#13,969
Six years ago today (March 31st, 2013) and nearly 7,000 blogs ago, we saw the first announced human infections from a new type of highly virulent (in humans) avian H7N9 virus in China (see China: Two Deaths From H7N9 Avian Flu).
This outbreak was surprising on a number of fronts.
This was neither the first, nor was it the last, `surprise' disease outbreak of the past dozen years.
- First, the virus was an avian H7 subtype, and while we'd seen human infections before with H7N7 and H7N2, and H7N3 (see A Brief History Of H7 Avian Flu Infections) they were almost always mild.
- Second, while the H7N9 virus was LPAI (low path) in birds, it was highly virulent - and often deadly - in humans.
- H7N9 quickly became the world's top novel flu threat as it continued to spread across China, evolving into dozens of new clades, subclades, and eventually even spawning an HPAI version.
- Less than a year earlier (2012), a new SARS-like virus - initially called nCoV, but later dubbed MERS-CoV - emerged in the Middle East. Since then more than 2000 cases have been confirmed, but the real burden is likely higher.
- In the spring of 2009 a novel swine-origin H1N1 virus jumped from North American pigs and sparked the first pandemic in 40 years.
- In 2014, a small festering Ebola outbreak in West Africa - an area that had never before reported the disease - turned into a multi-country epidemic that would claim well over 11,000 lives.
- Also in 2014, we saw the first human infections with a new HPAI H5N6 subtype in China, which continues to fester 5 years later.
- In 2016, the arrival of a little known mosquito-borne virus to the Americas - Zika - would force the WHO to declare a PHEIC (Public Health Emergency of International Concern) after thousands of children were born with Zika-related birth defects.
Which is why organizations like FluTrackers, and ProMed Mail, and bloggers like Crof and myself, spend so much time weeding through government reports and media accounts of disease outbreaks around the globe.Many, perhaps most, of these reports are over-hyped, or are false alarms. Often reports of `unknown' or `mystery' outbreaks turn out, upon closer inspection, to be something less than mysterious (see WHO Update On `Unknown Disease' Reported In Mali - Epidemic Malnutrition).
But the H7N9 epidemic announced in China 6 years ago began with reports (carried by FluTrackers) of three patients hospitalized with `atypical pneumonia' three weeks earlier.So, we track, and document `odd' reports from all over the world with the knowledge that most will turn out to be nothing of consequence, but every once in awhile we may stumble across something of value.
While it is too soon to know which category the following item will fall into, it has some of the characteristics flublogians look for. An outbreak of what is described as a `unknown respiratory infection', the quarantining (or isolation) of a number of patients, and a potential exposure to a known vector of exotic viruses.
In this case, it involves Chinese workers employed cleaning bat guano from a Manganese mine in Guyana. One has reportedly died, while more than a half dozen are hospitalized.Although I ran across the story a few hours ago, the newshounds at FluTrackers were way ahead of me, compiling reports overnight (see thread Guyana: Health authorities probe if respiratory infection killed 1 Chinese national, sickened 8 others).
While Hemorrhagic Dengue was initially mentioned as one possible cause of the illness, the most recent report (see below) has the virus still unidentified.
Minister of Public Health, Volda Lawrence, said the disease or virus which resulted in the death of a Chinese national, and have left eight other persons including a Guyanese hospitalized, has not been identified.
On Saturday, seven of the men who were cleaning a manganese tunnel at Matthew’s Ridge, North West District last week, were air-dashed to the city after the men contracted a virus or disease. They were part of a team of nine (eight Chinese and one Guyanese); however, one of the Chinese men died while receiving treatment on Saturday and one of the other survivors remained in Matthew’s Ridge.
In a late night interview following a high-level meeting on the developing issue, the health minister said doctors have not yet determined what the illness is; however, they continue to run a number of tests.
Minister Lawrence disclosed that “all the patients have displayed the same signs and symptoms which include pain, fever, headache and respiratory distress.”
(Continue . . . )
This could, admittedly, be almost anything; seasonal H1N1 or H3N2, histoplasmosis or other fungal infection (from bat guano), Dengue, etc.
But bats are also known carriers of coronaviruses, Henipaviruses like Nipah and Hendra, and more recently, have been shown capable of carrying novel flu viruses (see Curr. Opinion Virology: Viruses In Bats & Potential Spillover To Animals And Humans).Regardless of whether this report turns out to be anything of note, the next big public health threat is likely already quietly evolving somewhere in the world, just waiting for the right host, and the right opportunity, to begin its world tour.
The big question is not what, or when, or from where.
The only question that really matters is; will we be ready for it when it comes?
