Evidence of probable transmission of H7N9

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   A guest posted this elsewhere, and I think it's worthy of it's own post. Thanks for finding it in the first place 

Evidence of probable transmission of bird flu virus between two unrelated individuals							
November 18, 2015  in Medicine & Health / Diseases, Conditions, Syndromes							

        Influenza A (H7N9) as viewed through an electron microscope. 
Both filaments and spheres are observed in this photo. Credit: CDC

Previous reports of person to person 
transmissions have all occurred in family clusters, suggesting that 
either common exposures or genetic susceptibility might contribute to 
the infection.
The study describes two patients who shared the same ward in a district hospital in Zhejiang Province, China in February 2015.
The first (index) case was a 49 year old man who became ill after buying two chickens from a live poultry market
 for the wedding ceremony of his elder daughter. He developed a fever, 
cough, and sore throat and was admitted to a district hospital on 18 
February.
He was diagnosed with H7N9 virus on 24 February and was admitted to a
 specialist hospital ward with intensive care facilities. He died of 
multi-organ failure on 20 April.
The second case, a 57 year old man with a history of chronic lung disease
 (COPD), developed flu-like symptoms after staying on the same ward of 
the district hospital as the index case for five days (18 to 23 
February).
He was diagnosed with H7N9 virus on 25 February and died of respiratory failure on 2 March.
A total of 38 close contacts of both cases, including family members and health workers, were tested for the virus.
Two samples taken from the chickens purchased by the index patient as
 well as five of 11 samples from the live poultry market he visited were
 positive for H7N9 virus.
The second patient had no history of poultry exposure for 15 days 
prior to his illness. Samples from his home, from chickens raised by his
 neighbours, and a local chicken farm were all negative for H7N9 virus.
Yet the genetic sequence of H7N9 virus from the second patient was 
nearly identical to that from the index patient, and genetically similar
 to the virus samples taken from the live poultry market visited by the 
index patient.
The researchers stress that they cannot completely rule out an 
unidentified environmental exposure that might explain the H7N9 
infection in the second patient.
However, because no other common exposure was identified, they say 
"it seems most likely that the H7N9 virus was transmitted from the index
 case to the second case during their stay on the same ward."
Their findings also strongly suggest that the live poultry market is the most probable source of influenza H7N9 virus infection for the index case.
They say these results "should raise our concern about the increasing
 threat to public health" and they call for better training and hospital
 hygiene as well as enhanced surveillance of both patients with 
influenza-like illness in hospitals and chickens in live poultry markets.
"We should not accept nosocomial transmission, of any pathogen, in 
any setting," say experts from the Netherlands in an accompanying 
editorial.
Well described and researched case reports, such as today's study, 
are vital to keep researchers focused on promoting the wellbeing of 
patients in hospitals and otherhealthcare settings, they write.
We must remain alert for (re)emerging infections, including avian 
influenza, particularly when we still cannot tell how risks to humans 
will evolve. We also need to invest more in clinical, epidemiological, 
and virological research to unravel the risks posed by sporadic human 
infections with any avian influenza virus," they conclude.
"First and foremost, however, we should do no harm to our patients, 
and so should not accept nosocomial transmission, of any pathogen, in 
any setting."

        More information:
        Nosocomial transmission of avian influenza A (H7N9) virus in China: epidemiological investigation, www.bmj.com/cgi/doi/10.1136/bmj.h5765
Editorial: Nosocomial transmission of avian influenza virus A (H7N9), www.bmj.com/cgi/doi/10.1136/bmj.h5980

       Provided by British Medical Journal

http://medicalxpress.com/news/2015-11-evidence-probable-transmission-bird-flu.html

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jacksdad Members Profile Send Private Message Find Members Posts Add to Buddy List Executive Admin Joined: September 08 2007 Location: San Diego Status: Offline Points: 47251	Post Options Post Reply Quote jacksdad Report Post Thanks(0) Quote Reply Topic: Evidence of probable transmission of H7N9 Posted: November 19 2015 at 8:13am
	A guest posted this elsewhere, and I think it's worthy of it's own post. Thanks for finding it in the first place Evidence of probable transmission of bird flu virus between two unrelated individuals November 18, 2015 in Medicine & Health / Diseases, Conditions, Syndromes Influenza A (H7N9) as viewed through an electron microscope. Both filaments and spheres are observed in this photo. Credit: CDC Previous reports of person to person transmissions have all occurred in family clusters, suggesting that either common exposures or genetic susceptibility might contribute to the infection. The study describes two patients who shared the same ward in a district hospital in Zhejiang Province, China in February 2015. The first (index) case was a 49 year old man who became ill after buying two chickens from a live poultry market for the wedding ceremony of his elder daughter. He developed a fever, cough, and sore throat and was admitted to a district hospital on 18 February. He was diagnosed with H7N9 virus on 24 February and was admitted to a specialist hospital ward with intensive care facilities. He died of multi-organ failure on 20 April. The second case, a 57 year old man with a history of chronic lung disease (COPD), developed flu-like symptoms after staying on the same ward of the district hospital as the index case for five days (18 to 23 February). He was diagnosed with H7N9 virus on 25 February and died of respiratory failure on 2 March. A total of 38 close contacts of both cases, including family members and health workers, were tested for the virus. Two samples taken from the chickens purchased by the index patient as well as five of 11 samples from the live poultry market he visited were positive for H7N9 virus. The second patient had no history of poultry exposure for 15 days prior to his illness. Samples from his home, from chickens raised by his neighbours, and a local chicken farm were all negative for H7N9 virus. Yet the genetic sequence of H7N9 virus from the second patient was nearly identical to that from the index patient, and genetically similar to the virus samples taken from the live poultry market visited by the index patient. The researchers stress that they cannot completely rule out an unidentified environmental exposure that might explain the H7N9 infection in the second patient. However, because no other common exposure was identified, they say "it seems most likely that the H7N9 virus was transmitted from the index case to the second case during their stay on the same ward." Their findings also strongly suggest that the live poultry market is the most probable source of influenza H7N9 virus infection for the index case. They say these results "should raise our concern about the increasing threat to public health" and they call for better training and hospital hygiene as well as enhanced surveillance of both patients with influenza-like illness in hospitals and chickens in live poultry markets. "We should not accept nosocomial transmission, of any pathogen, in any setting," say experts from the Netherlands in an accompanying editorial. Well described and researched case reports, such as today's study, are vital to keep researchers focused on promoting the wellbeing of patients in hospitals and otherhealthcare settings, they write. We must remain alert for (re)emerging infections, including avian influenza, particularly when we still cannot tell how risks to humans will evolve. We also need to invest more in clinical, epidemiological, and virological research to unravel the risks posed by sporadic human infections with any avian influenza virus," they conclude. "First and foremost, however, we should do no harm to our patients, and so should not accept nosocomial transmission, of any pathogen, in any setting." More information: Nosocomial transmission of avian influenza A (H7N9) virus in China: epidemiological investigation, www.bmj.com/cgi/doi/10.1136/bmj.h5765 Editorial: Nosocomial transmission of avian influenza virus A (H7N9), www.bmj.com/cgi/doi/10.1136/bmj.h5980 Provided by British Medical Journal http://medicalxpress.com/news/2015-11-evidence-probable-transmission-bird-flu.html
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