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H7N9: The next pandemic?
April 2, 2013 9:11 PM   Subscribe


 
We've been very, very lucky thus far with the relatively limited impact of various animal-human viruses (SARS, bird flu part 1, swine flu). That luck will eventually run out.

Maybe "lucky" is the wrong word. We avoided disaster through a combination of efforts to stop the spread of the viruses among human hosts, eliminate infected animal host populations, and treat the symptoms of infected humans, especially by providing access to ventilators to the majority of those severely affected. But in all of those cases, the virus was not optimized for human-human transmission. Maybe this one is.
posted by charmcityblues at 9:20 PM on April 2, 2013 [12 favorites]


I'm getting an impassable sign-up window with the first link.

Maybe that's for the best though because this stuff scares me like no other.
posted by Defenestrator at 9:26 PM on April 2, 2013 [1 favorite]


Yay!
posted by [insert clever name here] at 9:32 PM on April 2, 2013


Non-paywall link to the first article.
posted by charmcityblues at 9:34 PM on April 2, 2013


The report I heard sounded like it was not as contagious as it could be, the family of the deceased were not infected. But perhaps it'll mutate.
posted by sammyo at 9:35 PM on April 2, 2013


[Swapped out first link for non-paywalled version; carry on.]
posted by LobsterMitten at 9:36 PM on April 2, 2013


Non paywall version is just first paragraph.
posted by dobbs at 9:37 PM on April 2, 2013


This is the way the Apocalypse happens. First there are warning signs, but you won't understand the full implications unless you pony up the subscription fee.
posted by twoleftfeet at 9:38 PM on April 2, 2013 [53 favorites]


Click the "read more" link, it should take you to the full article once and let you read it. Clear cookies if necessary.
posted by charmcityblues at 9:38 PM on April 2, 2013


Doesn't work for me. Tried 3 browsers, just brings up a paywall version.
posted by dobbs at 9:41 PM on April 2, 2013


(Still all paywalled up for me.) ProMED-mail - the Program for Monitoring Emerging Diseases is one of my favorite sites for learning about this sort of thing. Not only do they update round the clock, but the reports are moderated by infectious disease experts, so it's trustworthy and there's usually a calm editorial comment at the end of even the most hysterical source. The latest Background post on H7N9 in China is here.
posted by gingerest at 9:41 PM on April 2, 2013 [15 favorites]


But in all of those cases, the virus was not optimized for human-human transmission. Maybe this one is.

Optimization for human transmission is something that has to evolve, no? Another reason why catching these things before they blow through a large population of humans is important.

Maybe "lucky" is the wrong word. We avoided disaster through a combination of efforts to stop the spread of the viruses among human hosts, eliminate infected animal host populations, and treat the symptoms of infected humans, especially by providing access to ventilators to the majority of those severely affected.

Compared to the way we're neglecting global warming and asteroid mitigation, disease control seems to be the one kind of global disaster avoidance program where humanity's kind of got its act together.
posted by justsomebodythatyouusedtoknow at 9:49 PM on April 2, 2013 [4 favorites]


I'm going to watch Contagion again and wash my hands forever k?
posted by The Whelk at 9:52 PM on April 2, 2013 [5 favorites]


We've been very, very lucky thus far with the relatively limited impact of various animal-human viruses (SARS, bird flu part 1, swine flu). That luck will eventually run out.

I'm not sure why you think that's the case. It might very well be that we aren't lucky at all and there are reasons that they don't often mutate into easily human transmissible forms.
posted by empath at 9:53 PM on April 2, 2013 [1 favorite]


Because of the obvious threat to untold numbers of citizens due to the crisis that is even now developing, this radio station will remain on the air day and night. This station and hundreds of other radio and TV stations throughout this part of the country are pooling their resources through an emergency network hook-up to keep you informed of all developments. At this hour, we repeat, these are the facts as we know them. There is an epidemic of mass murder being committed by a virtual army of unidentified assassins. The murders are taking place in villages and cities, in rural homes and suburbs with no apparent pattern nor reason for the slayings. It seems to be a sudden general explosion of mass homicide. We have some descriptions of the assassins. Eyewitnesses say they are ordinary-looking people. Some say they appear to be in a kind of trance. Others describe them as being misshapen monsters. At this point, there's no really authentic way for us to say who or what to look for and guard yourself against. Reaction of law enforcement officials is one of complete bewilderment at this hour.
posted by entropicamericana at 9:53 PM on April 2, 2013 [10 favorites]



This is the way the Apocalypse happens. First there are warning signs, but you won't understand the full implications unless you pony up the subscription fee.


the world ends tomorrow or double your money back.
posted by philip-random at 9:54 PM on April 2, 2013 [3 favorites]


Thanks gingerest for the PROMED link.

On Monday, the Shanghai Animal Disease Prevention and Control Center tested 34 samples of pig carcasses pulled from the Huangpu River running through the city and found no bird flu viruses, the city government said in a statement. Thousands of dead pigs have been retrieved from the Huangpu River last month, sparking huge panic as well as satire among the public over tap water safety.

I don't know if news like that is promising because it shows human vigilance, or if it is evidence that the problem is so big and so weird that all is hopeless.
posted by cgk at 10:01 PM on April 2, 2013


I signed up with Facebook and so far I haven't had to pay any money.

The article is scary and quite solid - worth their getting your demographics.
posted by lupus_yonderboy at 10:02 PM on April 2, 2013 [1 favorite]


[I subbed in a different Foreign Policy link that worked for me without sign-up; people can try it and see if it works.]
posted by LobsterMitten at 10:03 PM on April 2, 2013


Compared to the way we're neglecting global warming and asteroid mitigation, disease control seems to be the one kind of global disaster avoidance program where humanity's kind of got its act together.

Maybe because the movies have been better.
posted by brundlefly at 10:20 PM on April 2, 2013 [1 favorite]


One very plausible explanation for this chain of Chinese events is that the H7N9 virus has undergone a mutation -- perhaps among spring migrating birds around Lake Qinghai. The mutation rendered the virus lethal for domestic ducks and swans. Because many Chinese farmers raise both pigs and ducks, the animals can share water supplies and be in fighting proximity over food -- the spread of flu from ducks to pigs, transforming avian flu into swine flu, has occurred many times. Once influenza adapts to pig cells, it is often possible for the virus to take human-transmissible form. That's precisely what happened in 2009 with the H1N1 swine flu, which spread around the world in a massive, but thankfully not terribly virulent, pandemic...

The Chinese National Influenza Center has posted the H7N9 genetic sequences of viruses from Li, Wu, and Han on the WHO flu site. A number of H7N9 sequences found in birds over the last few years are also posted: The human and bird strains do not match, though none of the birds strains were obtained from animals in 2013.


