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We are finally beginning to see some important information filtering through in relation to the H7N9 virus.

One thing that so far appears to be evident is the fact that the rate of new infections appears to be more or less linear, rather than having an exponential nature which would indicate a more likely trend towards a developing pandemic.

While any new infections are to be considered as bad news it is at least some small blessing that the infection rate is relatively stable.

To their continued credit the Chinese authorities have adopted a daily reporting on the progress of h7n9 and do seem to be doing all they can to combat this virus.

Their latest report indicates that there have now been 109 confirmed human infections with a total of 22 fatal outcomes.( mainland China only.)

This latest report also confirms that this virus has now been found outside China for the first time, however the victim does appear to have contracted it while working in China.

Human infection with avian influenza A(H7N9) virus - update
-----------------------------------------------------------
As of 25 April 2013 (16:30 CET), one laboratory-confirmed case of human infection with the virus has been reported by the Taipei Centres for Disease Control (CDC). The patient is a 53-year-old man who had been working in Jiangsu province from 28 March to 9 April 2013. He returned from Jiangsu via Shanghai on 9 April 2013, and became ill on 12 April 2013. The patient was laboratory confirmed with the virus on 24 April 2013.

To date, a total of 109 laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus including 22 deaths have been reported to WHO. Contacts of the confirmed cases are being closely monitored.

Link here...

[link to www.promedmail.org]

In the top left menu under the heading...

25 Apr 2013 Avian influenza, human (60): China H7N9 update

I mentioned in my last post that there has been some very helpful information filtering through about H7N9.

Most of this information has been detected through a very extensive and ongoing study being carried out by a specialized team in China.

Here below is a small extract from their report which is highly recommended reading for all.

Just follow the link below and you will be taken directly to that important report.

It has more extensive detail than provided here.



Results
Epidemiologic Characteristics of Confirmed Cases
From March 25 through April 17, 2013, respiratory specimens from 664 hospitalized patients with pneumonia of unexplained origin were tested, and 81 patients (12.2%) were confirmed to be infected with the H7N9 virus. Of 5551 respiratory specimens obtained from outpatients with an influenza-like illness through the sentinel surveillance system for influenza-like illness, 1 (0.02%) tested positive for the H7N9 virus. As of April 17, 2013, a total of 82 laboratory-confirmed cases of H7N9 virus infection and 2 suspected cases had been identified (Figure 1Figure 1
Date of Onset of Illness in First 82 Patients with Confirmed H7N9 Virus Infection, According to Province in China. and Figure 2Figure 2
Geographic Distribution of 82 Confirmed and 2 Suspected Cases of H7N9 Virus Infection in China, as of April 17, 2013.); cases were identified in the following provinces: Shanghai (31 confirmed cases and 1 suspected case), Zhejiang (25 confirmed cases), Jiangsu (20 confirmed cases and 1 suspected case), Anhui (3 confirmed cases), Henan (2 confirmed cases) and Beijing (1 confirmed case). The median age of patients with confirmed H7N9 virus infection was 63 years (range, 2 to 89); 38 cases (46%) occurred in persons 65 years of age or older, and 2 (2%) were in children younger than 5 years of age, both of whom had clinically mild upper respiratory illness (see Figure S1 in the Supplementary Appendix for the age distribution). Most confirmed cases occurred in males (73%), 84% of the case patients were urban residents, and 54 of 71 patients with available data (76%) had underlying medical conditions (Table 1Table 1
Epidemiologic Characteristics of 82 Patients with Confirmed H7N9 Virus Infection in China.). Among 46 of 54 case patients with sufficient data for a more specific classification of underlying conditions, 40 (87%) were considered to be at increased risk for influenza complications owing to age (<5 years or &#8805;65 years) or prevalence of certain underlying medical conditions.9 Four of the patients with confirmed cases (5%) worked as poultry workers: 3 slaughtered poultry at a live poultry market, and 1 transported live poultry.

A total of 81 of 82 patients with confirmed H7N9 virus infection (99%) were hospitalized. Among the 51 patients with confirmed cases for whom data were available, isolation precautions were instituted for 33 (65%) in an intensive care unit (ICU) because of severe lower respiratory tract disease. As of April 17, a total of 17 patients with confirmed H7N9 virus infection (21%) and 1 patient with suspected infection had died of acute respiratory distress syndrome (ARDS) or multiorgan failure, and 60 patients with confirmed cases and 1 with a suspected case remained critically ill; 4 with clinically mild cases had been discharged from the hospital, and 1 pediatric patient had not been admitted to the hospital. Among 82 confirmed cases of H7N9 virus infection, 7 (9%) were confirmed by means of virus isolation, 2 (2%) by means of serologic testing, and 73 (89%) by means of nucleic acid detection. Viral culture of 73 respiratory specimens that were confirmed as positive by means of real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assays and diagnostic testing of specimens from suspected cases are ongoing.

Data on recent exposure to animals were available for 77 of the 82 patients with confirmed H7N9 virus infection. Of these, 59 (77%) reported a history of recent exposure to animals, (Table 1): 45 (76%) to chickens, 12 (20%) to ducks, and 4 (7%) to swine; the exposures occurred either while they were working at or visiting a live animal market. Other animals that these 59 patients reported having been exposed to included pigeons, geese, quail, wild birds, pet birds, cats, and dogs. Information on a history of exposure to live animals is unclear for 5 patients with confirmed H7N9 virus infection, since the investigations are still ongoing. The estimated median incubation period in 23 patients with confirmed cases for whom detailed data on animal and environmental exposures was available was 6 days (range, 1 to 10) (Table S1 in the Supplementary Appendix).

Link here...

[link to www.nejm.org]

Information is beginning to point towards poultry as the most likley source of infection for the H7N9 virus currently circulating in China.

This brief article from the Lancet indicates this information, but if readers go to that short commentary, linked below, they will find a further link ( Comment)that will take them further to a larger publication with more detailed information on how those findings have come to light.

Poultry has been suspected as the source of human H7N9 transmission in China, where there have been over 100 cases and 20 deaths. In a fast-track Article, Chinese investigators obtained samples from live poultry markets suspected of being linked to human cases of H7N9 influenza. By comparing the viruses found in poultry with those found in human cases, investigators were able to confirm the infected poultry as the source of human H7N9 transmission. The findings have implications for how the outbreak should be controlled, and are discussed in a Comment and podcast.

Link here...

[link to www.thelancet.com]

For those interrested in a quick glance of where all the H7N9 infections have occurred so far, then this following link will take readers to an excellent resource provided to us by Professor Niman, who also provides much of the information posted here thanks to his excellent website, also linked below.

Here is the map link...

[link to maps.google.com (secure)]

And this link goes to Professor Niman's excellent web site, which readers should bookmark and check regularly.

[link to www.recombinomics.com]

The international team that went to China to investigate and assess the situation with H7N9 have apparently now completed their work and have produced their report from which the WHO has now offered the following News Release.

International H7N9 assessment team completes mission to China
Beijing, 24 April 2013 - A team of international and Chinese experts has completed its mission to visit Shanghai and Beijing and assess the avian influenza A (H7N9) situation, and to make recommendations to the National Health and Family Planning Commission (NHFPC).

