her when she was treated in Tuen Mun Hospital.

The Indonesian consulate confirmed the patient was 36-year-old Tri Mawarti.

The centre's controller, Dr Leung Ting-hung, said: "There is so far no evidence to show the virus has spread to another person. According to the assessments of the World Health Organisation and Centre for Health Protection, the risk of locals contracting H7N9 has not increased or changed."

Tri was transferred to the intensive care unit at Queen Mary Hospital in PokLam on Saturday, where she is in critical condition. Indonesia's vice-consul for public affairs Sam Aryadi said she would be offered as much help as possible.

Of the 17 classified as high-risk, 11 had tested negative in preliminary examinations but would undergo more tests, Leung said.

They are 10 members of the family the helper lived with and an Indonesian friend, aged 33, who accompanied her on November 17 to Shenzhen, where they killed and cooked a chicken.

All 17 were isolated at Princess Margaret Hospital in Kwai Chung. Five of them, who had shown no symptoms, would be transferred to the Lady MacLehose Holiday Village in Sai Kung, a site the government had reserved for quarantine purposes, Secretary for Food and Health Dr Ko Wing-man said.

Six of the 17 who had yet to be tested were patients at Tuen Mun Hospital while Tri was there for four days. Others under observation include staff from the clinics of Dr Simon Wong Siu-shan on Castle Peak Road - which Tri visited on November 25 - and Dr Wong Chun-yan in Tuen Mun, which she visited the next day. The rest are staff and patients of the two public hospitals and a member of ambulance staff who handled Tri's transfer.

Medical experts said that as Tri's infection was only confirmed after a third H7N9 test, this suggested a preliminary viral test might not be accurate enough. The University of Hong Kong's chair of virology, Professor Malik Peiris, said the virus might not be detectable when the strength was low.

"The avian influenza virus is found deep in the lungs. The patient's first two samples were taken from the upper respiratory tract because she was not so sick at the time. The third time it was taken from her lungs."

His university colleague, Ho Pak-leung, said evidence in four clusters of patients on the mainland suggested the virus could have developed a limited ability to pass from person to person.

The H7N9 virus has killed 45 of the 138 people infected on the mainland since the first human case was reported in February. One person has also been infected in Taiwan.

[Deleted]

This is getting spooky. I'm about ready to go into isolation mode. 

[dothedd]

Thank you LW for adding a photo to the thread.  Yes, it is indeed getting   spooky! 

 

[dothedd]

Hong Kong: "The Serious Response Level under the Government's Preparedness Plan for Influenza Pandemic is activated."
Hong Kong does NOT fool around!
-----------------------------------------------------
HK CHP: Update On H7N9 Epidemiological Investigation & Response

The impressiveness of Hong Kong’s CHP’s public health response to their first (apparently) imported case of H7N9 is only matched by their willingness to publicly disclose every step along the way.

Today, we’ve another long update, which contains the good news that so far – no other H7N9 positive cases have been detected.

Epidemiological investigation and follow-up actions by CHP on confirmed human case of avian influenza A(H7N9)

The Centre for Health Protection (CHP) of the Department of Health (DH) today (December 4) provided an update on the first confirmed human case of avian influenza A(H7N9) in Hong Kong.

"The CHP's epidemiological investigation, enhanced disease surveillance, port health measures and health education have been in full swing since the Government escalated the response level under the Preparedness Plan for Influenza Pandemic from 'Alert' to 'Serious'," a spokesman for the DH remarked.

As of 2pm today, no additional close contacts have been identified. The number of close contacts located remains at 17 while there are over 220 other contacts. Details are as follows:

(A) Specimens of the 17 close contacts all tested negative for the avian influenza A(H7N9) virus upon preliminary laboratory testing by the Public Health Laboratory Services Branch (PHLSB) of the CHP. They were prescribed with the antiviral Tamiflu prophylaxis and have to be quarantined for 10 days since their last contact with the patient. During isolation, if their health conditions change, further testing and surveillance will be conducted. They include:

Ten home contacts (including four with non-specific symptoms);
A female collateral aged 33, who visited Shenzhen with the patient; and
Six patients in Tuen Mun Hospital who stayed in the same cubicle with the confirmed patient (including one with non-specific symptoms).
Asymptomatic close contacts will be arranged to stay in the quarantine centre in Lady MacLehose Holiday Village in Sai Kung. It has been equipped with basic residential facilities, including suitable bungalows, rooms and activity premises.