Wow, frighteningly vivid stuff; the description of the events is horrifying - farmers dumping dead pigs into the river because they're terrified of having to report them to the government, e.g.
posted by mediareport at 10:23 PM on April 2, 2013


(Oh, re: paywalls - try typing the title into Google and click through from there; most sites allow major search engine referrals to get through their paywalls. Also, if you stop the Foreign Policy pages right away as they're loading you can get the text without the paywall block.)
posted by mediareport at 10:23 PM on April 2, 2013 [3 favorites]


I'm not sure why you think that's the case. It might very well be that we aren't lucky at all and there are reasons that they don't often mutate into easily human transmissible forms.

Hmm, everything I've read by experts, seems to argue that a large global pandemic is only a matter of time. WHO seems to concur with this view.

We have been lucky, but the ball is gonna land on black some time.
posted by smoke at 10:23 PM on April 2, 2013 [3 favorites]


When the apocalyptic epidemic comes, Sallie Mae better give me a reprieve.
posted by Rustic Etruscan at 10:23 PM on April 2, 2013 [5 favorites]


I'm not sure why you think that's the case. It might very well be that we aren't lucky at all and there are reasons that they don't often mutate into easily human transmissible forms.

Well, that would be pretty lucky, right? Anyway, I don't think epidemiologists through around the term "dice roll" in relation to animal-human viruses for funsies.
posted by charmcityblues at 10:31 PM on April 2, 2013


Oh yay! I have airplane travel to and from California at the end of May. That should be perfect timing.
posted by hippybear at 10:35 PM on April 2, 2013


Got to give it to the Chinese. They are educating their kids better than America, they are making tomorrow's technology today, and even their flu viruses are stronger and faster. How will we keep up?
posted by Blazecock Pileon at 10:36 PM on April 2, 2013


Those ProMED updates are great, and somewhat chilling; I can only imagine how hard epidemiologists have been working to trace possible connections among the victims. None so far ("There was no sign that any of the 3 had contracted the disease from each other, and no sign of infection in the 88 people who had closest contact with them") so looks like these are independent infections at multiple locations. That alone must have been a ton of work to sort out.

Strange, though, that the 87-year-old who died of H7N9 had two sons also sick with pneumonia in February, one of whom recovered and one of whom died, but neither of the sons had any trace of H7N9. Just ordinary deadly pneumonia, I guess.

The Huffington Post article has more about the possible role of the pigs:

Some have suggested the pigs were killed in an outbreak of circoviruses, another pathogen which infects swine. Others have said farmers are dumping pigs they can no longer sell to slaughterhouses after authorities moved to block dead pigs from entering the food chain...

Webby thinks pigs may be playing a role, but he's not convinced the dead animals were killed by the H7N9 virus. While pigs are highly susceptible to influenza viruses — and often serve as intermediary for bird viruses to become mammalian viruses — influenza doesn't generally kill pigs, he said. Even H5N1 viruses, which are so deadly to poultry and to people, don't cause severe illness in swine, said Webby. "It would be very, very surprising to see that amount of death (in pigs) with a flu virus. Even H5N1, pigs kind laugh at that virus."


Linked from one of the ProMED updates: Chinese officials sampled 34 dead pigs out of the thousands in the Huangpu River running through Shanghai and didn't find avian flu.
posted by mediareport at 11:03 PM on April 2, 2013 [1 favorite]


We've been very, very lucky thus far with the relatively limited impact of various animal-human viruses (SARS, bird flu part 1, swine flu).

I guess it depends on who you mean by "we": List of medical professionals who died during the SARS outbreak
posted by Mister Bijou at 11:12 PM on April 2, 2013 [1 favorite]


I'm going to go out on a very sturdy limb here and say this is overblown rumor-mongering based on scant reports and shoddy journalism. If, a year from now, I'm right, then you can all owe me 5 dollars. If I'm wrong then good luck getting the 5 bucks from me.
posted by Panjandrum at 11:13 PM on April 2, 2013 [15 favorites]


Mister_Bijou, when you consider the thousands of medical professionals likely exposed to the world's 8200+ documented cases, "we" still got pretty lucky by losing only 28 of them.
posted by gingerest at 11:55 PM on April 2, 2013 [1 favorite]


Nature International Journal of Science is saying that birds may act as silent carriers of the new virus:
A striking feature of the novel virus is that its H protein is structurally similar to that of viruses that don’t cause severe sickness in birds, and different from those that do, such as the H5N1 virus that has been ravaging poultry flocks in Asia since late 2002. Flu viruses that don’t sicken birds can, however, cause severe disease in humans simply because we lack any immunity to them. They also may be more lethal in people depending on how they bind to receptors in the human airways.
posted by FJT at 11:59 PM on April 2, 2013


Mister_Bijou, when you consider the thousands of medical professionals likely exposed to the world's 8200+ documented cases, "we" still got pretty lucky by losing only 28 of them.

Yeah, I guess you are right. Forgive me. it's all a bit too close to home. I was living in Hong Kong when SARS happened and lived through the fear that soon gripped the city, especially after a high-rise housing block - Amoy Gardens -- became infected. Inhabitants there got quarantined.

Most medical staff showed up for work, despite many falling sick and others dying. What was left unsaid was what happens if medical staff in large numbers stop showing up for work? Who's going to do the X-rays?

Many restaurants closed - some permanently - for lack of customers, this in a city where eating out is a way of life. People stopped shopping. Who wants to out in crowded HK and risk infection? Public transport workers went on short working weeks, for lack of passengers. Airlines cut back flights, again for lack of passengers. The local airline -- Cathay Pacific -- laid off staff on unpaid leave. Schools were suspended. Expats scrambled to get there wives and kids on planes heading outward-bound. Did I mention the government soon instigated 'temperature screening' at the airport and border for all travellers coming in and out?

In public, face masks became ubiquitous. And no one wanted to touch escalator handrails, elevator/lift buttons, ATM machines. (A set of keys is a good tool to use to punch the code at an ATM or hail an elevator/lift).

It's the tenth anniversary here. Yet the experience is still fresh in the mind. Like most people I didn't get infected, but witnessing a city of six million people tank like that is not soon forgotten.