"China's response has been exemplary," said Dr Keiji Fukuda, WHO's Assistant Director-General for Health Security. "Government agencies such as Chinese Center for Disease Control and Prevention (CDC) and local authorities of affected areas acted quickly, and have shared critical information such as genetic sequence and virus needed to analyze the situation and to be ready to make vaccine if needed in the future."

"The risks of such an outbreak situation are shared in a globalized world where we are all interconnected. This underlines the importance of the example set by China in following the International Health Regulations." Dr Fukuda added.

The team, which is jointly led by NHFPC and WHO, is comprised of international and Chinese experts in epidemiology, virology, clinical management, public health, and health policy. The purpose of the mission was to assess H7N9 situation and to provide recommendations.

During 19-23 April in China, the team met with those involved in the response, in both Beijing and Shanghai. In Beijing, the team met with staff from China CDC and Beijing CDC. In Shanghai, they met members of the city's H7N9 working group. They also met with the Shanghai Public Health Clinical Center, Shanghai Center for Disease Control and Prevention (CDC) and the Shanghai Center for Animal Disease Control and Prevention. The team visited a wholesale poultry market where they learned first hand about the effectiveness of the shut-down of these markets.

"China has experienced extraordinary diseases such as SARS and the 2009 influenza H1N1 Pandemic," said Dr Liang Wannian, Director General, Office of Health Emergency, NHFPC. "We are in new territory again with H7N9, but our experience has taught us how to face it."

The team noted the strong reporting systems and awareness in clinicians, municipal health and agricultural authorities in Shanghai, and the support offered by China CDC.

"The response reflects earlier and strong investments in health and preparedness made by China," said Dr Fukuda.

The team estimates that steps taken so far, such as the suspension of live bird markets in Shanghai, were timely and sound. In Shanghai, it appears that so far poultry infections are limited to live markets. However, they cautioned that experts still have only a limited understanding of the full extent of the disease.

The elements that warrant particular concern include the fact that the virus does not seem to cause visible illness in poultry, making it harder to track and control.

Almost all cases have been sporadic cases, but a few family clusters have been identified. However, we are not sure if the clusters were caused by common exposure to a source of virus or due to limited person to person transmission. Evidence so far is not sufficient to conclude there is person to person transmission. Moreover, no sustained person to person transmission has been found.

The disease has now caused sporadic infections in over 100 people, with the majority developing serious disease including over 20 deaths. It is as yet unclear how many people might have carried the disease without showing any signs of illness. What also remains unclear is whether the virus could gain the ability to become transmissible between people.

The potential development of human-to-human spread cannot be ruled out, which is why this virus and outbreak is being taken extremely seriously and followed so closely.

In light of this, the team highlighted the need for continued cooperation at the national and international level. At the national level, there is a need for the health and agricultural sectors to continue working closely together. Internationally, the continued sharing of information, guidance, findings, and the viruses themselves is critical.

For more information, please contact
Helen Yu
Communications Officer, WHO in China
Tel: +86 10 65327191
E-mail: [email protected]

Link here...

[link to www.wpro.who.int]

Here is an abstract of a study undertaken by a Chinese health team that looked at various aspects of preparedness for pandemics based on the current H7N9 experience and earlier H1N1 and H5N1 examples.

One must wonder what these investigators had to say about the World Health Organizations recent performances of not reporting these diseases as they should.

Clearly China dissaproves of the World Health Organizations recently adopted decisions as they, the Chinese, have adopted daily reporting which is in stark contrast to that of the World Health Organizations.

I take as a clear message of dissapproval and a very public demonstration of that, while at the same time demonstrating exactly what responsible actions need to be observed and practiced.

Again to the immense credit of the Chinese authorities.


Changes in and shortcomings of control strategies, drug stockpiles, and vaccine development during outbreaks of avian influenza A H5N1, H1N1, and H7N9 among humans.
Mei L, Song PP, Tang Q, Shan K, Tobe RG, Selotlegeng L, Ali AH, Cheng YY, Xu LZ.
SourceDepartment of Health Care Management and Maternal and Child Health, Shandong University, Ji'nan, Shandong, China.

Abstract
The purpose of this review is to provide a reference for the future prevention and control of emerging infectious diseases by summarizing the control strategies, the status of drugs and vaccines, and shortcomings during three major outbreaks of avian influenza among humans (H5N1 in 2003, H1N1 in 2009, and H7N9 in 2013). Data on and documents regarding the three influenza outbreaks have been reviewed. Results indicated that the response to pandemic influenza outbreaks has improved markedly in terms of control strategies, stockpiles of antivirals, and vaccine development. These improvements also suggest advances in disease surveillance, transparency in reporting, and regional collaboration and cooperation. These trends also foreshadow better prospects for prevention and control of emerging infectious diseases. However, there are shortcomings since strategies failed to focus on high-risk groups, quantitative and measurable results (both direct and indirect) were unclear, and quantitative assessment is still lacking.

Link here...

[link to www.ncbi.nlm.nih.gov]

For readers who would like to stay current on the progress that the H7N9 virus is making in China, the Chinese Centre for Health Protection has put up a special page dealing with all appropriate matters that they wish to make available for public consumption.

Based on their excellent performance in dealing with and their transparency of their dealings I would have to say that this would be a very good resource to have available.

Id suggest that all those who are interrested, to bookmark it for future reference.

Here is the link...

[link to www.chp.gov.hk]

New information from China on the spread of the H7N9 virus is indicating that it continues to slowly advance its coverage over greater areas to where it hasnt previously been detected.


H7N9 Spread To Nanchang Jiangxi
Recombinomics Commentary 12:00
April 26, 2013

Health authorities in east China's Jiangxi Province late on Thursday confirmed the province's first human case of H7N9 avian influenza.

A 69-year-old man surnamed Xiong, a local retiree in the provincial capital of Nanchang, showed symptoms of high fever, tight chest and diarrhea, and was admitted to the No. 3 Hospital in Nanchang, according to a statement issued by the provincial health department.

Link here...

[link to www.recombinomics.com]

Here we have a further report of H7N9 continuing to spread over even greater areas.

The further comment on the upcoming travel for Chinese people on the first of May is also worying and could lead to a pandemic trigger, especially when the mammalian adaptions appear to be signalling that trend.

H7N9 Spread To Fujian Province
Recombinomics Commentary 13:00
April 26, 2013

Fujian Province confirmed case of human infection with H7N9 avian influenza. Patients Luomou, male, 65 years old, Yongding County, Longyan City, Fujian Beizhen. On April 18 patients no obvious incentive to repeated coughing, with active chest tightness, fever. At 14:50 on the 23rd "cough, sputum, fever, shortness of breath two days," the chief complaint of stay in Longyan City Hospital. The provinces and expert consultation diagnosis of severe pneumonia, human infection of H7N9 avian influenza be diagnosed. Given anti-viral treatment, non-invasive respiratory support and comprehensive treatment of Chinese medicine, the condition has improved.

Break...

