CIDRAP: CDC tool for measuring pandemic preparedness used by scores of countries

Excerpt:

News Scan for Dec 27, 2013

A method developed by the US Centers for Disease Control and Prevention (CDC) and partners for assessing countries' pandemic influenza preparedness capabilities has been used by more than 40 countries to document preparedness and gauge progress, according to a report published Dec 23 in the journal Influenza and Other Respiratory Diseases.

Called the National Inventory of Core Capabilities for Pandemic Influenza Preparedness and Response, the tool was developed to provide a means of systematically collecting data on coverage, quality, and timeliness in 12 areas of preparedness and response.

The inventory was used by 40 countries in 6 WHO regions in 2008, according to the report. In 2010, it was used by 36 countries, and in 2012, by 39.

The areas included in the inventory are (1) country planning, (2) research and use of findings, (3) communications, (4) epidemiologic capability, (5) laboratory capability, (6) routine influenza surveillance, (7) national respiratory disease surveillance and reporting, (8) outbreak response, (9) resources for containment, (10) community-based interventions to prevent the spread of influenza, (11) infection control, and (12) health sector pandemic response.

Within each area of capability are specific indicators that are rated on a four-point scale. In the category resources for containment, for example, the indicators include availability of antivirals, storage facilities, exercises and practice, and distribution of materials.

Participants arrive at scores for each indicator through discussions guided by trained facilitators. According to the review, these discussions yielded meaningful information beyond numerical scores by bringing together key personnel involved in planning and making them aware of their collective efforts.
Dec 23 Influenza Other Respir Dis review
National Inventory Web page

WHO voices concern over China's vaccine-related deaths

BEIJING, Dec. 27 (Xinhua) -- The World Health Organization (WHO) on Friday expressed concern over recent infant deaths in China that were linked to hepatitis B vaccination, saying it will support the government's investigation into the cases.

At least 12 deaths have been reported since November after infants were vaccinated with hepatitis B shots produced by different companies in China. Health authorities are focusing on Shenzhen drug manufacturer BioKangtai, whose vaccines have been associated with most of the infant deaths.

The WHO supports China's decision to temporarily suspend use of the hepatitis B vaccine from the vaccine maker and investigate the cases, according to a statement from the organization's website.

"These deaths are very unfortunate, but the rapid reporting and investigation of the government speaks to the strength of the health and drug regulatory system to identify adverse events quickly and take action to prevent additional problems," said Dr. Bernhard Schwartlander, WHO Representative in China.

Continued:  http://news.xinhuanet.com/english/world/2013-12/27/c_133002298.htm

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update December 27, 2013

27 DECEMBER 2013 - On 20 December 2013, WHO has been informed of four additional laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Saudi Arabia.

Two cases are female health workers from Riyadh who have not reported any symptoms.

The third case is a 53 year-old male from Ryadh with underlying chronic diseases. He was hospitalized on November 26 and is currently receiving treatment in an intensive care unit. He had no exposure to animals and no travel history outside Riyadh region. He had contact with a confirmed case.

The fourth case is a 73 year-old male from Riyadh with underlying chronic diseases who died on December 18, three days after being hospitalized. He had exposure to animals but no travel history.

Globally, from September 2012 to date, WHO has been informed of a total of 170 laboratory-confirmed cases of infection with MERS-CoV, including 72 deaths.

Continued:  http://www.who.int/csr/don/2013_12_27/en/index.html

CDC EID: Use of Electronic Death Certificates for Influenza Death Surveillance

Volume 20, Number 1—January 2014

Research

 

 Elizabeth A. Bancroft²  and Sun Lee

Author affiliations: Los Angeles County Department of Public Health, Los Angeles, California, USA

 Abstract

Surveillance for influenza deaths has been used to gauge the severity of influenza seasons. Traditional surveillance, which relies on medical records review and laboratory testing, might not be sustainable during a pandemic. We examined whether electronic death certificates might provide a surveillance alternative. We compared information retrieved from electronic death certificates that listed influenza (or a synonym) with information retrieved from medical charts on which influenza deaths were reported by traditional means in Los Angeles County, California, USA, during the 2009 influenza A(H1N1) pandemic and 2 subsequent influenza seasons. Electronic death certificate surveillance provided timely information, matched the demographics and epidemiologic curve of that obtained from traditional influenza-related death surveillance, and had a moderately positive predictive value. However, risk factors were underreported on death certificates. Because surveillance by electronic death certificates does not require obtaining and reviewing medical records, it requires fewer resources and is less burdensome on public health staff.

http://wwwnc.cdc.gov/eid/article/20/1/13-0471_article.htm

CDC EID: Replicative Capacity of MERS Coronavirus in Livestock Cell Lines

Volume 20, Number 2—February 2014

Dispatch

 

Abstract

Replicative capacity of Middle East respiratory syndrome coronavirus (MERS-CoV) was assessed in cell lines derived from livestock and peridomestic small mammals on the Arabian Peninsula. Only cell lines originating from goats and camels showed efficient replication of MERS-CoV. These results provide direction in the search for the intermediate host of MERS-CoV.