If anyone is interested, for more on how life in the city changed there is this recent article: The Outbreak (Time Out Hong Kong)
posted by Mister Bijou at 1:11 AM on April 3, 2013 [22 favorites]


We've been very, very lucky thus far with the relatively limited impact of various animal-human viruses (SARS, bird flu part 1, swine flu)

Most of downtown Singapore emptied out because of SARS. My old neighbourhood, Pasir Panjang, took most of the last decade to bounce back after a dramatic outbreak at the (then famed) Pasir Panjang Wet Market; my old pub shuttered down and ended up being boarded up for many years after that. Know a couple who suffered a massive loss in their tourist-driven business because of SARS; so much so that it actually got difficult for them to arrange funds for their daughter's college education (happily for them, Singapore's scholarship system came to their rescue)

One of the ministers in power then told me that (at least Singapore Inc believed) Europe was on the verge of cancelling flights to Singapore (which would have been a death-knell for this highly globalized transport hub, had it happened); only last minute parlaying involving a combination of diplomatic and academic connections and such stopped them from doing so. We were talking about this last year, some nine years after the event; he was still visibly shaking at the memories.

This is even before we get to actual deaths and the actual conditions on the ground in Singapore then; we used to have mandatory temperature checks twice a day, all our university papers were fumigated/ sanitized before being handled, they had people in bunny suits the moment someone called the SARS hotline suggesting somebody may have been coughing excessively (I exaggerate, but only a bit; I personally know at least three people who were sent to mandatory confinement and checks)

Look, a lot of us here have bad bad memories of that period. The impact may have eventually been controlled, but it certainly wasn't limited by luck; a lot of livelihoods and national outcomes depended on getting rid of SARS, there was a massive massive directed effort at containing contagion.
posted by the cydonian at 3:12 AM on April 3, 2013 [12 favorites]


Perhaps those objecting to the word lucky would grant that we were fortunate that those outbreaks weren't as bad as predicted?
posted by Kirth Gerson at 4:14 AM on April 3, 2013


*checks shipping news for status of Madagascar ports*
posted by TheWhiteSkull at 4:27 AM on April 3, 2013 [9 favorites]


even their flu viruses are stronger and faster. How will we keep up?

Bioengineering a better plague. Lets say smallpox as the "instructions" for that are already out there.
posted by rough ashlar at 4:29 AM on April 3, 2013


H... seven...

...N... nine...

BINGHO! I HAVE A BINGHO!
posted by not_on_display at 5:18 AM on April 3, 2013 [1 favorite]


No matter how hard we try we keep failing to make ourselves extinct. Luckily there are people out there playing the long game, and will probably take care of that for us.
posted by blue_beetle at 5:29 AM on April 3, 2013 [1 favorite]


> We've been very, very lucky thus far with the relatively limited impact of various
> animal-human viruses (SARS, bird flu part 1, swine flu). That luck will eventually run out.

Isn't it pretty well established that HIV originated from nonhuman primate SIV? The Partial list of zoonoses is pretty striking: anthrax, cholera, dengue fever, ebola, lassa fever, black plague, west nile virus, yellow fever. Not all of them are viruses but that's not a whole lot of comfort.
posted by jfuller at 5:44 AM on April 3, 2013 [2 favorites]


That said, Betteridge's law of headlines: "Any headline which ends in a question mark can be answered by the word no."
posted by jfuller at 5:48 AM on April 3, 2013 [10 favorites]


Well, we will go extinct. The only question is when. And a virus is a likely scenario for at least a large population decrease.
posted by agregoli at 6:31 AM on April 3, 2013 [2 favorites]


From the larger point of view - an outbreak would help cut down on some of the excess population and slow climate change and possibly improve general living conditions.

A lot of people have pretty horrible lives. Its usually after outbreaks of such diseases as the Plague / Spanish Flu that living conditions for those remaining actually improve.

A virus like this is really not likely to cause the extinction of mankind. That's just not going to happen.
posted by mary8nne at 7:07 AM on April 3, 2013 [1 favorite]


I had the flu on a trans-Pacific flight last year, and I watched Contagion. Worst plane trip of my life.
posted by KokuRyu at 7:16 AM on April 3, 2013 [8 favorites]


I'm torn between feeling pity and revulsion for those of you who speak of the greater good caused by a pandemic. I guess it is easy to feel that way as long as it is happening to "unfortunates" someplace else. I hope you can maintain your attitude when it is those you care for that are falling ill.
posted by spock at 7:23 AM on April 3, 2013 [12 favorites]


Side note: Often there is an easy solution to getting around the paywalls. In Chrome, right click on the blocking feature, and choose Inspect Element which opens up a window with HTML at the bottom. Then start deleting, hitting undo if you delete the wrong thing. Often, you just look above the highlighted line for one that starts with "<iframe", click on it, and delete it. That method works here, except the screen is still shaded dark. The element to delete to remove the shading is the one marked "TB_overlay". Once you've done a few, it becomes very easy to do.
posted by Hubajube at 7:30 AM on April 3, 2013 [2 favorites]


I'm with you spock. Only for me, the revulsion definitely has more pull.
posted by saulgoodman at 7:45 AM on April 3, 2013 [1 favorite]


> Isn't it pretty well established that HIV originated from nonhuman primate SIV? The Partial list of zoonoses is pretty striking

Totally established. That list is more than little deceptive in the fact that the vast majority of its entries are ancient and/or exceedingly rare infections.
posted by Panjandrum at 7:49 AM on April 3, 2013


It could be years (hopefully never) before this virus mutates to permit human-to-human transmission (that would be the start of a Real Pandemic), but this is still worrying because it has already done something it has never done before (mutate to infect mammals, including now humans). Since it has never affected mammals before, let alone humans, there has probably been very little to no work done on anything that might even resemble an effective vaccine. I imagine that there is a lot of scrambling going on in labs and corporations around the world right now.
posted by spock at 8:00 AM on April 3, 2013


I, at least, have no pleasure towards people anywhere sickening or dying. Yes, this is likely not THE virus that will cause a pandemic that will wipe out most of humanity. But we're overdue for one of those.

There's nothing hateful or controversial about saying humans will go extinct, and geologically speaking, extinct soon. That's just obvious.
posted by agregoli at 8:11 AM on April 3, 2013


There's nothing hateful or controversial about saying humans will go extinct....

But, but ... god?
posted by aramaic at 8:31 AM on April 3, 2013


> That's just obvious.

None of what you have said is obvious, and the idea that we're headed for some species level extinction pandemic is neither uncontroversial nor "overdue." Our current sample size for sapient organism lifecycles is 1, and that experiment is still running, so let's not go drawing conclusion already.
posted by Panjandrum at 9:10 AM on April 3, 2013 [3 favorites]


Via Twitter: "Awesome/scary: If you like watching science unfold in real time, check out #H7N9 flu evolution wiki. http://epidemic.bio.ed.ac.uk/influenza_H7N9 "
posted by spock at 9:18 AM on April 3, 2013 [1 favorite]




Does anyone think maybe there was a "perfect storm" of conditions for some of these people who got infected? High levels of air pollution, close proximity to livestock, possibly unsanitary conditions. Considering no one so far got infected by another person, maybe it's not yet highly contagious. That's not to say it won't mutate.
posted by ChuckRamone at 9:29 AM on April 3, 2013


From the article at nature.org I linked to above, one of the real troublesome aspects of this virus is that, although it is a bird virus, it does not sicken/kill birds. With H5N1, birds died and you could see the trouble spots and take preventative action, such as culling the bird population to prevent more spread. This virus is in "stealth" mode.
posted by spock at 9:34 AM on April 3, 2013 [1 favorite]


If you dispute that humans will go extinct soon on the geologic time frame, you're not confronting reality.