However, the confirmation of H7N0 represents a significant jump, and the upcoming May 1 travel will likely spread H7N9 throughout China and beyond.

Break...

Although the sequences from human cases are closely related to those found in birds in live markets, the human PB2 sequences contain mammalian adaptation changes (E627K or D701N) signaling human to human transmission.

The movement of such changes to Fujian Province raises serious pandemic concerns.

Link here...

[link to www.recombinomics.com]

Here is the latest report of the overall progress of H7N9 in China as of the 25th of April 2013.

A discrepancy has appeared in the last couple of days with the number of fatal case being registered.

All are naturally tragic and we can only hope that the very large numbers of sick victims do make a full recovery.

2 of China's provinces today [25 Apr 2013] reported 3 more H7N9 influenza infections, while another province awaits test results for what may be its 1st case, according to official and media reports today.

The new case-patients include a 56-year-old man from Henan province who is hospitalized in critical condition and 2 women, ages 50 and 60, from Zhejiang province who are hospitalized in serious condition, Hong Kong's Centre for Health Protection (CHP) said in an update today [25 Apr 2013]. The new cases raised the number of lab-confirmed H7N9 infections to 112, which includes 22 [elsewhere given as 23] deaths.

Link here...

[link to www.promedmail.org]

In the left menu under the heading...

26 Apr 2013 Avian influenza, human (61): China H7N9 update

Catching up with current information that is known on the H7N9 outbreak in China.

The latest figures available as of Monday the 29th of April are as follows.

We are not hearing a lot on recoveries and discharges, which is concerning, however the number of fatalities being reported seem to have slowed considerably so it might hopefully be safe to interpret this as good medical intervention is having slow but positive impacts.

Lets hope so.

China H7N9 cases rise to 126
Date: Mon, 29 Apr 2013
Source: Xinhua [edited]
[link to news.xinhuanet.com]


China H7N9 cases rise to 126
----------------------------
Two more H7N9 cases have been reported tonight [29 Apr 2013], 1 in south east China's Fujian Province and 1 in north China's Shandong Province. The two cases bring the total number of infections on the Chinese Mainland and Taiwan to 126.
The new cases include an 80 year old farmer from Fujian who is now in a serious condition. 33 people have had close contact with the patient. The other case is a 4 year old boy from Shandong. The province's first confirmed case was the boy's father.
So far, 23 people have died of the virus nationwide. Cases have been reported in 10 provinces on the Chinese mainland, and 1 in Taiwan. Chinese medical experts have published new major findings on the flu strain in the international medical journal, the Lancet.

Link here...

[link to www.promedmail.org]

In the left heading under the heading...

30 Apr 2013 Avian influenza, human (64): China H7N9 update

The lates snapshot of the global situation with H5N1 avian influenza has been released and is as follows.

As we have already seen, Cambodia has been impacted quite considerably so far this year.

Lets hope that as the flu season now transits from the Northern Hemisphere to the Southern Hemisphere that instances of H5N1 avian influenza detections will deminish.

WHO reports 6 human H5N1 avian influenza cases during past 6 weeks
-------------------------------------------------------------​-----
According to a World Health Organization (WHO) summary and assessment on Friday [26 Apr 2013], from 12 Mar to 26 Apr 2013, there were a total of 6 new laboratory confirmed human cases with avian influenza A(H5N1) virus infection. The cases were from the following countries: Bangladesh (1), Cambodia (1), Egypt (2), and Viet Nam (2). The UN agency says that after investigation, the 6 cases are considered sporadic.

So far this year [2013], Cambodia has reported 10 cases of the lethal virus in humans, resulting in 8 fatalities. Health authorities say cases do not seem to be linked directly, and most had contact with sick poultry in their villages. Since 2003, there have been 628 laboratory confirmed human cases of avian influenza A(H5N1) virus infection officially reported to WHO from 15 countries, of which 374 died (about 60 per cent).

Link here...

[link to www.promedmail.org]

In the left menu under the heading...

30 Apr 2013 Avian influenza, human (65): H5N1

[link to www.recombinomics.com]

From this linked post, it would appear that our good old friends at the World Health Organization are back up their old agenda of promoting the spread of a pandemic against the people of the world.

Here we are seeing clear and factual, scientifically proven evidence of relevant and crucal facts, unmistakably indicating that the H7N9 virus is H2H transmisible and they are ignoring the facts attesting to just that.

This act (of denial?) is consistant with their decision to opt out of early reporting of pandemic type threats and resorting to monthly reporting and now, together with this demonstration of NOT observing the science that H7N9 is H2H transmissible, can has only one very sick common reason that can be attributed to it.

That unfortunately has to be the fact that the World Health Organization is actively engaging in practices that would greatly assist with the evolution of H7N9 in this case, giving it a "hear start" at becoming a pandemic threat to humanity.

There can be no other logical conclusion for this.

Please note Professor Niman's final, last paragraph comments.

Evidence For Sustained H7N9 Human Transmission
Recombinomics Commentary 03:15
April 30, 2013

The Zhejiang Provincial Center for Disease Control and Prevention has released full sequences from two H7N9 bird flu cases, A/Zhejiang/1/2013 (37M) and A/Zhejiang/2/2013 (64M), and they are to be commended for the rapid release of these important sequences. The age, gender, and collection dates suggest these sequences originated from the cases that generated A/Hangzhou/1/2013 (by the Hangzhou Center for Disease Control and Prevention) and A/Zhejiang/DTID-ZJU01/2013 (by the State Key Laboratory of Diagnosis and Treatment of Infectious Diseases at Zhejiang University). The recent sequences confirmed that the earlier case (37M) had H7 L226I and PB2 E627K, while the second case (64M) had H7 Q226L and PB2 D701N, all of which are mammalian adaptation markers. Both of these cases were fatal and detail was provided in the recent Lancet paper These sequences were from Patient #1 and Patient #3, respectively (see map).

Break...

This sustained transmission contradicts WHO statements, which rely on testing of upper respiratory tract samples, which have produced frequent false negatives. In contrast to the negative data cited by WHO, the exact matches in the two cases above provides clear evidence for sustained human transmission. Release of a full set of sequences from the Jiangsu case would be useful (and quite doable since the sequences from the first three gene segments were from an egg isolate).

The WHO claims of no evidence of H2H transmission, and the failure to address the identities in the human H7N9, continue to raise serious pandemic concerns.

Link here...

[link to www.recombinomics.com]

This next little gem could also be construed as a case of another government organization also NOT impressed or prepared to trust what is associated with the current workings of the World Health Organization.

This comes on the back of the Chinese flounting the World Health Organizations monthly reporting practices by daily reporting, as a silent demonstration of their dissaproval.

It appears that the credibility of the World Health Organization really is going down the toilet, and rightfully so.

US HHS Approves Emergency H7N9 Diagnostics
Recombinomics Commentary 21:15
April 30, 2013

On April 19, 2013, the Secretary determined that there is a significant potential for a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad and that involves the avian influenza A (H7N9) virus.

Break to last para...

The emergency notice by the US HHS provides addition evidence for efficient human H7N9 transmission, WHO denials notwithstanding.