(B) Over 220 other contacts, including two private doctors whom the patient consulted, their clinic staff, patients and accompanying relatives, health-care workers of Tuen Mun Hospital, Queen Mary Hospital and the ambulance service, and relevant hospital visitors, have remained well so far. Medical surveillance is ongoing and they have been offered Tamiflu prophylaxis.

The epidemiological investigation by the CHP, including contact tracing and tracing the source of infection, is ongoing.

"Upon the PHLSB's analysis, the genes of the virus of the confirmed case do not show any significant difference from the avian influenza A(H7N9) viruses isolated from human cases detected so far in the Mainland. There is also no evidence of genetic reassortment nor resistance to Tamiflu. We will continue to liaise and share the gene sequence based on established arrangements," the spokesman stressed.

Locally, enhanced surveillance over suspected cases in public and private hospitals is under way. The CHP will continue to maintain liaison with the World Health Organization (WHO), the Mainland and overseas health authorities to monitor the latest developments and obtain timely and accurate information. Local surveillance activities will be modified according to the WHO's recommendations.


"All border control points (BCPs) have implemented disease prevention and control measures. Thermal imaging systems are well in place at BCPs for body temperature checks of inbound travellers. The DH has liaised with the Auxiliary Medical Service and the Civil Aid Service to deploy additional manpower at BCPs to conduct random temperature checks using handheld devices," the spokesman remarked.


The Port Health Office of the DH has maintained liaison with the Shenzhen Entry-Exit Inspection and Quarantine Bureau while being on the alert for travellers and also cross-boundary students with fever or other symptoms. Suspected cases will be immediately referred to public hospitals for follow-up investigation.


Regarding health education to travellers at BCPs, distribution of health education pamphlets, the display of posters on avian influenza A(H7N9) in departure and arrival halls, in-flight public announcements, environmental health inspection and the provision of regular updates to the travel industry via meetings and correspondence have all been escalated. The DH will keep a close eye on the latest developments and adopt corresponding port health measures.


"We have enhanced publicity and health education on the prevention of avian influenza. Meanwhile, consulates, foreign domestic helpers' associations and non-governmental organisations serving ethnic minorities have been notified of the case, the latest developments and the preventive measures. Health educational materials are being distributed through them," the spokesman added.


An array of key publicity materials of the CHP, including those on avian influenza, influenza, guidelines for proper hand washing and personal and environmental hygiene in various languages, including Indonesian, Hindi, Nepali, Urdu, Thai and Tagalog, can be accessed in the CHP's website

(www.chp.gov.hk/en/submenu/424.html).

The CHP's hotline [phone]) has been set up for public enquiries and operates from 9am to 6pm. As of 4pm today, 37 enquiries were received.


"Travellers, especially those returning from avian influenza A(H7N9)-affected areas, with fever or respiratory symptoms are reminded to immediately wear facial masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should also pay special attention to patients who might have had contact with birds, poultry or their droppings in affected areas," the spokesman advised.


The spokesman also urged travellers not to visit live poultry markets in the affected areas and to avoid direct contact with poultry, birds and their droppings. If contact has been made, they should thoroughly wash their hands with soap and water.


Members of the public should remain vigilant and are reminded to take heed of the following preventive advice against avian influenza:

Poultry and eggs should be thoroughly cooked before eating;
Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment such as escalator handrails, elevator control panels or door knobs; or when hands are dirtied by respiratory secretions after coughing or sneezing;
Cover the nose and mouth while sneezing or coughing, and hold the spit with a tissue and put it into a covered dustbin;
Avoid crowded places and contact with fever patients; and
Wear a mask when respiratory symptoms develop or when taking care of fever patients.

The public may visit the CHP's avian influenza page for more information on avian influenza-affected areas.
 
www.chp.gov.hk/en/view_content/24244.html) and its website 
www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf 

[dothedd]

Woman with H7N9 remains critical, fellow patient has flu like symptoms on Facebook

Novel Hong Kong H7N9 Constellation Has Unique Aspects
By Tahilla on Dec 05, 2013 12:29 am

A/Hong Kong/5942/2013 also had same relationship with H7, N9, MP, and NS, including the presence of Q226L in H7. In addition, the H7 sequence had T131A, which was also uniquely found in A/Guangdong/1/2013. Similarly, the PB2 had E627K and was closely related to the PB2 in A/Guangdong/1/2013. However, the other three internal genes (PB1, PA, NP) were related to H9N2 sequences circulating in southern China (largely Hong Kong), but were distinct from the A/Guangdong/1/2013 sequences. Thus, A/Hong Kong/5942/2013 represents an independent introduction into humans, which reflects a constellation circulating in southern China that is distinct from the August H7N9 from Guangdong Province. This sequence data indicates H7N9 circulating in southern China is readily distinguished from the former and recent sequences in northern China, and there is significant heterogeneity in the southern sequences signaling widespread H7N9 in poultry in southern China.