I didn't say that a pandemic is what will take us out, only that we're overdue for one that reduces our population on earth drastically. We can extrapolate a lot from past cycles of disease. So yeah, disease news like this is somewhat disturbing, but I'm not panicked. The liklihood of this happening in my lifespan is remote, but that dosen't make it unlikely to happen at all.
posted by agregoli at 9:35 AM on April 3, 2013


There's nothing hateful or controversial about saying humans will go extinct, and geologically speaking, extinct soon.

Well, that's debatable. Someone might argue that we really don't have enough information that isn't too biased by our own (limited) POV to feel too confident one way or the other about this. But in any case, it's only the cheerleaders I find revolting.
posted by saulgoodman at 9:38 AM on April 3, 2013


If you dispute that humans will may go extinct soon on the geologic time frame, you're not confronting reality.

With one minor edit, I might be willing to sign up for your newsletter.
posted by saulgoodman at 9:38 AM on April 3, 2013


Mister_Bijou, when you consider the thousands of medical professionals likely exposed to the world's 8200+ documented cases, "we" still got pretty lucky by losing only 28 of them.

And while Carlo Urbani might have the only Wikipedia biography because he was the only foreigner killed by SARS on the ground, I remember stumbling on his article years ago as a pre-med, and being inspired by his bravery.

Here's a quote from the Wikipage:

Urbani had an argument with his wife, Giuliana Chiorrini, who said it wasn't responsible behaviour for the father of three children ages 4 to 17 to risk his life treating such sick patients.

Urbani replied, "If I can't work in such situations, what am I here for? Answering e-mails, going to cocktail parties and pushing paper?"


As a medical student, I can only be awed and humbled by his humility and bravery.

Here's another NYT Obituary detailing his life.
posted by kurosawa's pal at 9:46 AM on April 3, 2013 [5 favorites]


hippybear is destined to be bird flu's Patient Zero.
posted by elsietheeel at 10:15 AM on April 3, 2013 [1 favorite]


After all the zombie movies out there, it's kind of fun to imagine a pandemic, and that we'll be the few survivors to start over and do it right this time, but the reality is that victims of the next pandemic will be in poorer countries with large populations and poor medical infrastructure - like China, in this case.

It's also fun to think that a pandemic will solve our overpopulation problems, climate change, and resource depletion.

However, overpopulation is not our problem. There are plenty of resources to go around, and the majority of the world's population are not consuming the majority of the world's resources.

You can kill off a ton of brown people having a ton of brown babies who don't look or talk like us, but C02 emissions wouldn't go down.

The problem is countries with a small number of people, relatively, consume the majority of the resources and produce, per capita, the majority of C02 emissions.

So a pandemic culling our population won't help.

Fun to daydream about, though!

BTW, dying of a respiratory illness sounds like a totally shitty way to go. Let's find a cure for the flu.
posted by KokuRyu at 10:37 AM on April 3, 2013 [1 favorite]


There have always been and always will be flu pandemics that kill a few percent of the world. It's unlike we'll be able to stop them in the immediate future, but these are not going to really change population statistics in any significant way.

Even if you take the most unsentimental and utilitarian viewpoint, once a person has become an adult there is a great deal of money invested in them by society - it's simply wasteful for them to die. To reduce humanity's load on the planet, we need to convince people to have fewer kids, and to consume less individually, not kill some random percentage of "them" (and "them" might be "you"...)
posted by lupus_yonderboy at 12:21 PM on April 3, 2013 [1 favorite]


Hey, be as disrespectful towards me as you want (my newsletter?), but it's plain old reality that humans will not exist forever. You only have to look at the history of biological life on this planet, and the direction the planet is going in to know that. The resistance people have to this simple fact is interesting. It is certainly not debateable.
posted by agregoli at 12:29 PM on April 3, 2013


Everything That Happens Will Happen Today, Geologically Speaking
posted by Lorin at 12:52 PM on April 3, 2013 [3 favorites]


I think people have an optimistic view of how a pandemic would be handled in a developed nation. They think advanced health system means that we can keep people alive through heroic measures until they fight off infection or get the right drugs or whatever.

I suspect they are wrong. If there are a few dozen to thousand of people needed respirators and other measures then they get them and perhaps survive. But once tens to hundreds of thousands need such support, the system breaks down and people start dying in massive numbers. There just isn't enough to go around demand for doctors, facilities, respirators, antiviral drugs, etc if demand spikes due to a pandemic. And I think the system won't degrade nicely. It will fall down hard once things get bad enough.

We still don't really know what happened in 1918. It could happen again or it could be much worse next time.
posted by jclarkin at 1:03 PM on April 3, 2013


Is there a realistic way to prepare for flu season? Can anyone offer a lecture on viral safety?
posted by Strass at 1:14 PM on April 3, 2013


There have always been and always will be flu pandemics that kill a few percent of the world.

One thing that's different today: it is much harder to quarantine areas where a disease crops up. Fast intercontinental travel, etc.
posted by LobsterMitten at 1:18 PM on April 3, 2013


It is certainly not debateable.

Because we're absolutely certain our local observations about biological life are universal (without having to check), and there are no extent species on Earth that have survived multiple extinction events and have known histories dating in the billions of years. (Anyway this could be a topic in its own right, but is becoming a derail to this one instead, so that's my piece.)

I definitely think our ability to control disease spread in the US has actually diminished in recent history. The mere fact that hospitals and doctors offices have become such disease vectors themselves with the decline of house-calls and the overuse of antibiotics makes us more vulnerable. The global nature of travel these days is also a newer confounding factor to containment efforts.
posted by saulgoodman at 1:45 PM on April 3, 2013 [1 favorite]


I agree. We are fortunate enough to have lived during The Golden Age of antibiotic effectiveness (as well as overuse) and, as a result, we tend to think that there is nothing our modern medicine can't deal with. Meanwhile the number of antibiotic-resistant pathogens is on the increase.

