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Online Discussion: Tracking new emerging diseases and the next pandemic.

Mutated H7N9 now more infectious to humans

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Albert View Drop Down
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    Posted: March 23 2017 at 5:33am
(Avian flu) Mutated virus, more dangerous to humans, detected

A research team from the University of Hong Kong has identified a mutation in the H7N9 virus, which may explain why there has been a major outbreak of the avian flu strain on the mainland since autumn last year.
More than 500 people have been infected with the bird flu virus since then. More than a fifth of them have died.
One of the team's key investigators, Professor Chen Honglin, said the mutation has made the H7N9 virus much more infectious to humans.
Chen said the mutation emerged as early as 2000. He said by 2012 or 2013, almost all H9N2 virus carried this mutation. -RTHK

http://www.thestandard.com.hk/breaking-news.php?id=86494


Comment:  It seems that this thing is a hair away from going pandemic.  We will be lucky if it doesn't within the next 12 months.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Eight Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2017 at 10:02am
Of note is the otherwise slightly decreased mortality rate. It could be an artifact, but with increased cases and an apparently lower mortality rate that would seem to indicate attenuation and therefore host adaption. But, hey, who knows. 

Also, this is only increasing the rate at which it infects humans from, presumably, the infected avian hosts. A hair away from a pandemic, in my eyes, is the emergence of human-to-human transmission. There are some cases where this might have happened, but we aren't seeing a lot of that just yet. This is bad news, since it will increase the chance for such mutations to arise, but it's still a step or so away from sustained human-to-human.

Winter is coming to a close. Hopefully some of these strains die with it.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2017 at 12:31pm
That does tend to be a pattern with viruses like influenza - a trade of between it's ability to better infect a new host, and kill it. How much H7N9 might drop it's CFR is anyone's guess if it did go efficiently H2H, but it's starting with the bar set pretty high right now.

We're fortunate that it seems to be geographically stuck right now, because things are going to start getting chilly in the southern hemisphere soon.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 24 2017 at 1:20am
For years people have speculated that there is a relationship between mortality rate and transmission, and as the mortality rate decreases, the better chance of increased transmission as is begins to mutate.  That has always been a question mark for me, and the only thing people had to go on was using H5N1 as the model with an extremely high mortality rate.  This may not be the case as we are seeing the mortality rate increase with H7N9 along with the transmission.   Hopefully we don't find out, but at this rate, as the mortality increases, so is the transmission.    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: March 24 2017 at 11:48pm
Great discussion!  The surface receptors of strictly avian influenza like H5N1 and H7N9 must acquire the ability to attach to human sites efficiently, which is why it takes time for these viruses to evolve. 

I've always been a skeptic of H2H transmission with H5N1, and believed that cases occurred during the animal husbandry of keeping fowl, where cases were likely to really inhale a very high infectious dose deep into the lungs (from cleaning cages, disposing of dead birds etc.) 

It seems likely to me that, as the strictly avian viruses mutate to cause human illness more easily, they may also lose some of the traits that result in high morbidity and mortality in human hosts.  I can't find a good reference for this, but it does seem to hold true.  

I read papers like this late at night to help fall asleep!!  This has many answers to your questions: 


Off to bed now!  Clap
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2017 at 3:51am
It appears that various organizations believe an H7N9 pandemic is imminent.  This is not looking good.  My guess would be 1 - 2 years with H7N9 on the outside, or never.   This one is not looking good.

Stronger Precautions Urged for Bird Flu

CHINA - Two international organizations have stressed the high possibility of human-to-human transmission of the H7N9 virus, which saw the biggest outbreak in China over the past winter since first being reported in China in 2013.

The organizations urged the Chinese government to take more precautionary measures to prevent a possible bird flu epidemic.

"Experts agree that it is not a question of if, but when the virus will adapt in ways that facilitate efficient, sustained human-to-human transmission," according to a joint statement on Thursday from the World Health Organization and the United Nations Food and Agriculture Organization.

http://www.thepoultrysite.com/poultrynews/38363/stronger-precautions-urged-for-bird-flu/

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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2017 at 10:42am
Originally posted by Albert Albert wrote:

"Experts agree that it is not a question of if, but when the virus will adapt in ways that facilitate efficient, sustained human-to-human transmission," according to a joint statement on Thursday from the World Health Organization and the United Nations Food and Agriculture Organization.

http://www.thepoultrysite.com/poultrynews/38363/stronger-precautions-urged-for-bird-flu/



That is a really disconcerting statement, given how emphatic it is in predicting H2H transmission. To see one of those agencies come out and issue a warning like this is pretty significant - that they're both in agreement is very worrying.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 26 2017 at 1:52am
Not good news at all.  This bug is definitely rapidly changing.  You may have called it JD, on the 100th anniversary since 1918.  Of course it probably now also has the capability of mixing much easier with h1n1, for the 1918 replay.   Or maybe it will just be a flat h7n9 pandemic, who knows, but this pattern is getting concerning - and now a joint statement to prepare for sustained human transmission?  

