Two Waves of H7N9 - Credit Hong Kong’s CHP
Although it emerged less than two years ago (Feb 2013), the H7N9 avian influenza virus has already sparked two sizable human outbreaks in Eastern China – both peaking in late winter – and has shown that it is evolving in worrisome ways, prompting this warning last June from Eurosurveillance: Genetic Tuning Of Avian H7N9 During Interspecies Transmission.
Overall, due to the genetic tuning procedure, the potential pandemic risk posed by the novel avian influenza A(H7N9) viruses is greater than that of any other known avian influenza viruses.
While we can’t know what this winter holds in store for the H7N9 virus, studies released earlier this year (see EID Journal: H7N9 As A Work In Progress), show that the H7N9 avian virus continues to reassort with local H9N2 viruses, introducing new clades of the virus into China’s poultry population.
Admittedly, H5N1, H5N6, H10N8, H9N2, and H7N7 are not out of the running, but right now H7N9 seems to be the rising star in the avian flu world. Like its older cousin, H5N1, H7N9 shows distinct seasonality, with cases all but disappearing during the summer only to rise again during the winter.
After a slow summer, in mid-October we saw CHP: Mainland China Reports Two H7N9 Cases, and today we get this report from the Jiangsu MOH.
Ministry of Health and Family Planning Commission informed the province confirmed one case of human infection with the H7N9 avian influenza.
Patients Tianmou, female, 58 years old. Nov. 1 pm Expert Group on human infection diagnosis was in Nanjing confirmed cases of H7N9 avian influenza. Two weeks to go before the onset grocer bought a chicken and live slaughter, currently in a hospital in Nanjing, where the condition is extremely critical.
Hong Kong’s CHP also takes note of this announcement:
3 November 2014
The Department of Health (DH) is today (November 3) closely monitoring an additional human case of avian influenza A(H7N9) reported by the Jiangsu Provincial Commission of Health and Family Planning (the Commission), and hence called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.
According to the Commission, the patient is a woman aged 58 who visited a market and bought and slaughtered a chicken before onset. She is now hospitalised for treatment and is in critical condition.
To date, 441 human cases of avian influenza A(H7N9) have been confirmed on the Mainland in Zhejiang (139 cases), Guangdong (109 cases), Jiangsu (57 cases), Shanghai (41 cases), Hunan (24 cases), Fujian (22 cases), Anhui (17 cases), Jiangxi (eight cases), Beijing (five cases), Shandong (five cases), Henan (four cases), Guangxi (three cases), Xinjiang Uygur Autonomous Region (three cases), Jilin (two cases), Guizhou (one case) and Hebei (one case).
For now the world remains focused on the enormous public health and humanitarian tragedy of Ebola in West Africa, and rightfully so. But at the same time there are a handful of other viruses – including H7N9 – that continue to circulate in the wild that are better suited to spark a pandemic (see It’s Not Just Ebola).
Over the past 12 months we’ve seen the importation of H5N1 into Canada, MERS-CoV cases into the United States (along with 20+ other countries), imported H7N9 to Taiwan, Hong Kong & Malaysia, imported CCHF in the UK, Lassa fever in a traveler in Minneapolis, and the recently arrived Chikungunya virus has probably infected a million plus people in the Americas.
Ample reminders that even while we fight one viral foe, there is always the chance that we could be blindsided by another coming out of left field.