WHO Talks With China on Sending Bird Flu Team 

The World Health Organization is talking with the Chinese government about sending international experts to China to help investigate a new bird flu strain that has sickened at least 24 people, killing seven of them.

A 64-year-old retired man in Shanghai became the latest victim of the H7N9 bird flu virus that had previously not been known to infect humans, the city government said Monday.

The Shanghai government said the man died Sunday night, a week after first experiencing chills. He sought medical treatment last Wednesday for pneumonia-like conditions. By Sunday morning, his condition worsened, he was out of breath and was admitted to a ward for in-patient treatment. He died hours later.

Michael O'Leary, head of WHO's office in China, told reporters in Beijing on Monday that the international health organization had confidence in China's efforts to track and control the outbreak of H7N9 infections, but that growing interest in the virus globally has prompted WHO to consider sending a team.

The cases are of "great interest not only in the scientific community but in the world at large," O'Leary said at a joint press conference with China's national health agency. "WHO's responsibility in part is to make sure that we serve as liaison and linkage between China and the rest of the world."

The team would likely include epidemiological, laboratory and communications experts, but the matter was still being discussed by the two sides and it remained unclear if and when such a group would arrive, O'Leary said.

There could be additional infections, both among animals and humans, in other regions and authorities have stepped up measures to monitor cases of pneumonia with unexplained causes, said Liang Wannian, director of the Chinese health agency's H7N9 flu prevention and control office.

Liang said Chinese experts also were in the early stages of researching a possible vaccine for the virus, though it might not be needed if the virus remains only sporadically reported and if it does not spread easily among people.

The H7N9 strain previously was known only to infect birds, and officials say they do not know why the virus is infecting humans now. The virus has been detected in live poultry in several food markets where human cases have been found, leading officials to think people are most likely contracting the virus through direct contact with infected fowl.

Authorities have halted live poultry trade in cities where cases have been reported, and slaughtered fowl in markets where the virus has been detected.

Further investigations are underway and, for now, there's no evidence the virus is spreading easily between people. However, scientists are watching closely to see if the flu poses a substantial risk to public health or could potentially spark a global pandemic.

In 2003, China allowed WHO to send a five-member team to help investigate an outbreak of the fatal flu-like illness, SARS, after its own experts could not trace the source of the disease.

China's response at the time was slow. The government stayed silent for months after the first cases of an unidentified disease were reported, a cover-up that contributed to the spread of the virus to many parts of China and to two dozen other countries, killing hundreds of people.

International observers say that over the past decade, China's public health agencies have become increasingly forthcoming with information.

The World Health Organization says China is broadening its search for human cases of the new H7N9 flu. 

A spokesperson for the Geneva-based global health agency says China is starting to test for the new strain across the country. 

To date cases have been found only in four provinces in eastern China, near Shanghai. 

But Gregory Hartl says Chinese authorities are starting to test for the virus through the country’s surveillance network for influenza-like illnesses. 

That means people sick with flu-like illnesses who seek care at sites in the network across China could be tested for H7N9. 

To date China have confirmed 24 infections, with seven deaths. 

It’s not clear whether the clustering of cases in the four provinces means that those are the only places where infections are occurring, or whether broadening testing will turn up cases in more far-flung parts of the vast country. 

Hartl said the work to find the animal reservoirs of the virus is also continuing. China’s Agriculture Ministry and the U.N. Food and Agriculture Organization are collaborating, he said, and have collected more than 11,000 samples from various animal types to look for where the virus is hiding in nature. 

So far H7N9 has been found in pigeons, quails and chickens. 

Finding the virus in animals has been challenging because it currently doesn’t sicken or kill poultry. 

H7 flu viruses, like the better known H5 viruses, can come in two forms. They can be highly pathogenic, killing poultry, or can come in a low pathogenicity form. The new virus is the latter, meaning it can spread in a virtually invisible manner among poultry flocks. 

However, low path H7 and H5 viruses will typically evolve to become high path viruses, if they circulate among poultry for long enough. (The designations of low path or high path relate to how the viruses act in poultry, and not how deadly — or not — these viruses are for people who become infected with them.) 

Hartl says human infections continue to accumulate at a rate of two or three a day, but the WHO believes the cases are still sporadic, with “almost no evidence of human-to-human transmission of any type.” 

He explained he used the word “almost” because among the more than 600 contacts of cases that China is investigating, a few have shown signs of illness and need to be followed up.

Albert wrote:   Sounds to me that they suspect human-to-human transmission.

Although H7N9 is more easily transmittable from birds to humans than the original bird flu strain, H1N1, Cox said she expects to see limited human-to-human transmission."

http://abcnews.go.com/blogs/health/2013/04/08/h7n9-bird-flu-update-21-infected-6-dead/

The World Heath Organisation (WHO) has denied there is evidence the H7N9 bird flu virus is being transmitted between people in China.

Concerns over human transmission arose in Shanghai after two sons of an elderly man - who was one of the earliest deaths from H7N9 - developed respiratory illness and one died.

The virus was later ruled out by Chinese authorities and the WHO's China representative Michael O'Leary has confirmed that finding.

"The family cluster raises the possibility of human-to-human transmission, but two of the cases in that cluster have not been laboratory confirmed," he told reporters in Beijing.

"Although we do not know the source of infection, at this time there is no evidence of sustained human-to-human transmission."

China announced just over a week ago the virus had been found in humans for the first time, and the number of confirmed cases has since risen to 21, with six deaths.

Four of the deaths have been in the commercial hub of Shanghai, with the other two in the neighbouring province of Zhejiang.

Mr O'Leary praised China's transparency on the outbreak following criticism the announcement of the initial deaths was too slow.

"We are very satisfied and pleased with the level of information shared and we believe we have been kept fully updated on the situation," he said.

The first deaths from the virus were not reported by authorities until three weeks after they occurred.

Chinese officials said the delay in announcing the results was due to the time taken to determine the cause of the illness.

China faced condemnation a decade ago over accusations it covered up the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS), which eventually killed about 800 people globally.

AFP

The cases so far have all come from Shanghai and four surrounding provinces. Most have involved people who had direct contact with infected poultry. However, there might be milder cases of the illness that have gone undetected, acknowledged Liang Wannian, director of the Chinese health agency’s H7N9 flu prevention and control office.

What has frightened researchers is the speed with which the confirmed victims sickened and died. The 64-year-old man who was the latest victim sought medical treatment for a pneumonia-like illness on Wednesday, was admitted to the hospital on Sunday and died a few hours later. However, a 4-year-old boy from Shanghai was reported to have made a full recovery.