Link here...

[link to www.recombinomics.com]

The World Organization for Animal Health has produced a Press Release of the H7N9 situation in China following a joint mission of expert investigators in China.

Although recent indications are pointing to the obvious, that this outbreak is originating from poultry, I do not believe that this is the primary reservoir.

It simply cant be.

As the report clearly states, there have been NO cases of H7N9 emerging from highly confined, close contact venues as numerous poultry farming enterprises, holding millions of poultry.

Another report clearly points out that there have been a mere 47 positive detections from 70,000 tests on poulty, ( see the next post for details).

That extremely low number could well be cases where the poultry has been "back" infected from contaminated humans, and if the situation is considered as straight out poultry infections, then far greater numbers would have been naturally inffected within the farming flocks.

Either that or perhaps "false positives" are what has been recorded.

What are the statistics for "false positive" detections?

Clearly, careful and total sequencing of those positives would provide the answers to these questions.

The fact that live "wet' poultry markets appear to be the first point of detection of human infections, would be signalling looking far closer to these type of venues for the reservoir.

Even then I dont think that the evidence is sufficiently strong enough to make any conclusion resting with poultry, rather it appears that the poultry are only a secondary link which is sometimes appearing at live "wet" markets.

This is almost incidental in its nature and the only way to seriously make sensible conclusions is sequencing and following the timelines and origins of the various genetic markers that sequencing will reveal.

The fact is that there are far too few common denominators to work with, against a background of comparitively large numbers of infections that have no common ground.

That should indicate that the real functions at play here remain veiled at this juncture.

However, Im not a panel of experts who have been on location.

Here is the Press Release.

OIE expert mission finds live bird markets play a key role in poultry and human infections with influenza A(H7N9)
Paris, 30 April 2013 – The Ministry of Agriculture of the People’s Republic of China asked the Director General of the World Organisation for Animal Health (OIE) to send OIE experts to assess the situation with influenza A(H7N9) in animals and provide advice.

The mission took place in the spirit of the Tripartite framework between the OIE, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations. The WHO was leading a mission the week before in collaboration with the Chinese Ministry of Health, while FAO is represented in the country by its local officer, a veterinary doctor who provided support.

The OIE appreciated the availability and transparency of the Chinese authorities in sharing important information, acknowledged the rapid and considerable response made by the Veterinary services to investigate the animal source of human infections, and recognised their efforts to keep the international community informed about the disease situation, including official notifications to the OIE World Animal Health Information System (WAHIS).

According to the information and data collected, the mission confirms that many of the human cases of H7N9 appear to have a link with live bird markets. To date no human cases or animal infections of H7N9 have been detected on poultry farms. During the mission the team made the hypothesis that people could be infected through exposure to infected birds in markets or to a contaminated environment such as live poultry markets where virus is present.

The experts believe that live bird markets may play a key role in human and animal infections with H7N9 and that, even if the overall level of infection is relatively low (having not been detected yet in poultry farms), live bird markets provide an environment for amplification and maintenance of the H7N9 virus. Collaboration between human health and animal health sectors is useful to better understand transmission to humans.

The mission also confirms that currently infection with H7N9 does not cause visible disease in poultry therefore Veterinary Services must be especially involved in preventing its further spread in poultry, particularly through the supervision of the implementation of biosecurity measures on farms.

“Compared with H5N1, at this moment in time H7N9 is not pathogenic to poultry so there are no visible signs of infection, which makes surveillance, prevention and control of the virus in poultry a great challenge”, Dr Keith Hamilton, member of the OIE team, explained.

Because H7N9 infection is unlikely to show visible signs of disease in poultry, the use of reliable and accurate laboratory tests, complying with OIE Standards and guidance from OFFLU, will underpin surveillance and control of the H7N9 virus in poultry. OFFLU is the FAO/OIE global network of scientific expertise on animal influenza.

An extensive surveillance programme in animals is essential to establish the full extent and distribution of the H7N9 virus in the whole country. Effective surveillance will require cooperation between poultry owners and distributors and government Veterinary Services. Veterinary Services including laboratories will need appropriate resources for that purpose.

OIE Reference laboratories for avian influenza, including Harbin Veterinary Research Institute, other laboratories in China, as well as scientists of OFFLU are conducting research on H7N9 to better understand the characteristics of this virus and to ensure that more appropriate diagnostic testing protocols are publicly available.

Recommendations

In case of outbreaks, destruction of infected poultry by Veterinary Services as well as poultry that have been in contact with infected birds is recommended. Culling of at risk-animals must be done following requirements for acceptable killing methods as described in the OIE Code.

There is no evidence to suggest that the consumption of poultry or eggs fit for human consumption could transmit the AI virus to humans. It is safe to eat properly prepared and cooked meat and eggs. Specific precautions when plucking poultry are recommended.

More assessment is needed to swiftly know whether poultry vaccination could be considered as an efficient control option for H7N9. It will be also important to verify whether the H7N9 virus is transmissible from humans to animals because if established, it could be a potential channel for the global spread of the virus.

Trade

Preventing the national and international spread of the H7N9 virus must be a priority.

The strict application by local and national veterinary authorities of Member Countries of OIE science-based standards published in the OIE Terrestrial Animal Health Code (volume 2; chapter 10.4) can prevent spread of the virus from infected poultry. These standards apply to international trade in live poultry, poultry meat, eggs and even feathers.

The application of these international standards also prevents imposition of unjustified trade barriers by importing countries. Controlling illegal trade must also be a priority.

Link here...

[link to www.oie.int]

Here is the information of the number of positive detections of H7N9 in poultry testing in China.

OIE statement on live markets and H7N9
--------------------------------------
H7N9 is genetically a "bird flu", but one of the ongoing mysteries in the H7N9 outbreak in China is how -- with more than 125 people infected -- only 46 positive virus samples have been detected out of nearly 70 000 tests conducted on poultry and their environment.

Thus far, the virus has not been detected on farms or commercial poultry operations, only in a handful of samples taken from live bird markets.

Today [30 Apr 2013], the OIE -- which has been in meetings with China's Ministry of Agriculture -- released a press release on the H7N9 outbreak and the role they suspect that live-market birds may play in its spread [see item 1 above].

Utilizing phrases like "the team made the hypothesis", "the experts believe", and "live bird markets may play a key role" -- it is pretty obvious that major gaps remain in our understanding of how this virus is spreading and infecting humans.

The available data remain sparse and incomplete, and a lot of it -- frankly -- still doesn't fit together particularly well. All of which helps explain the lack of certainty.

Link here...

[link to www.promedmail.org]

In the left menu under the heading...

30 Apr 2013 Avian influenza (48): China, zoonotic LPAI H7N9, animal, OIE

Here is some very interresting information for those who have been searching for some relatively simple and affordable protection from breathing viruses in everyday life and especially in more confined spaces like that found on commuter transport.

Essentially the report confirms that properly fitted and used N95 masks will offer protection.

