Screenshot from Zhejiang Provincial Department of Health
# 8163
As the screen shot above indicates, this morning (Monday evening in China) – and for the fifth day in a row - Zhejiang Province is announcing the detection of new H7N9 cases, bringing that province’s total since the first of the year to nine.
As we noted yesterday, Zhejiang province has reported the largest percentage of H7N9 cases in China to date.
While we aren’t seeing much in the way of epidemiological information in these reports, these cases still appear to be sporadic, with no indication of sustained or efficient human-to-human spread of the virus.
Zhejiang Province, two cases of human infection with the H7N9 new bird flu cases
Release date :2014-01-13
Source: Provincial Health Office of Family Planning
January 13, 2014Zhejiang Provincial Health and Family Planning Commission January 13 briefing, the province today confirmed two cases of human infection with the new H7N9 avian influenza.
1, the temperature of a patient, female, 41 years old, currently residing in Cixi, Ningbo. January 13 confirmed human cases of avian influenza H7N9 infection. Now is severe, treatment at a hospital in the city of Ningbo.
2, patients Moumou, female, 59 years old, now living in Ningbo Jiangdong District. January 13 confirmed human cases of avian influenza H7N9 infection. Now is severe, treatment at a hospital in the city of Ningbo.
Last spring, when cases were rising in Eastern China, authorities shuttered live bird markets in the affected areas, which resulted in an immediate and dramatic drop in new cases (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission).
By mid-summer most of these markets had re-opened, and as long as the weather stayed warm, new cases did not reappear.
But now that winter has arrived, we are seeing another marked rise in human infections. While exposure to live birds in markets is still considered the most likely mode of infection, so far authorities have been reluctant to close these markets for more than a day or two for `cleaning & disinfection’.
Attempts in China, Indonesia, and in other countries attempts to close or strictly regulate live bird markets in the past have been met with tremendous public resistance (see 2009 blog China Announces Plan To Shut Down Live Poultry Markets In Many Cities). Purchasing live market birds is deeply ingrained in the culture, as it reassures the buyer that the bird is both fresh and healthy.
China’s ambitious plan, announced 4 years ago to `shut live poultry markets in all large and medium-sized cities throughout China’, obviously never happened.
There is certainly an economic impact of closing live markets, particularly in the weeks leading up to the Chinese Lunar New Year’s celebration, when poultry sales are brisk. And there are societal and cultural considerations I’m sure, as well.
But keeping these markets open, with the virus obviously jumping with relative ease to humans, is playing a dangerous game of `chicken’ with a nasty virus.
Aside from the human tragedy that each illness brings, every human infection is another opportunity for the virus to better adapt to human physiology, or another chance for it to reassort with an already `humanized virus’. No one knows when the `right’ combination will come up, or how many throws of the genetic dice this will take.
Hundreds. Thousands . . . Maybe it never happens.
But if it ever does, the costs of closing these markets now will pale compared to the costs of dealing with even a small epidemic, much less a pandemic.