 Like Novel Hong Kong H7N9 Constellation Has Unique Aspects o

H5N1: H7N9: Travellers to Hong Kong tested as Shenzhen stalls
By Tahilla on Dec 05, 2013 12:20 am

About 40 staff members would be added to border checkpoints to run temperature tests on travellers, Leung said. Public hospitals were urged to perform more thorough tests on suspected H7N9 cases, since Tri was diagnosed only upon more comprehensive testing, the Hospital Authority's chief infection control officer Dr Dominic Tsang Ngai-chong said. Across the border, attitudes towards the virus were more relaxed in the government and media. Sterilisation measures were little used at Shenzhen's markets.

Read in browser »

 H5N1: H7N9: Travellers to Hong Kong tested as Shenzhen stalls 

Clinics visited by H7N9 bird flu patient will remain open, doctors still working
By Tahilla on Dec 04, 2013 09:46 pm

Two private clinics in Tuen Mun remained open yesterday after they were identified as having treated an Indonesian domestic helper later diagnosed to be infected with the deadly H7N9 strain of bird flu. The two doctors who saw the ill helper late last month, along with nurses and patients who were present when she sought treatment, are among more than 200 people placed under observation by health authorities. Yesterday, a patient at the clinic of Dr Simon Wong Siu-shan said he was not worried the doctor might have been infected. "There is unlikely to be a big risk," the man said after consulting Wong, who treated H7N9 patient Tri Mawarti, 36, at his Castle Peak Road clinic on November 25. A nurse said Wong was busy seeing patients and had declined to be interviewed.

[dothedd]

5 December 2013

Epidemiological investigation and follow-up actions by CHP on confirmed human case of avian influenza A(H7N9)

The Centre for Health Protection (CHP) of the Department of Health (DH) today (December 5) provided an update on the first confirmed human case of avian influenza A(H7N9) in Hong Kong.

"The epidemiological investigation, enhanced disease surveillance, port health measures and health education are proceeding," a spokesman for the DH remarked.

As of 2pm today, no additional close contacts have been identified. The number of close contacts located remains at 17 while there are over 220 other contacts. Details are as follows:

(A) 17 close contacts remain under quarantine for 10 days since their last contact with the patient. Their specimens tested negative for the avian influenza A(H7N9) virus upon preliminary laboratory testing by the Public Health Laboratory Services Branch of the CHP. During isolation, if their health conditions change, further testing and surveillance will be conducted. They include:

1. Ten home contacts (including four with non-specific symptoms);
2. A female collateral aged 33, who visited Shenzhen with the patient; and
3. Six patients in Tuen Mun Hospital (TMH) who stayed in the same cubicle with the confirmed patient (including one with non-specific symptoms).

(B) Over 220 other contacts, including two private doctors whom the patient consulted, their clinic staff, patients and accompanying relatives, healthcare workers (HCWs) of TMH, Queen Mary Hospital (QMH) and the ambulance service, and relevant hospital visitors, are all under medical surveillance. Among them:

1. A patient who consulted Dr Wong Chun-yan and presented with non-specific symptoms tested negative for the avian influenza A(H7N9) virus; and
2. Twelve HCWs of TMH and QMH who presented with non-specific symptoms tested negative for the avian influenza A(H7N9) virus.

Locally, enhanced surveillance over suspected cases in public and private hospitals is underway. The CHP will continue to maintain liaison with the World Health Organization (WHO), the Mainland and overseas health authorities to monitor the latest developments and obtain timely and accurate information. Local surveillance activities will be modified according to the WHO's recommendations.

"All border control points (BCPs) have implemented disease prevention and control measures. Thermal imaging systems are in place at BCPs for body temperature checks of inbound travellers. The DH has liaised with the Auxiliary Medical Service and the Civil Aid Service to deploy additional manpower at BCPs to conduct random temperature checks using handheld devices," the spokesman said.

