WHO cautious, but no evidence of human-to-human infections recorded yet

A woman sells live chickens and ducks in downtown Hanoi. China has reported its second death from the H7N9 bird flu virus this year, prompting concerns that the virus might spread to Vietnam via cross-border poultry smuggling. PHOTO: AFP

Prompted by the spread of a new deadly bird flu strain across the border in China, Vietnamese authorities are rushing to implement preventive measures ahead of the expected surge in poultry consumption for Tet (Vietnam’s Lunar New Year holiday).

“Visitors to Vietnam are being screened to monitor their body temperature for early detection of those with fever,” deputy health minister Nguyen Thanh Long said.

“However, it is difficult because Tet is coming and there is going to be high consumption of chicken and ducks. [Illegal] markets selling livestock boom for a month around Tet, leading to high threats of pandemic,” he said.

The new rare virus strain that has everyone worried is called H7N9, as compared to the more common H5N1 and H1N1 that have plagued the region for years.

The Ministry of Health held a meeting with relevant agencies on January 13 to discuss prevention efforts against the bird flu, also known as avian influenza A.

At the meeting, Tran Dac Phu, director of the Preventive Health Department, said health inspectors will step up screenings at border gates.

Vietnam has recorded no cases of bird flu caused by the H7N9 strain virus so far but there is a possibility that it could spread in the country because it has appeared in China’s provinces near Vietnam, including seven cases in Guangdong, he said.

“This is a place that many Vietnamese people visit for tourism and trade,” Phu said. 

New virus

A suspected H7N9-infected patient died in southwest China's Guizhou Province, Xinhua news agency quoted local authorities as saying on January 13, in the second death from the virus in the past week.

The patient, identified only as a 38-year-old man from Meitan County, died on January 9 at a hospital in Zunyi City, a month after showing symptoms such as coughing and dizziness.

On January 10, a man from Fujian Province, also 38, died from the virus, Xinhua reported.

Meanwhile, a 65-year-old man infected with the H7N9 bird flu virus has also died in Hong Kong, the second such death in the city.

The man, the third person in Hong Kong to be diagnosed with the strain, came from the southern Chinese city of Shenzhen and had eaten poultry there, local media reported.

In China, human cases of the bird flu virus have also been reported in the provinces of Zhejiang, Jiangsu and Guangdong so far this year.

As of January 15, the World Health Organization (WHO) had been notified of 177 laboratory-confirmed cases of human infection with avian influenza H7N9 virus, including 51 deaths.

“Of the cases reported, there are 172 cases from mainland China, 2 cases from Taiwan and 3 cases from Hong Kong. Up to 77 percent of the cases were reported to have been exposed to live animals including to chickens or live poultry,” the WHO said in a statement to Vietweek.

Experts say there is no evidence yet of any easy or sustained person-to-person transmission of the strain.

But an early scientific analysis of probable transmission of the new flu from person to person published last August  gave the strongest proof yet that it can at times jump between people and so could cause a human pandemic, Reuters reported.

The WHO said the source of the human infections was still being investigated. The UN agency stressed that it does not advise any special screenings for people going in and out of China, nor does it recommend any travel or trade curbs.

Last April, the WHO warned the H7N9 virus was one of the most lethal that the medical community had faced in recent years.

"This is an unusually dangerous virus for humans," Keiji Fukuda, WHO's assistant director-general for health, security and the environment told a news conference in Beijing.

"We think this virus is more easily transmitted from poultry to humans than H5N1," he added, referring to the bird flu outbreak between 2004 and 2007 that claimed 332 lives.

"This is definitely one of the most lethal influenza viruses that we have seen so far." 

Outbreak fears

Following recent infections of H7N9 in China, Vietnamese officials are concerned that it can spread across the border due to migration and poultry smuggling.

Deputy health minister Long instructed relevant agencies to strictly monitor people with pneumonia and symptoms of acute respiratory infections, especially those coming from pandemic zones.

“Livestock smuggling across the border must be controlled,” he said.

Health facilities have to prepare medicine and chemicals to prevent and deal with bird flu outbreaks and ensure timely exams and diagnoses for people suspected of contracting the virus, he said.

Long said China has recently shut down many live poultry markets and it has had positive effects in preventing the spread of bird flu.

Phu, the director of the Department of Preventive Health, warned that people should not eat raw poultry blood pudding – considered a delicacy by many Vietnamese – because it can easily transmit the virus.

He also advised local tourists to study relevant information before going abroad and choosing “suitable destinations” to prevent virus infections.

Dao Xuan Thanh, deputy director of the Animal Health Department, said the biggest concern is poultry smuggling between China and Vietnam, which is expected to surge during Tet.

It is difficult to detect poultry carrying the H7N9 virus in the early stages as the animals show no symptom, he added.

In 2013, relevant authorities bust nearly 1,800 cases of poultry smuggling from China to Vietnam, seizing some 56,000 animals, 202,000 kg of meat, 2.7 million eggs and millions of young chicks and ducklings.

Thanh also warned against the lax surveillance of the domestic poultry trade.

His agency recently inspected 60 markets nationwide and found 590 of the total 9,000 poultry samples tested positive for avian influenza A.

Meanwhile, the Department of Preventive Health has warned about new strains of avian influenza A virus having been detected around the globe more often recently.

According to Phu, the agency director, H7N9 was detected in March last year. H10N8 was first discovered in December and H9N2 this month.

“It used to take several years for a new strain to really emerge, including the H5N1 spread in 2003 and H1N1 in 2009,” he said.

The WHO has not issued specific official warnings about a possible major spread of the virus, but has still called for vigilance.

“There has been, however, to date no evidence of direct or sustained human-to-human transmission, thus the current likelihood of community-level spread of this virus is considered to be low,” the organization said in the statement to Vietweek.

“Any animal influenza virus that develops the ability to infect people is a theoretical risk to cause a pandemic. However, whether the avian influenza A (H7N9) virus could actually cause a pandemic is yet to be seen.”