This has little to nothing to do with viruses, but it does speak to why there is such a high degree of confidence in medicine to meet any challenge - including those that it has never faced before.
posted by spock at 1:52 PM on April 3, 2013


It also makes it riskier for people to seek medical attention due to the increased opportunities for contracting opportunistic (now antibiotic resistant) bacterial infections.
posted by saulgoodman at 1:53 PM on April 3, 2013


Two more human cases of H7N9 in China today (including the third death, mentioned above). Total known human infections now at 9. http://news.xinhuanet.com/english/china/2013-04/03/c_132282994.htm. Meanwhile, China attempts to show that "they are on it".
posted by spock at 1:58 PM on April 3, 2013


For your consideration: seemoreglass' headlines paradox.

Headline: Is Betteridge's law of headlines true?

If the law is true, then according to the above headline the law is false.
posted by seemoreglass at 2:58 PM on April 3, 2013 [1 favorite]


See also where Betteridge broke his own "law": http://www.technovia.co.uk/2011/01/in-which-i-violate-my-own-law-of-headlines.html. It is more properly labeled an adage, which seem to have not quite the same inviolability as other "laws" that you may be familiar with in the sciences.
posted by spock at 3:17 PM on April 3, 2013


Everything That Happens Will Happen Today, Geologically Speaking

David Bryne Agrees With You.

actually just listen to the whole damn album. it's fuckin' great.
posted by hippybear at 5:30 PM on April 3, 2013 [2 favorites]


I just wanted to acknowledge that, yes, of course SARS was ghastly and left big scars on the peoples and cultures of Hong Kong, mainland China, Singapore, Vietnam, and Taiwan. The only sense in which that was lucky was that, terrible though it was, it could have been even worse in the affected areas and it could have spread even more widely. It is almost never comforting to hear about how something could have been worse, but in this particular case, I, for one, wasn't trying to comfort, but to point out that we're in danger of that worse scenario.

Laurie Garrett has been banging this drum for years: we need to put more resources into public health disaster preparation, because we are going to see a flu pandemic.
posted by gingerest at 5:34 PM on April 3, 2013


H7N9 Background map - Human cases as currently reported (2013-04-02). [via] H5N1
posted by unliteral at 8:43 PM on April 3, 2013


The first link is posted in full at Indian Strategic Studies.
posted by unliteral at 9:03 PM on April 3, 2013


The only sense in which that was lucky was that, terrible though it was, it could have been even worse in the affected areas and it could have spread even more widely.

Yes, my contention here was that the reason SARS didn't spread more widely wasn't luck; it was unprecedented co-ordination/ setting of standards etc by WHO, and a quick, concerted action by local health authorities in the hotspots. SARS is actually a very positive example of what health systems, both global and local, should do to contain contagion.
posted by the cydonian at 10:57 PM on April 3, 2013


Yes, my contention here was that the reason SARS didn't spread more widely wasn't luck; it was unprecedented co-ordination/ setting of standards etc by WHO, and a quick, concerted action by local health authorities in the hotspots.

Yes, but we were "lucky" (difficult term, I know) that the epicenter was highly developed and had a robust public health system, surveillance, etc.

No one is saying that SARS etc. was not a horrific experience for those who were affected, however tangentially. But so is seasonal influenza (which kills, annually, orders of magnitude more than SARS did) and cancer and HIV and cholera. What's is so terrifying about the novel viruses is the very really possibility that they cannot be contained with the measures that are available to us-- unlike the previous outbreaks, which were contained relatively efficiently (at great personal cost to health providers, and with great courage). The understanding that they could have been far worse isn't a minimization, it's acceptance of reality.
posted by charmcityblues at 11:40 PM on April 3, 2013


Are there metrics for viral contagiousness and virulence? I suppose you could measure that in infections/day and deaths/day, but it seems like there should be ways to classify these things.
posted by Strass at 6:05 AM on April 4, 2013


I'm curious--Does anyone know if there's any sort of correlation or relationship between the intensity of the flu/number of flu deaths and overall air quality of the place people are living because doesn't breathing in more pollution cause more stress on the respiratory system in general?
posted by astapasta24 at 6:43 AM on April 4, 2013


4th and 5th deaths reported today. Also a 10th person infected, (no make that 11, along with infected pigeons in Shanghai found).

Ten years after SARS, what has China learned?
posted by spock at 7:17 AM on April 4, 2013


Strass, I'm not an infectious disease epidemiologist, but there are tons of metrics. Case-fatality rate is the easiest to explain: proportion of the infected who die of the disease. Put into practice, it's more commonly the proportion of those hospitalized with laboratory-confirmed flu-related illness who die of their infection. But there are loads of host, environmental and viral factors that can be quantified and modelled to estimate the infectiousness and lethality of a viral disease at a particular place and time.
posted by gingerest at 6:08 PM on April 4, 2013




Sixth death reported. 14 human infections so far. Poultry markets in Shanghai province suspended and bird culling begins. http://www.chinadaily.com.cn/china/2013-04/05/content_16377588.htm
posted by spock at 5:10 AM on April 5, 2013


Meanwhile in Hong Kong, What is China doing then? According to the Ministry of Health of the PRC, Shanghai's Level III response* (as of 4th April 2013, and started on 2nd April 2013) is as follows:

Using my google translate skills and some help from a native speaker...
  • According to the Shanghai Monitoring/Oversight Body's Program for Prevention and Control of Avian Influenza (上海市卫生监督机构禽流感防控工作方案):
  • It is compulsory for the city's and county's supervisory health agencies to strengthen fever outpatient clinics at all levels of the health system, improve triage, disinfection and isolation, infectious disease monitoring/reporting systems and supervision; improve capabilities for laboratory testing of pathogens, supervision of centralised water supply units, that of key public places and schools; and to urge the relevant parties to diligently implement the appropriate measures to prevent and control the avian flu.

  • The Shanghai Centre for Disease Control and Prevention (CDC) has set up 43 surveillance sites and 130 outpatient fever clinics (these so far have not found SARS, H5N1, H7N9 and novel coronavirus)

  • The health department requires all health units of Shanghai's districts and areas to create/maintain small groups for epidemiologic prevention and control

  • For suspicious illness (not specified) or those with unknown causes/origins, these patients are to be sent to only 1 hospital -- the City Public Health Clinical Centre (市公共卫生临床中心) -- for investigation and treatment

  • Commence daily reporting via the "zero reporting" system (零报告制度), a system where according to Construction of Public Health Reporting System After SARS, hospitals would report the number of cases of H7N9 every day whether or not they had new cases. During the SARS outbreak, the MOH required all provinces, autonomous regions and municipalities to report their epidemic situation before 12am.

  • Strengthen medical emergency response and treatment. If any health unit/medical institution discovers pneumonia of suspicious or unknown origin, it is to be reported to the district and country CDC. The CDC is to immediately head over there and carry out epidemiological and laboratory investigations.