The Port Health Office of the DH is maintaining liaison with the Shenzhen Entry-Exit Inspection and Quarantine Bureau to stay alert for travellers and also cross-boundary students with fever or other symptoms. Suspected cases will be immediately referred to public hospitals for follow-up investigation.

Regarding health education for travellers at BCPs, the distribution of health education pamphlets, display of posters on avian influenza A(H7N9) in departure and arrival halls, in-flight public announcements, environmental health inspection and the provision of regular updates to the travel industry via meetings and correspondence have all been escalated. The DH will keep a close eye on the latest developments and adopt corresponding port health measures.

"We have enhanced our publicity and health education on the prevention of avian influenza. Meanwhile, consulates, foreign domestic helpers' associations and non-governmental organisations serving ethnic minorities have been notified of the case, the latest developments and the preventive measures. Health educational materials are being distributed through them," the spokesman added.

An array of key publicity materials of the CHP, including those on avian influenza, influenza, guidelines for proper hand washing and personal and environmental hygiene in various languages including Indonesian, Hindi, Nepali, Urdu, Thai and Tagalog, can be accessed in the CHP's website (www.chp.gov.hk/en/submenu/424.html).

The CHP hotline [phone]) has been set up for public enquiries and operates from 9am to 6pm. As of 4pm today, 57 calls had been received.

"Travellers, especially those returning from avian influenza A(H7N9)-affected areas with fever or respiratory symptoms, are reminded to immediately wear facial masks, seek medical attention and reveal their travel history to a doctor. Healthcare professionals should also pay special attention to patients who might have had contact with birds, poultry or their droppings in affected areas," the spokesman advised.

The spokesman also urged travellers not to visit live poultry markets in the affected areas and avoid direct contact with poultry, birds and their droppings. If contact has been made, they should thoroughly wash their hands with soap and water.

Members of the public should remain vigilant and are reminded to take heed of the following preventive advice against avian influenza:

* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment such as escalator handrails, elevator control panels or door knobs; or when hands are dirtied by respiratory secretions after coughing or sneezing;
* Cover the nose and mouth while sneezing or coughing, and hold the spit with a tissue and put it into a covered dustbin;
* Avoid crowded places and contact with fever patients; and
* Wear a mask when respiratory symptoms develop or when taking care of fever patients.

The public may visit the CHP's avian influenza pageavian influenza-affected areas.  www.chp.gov.hk/en/view_content/24244.html) and its website www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf

[dothedd]

Hong Kong confirms second case of H7N9 bird flu in a week
December 6, 2013 11:29pm


HONG KONG - Hong Kong has confirmed its second case of the deadly H7N9 bird flu, days after the first, as the virus spreads beyond mainland China, authorities said on Friday night.

The victim, an 80-year-old man from the neighboring Chinese city of Shenzhen, is in a stable condition in a hospital in Tuen Mun on the outskirts of Hong Kong and will be transferred to an isolation facility.

"There is no evidence that this virus can cause sustained human-to-human transmission, so the risk of widespread or community-wide outbreak at this stage is low," said Dr Leung Ting-hung, controller of the Centre for Health Protection. But the city is maintaining its influenza pandemic response level at "serious".

On Monday, Hong Kong's officials said a 36-year-old Indonesian domestic helper with a history of contact with poultry and travel to Shenzhen had been confirmed to be infected with H7N9 and had been hospitalized in a critical condition.

"I don't think at this stage we can find any evidence of any links between the two cases. We have no evidence that they had come into contact with each other," Leung added.

The H7N9 strain killed around 45 of some 135 people it infected in mainland China earlier this year, before appearing to peter out during the summer.

This year marks the 10th anniversary of the outbreak of Severe Acute Respiratory Syndrome, which killed nearly 300 people in Hong Kong and had a significant impact on the city's economy.