Infection Control and Hospital Epidemiology © 2013

The University of Chicago Press

Abstract:

Objective.&#8195;Specification of appropriate personal protective equipment for respiratory protection against influenza is somewhat controversial. In a clinical environment, N95 filtering facepiece respirators (FFRs) are often recommended for respiratory protection against infectious aerosols. This study evaluates the ability of N95 FFRs to capture viable H1N1 influenza aerosols. Methods.&#8195;Five N95 FFR models were challenged with aerosolized viable H1N1 influenza and inert polystyrene latex particles at continuous flow rates of 85 and 170 liters per minute. Virus was assayed using Madin-Darby canine kidney cells to determine the median tissue culture infective dose (TCID50). Aerosols were generated using a Collison nebulizer containing H1N1 influenza virus at TCID50/mL. To determine filtration efficiency, viable sampling was performed upstream and downstream of the FFR. Results.&#8195;N95 FFRs filtered 0.8-&#956;m particles of both H1N1 influenza and inert origins with more than 95% efficiency. With the exception of 1 model, no statistically significant difference in filtration performance was observed between influenza and inert particles of similar size. Although statistically significant differences were observed for 2 models when comparing the 2 flow rates, the differences have no significance to protection. Conclusions.&#8195;This study empirically demonstrates that a National Institute for Occupational Safety and Health–approved N95 FFR captures viable H1N1 influenza aerosols as well as or better than its N95 rating, suggesting that a properly fitted FFR reduces inhalation exposure to airborne influenza virus. This study also provides evidence that filtration efficiency is based primarily on particle size rather than the nature of the particle’s origin.

Link here...

[link to www.jstor.org]

@UKANON
Hey, its me! Guess I could of found you on here, how is everyone and everything? Me and Grasshopper are coming over in 4 weeks will be great seeing you again! Much love

Sorry Arkay and MzTreeChick, hope you two are well looks like you are all enjoying the thread! :) You guys are doing a great job! :)

G'day Arkay

Seems like we will not be getting reliable information from China in the future (as if they would tell the truth anyway).

The Chinese government is not releasing daily information anymore, instead giving a weekly briefing.

I'd suggest folks get their masks, handwash and infection control preps ASAP as this could spread quickly. Don't wait until the last moment as history has taught us that decent N95masks will be hard to get.

I don't know about the US but in Australia, mask wholesalers rarely have more than 30,000 units on the shelf at any given time.

Keep up the good fight mate

Rickster

Good to see you Rickster, and many thanks for your input and pleasant comments.

arkay

Now I have to say that I am absolutely livid with what news I have just turned up.

With the undeniable help and collusion with the World Health Organization and the Saudi Arabian Authorities we now might be very well looking at that feared pandemic very quickly appearing on our doorsteps.

It has been somewhat obvious that the situation in China with the emergence and progress of the H7N9 virus, that all attention was and still might be focussed on that matter.

But other matters with already known presences around the globe didnt just stop.

Now we are hearing this horrifying news that there have been Five fatal outcomes in Saudi Arabia from the novel coronavirus that has been circulating there.

How many more people are infected with it?

I cannot condem both the World Health Organization and the Saudi Arabian Authorities severely enough for placing the worlds population at such perilous risk and for what I am certain has greedy 'Pilgrimage Tourism' considerations at it roots.

One can only hope that the muslim community cares enough for its followers to at least warn and ideally discourage pilgrimage travels to Saudi Arabia until the real extent of this approaching emergency comes into light and is fully revealed to the world.

If not then pilgrims will face two massive issues.

The first being the obvious risk to their own personal lives, but also their possible involvement in assisting with spreading this coronavirus to the four corners of the globe through their travels.

There is absolutely no forgiveness for these actions from the Saudis and the World Health Organization and if this coronavirus does get out of hand I honestly believe that the Saudis should bear a moral responsibility to fully cover the financial burden that will come with all cases of people suffering with this novel coronavirus.

These actions should be judged as crimes against humanity.

Five Saudis have died of a new SARS-like virus during the past few days and two more are being treated in an intensive care unit, the health ministry said. In a statement cited by the Saudi SPA agency late on Wednesday, the ministry said that all the deaths occurred in the Ahsaa province in the oil-rich eastern region of the kingdom. Known as novel coronavirus or hCoV-EMC, the virus was first detected in mid-2012 and is a cousin of Severe Acute Respiratory Syndrome (SARS), which triggered a scare 10 years ago when it erupted in east Asia, leaping to humans from animal hosts.

Link here...

[link to hisz.rsoe.hu]

In relation to the H7N9 outbreak in China, the CDC has prepared this following document that outlines their current outlook and activities with regard to the situation.

Emergence of Avian Influenza A(H7N9) Virus Causing Severe Human Illness — China, February–April 2013
Early Release
May 1, 2013 / 62(Early Release);1-6


On March 29, 2013, the Chinese Center for Disease Control and Prevention completed laboratory confirmation of three human infections with an avian influenza A(H7N9) virus not previously reported in humans (1). These infections were reported to the World Health Organization (WHO) on March 31, 2013, in accordance with International Health Regulations. The cases involved two adults in Shanghai and one in Anhui Province. All three patients had severe pneumonia, developed acute respiratory distress syndrome (ARDS), and died from their illness (2). The cases were not epidemiologically linked. The detection of these cases initiated a cascade of activities in China, including diagnostic test development, enhanced surveillance for new cases, and investigations to identify the source(s) of infection. No evidence of sustained human-to-human transmission has been found, and no human cases of H7N9 virus infection have been detected outside China, including the United States. This report summarizes recent findings and recommendations for preparing and responding to potential H7N9 cases in the United States. Clinicians should consider the diagnosis of avian influenza A(H7N9) virus infection in persons with acute respiratory illness and relevant exposure history and should contact their state health departments regarding specimen collection and facilitation of confirmatory testing.

Epidemiologic Investigation
As of April 29, 2013, China had reported 126 confirmed H7N9 infections in humans, among whom 24 (19%) died (1). Cases have been confirmed in eight contiguous provinces in eastern China (Anhui, Fujian, Henan, Hunan, Jiangsu, Jiangxi, Shandong, and Zhejiang), two municipalities (Beijing and Shanghai), and Taiwan (Figure 1). Illness onset of confirmed cases occurred during February 19–April 29 (Figure 2). The source of the human infections remains under investigation. Almost all confirmed cases have been sporadic, with no epidemiologic link to other human cases, and are presumed to have resulted from exposure to infected birds (3,4). Among 82 confirmed cases for which exposure information is available, 63 (77%) involved reported exposure to live animals, primarily chickens (76%) and ducks (20%) (3). However, at least three family clusters of two or three confirmed cases have been reported where limited human-to-human transmission might have occurred (3).

The median age of patients with confirmed infection is 61 years (interquartile range: 48–74); 17 (21%) of the cases are among persons aged &#8805;75 years and 58 (71%) of the cases are among males. Only four cases have been confirmed among children; in addition, a specimen from one asymptomatic child was positive for H7N9 by real-time reverse transcription–polymerase chain reaction (rRT-PCR). Among the 71 cases for which complete data are available, 54 (76%) patients had at least one underlying health condition (3). Most of the confirmed cases involved severe respiratory illness. Of 82 confirmed cases for which data were available as of April 17, 81 (99%) required hospitalization (3). Among those patients hospitalized, 17 (21%) died of ARDS or multiorgan failure, 60 (74%) remained hospitalized, and only four (5%) had been discharged (3).

