Zhejiang Province – Credit Wikipedia
# 8050
Although I’ve yet to see it confirmed via official government channels, local media (including Xinhuanet) are reporting that yesterday’s newly reported H7N9 infection (see Media Reports: New H7N9 Case in Hong Kong & Zhejiang Province) – a 30 year-old male – is a relative of the 57 year-old male hospitalized last week with the virus (see China: Zhejiang Province Reports H7N9 Case).
Whenever we see two or more avian flu infections in close proximity, the question of human-to-human transmission comes up.
As we’ve discussed before, when it comes to proving human-to-human (H-2-H) transmission of an emerging virus, the bar is set pretty high. When there are other, equally plausible explanations (e.g. shared environmental, or live bird exposures), then H-2-H cannot be assumed.
Since we’ve seen suspected limited H-2-H transmission of the H7N9 virus in the past (see BMJ: `Probable Person-to-Person Transmission’ Of H7N9), another instance – while of epidemiological interest - wouldn’t be a game changer. We take notice primarily because it could be the first visible step in a chain of transmission.
Should we begin to see evidence of efficient ongoing H-2-H transmission (ie. 3rd, 4th, 5th generation transmission) - then things begin to get more interesting. But even then, it wouldn’t necessarily signal the start of a major epidemic.
In 2006, we saw large clusters of H5N1 infection in both Indonesia and Turkey, and yet, it never managed to gain enough momentum to spark a pandemic (see 2006 Karo Cluster Involved H2H Transmission). Similarly, a family cluster in Pakistan in 2007 raised concerns, but once again failed to catch fire (see EID Journal: Unraveling Pakistan’s H5N1 Outbreak).
Here then, via Xinhuanet, is the latest on the Zhejiang cluster.
Added 1 new case of human infection in Zhejiang Province H7N9 avian influenza
December 07, 2013 Source: qianjiang evening news
Inform the PRC Zhejiang Provincial Health Department on December 6, 1 new cases of human infection in Zhejiang Province H7N9 avian flu cases . At risk patients, male, 30 years old. On December 5 confirmed, first affiliated hospital of Zhejiang University School of medicine now.
This reporter learned that, the infection H7N9 avian flu virus risk, was in a hospital of Zhejiang University last Wednesday the 57 confirmed Mr Chang's son-in-law.
So far, Zhejiang H7N9 avian flu infections increased from 4 in the second half, including jiaxing H7N9 avian flu patients died.
Currently, Zhang Yu and father-in-law, lived in a hospital infectious diseases Department of Zhejiang University in isolation wards. Most H7N9 avian flu patients admitted to the ward first half of the year.
Zhejiang and a Deputy Director of the infectious diseases Department LEUNG Wai Fung, told reporters last week confirmed a critical condition, is still in the rescue.
Last week, Mr fever, pneumonia, home to Zhejiang Anji register for emergency treatment, treatment process, sudden illness, respiratory failure. Were confirmed infected H7N9 avian flu.
Relatives told doctors, 6 chickens raised at home, before the disease is usually fed chickens, cleaning the chicken manure. Doctors speculated that Zhang H7N9 avian flu infection, most likely related to these birds carry the virus. Mr CHEUNG was diagnosed shortly after their son-in-law Mr danger symptoms of high fevers. After the examination, the throat swab H7N9 virus were positive, at present, Mr Yu accepted, including antiviral "four against two balancing" treatment, his condition is stable, conscious, do not need the help of ventilators and other equipment assisted breathing.
Father-in-law both continuous H7N9 avian influenza viruses, two were exposed to infected poultry, or "person to person" results? Yesterday, after the expert consultation, still do not prove that the two are "person-to-person" infection.
Our correspondent Wang Rui
The `fitness’ of the H7N9 virus for human (or at least mammalian) hosts has been the subject of a good deal of research and debate over the past 6 months, with conflicting results. Two days ago we saw research (see TSRI: H7N9 Virus Still Binds Preferentially to Avian Receptors) suggesting that the virus (at least samples taken last spring) isn’t ready for prime time, while other studies (see mBio: H7N9 Naturally Adapted For Efficient Growth in Human Lung Tissue) are less sanguine.
Whatever the case (and with influenza viruses, that status can change quickly), thus far we’ve only seen widely scattered, sporadic human infections and a handful of small family clusters in the wild. The big unknown is the prevalence and significance of mild, or asymptomatic infections, and there we can only guess.
So we watch cases like the ones this week in Hong Kong and Zhejiang province closely, for any signs that this pattern is changing.
The good news, so far, is that we haven’t seen compelling evidence that it has.