Zhejiang new case of human infection of bird flu H7N9

December 7, 2013 08:04:48 Source: Evening News

WASHINGTON Health Department of Zhejiang Province, Dec. 6 briefing, Zhejiang add one case of human infection with H7N9 avian influenza cases . Patients Mr. Yu, male, 30 years old. Confirmed on 5 December, and now the First Affiliated Hospital, Zhejiang University School of Medicine for treatment.
　　
Reporters learned that the infection of H7N9 avian influenza virus of Mr. Yu, Zhejiang University is in a hospital last Wednesday confirmed 57-year-old Mr. Zhang's son.
　　
Up to now, the second half of H7N9 avian influenza infection in Zhejiang Province increased by 4 people, including one case of H7N9 bird flu in Jiaxing died.
　　
Currently, Mr. Yu Zhang, together with the father, lived in a hospital infection Zhejiang Branch isolation ward. Admitted to the ward in the first half of this year over most of the H7N9 bird flu patients.
　　
Zhejiang an infection, deputy director Joseph Leung told reporters last week confirmed Zhang critical condition, still in the rescue.
　　
Last week, Mr. Zhang fever pneumonia, from Zhejiang Anji home to an emergency room visits during sudden exacerbations, respiratory failure. After being diagnosed with the H7N9 avian influenza infection.
　　
Doctors told the family, the family kept six chickens, chickens before the disease usually is Zhang, cleaning chicken. Doctors have speculated that Zhang H7N9 avian influenza infection, probably related with these birds carry the virus. Mr. Zhang was diagnosed shortly after their son Mr. Yu high fever symptoms. After testing, the swabs were positive for H7N9 virus, at present, Mr. Yu received, including anti-virus, including the "Four anti-two balancing" treatment, his condition is still stable, conscious and does not need the help of ventilator-assisted breathing equipment.
　　
Wengxu two consecutive recruit children in the H7N9 avian influenza virus, is the result of two people were exposed to infected poultry, or "person to person" is? Yesterday, after consultation experts said, can not prove that the two were "person to person" infection. The reporter Rui

zhttp://news.xinhuanet.com/politics/2013-12/07/c_125822263.htm

[Deleted]

 Whoever translated the article in message 73 "should not give up their day job".

[dothedd]

Hong Kong quarantines 19 people over second bird flu case
December 8, 2013 1:53am

HONG KONG - Hong Kong on Saturday quarantined an additional 19 people after the city confirmed its second human case of the deadly H7N9 bird flu, less than five days after it confirmed its first, officials said.

The 19 people were close contacts of the second carrier of H7N9 in the city -- an 80-year-old Hong Kong man who had been living in the neighboring mainland Chinese city of Shenzhen.

The man developed a fever and was found to be infected with the virus on Friday after he was admitted to the city's Tuen Mun hospital on Tuesday due to underlying medical conditions.

"Nineteen close contacts of the patient have been quarantined," a government statement released late Saturday said.

Out of the 19 quarantined, 13 had stayed in the same cubicle with the elderly man at the city's Tuen Mun hospital, five were his family members, and one other was the taxi driver who drove him from the border to the hospital, the statement said.

Eighteen of the quarantined patients have tested negative for the deadly virus, while the test results for an "asymptomatic" patient was pending. All 19 will be quarantined for 10 days since their last contact with the carrier.

Officials are still investigating whether or not the 80-year-old patient, who remains in stable condition, had come into contact with poultry on the mainland.

On Monday the city admitted a 36-year-old Indonesian domestic helper who was infected with the virus.

"She has a history of traveling to Shenzhen, buying a chicken, slaughtering and eating the chicken," Hong Kong health minister Ko Wing-man had said of the patient, who remains in a critical condition.

Health officials said they have not found any links between the two cases.

The government has placed 17 people who had been in close contact with the Indonesian patient under quarantine since Tuesday.

Hong Kong is especially alert to the spread of viruses after an outbreak of Severe Acute Respiratory Syndrome (SARS) swept through the city in 2003, killing 299 people and infecting around 1,800.

In all, 138 human cases of H7N9 have been reported in mainland China since February with 45 deaths, according to the World Health Organization. — Agence France-Presse

[dothedd]

December 7, 2013, Saturday (Shanghai Daily).
The city’s hospitals all reported a rise in the number of patients with respiratory problems over the past few days. Huadong Hospital said there had been a 30 percent increase.

Dr Zhou Min of Ruijin Hospital’s respiratory disease department said outpatients increased 20 to 30 percent, with emergency cases up 50 to 60 percent. “Winter is always the peak time for patients with respiratory syndromes due to the cold weather, while the poor air quality can trigger asthma and lung infections,” she said.

Shanghai Children’s Hospital said it had seen more than 5,000 outpatient and emergency cases this week, a quarter more than the same period of last year.

A recent cold front and the haze were said to be the major cause of respiratory infections and asthma in children while almost a third of them suffered from diarrhea.

This is a perfect cover for H7N9 to both mix with seasonal inflluenna and go multiply undetected. (patients with H7N9 have sometimes tested positive only after the 3rd attempt. The test is not that good.)