Article Contents

• The Study
• Conclusions
• Acknowledgments
• References
• Figure 1
• Figure 2
• Table
• Suggested Citation

-snip-

Conclusions

Transmission of MERS-CoV between humans is still limited, and the identification of an intermediate animal host could enable the development of public health measures to prevent future spread of the virus among humans. Although MERS-CoV neutralizing antibodies have been detected in camels from Oman, Spain, and Egypt, the virus has not previously been detected in camels (8,9). An informed focusing of investigations on a select group of species, such as camels, could benefit epidemiologic investigations. To identify potential intermediate host species of MERS-CoV, we used in vitro testing to determine virus permissiveness in select cell culture models. In general, cell lines cannot depict the full pathogenicity of in vivo infection because infection is influenced by epithelium-specific differentiation of target cells and the presence of immune cells. However, for viruses such as CoVs, whose tropism is believed to be determined mainly by the availability of an appropriate entry receptor (10), epithelial cell cultures could indeed constitute valid surrogates of virus permissiveness in vivo. With these limitations in mind, our results are in concordance with the findings of MERS-CoV neutralizing antibodies in camels and with information regarding patient contact with animals in reports of 2 human cases of MERS-CoV infection (11,15). One of the patients owned a farm on which camels and goats were kept. Before onset of his own illness, the patient reported illness in several goats on his farm. The patient did not have direct contact with animals, but he reported having eaten goat meat and having had contact with one of the animal caretakers, who suffered from respiratory disease (15). The second patient reported direct contact with a diseased camel shortly before onset of his symptoms (11).
In our study, production of infectious virus particles was seen in goat lung and kidney cells and in camelid kidney cells. Excretion patterns indicative of kidney infection should be investigated once further clues to the identity of the MERS-CoV animal reservoir become available. Our preliminary findings suggest that ungulates, such as goats and camels, are a possible intermediate host of MERS-CoV; thus, exposure to urine and feces from these animals might constitute a source of human infection. Moreover, food products derived from these animals (e.g., meat and milk) should be tested for their potential to transmit MERS-CoV. The results of our study suggest that investigations into the MERS-CoV animal reservoir and intermediate host should focus on caprid (e.g., goats) and camelid hosts, and we identified several new cell lines for use in virus isolation studies.

Dr Eckerle is a virologist at the Institute of Virology in Bonn, Germany. Her primary research interest is characterization of novel and emerging zoonotic viruses.

http://wwwnc.cdc.gov/eid/article/20/2/13-1182_article.htm

#MERS #Coronavirus Saudi Arabia MOH Reports 5 New Cases - December 26, 2013

[My last report out of the Ministry of Health in Saudi Arabia was of 4 new cases, reported on December 20, and can be found here.  It a nutshell, what we have below is a 57 yo, under treatment.  We have a 73 yo who is confirmed and has died.  The remaining 3 cases are all in the healthcare field, and have had contact with confirmed cases, yet are asymptomatic.  Both the 57, 73 and 2 Healthcare workers were reported on the 20th, thus this is repeated.  One Healthcare worker  is a new report since the 20th.]

In the context of the work of epidemiological investigation and ongoing follow-up carried out by the Ministry of Health for the virus (Corona) the new strain of AIDS Middle East respiratory MERS-CoV Ministry announces the registration of five cases in Riyadh, the first citizen at the age of 57 years old, suffering several chronic diseases, and receiving treatment care Concentrated, asking God has cured, the second citizen at the age of 73 years old, had been suffering several chronic diseases, has passed away, may he rest in peace, and the third is a resident at the age of 43 years, working in the health sector and the contact with the confirmed cases, and has no symptoms, and the fourth a resident at the age of 35 years, working in the health sector, and Mkhalt of confirmed cases and has no symptoms, and the fifth citizen at the age of 27 years, working in the health sector, and Mkhalt of confirmed cases, and has no symptoms, asking God for their healing all. http://www.moh.gov.sa/CoronaNew/PressReleases/Pages/mediastatemenet-2013-12-25-001.aspx

Hong Kong 80(M) Case

This is my info on this case

Date of Report:  12/6/13

Name:  80/83(M)

From:  Shenzhen

Adm:  11/13 – 29 Shenzhen Bao’an District People’s Hosp.