  • Improve the dissemination to the public of health education and of how to prevent/control avian influenza

  • Surveillance of the sale of poultry and the wholesale market (the notice elaborates but I've no time to translate)
Also Shanghai bans entry of live poultry from other parts of China and, as pointed out by spock, has started culling live poultry.


I really hope the respective Chinese health departments are as on top about this as Taiwan and Hong Kong currently are and as ChinaDaily seems to say that it is. I'm not as sure if the other provinces in China such as Jiangsu and Anhui have the same gameplan as Shanghai.

According to Gregory Hartl, news coordinator in the office of the director-general of the WHO,"The China CDC is very active and really enthused in doing all the medical work on this. They are investigating various animal sources and are trying to determine the extent of the spread of this virus...". "

The same article (but with an unknown source): "The Chinese health bureau said it is monitoring suspicious cases of the flu, and local health officials have created teams of experts to research the virus. Officials at schools and hospitals, where cases of flu spread more quickly, are on the lookout for fevers and flulike symptoms including respiratory problems."

Xinhuanet:: "The health authorities in Jiangsu have designated 16 leading hospitals to accept new cases in a bid to offer better treatment and reduce the mortality rate.

The health bureau in Beijing has ordered hospitals to include the testing of H7N9 bird flu in routine monitoring and to train hospital staff on how to treat pneumonia caused by unknown factors.

Health authorities in Shandong Province have ordered morning tests of fever, cough and other respiratory symptoms at schools, nurseries and poultry farms."


*The press release describing Shanghai's level III responses was taken from a list of press releases from the Ministry of Health of the PRC. Yep, more where that came from.

The Qingming Festival (or Tomb-Sweeping Day) was on 4th April. This was an occasion where people would visit the graves or tombs of their ancestors, sweep them and tend to them. Some of my classmates went travelling to other parts of China during the last few days when we had a vacation. I'm really hoping not more people have caught it (from contact with poultry) over the brief vacation.

So, is it enough, what China's health system is doing? I don't know. Maybe? It remains to be seen. Although China's government seems totally on-the-ball at the moment, it would be much, much better for the confidence of its own people if it could only be more transparent about what it's doing to the level that Hong Kong is, and shake off some paternalism. This especially at the level of individual hospitals, unlike this alleged cover-up at Shanghai No. 5 People's Hospital. Because I mean seriously, look at some of the comments that are being posted here. Clearly a result of lack of timely information when the mysterious cases of pneumonia first sprang up. China's CDC is very on-the-ball at the moment but not reporting those first few cases as early as Hong Kong did with its first suspected case was not a good way to begin.

Lastly, hi MeFi, first post here. Been lurking for awhile. Glad to be part of an awesome community. Also, my apologies, this really ran on huh...
posted by rozaine at 7:15 AM on April 6, 2013 [5 favorites]


21st case of confirmed H7N9 in China today.
posted by spock at 10:51 AM on April 7, 2013


Now up to 24 cases and 7 deaths.
posted by spock at 12:24 PM on April 8, 2013


South China Morning Post article this morning: H7N9 may mutate 8 times faster than regular flu
Source (requires registration): http://www.scmp.com/news/china/article/1211077/h7n9-bird-flu-may-mutate-8-times-faster-regular-flu-study-finds

The new bird flu could be mutating up to eight times faster than an average flu virus around a protein that binds it to humans, a team of research scientists in Shenzhen says.

Dr He Jiankui, an associate professor at South University of Science and Technology of China, said yesterday that the authorities should be alarmed by the results of their research and step up monitoring and control efforts to prevent a possible pandemic.

With genetic code of the virus obtained from mainland authorities, the team scrutinised haemagglutinin, a protein that plays a crucial rule in the process of infection. The protein binds the virus to an animal cell, such as respiratory cells in humans, and bores a hole in the cell's membrane to allow entry by the virus.

The researchers found dramatic mutation of haemagglutinin in one of the four flu strains released for study by the central government. Nine of the protein's 560 amino acids had changed. In a typical flu virus, only one or two amino acids could change in such a short period of time, He said.

"It happened in just one or two weeks. The speed may not have caught up with the HIV, but it's quite unusual for a flu."

The fast mutation makes the virus' evolutionary development very hard to predict. "We don't know whether it will evolve into something harmless or dangerous," He said. "Our samples are too limited. But the authorities should definitely be alarmed and get prepared for the worst-case scenario."

The origin of the virus was puzzling due to its novelty, but He's research suggested some clues that differ from the mainland authorities' theories.

His team compared the new virus strain to all other H7N9 viruses identified in Europe and in other Asian countries that were cited by the Ministry of Agriculture as possible origins of the new bird flu, but found them all very different.

In fact, the new bird flu was quite similar to some familiar domestic viruses such as H9N2, H11N9 and H7N3 found in Zhejiang and Jiangsu.

He said researchers could not rule out the possibility that the new virus was carried into China by wild birds, but it was more likely to be of local origin.

posted by spock at 5:16 AM on April 10, 2013


As I said above, I'm not an infectious disease epidemiologist. Dr. Tara C. Smith is, and she had a nice piece in Slate about this today.
posted by gingerest at 8:41 PM on April 10, 2013


Today's news: A total of 38 confirmed cases have now been reported in China with 10 deaths. In other ominous news, A gene mutation known to help influenza resist Tamiflu was found in the first of three H7N9 bird-flu patient specimens in China, sequence data show.

Still no signs of human-to-human transmission, thankfully.
posted by spock at 10:14 AM on April 11, 2013


China Bird Flu Outbreak May Stem From Numerous Sources
"If this is let spread from where it is now, it will evolve further. That's what viruses do. If it isn't contained now, that will almost certainly happen."

Scientists tracking the H7N9 virus need more information about the ecosystems of birds in China, including those in live markets, feeder farms and wild populations, to better understand and tackle the virus, said Maria Zambon, director of the U.K.'s national influenza center. That will provide a clearer view of how easily H7N9 spreads and how best to control it...

Local governments must collect tissue samples from birds at poultry markets nationwide in the hunt for the cause of the outbreak, Chinese officials said yesterday. The process is more complicated because the virus doesn't seem to harm the birds, eliminating the ability to track it by following a path of dead fowl, Webby said.

There is no evidence yet that the virus is spreading from human to human... "It's got the sort of characteristics that are somewhat unusual for a poultry virus. But the background knowledge on this is pretty sparse. It's early days still."
posted by kliuless at 3:45 PM on April 11, 2013


"All pandemic viruses have acquired this [mammalian cell] binding and polymerase activity," says Fouchier. "The H7N9 has these characteristics. So the question is, what else does it need – if anything?"

