Friday, August 26, 2016

Guangdong Province Reports A Human Infection With H9N2

Credit - Wikipedia


From the Health and Family Planning Commission of Guangdong Province website this morning we get notification of a recent H9N2 case - although it isn't at all certain how recent - since onset and recovery dates are not provided.

Only about 30 human infections have been confirmed by WHO since 1999 (see FluTracker's List), and almost half (13 of 29) of those have been reported in the past two years. 

Last year, 9 cases were reported - mostly from China and Egypt - while earlier this summer Guangdong Province reported the 3rd known case of 2016, a Child with H9N2 In Serious Condition.

A 2014 seroprevalence study, however, found antibodies against H9N2 ranged from 5.9% to 7.5% among poultry exposed individuals in Egypt, suggesting human infection is far more common than the official tallys would suggest. 

At the end of May, in Detection Of Airborne H9 Nucleic Acid In Chinese Live Poultry Market, we looked at an article appearing in the Chinese Medical Journal which found ample environmental evidence of viral contamination, and reports the first positive detection of Airborne H9 (presumably H9N2) in a Chinese LPM.

First the (bare bones) report from Guangdong Province, and then I'll return with a bit more.

Monitoring the province found a case of H9N2 cases

2016-08-25 16:27:10   Ministry of Health and Family Planning Commission  | 

[Letter] Guangdong health font


August 25, 2016, the province monitoring found one case of H9N2 cases. 29-year-old female patient, now living in Zhongshan City. The patient got better, in Guangzhou designated hospital.

Experts believe that the provincial Prevention: H9N2 virus is a subtype of influenza A virus, the source of the virus is poultry in bird flu more common for people is a low pathogenic virus. The case of human infection with H9N2 found in sporadic cases belong to lower the risk of virus transmission.

Experts advise: the public should remain vigilant and take precautions.

To wash their hands: after contact with poultry, wash hands before meals and after.
    To cook: poultry and eggs should be cooked before eating.

To early treatment: If you develop fever, cough, headache, general malaise and other respiratory symptoms, should as soon as possible to the nearest medical institution for treatment. If before contact with birds, to take the initiative to tell the doctor.

    Do not eat dead poultry.
    Do not buy poultry products from unknown sources.
    As far as possible to avoid live bird markets.

Although a LPAI (low path) virus in poultry, and usually producing only mild illness in humans, H9N2 is nevertheless viewed with suspicion as it reassorts readily with other avian viruses, and its internal genes make up the backbone of many dangerous HPAI viruses (H5N1, H5N6, H7N9, etc.).
And in recent years, we've seen H9N2 acquire some worrisome mammalian adaptations as well, as reported in:

Whether as a standalone virus, or an accomplice to some other subtype, H9N2 is gaining a reputation as a virus to watch. 

So much so, that in early 2014, The Lancet carried a report entitled Poultry carrying H9N2 act as incubators for novel human avian influenza viruses by Chinese researchers Di Liu a, Weifeng Shi b & George F Gao that recommended the slaughter of all poultry carrying the virus to help prevent the emergence of new novel subtypes.

A drastic, and difficult task, given that the virus is reportedly  rife throughout Asian and Middle Eastern poultry.