While I try never to make any predictions as to what influenza – avian, human, or otherwise – is likely to do, it does seem as if we are facing an unusually large number of flu flashpoints this winter.
- HPAI H5 viruses, carried by migratory birds, are expected to return and threaten both European and North American poultry operations this fall.
- Egypt’s unprecedented epidemic of H5N1 cases – which infected roughly 160 people over 5 months last winter – is expected to resume as well.
- Western Africa and Eastern Europe have seen a resurgence in H5N1 reports over the past 12 months
- Vietnam, Laos, and China continue to report sporadic H5N6 and H5N1 outbreaks (including occasional human infections)
- And last but not least, China is expected to enter its 4th H7N9 epidemic season once again this winter.
We’ve already seen 3 human H7N9 cases announced over the past two weeks by China’s MOH, and concerns run high that - like H5N8 and H5N1 – H7N9 could eventually migrate to neighboring countries. Unlike all of the other avian flu viruses of concern, H7N9 spreads silently in poultry, and is only highly pathogenic in humans.
Add in an unpredictable seasonal flu, the possibility of seeing new reassortant viruses emerge, and the possible incursion of existing viruses into new areas, and you have the potential for a very busy flu season.
While there are plenty of threats to choose from, the recent reappearance of H7N9 in China induced the FAO to release the following statement yesterday:
Countries urged to prepare for expected increase in virus activity
15 October 2015, Rome – Raising the alarm for poultry-related livelihoods and public health, FAO warned countries today that a fourth wave of avian influenza H7N9 has already begun.
The novel A(H7N9) avian influenza virus originally emerged in humans in China in early 2013. Each winter since, southern China has witnessed an upsurge in human infections.
H7N9 spreads silently in poultry, since it causes little to no illness in birds. It can infect people through direct contact with infected birds or their secretions. Surveillance in China has shown that H7N9 has become well established in poultry populations in south-eastern parts of the country, and the virus can cause mild to severe disease in humans, and in some cases even death . According to official numbers released by Chinese authorities, H7N9 has caused mortality in roughly 40 percent of reported human infections. Out of the 678 human cases reported to date, 271 have died.
FAO marked the beginning of Wave 4 on 2 October after Chinese authorities in Zhejiang Province reported the first two human cases since July. According to Dr Eran Raizman, head of FAO’s Emergency Prevention Service, these are indicators of things to come.
“We expect human cases to rise sharply in the coming weeks or months, as has happened in previous years. This is due in part to the seasonal behaviour of the virus, helped along by critical gaps in biosecurity commonly found in the poultry industry.”
As shown by over a decade of studies by FAO and partners, a lack of good biosecurity has exacerbated the situation in southeast Asia when it comes to avian influenza viruses. Mixing of species, lack of flock identification and movement control, close contact between birds at live bird markets and many other factors enable viruses to circulate among poultry and sometimes spread to humans. China’s neighbours continue to be highly at risk due to their close geographic vicinity and poultry trade links.
Moreover, H7N9 is a major livelihood concern. In order to protect the public, poultry with H7N9 infection must be destroyed. These harsh but necessary control efforts can place great strains on the vulnerable people who depend on poultry. Families often lose their entire businesses and means of subsistence, and many governments may not have sufficient emergency funds to compensate those affected.
“H7N9 is still a serious problem, and it is not going away any time soon,” added Dr Raizman. “Countries need to push now more than ever for better and safer production approaches in the poultry sector, from farming to transport and marketing. Integrating good biosecurity practices into the way the poultry sector does business is the only way countries can effectively reduce the risks posed by H7N9 and other avian influenza viruses.”
FAO is calling on countries to intensify biosecurity along the poultry value chain. To assist in this regard, FAO has just published two new additions to its series of guidelines for addressing H7N9:
For the full set of FAO guidelines, visit here.
FAO has been monitoring H7N9 since its emergence and produces biweekly updates available online here.
FAO’s work on H7N9 is made possible in part by support from the United States Agency for International Development (USAID), a key partner in the fight against avian influenza.