- source http://www.newscientist.com/article/dn23368-china-bird-flu-may-be-two-mutations-from-a-pandemic.html
posted by spock at 8:03 PM on April 11, 2013


All influenza network laboratories in the 31 provincial regions on China's mainland are now capable of testing for the H7N9 bird flu virus. source

Conflicting signals on the virus' resistance to Tamiflu and Relenza: A gene mutation known to help resist Tamiflu, one of the drugs recommended for treating H7N9, was found in the first of three H7N9 specimens from a Shanghai patient. The mutation, known as R292K, causes high-level resistance to the Roche-made drug and reduced sensitivity to a related drug from GlaxoSmithKline, Relenza, also recommended for treating H7N9 patients, according to information posted on the website of the Global Initiative on Sharing Avian Influenza Data.

Other H7N9 specimens from a patient in Shanghai and one in Anhui province do not show the mutation.

The finding warranted further analysis, a director at Japan's National Institute of Infectious Diseases in Tokyo, Masato Tashiro, said.

However, the World Health Organisation issued a statement saying preliminary tests had so far found no evidence that the H7N9 bird flu strain had developed resistance to Tamiflu and Relenza.

Tashiro said: "When you look at the raw data and compare the three strains of the virus, there's a signal from one strain that is less sensitive to both of the neuraminidase inhibitors (Tamiflu and Relenza)." It was "not a strong signal, but there's a possibility" of resistance.
- source

While China reports a vaccine can be developed in "7 months", this report concludes that "Vaccine development for H7N9 flu problematic -Viruses in H7 family prove resistant to vaccines developed so far" http://www.cbc.ca/news/health/story/2013/04/12/flu-vaccine-h7n9-china.html.

A grim portrait of the effects of the disease from the NYTimes.
posted by spock at 5:37 AM on April 12, 2013


Another day, another H7N9 death, bringing the total fatalities to 11. Confirmed cases now up to 43. Source: http://news.xinhuanet.com/english/china/2013-04/12/c_124575544.htm
posted by spock at 12:07 PM on April 12, 2013


First case of H7N9 found in Beijing (780 miles NW of Shanghai).
http://www.reuters.com/article/2013/04/13/us-birdflu-china-new-strain-idUSBRE93C00W20130413
posted by spock at 8:28 PM on April 12, 2013


China now reporting 49th case "The 56-year-old patient, surnamed Gu, is husband to a woman who had been confirmed with H7N9 infection and died on April 3.

Health experts, however, say there is not sufficient evidence to show that Gu has acquired the virus from his wife." http://news.xinhuanet.com/english/health/2013-04/13/c_132306391.htm
posted by spock at 5:45 AM on April 13, 2013


spock, even though it fills me with dread, I really appreciate your continued updates building a timeline here. Thank you for keeping up with this.
posted by LobsterMitten at 8:57 AM on April 13, 2013


It fills me with dread also. We may be looking at the beginning some something historic. The Spanish Flu killed more people than all of WWI but it was so long ago that many think it is no longer even possible to see a pandemic on that scale. I wish they were right.
posted by spock at 9:38 AM on April 13, 2013


Yeah, thanks for doing this spock. I've been popping back in every few days for your updates.
posted by Strass at 2:34 PM on April 13, 2013


Total cases now at 51 as two were confirmed, the first in a province in central China. This Forbes report does a nice summary of why there is growing concern about H7N9 as a global threat.
posted by spock at 9:09 PM on April 13, 2013


Total cases now at 57 with two more deaths (making a total of 13, I believe). Rates of infection seem to be increasing. The four most recent cases are all in serious condition.
http://news.xinhuanet.com/english/health/2013-04/14/c_132307931.htm
posted by spock at 6:30 AM on April 14, 2013


60
posted by spock at 10:34 AM on April 14, 2013


Strange story developing here. A 4 year old boy tested positive for H7N9 but is exhibiting no symptoms. For some reason, this article mentions human-to-human transmission being suspected in this case, but I'm not clear as to why they think that. More to come, I'm sure.
http://www.forbes.com/sites/russellflannery/2013/04/14/four-year-old-boy-is-suspected-to-be-beijings-second-h7n9-bird-flu-case/

Meanwhile, a chinese tourist brings the first case of H7N9 to Taiwan (coincidentally, also a 4 year old boy). http://www.eturbonews.com/34315/chinese-tourist-brings-h7n9-avian-influenza-taiwan
posted by spock at 8:03 PM on April 14, 2013


A better article on the 4 year old in Beijing and the significance of asympomatic cases: http://www.thejakartaglobe.com/international/symptom-free-bird-flu-case-suggests-wider-h7n9-spread/585762

posted by spock at 8:11 PM on April 14, 2013


The WHO now has an official site for H7N9.

This is a Google translated report about a village with a H7N9 infected girl about 20km from Beijing that is now being partially closed off/controlled access by "security" (presumably military): http://translate.google.com/translate?sl=zh-CN&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&eotf=1&u=http%3A%2F%2Fwww.aboluowang.com%2F2013%2F0415%2F299023.html&act=url
posted by spock at 8:25 PM on April 14, 2013


Correction: The Taiwan case has apparently tested negative for H7N9: http://focustaiwan.tw/news/aall/201304140024.aspx
posted by spock at 9:03 PM on April 14, 2013


The CDC issues travelers precautions to U.S. citizens. (Level 1)

Analysis: Gene swapping makes new China bird flu a moving target

Currently at 62 cases and 14 deaths.
posted by spock at 5:15 AM on April 15, 2013




At the risk of editorializing, it seems that there has been a sudden change in transparency in China, perhaps in response to the news of a $1.6B USD loss in the poultry sector of China's economy. The only headlines today seem to be blowing sunshine and the number of infections and deaths remains not only unchanged, but backing up. All of these stories have datelines of 4/16.

Chicken safe when boiled thoroughly: academician Xinhuanet 2013-04-16 00:17 (states 63 infections and 14 deaths)

4-year-old boy's case suggests virus immunity Xinhuanet 2013-04-16 09:08 (not the lesson that scientists in other parts of the world are drawing from the asymptomatic case)

Beijing girl infected with H7N9 recovering Xinhuanet 2013-04-16 09:49

Poultry sector hit by 10b yuan loss Xinhuanet 2013-04-16 10:21

Bird flu under control in China Xinhuanet 2013-04-16 11:10 (rolls back the number of infections to 60 and deaths to 13)
posted by spock at 5:13 AM on April 16, 2013 [1 favorite]


71
posted by spock at 8:05 AM on April 16, 2013


Now up to 77 cases and 16 deaths. "During the period from 6 p.m. on Monday to 8 p.m. Tuesday, China confirmed 14 new cases of H7N9 avian influenza..."
posted by spock at 1:14 PM on April 16, 2013