Adm:  12/3 - transferred to Princess Margaret Hospital.

Sym’s on arrival:  no fever.

Status:  12/9 Stable

Timeline:

12/3 arrived HK w/3 family members via Shenzhen Bay Port & took taxi to Tuen Mun Hospital & was adm for chronic illness

12/6:  developed fever & put in isolation 

Family members who accompanied him remain unsymptomatic.

Taxi Driver & his 3 family members (1 man & 2 women) on 12/3 to contact hotline.

Contact tracing underway.

12/8 update:  critical condition.  7 of the 19 were moved from Princess Margaret Hospital to a quarantine centre set up at the Lady MacLehose Holiday Village in Sai Kung.  The rest remain in the hospital in Kwai Chung.

1 or 2 of 19 had mild sym’s of upper resp. tract infetion.

Experts believe some chickens in Shenzhen had been infected with the virus.

12/9 update:  19 close contacts tested neg (include 13 adm to Tuen Mun Hosp & given Tamiflu; 5 family member @ Princ. Marg. Hosp. asymptomatic; Taxi Driver @ Princ. Marg. asymp.) 130 others tested negative.

DOD:  12/26/13

#H7N9 Hong Kong continued suspension of live poultry to Hong Kong, Shenzhen

December 24, 2013

Secretary for Food and Health Ko Wing-man said that arrangements for the suspension of live poultry for Shenzhen to Hong Kong will continue, temporarily set released date. 

After Ko Wing Man today (December 24) at a public event meeting with the media, said Hong Kong's first confirmed case of H7N9 in early cases, suspension of live poultry to Hong Kong, Shenzhen, currently passed on the 21st of medical surveillance, but in view of Shenzhen after another in environmental samples the discovery of the virus, some human cases, it was decided to maintain the measures. 

He pointed out that the present arrangement for supply to Hong Kong is a closed-end management of live poultry, poultry farms from registration for shipped to Hong Kong, not mixed with other poultry; Mainland authorities have also been to Hong Kong farms registered for samples, so far there is no any samples were positive, so do not for a total ban on live chickens to Hong Kong. 

For farms in Hebei Baoding have detected H5N2 virus, Ko Wing-man, said that the farms had no live poultry to Hong Kong, but the virus is highly pathogenic, the authorities will closely monitor the development of the epidemic.

Hong Kong confirms first death from #H7N9 bird flu

Translation
December 26, 2013

HONG KONG (Reuters) - An 80-year-old man infected with the H7N9 bird flu virus has died in Hong Kong, the government said on Thursday, in the first such death in the city after the virus surfaced in early December.

The man, the second person in Hong Kong to be diagnosed with the virus strain, lived in the southern Chinese city of Shenzhen and had eaten poultry there, media reported.

The H7N9 strain was first reported in humans in February in mainland China, and has infected at least 139 people in China, Taiwan and Hong Kong, killing more than 40.

Experts say there is no evidence of any easy or sustained human-to-human transmission of H7N9, and so far all people who came into contact with the man had tested negative for the strain, authorities said.

(Reporting by Twinnie Siu and James Pomfret; Editing by Nick Macfie)

http://www.newsdaily.com/

CDC HAN: Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season

Distributed via the CDC Health Alert Network
December 24, 2013, 14:30 ET (2:30 PM ET)  
Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season

Summary

From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. The pH1N1 virus that emerged in 2009 caused more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.
Seasonal influenza contributes to substantial morbidity and mortality each year in the United States. In the 2012-13 influenza season, CDC estimates that there were approximately 380,000 influenza-associated hospitalizations [1]. Although influenza activity nationally is currently at low levels, some areas of the United States are already experiencing high activity, and influenza activity is expected to increase during the next few weeks.
The spectrum of illness observed thus far in the 2013-14 season has ranged from mild to severe and is consistent with that of other influenza seasons. While CDC has not detected any significant changes in pH1N1 viruses that would suggest increased virulence or transmissibility, the agency is continuing to monitor for antigenic and genetic changes in circulating viruses, as well as watching morbidity and mortality surveillance systems that might indicate increased severity from pH1N1 virus infection. In addition, CDC is actively collaborating with state and local health departments in investigation and control efforts.
CDC recommends annual influenza vaccination for everyone 6 months and older. Anyone who has not yet been vaccinated this season should get an influenza vaccine now. While annual vaccination is the best tool for prevention of influenza and its complications, treatment with antiviral drugs (oral oseltamivir and inhaled zanamivir) is an important second line of defense for those who become ill to reduce morbidity and mortality. Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who is hospitalized; has severe, complicated, or progressive illness; or is at higher risk for influenza complications.