Chinese public health officials have investigated human contacts of patients with confirmed H7N9. In a detailed report of a follow-up investigation of 1,689 contacts of 82 infected persons, including health-care workers who cared for those patients, no transmission to close contacts of confirmed cases was reported, although investigations including serologic studies are ongoing (3). In addition, influenza surveillance systems in China have identified no sign of increased community transmission of this virus. Seasonal influenza A(pH1N1) and influenza B viruses continue to circulate among persons in areas where H7N9 cases have been detected, and the Chinese Centers for Disease Control and Prevention has reported that rates of influenza-like illness are consistent with expected seasonal levels.

CDC, along with state and local health departments, is continuing epidemiologic and laboratory surveillance for influenza in the United States. On April 5, 2013, CDC requested state and local health departments to initiate enhanced surveillance for H7N9 among symptomatic patients who had returned from China in the previous 10 days (5). As of April 29, 37 such travelers had been reported to CDC by 18 states. Among those 37 travelers, none were found to have infection with H7N9; seven had an infection with a seasonal influenza virus, one had rhinovirus, one had respiratory syncytial virus, and 28 were negative for influenza A and B. Among 31 cases with known patient age, seven travelers were aged <18 years, 13 were aged 18–64 years, and 11 were aged &#8805;65 years.Among 31 cases with known patient age, seven travelers were aged <18 years, 13 were aged 18–64 years, and 11 were aged &#8805;65 years. Additionally, influenza activity in the United States is low and continues to decrease, with morbidity and mortality surveillance systems reporting activity below seasonal baseline levels. Although low numbers of influenza viruses are being detected, the majority in recent weeks have been influenza B.*

Laboratory Investigation

As of April 30, 2013, Chinese investigators had posted 19 partial or complete genome sequences from avian influenza A(H7N9) viruses to a publicly available database at the Global Initiative on Sharing All Influenza Data ( [link to www.gisaid.org).] Sequences are from viruses infecting 12 humans and five birds, and two are from viruses collected from the environment. These sequences indicate that all eight genes of the H7N9 virus are of avian origin, with the closest phylogenetic relatives from three Eurasian influenza virus lineages (H7N3 from domestic ducks, H7N9 from wild birds, and H9N2 from birds widely distributed throughout East Asia). In addition, genetic changes in the sequences are present that have been associated with adaptations leading to enhanced virus binding to and replication in mammalian respiratory cells and increased severity of infection (2,4,6).

CDC's Influenza Division Laboratory has received two H7N9 influenza viruses (A/Anhui/1/2013 and A/Shanghai/1/2013) from the WHO Collaborating Centre for Reference and Research on Influenza at the Chinese Center for Disease Control and Prevention (Figure 3). Full characterization of these viruses is ongoing; however, studies to date have shown robust viral replication in eggs, cell culture, and the respiratory tract of animal models (ferrets and mice). At higher inoculum doses (106–104 plaque forming units), the virus shows some lethality for BALB/c mice.

Laboratory testing of the A/Anhui/1/2013 virus isolate at the Chinese Center for Disease Control and Prevention, CDC, and other laboratories indicates that this virus is susceptible to oseltamivir and zanamivir, the two neuraminidase-inhibiting (NAI) antiviral drugs licensed in the United States for treatment of seasonal influenza. The genetic sequence of one of the publicly posted H7N9 viruses (A/Shanghai/1/2013) contains a known marker of NAI resistance (2). The clinical relevance of this genetic change is under investigation but it serves as a reminder that resistance to antiviral drugs can occur spontaneously through genetic mutations or emerge during antiviral treatment. The genetic sequences of all viruses tested showed a known marker of resistance to the adamantanes, indicating that, although these drugs (amantadine and rimantadine) are licensed for use in the United States, they should not be prescribed for patients with H7N9 virus infection.

Immediately after notification by Chinese health authorities of the H7N9 cases, CDC began development of a new H7 diagnostic test for use with the existing CDC influenza rRT-PCR kit. This test has been designed to diagnose infection with Eurasian H7 viruses, including the recently recognized China H7N9 and other representative H7 viruses from Southeast Asia and Bangladesh. On April 22, this new H7 test was cleared by the Food and Drug Administration for use as an in vitro diagnostic test under an Emergency Use Authorization, thus allowing distribution and use of the test in the United States. The CDC H7 rRT-PCR test is now available to all qualified U.S. public health and U.S. Department of Defense laboratories and WHO-recognized National Influenza Centers globally and can be ordered from the Influenza Reagent Resource ( [link to www.influenzareagentresource.org).] Access to the CDC H7 rRT-PCR test protocol is available at http:/www.cdc.gov/flu/clsis. Guidance on appropriate biosafety levels for working with the virus and suspect clinical specimens is being developed.

Animal Investigation and U.S. Animal Health Preparedness Activities
As of April 26, reports from the China Ministry of Agriculture indicate that 68,060 bird and environmental specimens have been tested, 46 (0.07%) were confirmed H7N9-positive by culture (7). The H7N9 virus has been confirmed in chickens, ducks, pigeons (feral and captive), and environmental samples in four of the eight provinces and in Shanghai municipality (Figure 1). As of April 17, approximately 4,150 swine and environmental samples from farms and slaughterhouses were reported to have been tested; all swine samples were negative.† The China Ministry of Agriculture is jointly engaged with the National Health and Family Planning Commission in conducting animal sampling to assist in ascertaining the extent of the animal reservoir of the H7N9 virus. Sampling of animals is concentrated in the provinces and cities where human cases have been reported. Poultry markets in Shanghai and other affected areas have been closed temporarily, and some markets might remain closed.

The U.S. Department of Agriculture (USDA) has set up a Situational Awareness Coordination Unit with a core team of subject matter experts and other USDA representatives, including the Animal and Plant Health Inspection Service (APHIS), the Agricultural Research Service (ARS), the Food Safety and Inspection Service, and the Foreign Agricultural Service. USDA and CDC are working collaboratively to understand the epidemiology of H7N9 infections among humans and animals in China. To date, no evidence of this strain of avian influenza A(H7N9) virus has been identified in animals in the United States. The U.S. government does not allow importation of live birds, poultry, and hatching eggs from countries affected with highly pathogenic avian influenza. The current U.S. surveillance program for avian influenza in commercial poultry actively tests for any form of avian influenza virus and would be expected to detect avian influenza A(H7N9) if it were introduced to the United States. A screening test for avian influenza is available from the National Animal Health Laboratory Network and the National Veterinary Services Laboratories (NVSL), which can be used together with confirmatory tests at NVSL to detect this strain of avian influenza A(H7N9) in poultry and wild bird samples.