[dothedd]

H7N9 in Zhejiang (right outside Shanghai), human to human could not be excluded.
Zhejiang new case of human infection cases of H7N9 human transmission could not be excluded
2013-12-08 09:41 Youth Times

The day before yesterday, the provincial Health Department, the province added one case of human infection with the H7N9 avian influenza. Patients Yu, male, 30 years old, was diagnosed on December 5, now Zheda a hospital.

Disease Control and Prevention deputy director CHEN En-fu revealed that Yu is November 27th a confirmed H7N9 infected Angie's son, usually the two do not live together, when their father had a history accompanying the onset. Yu onset of certain specific reasons still under investigation, did not rule out the possibility of human transmission of the H7N9 virus.

[dothedd]

Dec 7, 2013 15:44:19 GMT -5 @patiencetried said:

 Whoever translated the article in message 73 "should not give up their day job".




PLEASE FEEL FREE TO IMPROVE IT IF YOU WISH.....

[dothedd]

CENTER FOR DISEASE CONTROL AND PREVENTION

www.cdc.gov/flu/avianflu/h7n9-references.htm 

[dothedd]

  A MERRY CHRISTMAS TO ALL ... AND TO ALL A GOOD NIGHT!  

[dothedd]

Chinese Bird Flu Mutates; A(H7N9) Becomes Resistant To Drugs Without Losing Ability To Spread


Dec 10, 2013 06:28 PM EDT

In a new study published today, researchers have discovered that the Chinese bird flu strain, A(H7N9), has a mutation immunizing it to common anti-viral drugs. While this doesn’t necessarily herald cause for concern of a pandemic, the researchers recommend using anti-viral drugs with caution.

Many seasonal influenza strains become less transmissible after they become resistant to drugs such as Roche’s Tamiflu. But the scientists found that the avian influenza strain, doesn’t work in the same way. It maintains its ability to be transmitted, even after it develops an immunity to drugs. The researchers urge doctors to make wise choices when handing out anti-viral medications for H7N9 cases — they should avoid using common drugs like Tamiflu, which could help build resistance in the virus, the researchers suggested.

“Without baseline human immunity to the emergent avian influenza A(H7N9)… [anti-viral drugs] are vital for controlling viral replication in severe infections,” the study authors wrote in their abstract. Nicole Bouvier, a lead author of the study published in Nature Communications, told Reuters that it’s important to know that “these H7N9 viruses seem to transmit fairly inefficiently overall. But what was surprising about our study was that the drug-resistant virus was no less efficient than the drug-sensitive one. Usually what we see with influenza, is that resistance…also confers a fitness disadvantage on the virus.” Bouvier and her team worked at the Mount Sinai School of Medicine in New York.

The researchers had received a sample of the H7N9 virus from a patient in China. They tested its response to Tamiflu, or oseltamivir, which is commonly used to treat the flu. Bouvier found that H7N9 was resistant to Tamiflu but that it could still spread to human cells in laboratory dishes.

The virus was first confirmed in a human earlier this year in China. Since March, there have been 143 people infected with H7N9 in China. Forty-five of them have died. Even back then, scientists worried about the extent of the damage H7N9 could produce, but so far it hasn’t caused a pandemic. Perhaps this is in part due to the strain’s difficulty in being transmitted from human to human. Today, the World Health Organization (WHO) reported two new bird flu patients in China, who are currently in critical condition. Reuters reports that another team of researchers in the U.S. has also been studying the H7N9 virus, and claims that it would need to undergo several mutations before becoming easily spreadable through humans. Currently, it is mostly transmittable through infected birds or other animals, or by handling contaminated poultry.

New Strain of H7N9....They found it was highly resistant to Tamiflu, but also that it still had the ability to infect human cells in a laboratory dish, and spread between laboratory animals just as efficiently as its non-mutated counterpart.

"This is unusual, as it is known that when seasonal influenza viruses gain resistance to drugs, it usually happens at a cost to the virus - the cost being a reduced ability to transmit between hosts and to grow within them," they wrote.

And since it is known that treating flu with antivirals can lead to drug resistance "this study further underscores the need of prudent use of antivirals in H7N9 influenza infections".

[dothedd]

How the Flu Virus Changes

Flu viruses constantly change and mutate. Sometimes these mutations result in viruses that move from animals to humans.

