A CDC scientist uses a pipette to transfer H7N9 virus into vials for sharing with partner laboratories for public health research purposes.
# 7196
While it remains to be seen just how much of a threat the H7N9 virus will pose to global health, the CDC – quite prudently – is taking steps to prepare, should this virus eventually pose a pandemic threat.
A few excerpts from a CDC posting from today, and then I’ll return with a bit more, including what you should be doing now to prepare as well:
H7N9 Update; CDC Pandemic Preparedness Activities Progress
April 26, 2013 – The number of human infections with avian influenza A (H7N9) in China has risen to 109; with 23 deaths.* There are still no reports of H7N9 in the United States. While there is no evidence of sustained human-to-human spread of this virus, CDC is taking routine pandemic preparedness measures to prepare for that possibility.
This update contains information on CDC laboratory activities to date, an update on the H7N9 outbreak in China and background information on RT-
PCR tests.
CDC Activities to Date Include:Growing and Sharing the Virus
The first H7N9 virus isolate from China was received by CDC on Thursday, April 11, 2013. The virus was immediately inoculated into hundreds of eggs to grow more of the virus. The virus replicated well in eggs – not unusual for an avian influenza virus – and CDC was able to begin packaging vial samples of virus to distribute to other laboratories on Monday April 15, 2013. At this time, CDC has sent H7N9 isolates to 5 laboratories, including the United States Department of Agriculture. Only laboratories with the proper permits can receive the H7N9 virus isolate.
Conducting Studies with the Virus
CDC is using the H7N9 virus isolate to learn more about how the virus causes disease and its potential to spread among humans. Studies using cell cultures and animals will provide information about the severity of associated disease, as well as the pathology of the infection (what the virus does to the body either directly or indirectly). Additionally, animals are used to conduct studies on how the virus spreads. So far these studies have confirmed that this virus spreads between animals through close contact, which was expected. Studies to determine whether this virus can be spread in respiratory droplets through the air are ongoing.
Collecting Antiserum
Animal studies also allow for the collection of antiserum (antibodies) to these viruses so that the animals’ immune responses to the virus can be examined and other studies on immunity can be performed. Methods to detect immune responses in human serum are under development and will be used to study population immunity to the H7N9 virus. These studies are just getting underway; results are not expected for some time. The antibody tests also will be used to see if the candidate H7 vaccine viruses in development are a good match to the wild virus detected in China.
Creating a Test to Detect This Virus
CDC has completed work on new laboratory diagnostic test materials to identify human infections with the new avian influenza A (H7N9) virus. Influenza diagnostic tests already in use at qualified public health laboratories identify the new H7N9 virus as “unsubtypable” influenza A viruses, but cannot specifically identify the H7N9 subtype. The CDC H7N9 test materials are intended for use with real-time RT-PCR (reverse-transcriptase polymerase chain reaction), a highly accurate and sensitive laboratory test for detecting and identifying flu viruses in respiratory specimens by type and subtype. Providing this test to qualified public health laboratories will allow for more rapid testing of H7N9, though any H7N9-positive samples will continue to be sent to CDC for confirmation. Domestic and international shipping of these diagnostic test materials began this week.
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Developing a Vaccine Virus Candidate
CDC reports continued progress in developing an H7N9 candidate vaccine virus that could be used to manufacture H7N9 vaccine should that become necessary.
Testing for Antiviral Susceptibility
CDC also has tested the H7N9 virus isolate it received from China to see if it is susceptible to the influenza antiviral drugs oseltamivir/Tamiflu® and zanamivir/Relenza®. Laboratory testing at CDC indicates that this first virus isolate received on April 11 is sensitive (susceptible) to these `neuraminidase inhibitors’ (NAIs) the two antiviral drugs now recommended to treat seasonal flu.
Testing showed the virus would be resistant to the adamantanes, another class of antiviral drugs that are not currently recommended for use because of widespread resistance.
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Supporting Investigation in China
CDC received a request for bi-lateral assistance from China and a CDC team is in country now supporting the domestic outbreak investigation and response.
You’ll also find an update on the outbreak in China.
Update on H7N9 in China
While some mild illness has been reported in H7N9 patients, most have had very severe illness. China is reportedly treating H7N9 cases and recommending treatment of their symptomatic contacts with oseltamivir.
Since this H7N9 virus is a novel influenza virus with pandemic potential, the source of the human infections and how this virus spreads is being carefully investigated. H7N9 has been detected in Chinese poultry. While the investigation is ongoing, the current working assumption is that most people have been infected with the virus after having contact with infected poultry or contaminated environments. A New England Journal of Medicine (NEJM) article authored by Chinese public health officials released on Wednesday, April 24, 2013 reports that 77% of the first 82 H7N9 patients had some animal exposure.
While there will be some in the media who may make a lot more out of these steps than is deserved, the CDC is simply taking the prudent, early steps one would expect them to take in the face of an unknown viral threat.
Government preparation is important, but a nation’s resilience in the face of a major crisis – whether it be local or global - truly comes from the bottom up, not from the top down.
Which is why businesses, organizations, families and individuals ought to be taking a page from the CDC’s play book and dusting off, reviewing, and updating their own Pandemic and Disaster Plans.
Not just because of the H7N9 virus, but because a wide range of disasters can happen anyplace and at anytime.
Earthquakes, tornadoes, hurricanes, floods, industrial accidents, and yes . . . even terrorist attacks, such as we saw last week in Boston . . . can all disrupt, or threaten our lives.
Being prepared doesn’t mean going to extremes.
You don’t have to dig a bunker, or set aside 10 years worth of canned goods. Nor should you overly focus on any one particular threat, or scenario.
Instead, the smart money is on taking basic preparedness steps against `All Hazards', including those you may not automatically assume are a threat where you live.
Everyone should have a well thought out disaster and family communications plan, along with a good first aid kit, a `bug-out bag’, and sufficient emergency supplies to last a bare minimum of 72 hours.
Based on the events in Japan (or after Hurricane Katrina in New Orleans, or the earthquake in Haiti) 3 days of supplies many not be enough for a truly worst case scenario.
The County of Los Angeles Emergency Survival Guide calls for having 3 to 10 days worth of food and water. Personally, I believe that 2-weeks of supplies isn’t an unreasonable goal, particularly if you live in earthquake or hurricane country.
The L.A. guide may be downloaded here (6.5 Mbyte PDF).
For more information on preparedness, I would invite you to visit:
FEMA http://www.fema.gov/index.shtm
READY.GOV http://www.ready.gov/
AMERICAN RED CROSS http://www.redcross.org/
And lastly, you may wish to revisit some of my earlier preparedness essays, including:
In An Emergency, Who Has Your Back?
Because, by the time you recognize that a disaster is at your doorsteps, it is probably too late to prepare for it.