The transmission is increasing along with the mortality rate.  The mutation models vs. ease of transmission apparently were not correct over the years.  The 1918 flu also mutated to a more severe form. 

I believe the 1918 pandemic flu began in May?  

On another note, the worst news is that Tamiflu and anti-virals are going to be useless with this one. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 26 2017 at 2:34am
Stronger precautions are urged for bird flu


By Wang Xiaodong | China Daily USA | Updated: 2017-03-24 07:31

Two international organizations have stressed the high possibility of human-to-human transmission of the H7N9 virus, which saw the biggest outbreak in China over the past winter since first being reported in China in 2013.

The organizations urged the Chinese government to take more precautionary measures to prevent a possible bird flu epidemic.

"Experts agree that it is not a question of if, but when the virus will adapt in ways that facilitate efficient, sustained human-to-human transmission," according to a joint statement on Thursday from the World Health Organization and the United Nations Food and Agriculture Organization.

There was no evidence of sustained human transmission of the virus, but H7N9 has continued to change, the statement said.

Researchers recently identified two separate genetic lineages of H7N9, adding complications to the making of candidate virus vaccines, the first step in developing vaccines for birds and humans, it said.

The University of Hong Kong said on Wednesday that its researchers had identified a mutation in H7N9 avian flu that can enhance its ability to infect humans.

In February, the Chinese Center for Disease Control and Prevention said H7N9 had mutated to a new strain in South China, which did not affect the virus's ability to spread between humans but made it more dangerous among poultry.

China reported 352 human cases of H7N9 in the first two months of the year, resulting in 140 deaths, according to the National Health and Family Planning Commission.

"We have a short window of time - before the next seasonal outbreak in winter - to get ahead of the virus and prevent a SARS-type event," the joint WHO-UNFAO statement said, adding that during this short window, policymakers need to have immediate intervention steps ready to control the virus.

"This may involve a mix of market closures and poultry vaccinations as a requirement for market access," it said, adding that over 90 percent of reported cases involved individuals in direct contact with live poultry or a market selling live poultry.

Once a problem is identified, the intervention steps need to be fully implemented before the next seasonal peak, which is during the Chinese New Year holiday, it said.

Chinese authorities have taken measures since winter, such as closing live poultry markets, to control and prevent the virus.

Live poultry markets in Changsha, the capital of Hunan province, were suspended for three weeks beginning March 17, according to the city's health commission.

In Anhui province, most cities and counties have closed live poultry markets since February, local media reported.

The WHO-UNFAO statement said China needs to intensify enforcement of the closure of live poultry markets to eliminate the threat.

Sporadic cases of bird flu may last until late April, according to the China CDC. Currently, there is no vaccine for the virus, but several Chinese companies have received approval from the China Food and Drug Administration for clinical trials of vaccines.

Premier Li Keqiang said in February that China will promote business models that feature large-scale farming, centralized slaughtering and cold-chain transportation, including the keeping and selling of poultry in chilled conditions, to prevent similar poultry-related disease outbreaks.

wangxiaodong@chinadaily.com.cn

http://usa.chinadaily.com.cn/epaper/2017-03/24/content_28666643.htm


Comment:  A Sars-type event would indicate it's about to spread slowly via limited h2h transmission.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: March 26 2017 at 10:05am
Please don't let me be right about this one Shocked

H1N1 first showed up in the early part of 1918 - possibly as early as January. I can only assume it survived the transition period between the first and second waves in the colder temperatures of the Southern Hemisphere's winter. Hopefully H7N9 will stay geographically pinned down in China and not head south as their flu season comes to an end.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 26 2017 at 10:23am
There is a reason why first reports from U.S. Health Officials stated the latest mutations were not more infectious, until the Hong Kong researchers announced it.  The same reason why they can't determine if H7N9 is in fact resistant to antivirals.  Quite simply, China is not releasing samples, and they haven't since 2013.  The only info the world gets is spoon-fed information from China, and we all know how much they can be trusted.