Antigenic drift refers to changes to the flu virus that happen slowly over time. This causes the changes to the seasonal flu that require us to get vaccinated against the flu each year.

Antigenic shift results when two different flu strains combine and infect the same cell. This mutation is what allows flu viruses to move from animals to humans.
How do flu viruses change?

Flu viruses are constantly changing and mutating. These changes can happen slowly over time or suddenly.

Antigenic drift is when these changes happen slowly over time. These changes happen often enough that your immune system can’t recognize the flu virus from year to year. That is why you need to get a new flu vaccine each year. The flu vaccine protects you against that season’s three or four most common flu virus strains.

Antigenic shift is when changes happen suddenly. This occurs when two different flu strains infect the same cell and combine. This may create a new flu subtype. Because people have little or no immunity to the new subtype, it can cause a very severe flu epidemic or pandemic.

How do flu viruses move from animals to humans?

Flu viruses move from animals to humans because of antigenic shift. Antigenic shift can happen in three ways:

Antigenic Shift 1
A duck or other aquatic bird passes a bird flu strain to an intermediate host such as a chicken or pig.
A person passes a human strain of influenza A to the same chicken or pig.
When the viruses infect the same cell, the genes from the bird strain mix with genes from the human strain, making a new strain.
The new strain can spread from the intermediate host to humans.

Antigenic Shift 2
A bird strain of flu can jump directly from a duck or other aquatic bird to humans.

Antigenic Shift 3
A bird strain of flu can jump directly from a duck or other aquatic bird to an intermediate animal host, such as a chicken or pig, and then to humans.
The new strain may evolve and spread rapidly from person to person. If so, it could result in a pandemic.

[dothedd]

China confirms new human H7N9 case

English.news.cn 2013-12-18 18:32:09

GUANGZHOU, Dec. 18 (Xinhua) -- South China's Guangdong Province reported its third human H7N9 case in four days on Wednesday, raising the total H7N9 cases in the province to five since August.

The new patient is a 62-year-old resident surnamed Liang in Yangjiang City, said the provincial health authority. He is in critical condition.

A 39-year-old man in Dongguan City and a 65-year-old woman in Yangjiang were confirmed to have been infected by the H7N9 strain on Sunday and Monday, respectively.

So far, Guangdong has confirmed five human H7N9 cases since Aug. 10, with two in Dongguan, two in Yangjiang and one in Huizhou City. Its first case, a 51-year-old woman in Huizhou, recovered in September after being treated in a hospital for more than one month.

The province dispatched five inspection teams to 21 cities and a district on Wednesday to strengthen H7N9 prevention and control efforts.

The Chinese mainland has reported 143 human infections of the deadly bird flu virus since it emerged in March. Earlier this month, Hong Kong also confirmed its first two H7N9 cases, including an Indonesian national and a mainland resident.

Also on Wednesday, health authorities in east China's Jiangxi Province confirmed a human case of H10N8, a new strain of bird flu known to affect humans.

A 73-year-old woman who died of respiratory failure on Dec. 6 was later confirmed to have been carrying the H10N8 virus by the Chinese Center for Disease Control and Prevention, according to the provincial health department. The statement did not mention whether her death was connected to the bird flu virus.

[dothedd]

H7N9
More than a third of patients infected with a new strain of bird flu died after being admitted to the hospital earlier this year, Chinese researchers report in a new study.

Since the new H7N9 bird flu first broke out in China in late March, the strain has infected more than 130 people and killed 37.

The World Health Organization (WHO) has previously described H7N9 as 'one of the most lethal influenza viruses' it has ever seen and said it appeared to spread faster than the last bird flu strain, H5N1, that threatened to unleash a pandemic.

After making some adjustments for missing data, the Chinese scientists estimated the overall death rate to be 36 per cent.

Precautions: An employee wearing a protection suit sprays disinfectant on chickens at a poultry market in Hefei, Anhui, China, last month.

The outbreak was stopped after China closed many of its live animal markets - scientists had assumed the virus was infecting people through exposure to live birds.

That makes the new strain less deadly than H5N1, which kills about 70 per cent of the people it infects.

Still, H7N9 is more lethal than the swine flu that caused a 2009 global epidemic. That had a death rate of less than one per cent.

More...
Doctors fear bird flu strain which has killed 36 in China has become resistance to antiviral drugs

The results were released in two papers on the H7N9 strain, published online Monday in the journal Lancet.