APHIS is working with the U.S. Department of the Interior to prepare a pathway assessment, using current literature, to assess evidence for potential movement of Eurasian avian influenza viruses into North America via wild birds. USDA is conducting animal studies to characterize the virus pathogenicity and transmission properties of this virus in avian and swine species. Preliminary results from studies performed on poultry by ARS in high-containment laboratories indicate that chickens and quail are showing no signs of illness but are shedding avian influenza A(H7N9) virus in these studies (Southeast Poultry Research Laboratory, unpublished data; 2013). ARS also has completed a preliminary antigenic mapping study to help identify virus isolates that could be used to develop a vaccine for poultry if needed.

Reported by
China–US Collaborative Program on Emerging and Re-emerging Diseases, Chinese Center for Disease Control and Prevention and CDC, Beijing, China. US Dept of Agriculture. Div of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; Div of State and Local Readiness, Office of Public Health Preparedness and Response; Influenza Coordination Unit, Office of Infectious Diseases; Influenza Div, Immunization Svcs Div and Office of the Director, National Center for Immunization and Respiratory Diseases; CDC. Corresponding contributor: Daniel Jernigan, MD, [email protected], 404-639-2621.

Editorial Note
After recognition of the first human infections with avian influenza A(H7N9), Chinese public health officials and scientists rapidly reported information about identified cases and posted whole virus genome sequences for public access. During April, laboratory and surveillance efforts quickly characterized the virus, developed diagnostic tests, generated candidate vaccine viruses, identified cases and contacts, described clinical illness, evaluated animal sources of infection, and implemented control measures. Preliminary investigations of patients and close contacts have not revealed evidence of sustained human-to-human transmission, but limited nonsustained human-to-human H7N9 virus transmission could not be excluded in a few family clusters (3). Despite these efforts, many questions remain.

The epidemiology of H7N9 infections in humans so far reveals that most symptomatic patients are older (median age: 61 years), most are male (71%), and most had underlying medical conditions. In comparison, among the 45 avian influenza A(H5N1) cases reported from China during 2003–2013, the median patient age is 26 years (8). This difference in median age might represent actual differences in exposure or susceptibility to H7N9 virus infection and clinical illness, or preliminary H7N9 case identification approaches might be more likely to capture cases in older persons. Ongoing surveillance and case-control studies are needed to better understand the epidemiology of H7N9 virus infections, and to determine whether younger persons might be more mildly affected, and therefore less likely to be detected via surveillance.

Available animal testing data and human case histories indicate that most human patients have poultry exposure; however, relatively few H7N9 virus–infected birds have been detected. During the month after recognition of H7N9, increasing numbers of infected humans have been identified in additional areas of eastern China, suggesting possible widespread occurrence of H7N9 virus in poultry. Enhanced surveillance in poultry and other birds in China is needed to better clarify the magnitude of H7N9 virus infection in birds and to better target control measures for preventing further transmission.

The emergence of this previously unknown avian influenza A(H7N9) virus as a cause of severe respiratory disease and death in humans raises numerous public health concerns. First, the virus has several genetic differences compared with other avian influenza A viruses. These genetic changes have been evaluated previously in ferret and mouse studies with other influenza A viruses, including highly pathogenic avian influenza A(H5N1) virus, and were associated with respiratory droplet transmission, increased binding of the virus to receptors on cells in the respiratory tract of mammals, increased virulence, and increased replication of virus (5). Epidemiologic investigations have not yielded conclusive evidence of sustained human-to-human H7N9 virus transmission; however, further adaptation of the virus in mammals might lead to more efficient and sustained transmission among humans. Second, human illness with H7N9 virus infection, characterized by lower respiratory tract disease with progression to ARDS and multiorgan failure, is significantly more severe than in previously reported infection with other H7 viruses. Over a 2-month period, 24 deaths (19% of cases) have occurred, compared with only one human death attributed to other subtypes of H7 virus reported previously. Third, H7N9-infected poultry are the likely source of infection in humans, but might not display illness symptoms. Consequently, efforts to detect infection in poultry and prevent virus transmission will be challenging for countries lacking a surveillance program for actively identifying low-pathogenicity avian influenza in poultry. In the United States, an active surveillance program is in place that routinely identifies low–pathogenicity viruses. If this newly recognized H7N9 is detected, public health and animal health officials should identify means for monitoring the spread of asymptomatic H7N9 virus infections in poultry and maintain vigilance for virus adaptation and early indications of potential human-to-human transmission.

Beginning in early April 2013, CDC and U.S. state and local health departments initiated enhanced surveillance for H7N9 virus infections in patients with a travel history to affected areas. A new CDC influenza rRT-PCR diagnostic test has been cleared by the Food and Drug Administration under an Emergency Use Authorization and is being distributed to public health laboratories to assist in evaluating these suspect cases. Clinicians should consider the possibility of H7N9 virus infection in patients with illness compatible with influenza who 1) have traveled within &#8804;10 days of illness onset to countries where avian influenza A(H7N9) virus infection recently has been detected in humans or animals, or 2) have had recent contact (within &#8804;10 days of illness onset) with a person confirmed to have infection with avian influenza A(H7N9) virus. Because of the potential severity of illness associated with avian influenza A(H7N9) virus infection, CDC recommends that all H7N9 patients (confirmed, probable, or under investigation for H7N9 infection) receive antiviral treatment with oseltamivir or zanamivir as early as possible. Treatment should be initiated even >48 hours after onset of illness. Guidance on testing, treatment, and infection control measures for H7N9 cases has been posted to the CDC H7N9 website (9).

On April 5, CDC posted a Travel Notice on the Traveler's Health website informing travelers and U.S. citizens living in China of the current H7N9 cases in China and reminding them to practice good hand hygiene, follow food safety practices, and avoid contact with animals (10). CDC and WHO do not recommend restricting travel to China at this time. If travelers to China become ill with influenza signs or symptoms (e.g., fever, cough, or shortness of breath) during or after returning from their visit, they should seek medical treatment and inform their doctor about their recent travel. Travelers should continue to visit www.cdc.gov/travel or follow @CDCtravel on Twitter for up-to-date information about CDC's travel recommendations.

Given the number and severity of human H7N9 illnesses in China, CDC and its partners are taking steps to develop a H7N9 candidate vaccine virus. Past serologic studies evaluating immune response to H7 subtypes of influenza viruses have shown no existing cross-reactive antibodies in human sera. In addition, CDC has activated its Emergency Operations Center to coordinate efforts. In the United States, planning for H7N9 vaccine clinical trials is under way. Although no decision has been made to initiate an H7N9 vaccination program in the United States, CDC recommends that local authorities and preparedness programs take time to review and update their pandemic influenza vaccine preparedness plans because it could take several months to ready a vaccination program, if one becomes necessary. CDC also recommends that public health agencies review their overall pandemic influenza plans to identify operational gaps and to ensure administrative readiness for an influenza pandemic. Continued collaboration between the human and animal health sectors is essential to better understand the epidemiology and ecology of H7N9 infections among humans and animals and target control measures for preventing further transmission.

Link here...

[link to www.cdc.gov]

Further information on the novel coronavirus situation in Saudi Arabia is sited here with a breakdown of the "cases (and deaths) by country of report":

Of particular note is the last comment again noting the need for greater information, which at this stage Id imagine is never going to be forthcoming.


