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Human infection with avian LPAI H9N2 remains only rarely reported (see FluTrackers List)) - but serological studies suggest mild cases may be far more common than we know - and despite a generally mild presentation in humans, the CDC and WHO consider the virus to have at least some pandemic potential (see CDC IRAT SCORE).
Although most cases have been reported from China, Egypt, and Bangladesh, a little over 2 weeks ago, in EID Journal & IJID : Human Infection With LPAI H9N2 - India & Oman, we looked at reports of human infection in two new countries.A month ago, in Viruses: Characterization of the H9N2 Avian Influenza Viruses Currently Circulating in South China, we looked at a a new study, published in the journal Viruses, that reported that China's current crop of H9N2 viruses continues on an evolutionary path that increases its pandemic potential.
Today Taiwan's CDC & MOH are both carrying reports of two new H9N2 cases from Mainland China, reported to the WHO in November; one from Fujian Province (F,4), and the other from Anhui (F,5).
First the translated report, then I'll return with a bit more.
Mainland China has reported 2 cases of H9N2 influenza. People are advised to implement the principle of "five to six" when visiting the epidemic area.
Source: CDC
Date Filed : 108-12-10
Updated: 108-12-10
The World Health Organization (WHO) announced on December 4 that mainland China will report one new case of H9N2 on November 12th and 22nd, which will be the first two new cases of influenza A in mainland China during this epidemic season (from October). There was no association between cases. One of them was a 4-year-old girl from Sanming City, Fujian Province. She developed symptoms on October 26 this year, and her condition was mild. The other was a 5-year-old girl from Fuyang City, Anhui Province. He has recovered, and both cases had a history of poultry or poultry slaughterhouse exposure before onset.
There have been 39 cases of global H9N2 influenza since 2013, mostly in mainland China. The rest of the country includes Hong Kong (1 case, imported from Guangdong Province), Egypt (3 cases), Bangladesh (2 cases), and Oman (1 case). ); So far, there has been 1 death, with a fatality rate of 2.6%. The WHO said that since the virus is still detected in poultry and the environment, cases are expected to occur, but the risk of human-to-human transmission is low because the virus has not been capable of continuous transmission among humans.
The Department of Disease Control said that although most human H9N2 cases were mild, a case of severe pneumonia was reported for the first time in March this year. It is a 9-year-old boy in Jiangsu who has a history of exposure to the live poultry market and the public must remain vigilant. At present, the CDA has listed the new type A influenza tourism epidemic in Anhui Province, Beijing, Fujian, Guangdong, Guangxi Zhuang Autonomous Region, Hunan Province, Jiangsu Province, Inner Mongolia Autonomous Region, and Yunnan Province as the second level alert (Alert) , Other provinces and cities are listed as the first level Watch.
The CDA reminded that when traveling to mainland China, the principle of "five to six and no" should be implemented. Fifth: poultry and eggs should be cooked, hands should be washed with a soapy base, masks should be provided for prompt medical attention if symptoms occur, and long-term contact with birds Those who need to be vaccinated against influenza, have a balanced diet, and take appropriate exercise; 6 No: do not eat raw poultry eggs or products, do not smuggle and purchase meat from unknown poultry, do not contact or feed migratory birds and birds, do not release and Randomly discard birds, do not mix breeding birds with other poultry and livestock, do not go to places with no air circulation or crowded people.
If you have a fever or flu-like symptoms when returning to China, you should take the initiative to inform airline personnel and quarantine personnel at airports and ports; if you experience the above symptoms after returning to China, you should wear a mask to seek medical treatment as soon as possible, and inform the physician of your history of travel contact. For related information, please refer to the CDC website (https://www.cdc.gov.tw/), or call the toll-free epidemic prevention line 1922 (or 0800-001922) for inquiries.(Continue . . . )
Beyond the fact that LPAI H9N2 may infect humans far more often than case reports suggest, this virus is a concern because:
- H9N2 has become widespread - even ubiquitous - among poultry across Asia and the Middle East, and has made recent inroads into Africa.
- H9N2 reassorts easily with other viruses, and its internal genes are often found inside many HPAI viruses (including H5N1, H5N6, and H7N9) - (see The Lancet's Poultry carrying H9N2 act as incubators for novel human avian influenza viruses)
- H9N2 viruses continue to accrue evolutionary changes, which include mammalian adaptations, and increased binding to human receptor cells (see PLoS Path: Genetics, Receptor Binding, and Transmissibility Of Avian H9N2).
Virology Journal: Mouse-adapted H9N2 Avian Influenza Virus Causes Systemic Infection in Mice
Viruses: A Global Perspective on H9N2 Avian Influenza Virus
OFID: Avian H5, H7 & H9 Contamination Before & After China's Massive Poultry Vaccination Campaign
J. Virology: Genetic Compatibility of Reassortants Between Avian H5N1 & H9N2 Influenza Viruses
Virology: Receptor Binding Specificity Of H9N2 Avian Influenza Viruses
EID Journal: Two H9N2 Studies Of Note