One article compared the new H7N9 strain with the H5N1 strain, using data from confirmed cases of H7N9 (130 patients) and H5N1 (43 patients) that were reported until May 24, this year.

It found that both viruses were related to exposure to poultry - 75 per cent of patients infected with H7N9 and 71% of those with H5N1.

New strain: Researchers found that the virus effectively mutated to resist treatment in three of 14 cases (file picture)

Though there was little evidence, save for a small cluster, to show that H7N9 transmitted from human to human.

The new flu strain appears to infect older people more. Researchers found the average age of infected patients was 62 years, compared with 26 for H5N1.

Men in urban areas appear to be more prone to infection than women.

'The good news is that numbers of (H7N9) cases have stalled,' Cecile Viboud and Lone Simonsen of the U.S. National Institutes of Health wrote in a commentary accompanying the article.

However, they warned that the threat of the virus still 'persists' and predicted that the strain might return in the winter, when flu viruses are typically most active.

Resistant: Three Shanghai sufferers of a strain of bird flu which has killed 36 people in China have shown resistance to antiviral drugs such as Tamiflu...


That assessment echoes the WHO, which earlier this month also warned of the virus adapting and becoming resistant to therapy.

Shanghai doctors treating 14 sufferers of the H7N9 virus recently found that it had become resistant to Tamiflu in three of the patients.

Researchers at the Shanghai Public Health Clinical Centre said that while the drug reduced levels of the virus in 11 of the patients, genetic testing of bird flu in the three who did not respond to treatment showed it was able to effectively mutate to resist Tamiflu.


Read more: www.dailymail.co.uk/news/article-2347227/H7N9-More-THIRD-patients-new-bird-flu-strain-die-despite-hospital-treatment.html#ixzz2nqQ2M5lQ

[dothedd]

AN INTERESTING ARTICLE:
 
December 17, 2013
Health News

VIDEO www.wfaa.com/news/health/236215121.html

Mystery illness claims 4 lives in Montgomery County

MONTGOMERY COUNTY, Texas -- Officials with the Montgomery County Health Department are on a mission to find out more about a mystery flu-like illness.
So far, half of the people who have come down with it have died.
According to the health department, all of the patients have had flu-like and/or pneumonia like symptoms. However, all of them have tested negative for the flu.
There have been eight confirmed patients ranging in age from 41 to 68. Four of those patients have died.
Sources told WFAA sister station KHOU that two of the surviving patients are being treated at Conroe Regional Medical Center and are “very sick."
Those sources said doctors are being advised to use extra precaution to prevent this from spreading.
It’s unclear if any of the patients had pre-existing conditions.
The Montgomery County Health Department is waiting on more conclusive test results. Officials are hoping they will have more answers in the days to come.

[dothedd]

HEADS UP!

China
Jan. 20, 2014
H7N9 Bird Flu in Shanghai Kills First Medical Worker, Renewing Transmission Fears

The H7N9 bird flu virus has claimed the life of a medical professional in Shanghai, renewing concerns that the virus can spread between people.

An unnamed hospital official told South China Morning Post that there was no evidence that the thoracic surgeon, who died on Saturday morning, had been in contact with live poultry recently. However, he could have treated patients with pneumonia, a symptom of H7N9 infection.

“If the diagnosis is confirmed and no [bird] exposure history is elicited, this does point slightly more to the possibility that H7N9 may be more transmissible between humans than H5N1,” said Yuen Kwok-yung, a microbiologist at the University of Hong Kong.

The H7N9 strain of bird flu was found to have been transmitted from human to human for the first time in August, when a woman caring for her H7N9-stricken father in a hospital in eastern China herself contracted the virus.

The World Health Organization said Monday that it had been notified of more than 40 confirmed human H7N9 infections this month in China.

Reuters
Health officials in protective suits put a goose into a sack as part of preventive measures against the H7N9 bird flu at a poultry market in Zhuji, Zhejiang province January 5, 2014.

Read more: H7N9 Bird Flu Kills First Doctor | TIME.com world.time.com/2014/01/20/h7n9-bird-flu-kills-medical-professional/#ixzz2r2zfbe3X

[Deleted]

We knew it was only a matter of time.

[grits]

So many of you wouldn't believe us but we kept on telling you that being chicken crap could kill somebody.

[Deleted]

We've got what we think is H1N1 hitting our town really hard, taking 2 weeks to recover. One person has died. Anything worse, like this, and we'd be hurting.