Tuesday, January 27, 2015

Referral: VDU On Societal Change And H7N9


H7N9 Waves – Credit Dr. Ian Mackay VDU Blog


# 9633


With H7N9 surging once again in China (although how badly, is hard to tell), and H5N1 setting `personal best’ records in Egypt this winter, bird flu is back with a vengeance, and we once again find ourselves collectively playing `chicken’ with some very nasty avian threats.  


And if that weren’t enough, in the wings (and legs, breasts, and thighs) are upstarts like H10N8 and H5N6.

The primary conduit of these avian viruses to humans is through direct contact with infected birds - often at live markets - the preferred venue for purchasing meat for hundreds of millions of people around the globe.  Today Dr. Ian Mackay muses on the need for societal change if hope to head off these emerging avian viruses before they figure us out.   


Societal change and H7N9..

The importance of societal change for controlling infectious disease outbreaks really cannot be over-stated. 
For Ebola virus disease, it came down to stopping the tradition of direct contact with the body of those who have died and direct contact in general. For MERS it seems that occasional camel contact triggers insertion of the MERS-CoV virus into hospitals where lax infection prevention and control practices add to the case load.

For influenza A(H7N9) virus cases, it is the habit of obtaining live poultry from retail markets where rare virus-laden chooks are culled and handed over because of a desire to see, choose and purchase the tastiest fresh chicken.

(Continue . . .)


While closing live markets has been proven to reduce the spread of H7N9 (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission), and seems an obvious mitigation step, generations of tradition (and practical considerations in places where home refrigeration is still rare) make it difficult to implement.


We’ve seen China, Egypt, and Indonesia repeatedly try – and fail – to permanently close live markets.


Of course, when it comes to taking what seems like sensible steps to stop the spread of deadly diseases, we in the `Western world’ don’t exactly have clean hands.  Literally.

Lapses in hand hygiene in hospitals still cause tens of thousands of (often fatal) infections each year (see Assessment Of Hand Hygiene Strategies In US Healthcare Facilities  & Hand Hygiene Among Doctors Exposed).

Half of all Americans eschew the flu vaccine every year, and you really don’t want to know the statistics on handwashing in public restrooms (well, if you do, see And Yet, They Still Call It Wellington  & Before You Ask To Borrow Someone’s Cell Phone . . .).

Some days it is hard to be optimistic about the reduction of infectious diseases around the globe when humans seemingly go out of their way to find  ways to aid and abet their spread.  


But on the plus side, as a disease blogger, I’m unlikely to run out of material to write about.

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