continued:  http://emergency.cdc.gov/HAN/han00359.asp

 

#H7N9 China gdong Vice Governor: concentrate all forces to the prevention and control of avian influenza H7N9

Translation
December 23, 2013
China news agency, Guangzhou, December 23 (Reporter Suo Youwei) - The Guangdong provincial government has sent five teams to the province over the supervision and supervision of human infection with H7N9 avian influenza cases.

Vice Governor of Guangdong Province, said Lin Shaochun 23, 2009, at present, to further implement departmental responsibilities to perform their duties and concentrate all forces to prevent and control the epidemic, to minimize human infection and mortality. 　　

Lin Shaochun 23, presided over a meeting to hear reports on the situation of each steering group supervision, analyzing current human infection with H7N9 avian influenza situation, analyze problems, study and plan the next step prevention and control work. He said, from the inspection situation across the province in accordance with the Guangdong provincial government's deployment, strengthen joint prevention and control, effective and orderly conduct of the prevention and control work. 　　

The inspection work for the problem found, Lin Shaochun said, the country, the relevant units, especially health, agriculture, industry and commerce, forestry and food and drug supervision departments to promptly address gaps, loopholes and effectively to people infected with the H7N9 bird flu prevention and control measures implemented. 

Recently, agriculture, commerce, forestry and other sectors should also study issued guidance to enhance the live poultry farms and live poultry wholesale trade, and standardize management wildfowl transactions. 

To further improve the grassroots medical institutions, medical institutions H7N9 detection device configuration, testing business to strengthen the medical staff training to improve detection capabilities, so early detection, early treatment, early treatment.

Lin Shaochun said that the country, the relevant units must be mentally prepared to fight a protracted war, ideologically more attention, want to learn more on ways to measure the implementation of a more pragmatic, comprehensive good winter and spring of human infection with H7N9 avian influenza.

http://news.cnr.cn/native/gd/201312/t20131224_514475415.shtml

#H7N9 China Shenzhen patient off vent, conscious, another month of treatment needed

Translation
December 23, 2013

　It is understood that, as of 23 noon 12 am, a strong Euro has been in a hospital intensive care unit using a ventilator for 5 days. Previously, hospitals Tamiflu treatment to effectively control their body's bird flu virus, but because of secondary bacterial infection caused severe sepsis, hospital only senior antibiotic production back to the U.S. for treatment of their purchase by pharmaceutical companies from Hong Kong.

　　"The bird flu virus patients have all been negative, no H7N9 bird flu virus, severe sepsis have been effectively controlled, the condition has improved a lot." Zhoubo Ping revealed that 23, at 12 am, the hospital has been removed for patients ventilator, the patient is conscious. Patients who go to the market before the onset of claiming to buy food.

　　"Probably because there is live bird markets, poultry droppings, feathers, etc. are likely to carry H7N9 virus contaminated air, people after the onset of the respiratory tract by inhalation, easy to spread bird flu, but still can not confirm the specific source of infection." 周伯平 said.

　　According to reports, although a strong European disease has been effectively controlled, but he is still in a state of dying, but also far less than the discharge standards. "Treatment time is also needed at least a month or more, these two days will continue to use Tamiflu." It is reported that, for the follow-up treatment of patients with advanced antibiotics will be based, in order to control the bacterial infection.