82 cases & 17 deaths
posted by spock at 9:07 AM on April 17, 2013


Expert: Family-clustered H7N9 cases unable to prove human-to-human transmission. Three members of same family infected. Two are now dead.
posted by spock at 10:49 AM on April 17, 2013




So far on the 18th we have one new case reported.
posted by spock at 9:59 PM on April 17, 2013


Spock, thank you so much for doing this. I come here every day to keep up too. Your updates have been very helpful.
posted by rozaine at 11:05 PM on April 17, 2013


I've been reading this thread from the safety of my isolation chamber!
posted by The Whelk at 7:08 AM on April 18, 2013


Confirmed cases now at 87 (5 new cases on the 18th. It is now the 19th in China).
posted by spock at 10:05 AM on April 18, 2013


Language is beginning to change regarding human-to-human transmission.
http://www.usnews.com/news/articles/2013/04/18/chinese-government-suspects-human-to-human-transmission-of-h7n9-bird-flu

Including:
Further investigations are still under way to figure out whether the family cluster involved human-to-human transmission," Feng Zijian, of the Chinese Center for Disease Control and Prevention, told the newspaper.
There's no evidence yet of sustained human-to-human transmission, but the team will be looking into this," he says.

Even if the disease can be spread between humans, a pandemic is not a certainty, experts say. In order to spread quickly, the virus would need to mutate to a form that is spread through incidental or casual contact. Transmission between family members is often a first step, because they generally have prolonged contact over the course of several days.
Also, people should not fixate on the mortality rate. Transmissibility is more important than mortality rates when evaluating the danger of pandemics. For example:
"The Spanish flu which killed millions only had a couple percent mortality rate," he says. "If this virus mutates to be transmissible from human-to-human it will be a major issue. You have the perfect storm of pandemic flu virus in that it's highly pathogenic and could potentially be spread easily."
posted by spock at 11:33 AM on April 18, 2013 [1 favorite]


You're doing sterling work, spock. Sterling work that makes me want to quit my job and stay indoors forever, but sterling work just the same.
posted by Rustic Etruscan at 11:43 AM on April 18, 2013 [1 favorite]


Heh. Thx. One more article: This one is fairly technical, but I will try to extract the interesting pieces/questions that it raises.
The genetic distance between samples collected in China suggest that this virus may have been circulating for months before it was finally detected, but in what host remains a subject of debate.

Also of concern to these researchers was the finding of the PB2 E627K mutation in the human isolates, but not in those collected from birds.

This substitution - the swapping out of the amino acid Glutamic acid (E) at position 627 for Lysine (K) – has been linked to increased influenza virulence in the past.
How can this be? Two possibilities:
Remarkably, the PB2 segments of the four available human virus genome sequences from China all carry this E627K substitution, which is absent in the virus isolates obtained from birds and the environment [2]. In addition, three of the four infections with the virus with PB2 E627K were fatal. There are two plausible explanations for this observation:
the mammalian adaptation markers are selected during replication in humans following exposure to viruses that do not have this mutation, which are circulating in animals;
the mammalian adaptation markers result from virus replication in animals from which humans become infected.
The relatively protracted disease course in the current outbreak of A(H7N9) virus infection, with relatively mild symptoms at first, followed by exacerbation in the course of a week or longer, is suggestive of the first hypothesis, similar to the outbreak in the Netherlands. (H7N7 in 2003)
Therefore, an outstanding question is whether the A(H7N9) viruses are more readily mutating in humans or milder cases are being missed.
posted by spock at 11:51 AM on April 18, 2013


According to this blog post: the U.S. Center for Disease Control and Prevention (CDC) had a 2 PM EDT conference call today with clinicians in which they officially asked hospitals and doctors to begin looking for signs of human infection with H7N9 avian flu (in the U.S.)

http://www.scottmcpherson.net/journal/2013/4/18/cdc-begins-actively-looking-for-h7n9-in-the-united-states.html

I can't yet verify the accuracy of this post, but it sounds legit.
posted by spock at 1:41 PM on April 18, 2013


We are fortunate enough to have lived during The Golden Age of antibiotic effectiveness (as well as overuse) and, as a result, we tend to think that there is nothing our modern medicine can't deal with. Meanwhile the number of antibiotic-resistant pathogens is on the increase.

More Than Half Of U.S. Meat Contains Antibiotic-Resistant Bacteria

Despite Growing Threat Of Deadly Superbugs, New Antibiotic Research Screeches To A Halt
posted by homunculus at 1:43 PM on April 18, 2013


The European Center for Disease Prevention and Control has now created pages for H7N9
ECDC: H7N9

Also CDC Interim H7N9 Infection Control Guidelines prevention guidelines for health care workers: HCW (Health Care Workers) exposed to probable or suspected H7N9 patients should be wearing a fitted N95 respirator, gloves, gown and eye protection.

Also the earlier referenced CDC conference call has been verified to have been a COCA call.
posted by spock at 3:18 PM on April 18, 2013




91 cases. WHO team lands in China (what took so long)?
posted by spock at 5:55 AM on April 19, 2013


Dr. Michael O’Leary, the World Health Organization’s representative in China, gave a media briefing overnight, and answered journalist’s questions. In this briefing, O’Leary describes three "clusters" of cases where human-to-human transmission may have occurred.
posted by spock at 7:31 AM on April 19, 2013


95 cases and now 18 deaths
posted by spock at 6:43 AM on April 20, 2013


After the story above, another story reported a new case in Shanghai. I believe that now makes the total number of cases 96.
posted by spock at 6:49 AM on April 20, 2013




101 cases and 20 deaths
posted by spock at 6:51 AM on April 21, 2013


Thanks to everyone who is providing useful updates in this thread.
posted by salvia at 11:51 AM on April 21, 2013


"In the past 24-hours there have been three more cases and one more fatality (preliminary, still awaiting confirmation from the WHO) which brings the total to 105-cases including 21-deaths. This equates to a case fatality rate of 20%. For context SARS was 9.6%."
- source
posted by spock at 9:48 AM on April 22, 2013


108 cases, 22 deaths
posted by spock at 3:14 PM on April 23, 2013


There's also a new H7N9 thread.
posted by LobsterMitten at 7:49 PM on April 23, 2013


I will now be putting all updates in the new thread, and encourage others to do the same. Thx!
posted by spock at 4:25 AM on April 24, 2013


Most airports also had (and I think Japan still does this as a matter of course) heat-sensing cameras

Ahhh... thats what that was then. Well they are still doing this in Korea too then, at Incheon two days ago I walked through one of these setups but had no idea what it was for (just labelled "Quarantine" in English and a camera, I was baffled as to what a camera was doing with respect to quarantine/disease but makes sense now).
posted by wildcrdj at 2:43 AM on April 25, 2013


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