There have also been reports that some of the viruses may no longer be susceptible to oseltamivir — sold as Tamiflu — and other flu drugs of the same class. There are few drugs that treat influenza, and if H7N9 became resistant to these drugs, it would be a highly unwelcome development. But the CDC’s Davis said so far it appears that the cases of resistance have involved hospitalized people who were taking the drugs for protracted periods.

Resistance can evolve during treatment, but resistance among viruses that haven’t yet been exposed to the drug would be more alarming, he and Jernigan said.

Scientists at the CDC would like to test virus samples from China to ensure that the flu drugs are still effective. But a disease diplomacy problem is getting in the way of that work.

While China has been reporting cases and sharing the genetic sequences of viruses, it has not shared actual virus samples with the United States since the early days of the H7N9 outbreak, Jernigan said.

Thanks to developments in synthetic biology, genetic sequences can be used to make sample viruses that can tell scientists a lot about how a virus behaves. Still, viral samples would be useful. “Synthetic biology is amazing. But it still takes time,” said Davis.

Jernigan said scientists at the China CDC collaborate openly with their international colleagues. But a green light to share viruses would need to come from other parts of the government. He said efforts are underway to try to open those doors.

https://www.statnews.com/2017/02/28/bird-flu-surge/


Comment:  Only response to this about China is, A**holes.  Excuse my French.


 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Eight Quote  Post ReplyReply Direct Link To This Post Posted: March 27 2017 at 5:23am
Honestly if China keeps stonewalling the CDC they need to simply make recombinants on their own. This is quite feasible, but perhaps a bit pricey--nothing the CDC can't handle. And of course China deserves an obligatory middle finger for witholding samples. It goes against standard scientific protocol and all logic. 

As far as mortality and transmission, I was a bit wrong when I remembered this paper in question, although it is with H7N1:

https://www.ncbi.nlm.nih.gov/pubmed/24696487

Verdict: Low sample size, but no apparent decrease in pathogenicity required for airborne Ferret-to-Ferret transmission. 

Thinking it over, I doubt we'd see attenuation in humans if we don't even have substantial H2H. We are probably just observing either strain differences or statistical artifacts. Neither of which is comforting since we're still looking at Smallpox-level mortality.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Rishat Quote  Post ReplyReply Direct Link To This Post Posted: April 17 2017 at 4:14am
У меня врождённый и приобретённый иммунитет к инфекционным заболеваниям . Заражаюсь как обычный человек, но болею 2-4 дня или совсем не болею. Возраст 38 лет пол мужской
Предлагаю сделать вакцину против зика из моей крови. Но так я больной предлагаю сделать вакцину из компонентов моей крови. А имменно из иммуноглобулина. Мусульманин. В СВЯЩЕННОМ КОРАНЕ не сказано что нельзя делать вакцину из крови мусульманина в чрезвычайных ситуациях. Всевышний Аллах разрешит сделать вакцину из моей крови. Мусульманин. 3 раза в день принимаю тахарат в холодной водопроводной воде, а 2 раза в ледяной воде из колонки, ноги мою раз в день но в тёплой воде, а это микро закаливание. Врождённый иммунитет: болею не сахарным диабетом, диабетом другого типа. Много пью воды. IC - Ну кто - то должен получить его в лабораторию, взять образец и запустить последовательность. Тогда он будет знать наверняка. Если есть антитела в там - мир , возможно , потребуется их.

А также кто должен получить его в лабораторной работе взять пробу и выполните последовательность . Затем он будет знать наверняка. Если имеются антитела есть в мире - может потребоваться их.
По мнению американских врачей. ПОМОГИТЕ мне доказать мой иммунитет . Мне осталось жить не более 4 лет , могу умереть через несколько часов. У меня заболевание Оливо понто церибральная дегенерация с отрофией мозжечка. Одно из проявлений этой болезни не контолируемое слюно выделениеи из за этого постоянно давлюсь при приёме пищи а при совокупности с не сахарным диабетом к концу дня слюна становится тугой и я давлюсь когда спокойно сижу. Это продолжается пока я не приму лекарство от не сахарного диабета. И ещё у меня шаткость походки и двоение в глазах. Так что я могу попасть под машину. Но состояние здоровья постоянно ухудшается. Прошу прислать в Альметьевск эксперта иммунолога для проверки моего иммунитета. Я буду последней линией обороны человечества от инфекционных заболеваний. Есть ещё одно доказательство иммунитета
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Rishat Quote  Post ReplyReply Direct Link To This Post Posted: April 17 2017 at 4:18am
Предлагаю сделать вакцину против гриппа H7N9 из моей крови.
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