#Coronavirus #MERS Saudi Arabia Turaif Rumors of Case

[Turaif (Arabic: طريف‎) is a town in Northern Borders Province (also known as Al-Hudud ash Shamaliyah),Saudi Arabia, close to the border with Jordan. ~wikipedia~]

Translation
12/22/13


spread hours before across social networking sites reported the first case of Corona Hospital in Arar Central sparking panic among residents Arar was among the official spokesman for the Ministry of Health in the North of Mr. Fahad Al-Shammari health of what has Tdoualh through networking sites that there is a reluctance great by the reviewers and the sick for reviewing Arar Central Hospital grounds that the spread of infectious disease. spokesman added that the registration of the case just a rumor and did not have any record of the case and hope of all citizens not to yield to such rumors.

http://www.turaif1.com/news.php?action=show&id=12712 

#H7N9 China: Guangdong province closed for disinfection of live bird markets today

Translation
December 23, 2013
Excerpt:

Guangdong Provincial Government yesterday held a press conference to explain the preventive measures, experts mentioned early diagnosis, medications are still effective against avian flu. Today, the province's provincial government has also decided to live bird markets closed for disinfection before the Spring Festival this month on the 31st and then closed for disinfection day there, but stressed that the poultry farms through quarantine are safe and reliable, but not for live chickens tested positive avian flu, is prohibited without the whole Guangdong Province trading of live poultry.

　　Rapid diagnosis is not ideal

　　Since their discovery was first reported in August, six cases of infection of H7N9 avian influenza cases 441 close contacts, medical observation and detection etiology are no unusual or someone infected, so the present situation in Guangdong or spread of the disease from spreading The possibility is very low, and no human to human transmission like appearance, but it is expected there will still be sporadic cases.

　　Zhong Nanshan said in a press conference, H7N9 bird flu confirmed by the onset to take the longest 13 days, and more cases of bird flu are more severe in patients in Shenzhen, for example, immediate treatment after admission, not very late, but the disease is still developing rapidly. He also considered the effect of rapid diagnostic tests for the virus is not ideal, some patients admitted to hospital three times after the test was testing out the bird flu virus, so a delay of more than patients diagnosed affect the treatment, resulting in two of them worsening. He believes that genetic testing must be referred to the PCR can be effectively detected. When asked about the opportunity to appear around the H10N8 and H7N9 cases, if two viruses simultaneously, will have a more serious situation, he responded that moment we can see the situation, while not occur in case, but ten micros.

http://www.singpao.com/xw/yw/201312/t20131223_479804.html 

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update December 22, 2013

22 December 2013 - On 20 December 2013, WHO has been informed of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in United Arab Emirates (UAE).

A 68 year-old male with onset of illness on 13 December, was admitted to hospital on 14 December 2013 for Joint replacement, he was also complaining of cough and transferred to the intensive care unit on 16 December due to rapid deterioration. On 19 December 2013, the diagnosis was laboratory confirmed for MERS-CoV. The patient has underlying medical conditions. Preliminary investigations reveal that he had no recent travel history and no contact with animals, and no contact with laboratory confirmed case. Investigation among family and healthcare contacts is ongoing.
Globally, from September 2012 to date, WHO has been informed of a total of 166 laboratory-confirmed cases of infection with MERS-CoV, including 71 deaths.
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.
Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhoea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.
Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.
All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.
People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.
WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

http://www.who.int/csr/don/2013_12_22/en/index.html 

H5N2 bird flu areas sealed off in N China

SHIJIAZHUANG, Dec. 22 (Xinhua) -- Areas within 3 km of a farm in north China's Hebei Province, the site of an H5N2 bird flu outbreak in poultry, were confirmed to have been sealed off, according to local government.

The disease killed 4,000 chickens raised at the farm in Baoding City after they showed symptoms of suspected avian flu on Dec. 17, according to the Ministry of Agriculture.

The National Avian Influenza Reference Laboratory on Saturday confirmed the epidemic was caused by the H5N2 avian influenza virus after testing samples collected at the farm.

Local authorities have sealed off and sterilized the infected area, where a total of 125,700 chickens have been culled and safely disposed of to prevent the disease from spreading.

Bird flu, or avian influenza, is a contagious disease of animal origin caused by viruses that normally only infect birds and, less commonly, pigs. It can be fatal to humans.

Earlier this week, four new human cases of H7N9 bird flu were confirmed in south China's Guangdong Province.

http://news.xinhuanet.com/english/china/2013-12/22/c_132987133.htm 

#H7N9 Shenzhen 38yo Case Started Tamiflu Too Later After Onset

[This article states what I have bolded in the previous post, but more clearly]
Translation
December 21, 2013

Shenzhen Special Zone Daily (Reporter Sheng Jiawan) patient was a 38-year-old in Europe, why the disease is so critical? Third People's Hospital Zhoubo Ping said that this is mainly because of the patient's condition to intervene too late. Early symptoms of H7N9 avian influenza is not different from ordinary flu. Zhoubo Ping reminder, flu-like symptoms need immediate medical attention and inform the history of exposure to poultry.

