Credit Eurosurveillance Journal
# 7016
The journal Eurosurveillance published an editorial today on the potential impact that the newly emerging H7N9 avian flu virus might eventual have for Europe.
While this article may be Euro-centric, it is fair to say that the concerns of Europe over this virus are very much the concerns of the rest of the world.
A novel reassortant avian influenza A(H7N9) virus in China – what are the implications for Europe
A Nicoll , N Danielsson
After outlining the events that led to the detection of this virus, and our current (albeit limited) understanding of its epidemiology, the authors write:
(Excerpts, but follow this link to read it in its entirety).
What are the possible implications of the current situation for Europe and European citizens and which actions should the EU take and which ones have been taken already? The European Centre for Disease Prevention and Control (ECDC) published its first risk assessment on 3 April and is providing updated assessments and short reports on the epidemiology as new information emerges [16].
Several guidance documents on prevention of infections, infection control and case management developed earlier for influenza A(H1N5) by ECDC, WHO and Member States are, with some modifications, applicable to the current situation [16-18]. Visitors to China and other countries where avian influenzas have caused severe human disease of late [9], should avoid visiting bird markets and follow basic hygienic measures. Persons returning from China who develop severe respiratory infection within 10 days should be evaluated and tested for the new virus to rule out such infection [17], though most likely another infection will be detected. Case management and infection control guidelines for A(H5N1) apply in the short term. This will include antiviral treatment given that the Chinese CDC promptly established that the A(H7N9)viruses are susceptible to neuraminidase inhibitors [4,5].
<SNIP>Overall, how concerned Europe should be cannot yet be determined. The new virus is a reassortant virus based on an haemaglutinin antigen A(H7) to which most humans will not have been exposed. Therefore, if human-to-human transmission starts, and that is only an ‘if’, population immunity cannot be presumed. It would have to be assessed now by determining age-specific sero-reactivity of human sera to this influenza A(H7N9) virus as a priority. Immunity, or lack of it, in the human population are key data required for assessing pandemic risk. As stated above, they needed to come from field investigations in China as well as seroepidemiological studies in Europe based on protocols developed precisely for such situations [20].
At this very moment it cannot be ruled out that there are some human-to-human transmissions causing mild or asymptomatic infections as happened in the Netherlands in 2003. It also remains unclear to what extent the predominance of severe disease may represent a bias because mainly people with severe disease are tested. Investigations of patients’ contacts including serological studies, will clarify this point. Such investigations orchestrated by the Chinese CDC are underway.
Over the coming hours, days, and weeks we will undoubtedly see a good deal more expert analysis of this virus as more data becomes available.
Stay tuned.