[In the newswire above there are reports of 7 newly diagnosed cases of severe illness including 5 deaths attributable to infection with the novel coronavirus (nCoV).

In prior reports the total number of reported/confirmed cases had been 17, with 11 deaths. If the accounts in the newswire above are correct, there are now 24 confirmed cases with 16 deaths.

As of today, 2 May 2013, the breakdown of cases (and deaths) by country of report is:
- Saudi Arabia: 16 (11 deaths)
- Jordan: 2 (2 deaths)
- UK: 4 (one patient from Qatar -- under treatment, 3 patients from UK -- one with history of travel to Saudi Arabia and Pakistan prior to illness; one recovered, 2 deaths)
- Germany: 2 (one patient from Qatar -- discharged, one patient from the UAE -- one death).

This nCoV is genetically closely related to a bat coronavirus. The actual route of transmission to humans has not yet been definitively defined. Contact with farm animals has been noted in a number of the cases (see prior ProMED-mail posts).

Information on the dates of onset of illness, age, and gender of cases, possible exposures (animal and human) and other information from epidemiologic investigations would be greatly appreciated.

Link here...

[link to www.promedmail.org]

In the left menu under the heading...

02 May 2013 Novel coronavirus - Eastern Mediterranean (16): Saudi Arabia, RFI

Last Edited by arkay on 05/03/2013 01:32 AM

The WHO has released some information of the current state of H7N9 in China.

The new H7N9 avian flu virus has been detected in one more patient in China, a finding that brings the number of cases in the outbreak to 128, which includes 24 deaths. [Now 26 deaths according to WHO; see part [2] below]. The patient is a 69 year old man from Hunan province, located in south-central China, according to a statement today [1 May 2013] from Hong Kong's Centre for Health Protection (CHP). The man -- Hunan province's 2nd H7N9 case-patient -- is hospitalized in critical condition.

The World Health Organization (WHO) yesterday [30 Apr 2013] updated its "frequently asked questions" background information on the H7N9 virus, which said that although evidence points to live poultry as the source of infections, investigations haven't confirmed that the birds are the primary or only source. Addressing the role of live-bird markets in the transmission of the virus, WHO said the markets should be periodically closed and emptied of all birds for regular cleaning. New birds brought into the market should be regularly sampled and tested to detect diseases early. WHO said regular maintenance of market environments can help minimize economic disruptions and the impact on a key source of protein for people. It also noted that the markets help ensure that the bird trade isn't diverted to channels of uncontrolled sales.

Until more information is known about the infections, it's difficult to determine whether the H7N9 virus poses a significant risk of person-to-person spread in the community, WHO said. "This possibility is the subject of epidemiological investigations that are now taking place." It's not known yet whether H7N9 is a pandemic threat, the agency said. Animal viruses that infect people theoretically carry a pandemic risk, but some animal influenza viruses known to infect people haven't sparked pandemics.

Regarding potential risks to health care workers, WHO said standard and extra precautions should be taken when caring for patients with suspected or confirmed H7N9 infections. In China and Taiwan, monitoring of close contacts of H7N9 patients turned up some instances of respiratory symptoms in health workers who cared for H7N9 patients, but so far, tests have not confirmed H7N9 flu in any worker

Link here...

[link to www.promedmail.org]

In the left menu under the heading...

02 May 2013 Avian influenza, human (69): H7N9, WHO update

I am a little puzzled as to why it has taken so long for the following information to emerge.

Again, we appear to be witnessing a type of censoring of information on infection reporting.

This time the particular reports are of H1N1 swine flu and the country is Vietnam.

To my best knowledge these earlier positive tests going back to the beginning of the year as quoted have not been spoken of before.

Also, Vietnam has had a pretty good record with their transparency on these matters up till now, and one can only wonder if the World Health Organization is working in the background to affect these changes, as they are totally consistant with how they appear to want to have things done.

According to the Center for Preventive Medicine in the northern province of Lao Cai, five of the patients who contracted A/H1N1 Flu virus in Quang Kim Commune in Bat Xat District are showing positive signs of recovery after receiving treatment at the General Hospital. These patients had been hospitalized after complaints of fever, cough, and respiratory problems. Test results showed positive for H1N1 virus. Following this, health authorities then rushed to their neighborhood to take more samples for testing as well as advised local medical workers to tighten supervision on those who had directly come into contact with the patients. The Ministry of Health has said that since the beginning of the year, the number of people contracting H1N1 virus are on an upward trend, with virus being transmitted through the respiratory system. Tran Nhu Duong, deputy head of the Central Hygiene and Epidemiology Institute, said out of 962 samples taken in the first fourth months, 119 proved positive.

Link here...

[link to hisz.rsoe.hu]

It's absolutely mind boggling Arkay..... WHO are complicit in the Saudi coverup just as they are with today's stunning revelation that Chinese idiots have been fucking around mixing bird flu strains with human influenza in VET LABS.

WHO are the world's self appointed biosecurity police and they would/should have known what China was up to.

The fact that we now have 2 potential pandemic possibilities to deal with makes me wonder how these mutations escaped the radar.

Hmmmm..... it' starting to smell like 2009 all over again

Yes Rickster.

I have a very bad feeling about all the things that are coming to light at present and even more so at what isnt but should be publicly known information.

All these little snippets always seem to revolve around the World Health Organization and we can only hope that some of our readers, those who are close to the coal face and who are able to ask difficult questions, will be doing so.

I know that I am not alone on this, but for a long time now I have been suspicous that there has been an active program to hinder progress aginst these dangerous pathogens and also passively assist with their spread and evolution, and Ill once again name the biggest offender that I have held the greatest suspicion against.

Everyone knows my position here, but just to be certain it is the World Health Organization.

When are they going to be held accountable for their actions?

arkay

If anyone has any doubt regarding the intense stance that I have been taking against the World Health Organizations practices then a quick look at the following post by Professor Niman might help eliminate any possible doubts regarding my stance.

To use the word "vague" when referring to the World Health Organizations reporting is revealing enough, but the Professors final paragraph is nothing less than total damnation.

He is to be highly commended for demonstrating so plainly his professional opinion on these matters and one can only wonder at the professional horror and insult he and persumably all his colleagues must be feeling over this unbelievable a culpable behavoir from the World Health Organization.

WHO's Vague Report On Beta2c Coronavirus Cluster In Al-Ahsa
Recombinomics Commentary 23:00
May 2, 2013

The Ministry of Health in Saudi Arabia has informed WHO of seven new laboratory confirmed cases of infection with the novel coronavirus (nCoV), including five deaths.

Two patients are currently in critical condition.

Preliminary investigation show no indication of recent travel or animal contact of any of the confirmed cases. The confirmed cases are not from the same family.

Break to last paragraph...

WHO’s failure or unwillingness to provide the most basic information on a reportable disease like a novel coronavirus with a case fatality rate above 67%, and its ongoing dysfunction, continue to be hazardous to the world’s health.

Link here...

[link to www.recombinomics.com]