It is reported that 9 patients symptoms of fever, cough, etc., but until the 14th referred to the City People's Hospital before starting antiviral therapy. An interval of five days, resulting in various organs viruses, destroy the patient's immune system.Zhoubo Ping said that from the perspective of the current treatment of patients, the virus sensitive to Tamiflu, if you find people infected with H7N9 bird flu, early treatment, then the virus itself is not terrible. Moreover, people are not susceptible to the virus, and no variation, not person to person, so the possibility is very small concentration of the outbreak.

http://news.ifeng.com/gundong/detail_2013_12/21/32354342_0.shtml 

Shenzhen: the first case of H7N9 infection in patients in critical condition has not yet been confirmed by a source

Translation

December 22, 2013

Yangcheng Evening News reporter Wang reports: Reporters yesterday from the first case of human infection with H7N9 admitted to Shenzhen bird flu in Shenzhen Third People's Hospital informed patients in Europe currently busy strong sense though awake, but still in a relatively difficult period in critical condition, need to continue to use mechanical ventilation. Hospital staff and respiratory expert group, ICU specialists will jointly conduct consultations to patients every day, and under the guidance of the city antiviral avian influenza prevention and control expert groups, anti-bacterial infection treatment, patients avoid organ failure continues.But still can not confirm the source of infection in patients.

Serious bacterial infection in vivo

Third People's Hospital of Shenzhen, Shenzhen yesterday informed the first human avian influenza H7N9 virus infection confirmed cases of the relevant circumstances, the patient Europe Wang Qiang, 38, male, Han nationality, Gaozhou people live Longgang District Nanling, "because fever, cough, sputum, wheezing nine days, adding two days ", on at 13:30 on the 18th transferred by the Shenzhen Municipal People's Hospital of Shenzhen Third People's Hospital of flu three subjects.

Third People's Hospital of Shenzhen, Shenzhen H7N9 virus prevention and control team leader Zhoubo Ping said that the current H7N9 avian flu mainly based on national treatment for patients in Europe Wang Qiang determine treatment options, mainly for anti-viral therapy and assisted ventilation. "The patients also infected with the concentration of sepsis, multiple organ dysfunction occurs, the need for anti-infective therapy and other treatments. Patient has been basically clear, but inserted a tube on a ventilator, unable to speak."

Director of the Division of Infectious Diseases, Shenzhen Third People's Hospital Yuan Jing said, according to the EU for patients every day viral Wang Qiang be detected, the patient virus content currently has decreased, from sputum has not detected the virus, detected in other parts of the body fewer virus, viral control, but there have been more serious bacterial infection.

So ill patients treated late

According to reports, Wang Qiang Europe where the patient care unit is equipped with two medical staff, in addition to a physician, a nurse and another ventilator management, both 24 hours personal care. Doctors and nurses also wear respiratory diseases prevention and control in accordance with the provisions of the protective clothing, wear N95 masks, protective glasses and hat. "The risk of hospital infections is not other people." Zhoubo Ping said.

Zhoubo Ping said that patients treated late, delayed treatment. The 9th disease, the 14th began to use Tamiflu, 5,6 genius begin with, but still very good therapeutic effect of Tamiflu, found that there is a positive part of the patient is detected yesterday, but not much viral load.

Experts say the need not hoard Radix

Proximal time for some people to hoard Radix prevention of H7N9 cases, Zhoubo Ping said that it did not need to, "Avian flu is not an ordinary flu, there is no indication that will person to person, do not need to buy Radix."

Zhoubo Ping said, H7N9 bird flu virus is mainly transmitted to humans by birds.Zhoubo Ping advised the public to minimize contact with poultry, try not to buy live chickens in the live bird markets. "If less contact, less chance of infection if exposed to birds, with flu-like symptoms such as fever, cough, etc., should first go to the hospital."

Currently Shenzhen major hospitals have increased the unexplained pneumonia and suspected cases of screening. Zhoubo Ping said that the conditions allow it, the proposed closure of live bird markets.

Reporters learned that the H7N9 avian influenza virus has been detected in the South Bay Cambridge Meat Market Longgang live poultry stalls resume business. But H7N9 avian influenza virus has been detected in Longgang Henggang Paibang market has not yet operating, the relevant responsible person said might have to wait until next week before opening. Nanling integrated market of live poultry stalls all off, when it resumed operations Not be notified.

http://gz.ifeng.com/fygy/detail_2013_12/22/1624729_0.shtml