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Re: Is H7N9 Spreading from Human to Human in China?
There is an additional possibility that springs to mind: vermin. Again, H7N9 infected pigs or other dead animals that had washed ashore would have been fed upon, and vermin are pervasive in cities and buildings and could be a spread vector.
Pigs have been reported as dying in very large numbers in China over the last months. Chinese authorities have unequivocably stated that they have not found H7N9 in any of the carcasses they tested.
One, possibly two of the victims was a butcher. None of the rest of the victims worked with amimals. So, where did they come in contact with a disease carrier? Some were infected in differing provences. Therefore, it is obvious that the source of the infection must be fairly widespread or, something that all have in common such as a water source.
Would have more, many more simultaneous pockets of cases in a more concentrated area with a shared water source
So, if it wasn't the pigs that were dumped in the rivers that contaminated the water these people drank, then we are left with the assumption that a HUGE number of chickens
simultaneously infected? and becoming infectious to humans simultaneously ALSO?
It would be great to know we were getting legitimate information but that's not the case. There isn't any way we know because of censorship and government control whether there is also a coinciding, milder respiratory epidemic happening at the same time. With a low CFR, there could be thousands of cases out there - with a 1918 like CFR, there would be less, but still a considerable amount.
Perhaps, humans gave it to the piggys hence the reason they started dying AFTER the first known human cases? Could ground zero for the first human epidemic be upriver from Shanghai?
H2H controversy will stay unclear until the first case is detected outside of China.
H2H controversy will stay unclear until the first case is detected outside of China.
Bingo
until this pierces the veil and is found in a Western country we cant possibly say anything with certainty - well except that we certainly do not have the full story
(sadly lets hope it shows up in a competent country like Germany because then the transparency will be considerably better)
Re: Is H7N9 Spreading from Human to Human in China?
Perhaps the biggest problem with the pig hypothesis as the source is that there are so few confirmed cases from Shanghai as noted by Farmer. The Huangpu River is the major water source for the largest city in the world and is now heavily chlorinated (Wikipedia link), although Wikipedia reports that some of the dead pigs had ear tags from Jiaxing, Zhejiang Province. Background information on the Huangpu River from 1997 can be found here.
Pigs share a lot in common with humans regarding influenza viruses. Curiosity's suggesting that humans infected pigs up river is a speculative, but possible, alternative scenario, until we get further information.
Re: Is H7N9 Spreading from Human to Human in China?
There are so many unknown about this event that is almost impossible to speculate what is going to happen in few days.
But a thing is almost sure: Shanghai is a global travel and trade hub.
If this virus is really prone to human-to-human transmission without further adaptation, in few weeks all cities in the world will be able to detect new cases.
So, our media scanning should target main travel route from Shanghai to other region of the Pacific, for example.
Re: Is H7N9 Spreading from Human to Human in China?
I find the pig/water scenario as an unlikely source of the infection myself but, it cannot be ruled out completely. As to the dead pig dumping timeline, if the number of pigs at first was small then we probably would not have read of the the first
animals disposed of in the river. It is my understanding that dumping dead pigs into rivers is a fairly common practice. Furthermore, I have never heard of a flu virus that could not be killed with chlorine bleach. So, the river as a focus for infections
is problematic. And, I too am well aware of a veracity problem with information coming out of China
.
I was unable through a 45 minute search to find any reliable sources indicating rodents as vectors for influenza. Interesting thought though. It is my understanding that mice used for testing for research have all been genetically altered.
Flu is usually passed as droplets and inhaled deep into lung tissue. So the most likely avenue is to have someone breathe the same air you are breathing. Transmission can also occur by touching contaminated surfaces then touching a mucus
membrane. As some of the victims rarely left their places of abode is is highly unlikely they came into very close contact with either uncooked chicken or pork. That brings us back to the conclusion that H2H is the most likely culprit. Albeit with a
virus that hasn't yet overcome the obstacles for easy transmission.
Please do not ask me for medical advice, I am not a medical doctor.
Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
Thank you,
Shannon Bennett
Re: Is H7N9 Spreading from Human to Human in China?
Yes, I agree, major city connections to Shanghai.
One thing I don't understand is why does the WHO say with near conviction that there is no evidence of H2H transmission? Particularly when the outbreak is so unusual?
This is not comparable to the H5 event in Hong Kong in 97 where a few cases were detected over a much smaller geographic area with coinciding sick/dying birds. This event is not even comparable to the H1N1 event where multiple severe cases with unknown disease were detected in Mexico City AND two cases were located in separate US geographical areas. This event is more like a combination of both over a large area - how could they know or what evidence do they have that indicates it is NOT an efficient transmission between humans?
It seems more major cities would be on increased alert if WHO guidance at least included the plausibility it could be H2H spread - or simply that they don't know and until they do, be cautious!
Re: Is H7N9 Spreading from Human to Human in China?
I am guessing that if the WHO were to advise possible H2H that would trigger very expensive and widespread public health response plans. They probably do not want to go there any time soon.
Re: Is H7N9 Spreading from Human to Human in China?
Right after I posted the last article, I read the WHO link post re: FAQ update. The WHO is now indicating there is a possibility for person to person transmission.
From the WHO FAQ:
7. How did people become infected with the influenza A(H7N9) virus?
Some of the confirmed cases had contact with animals or with an animal environment but the virus has not thus far been found in animals. It is not yet known how these persons became infected. The possibility of animal-to-human transmission is being investigated, as is the possibility of person-to-person transmission.
12. Is the general population at risk from the influenza A(H7N9) virus?
We do not yet know enough about these infections to determine whether there is a significant risk of community spread. This possibility is the subject of epidemiological investigations that are now taking place
until this pierces the veil and is found in a Western country we cant possibly say anything with certainty - well except that we certainly do not have the full story
(sadly lets hope it shows up in a competent country like Germany because then the transparency will be considerably better)
I think that we also need to be very vigilant in searching for any suggestion that a health care worker is ill. That's especially true because the earliest cases were apparently treated without use of isolation or protective gear. If any cases show up, that's going to take this to a whole 'nother level.
"What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon
"The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston
Re: Is H7N9 Spreading from Human to Human in China?
What "evidence" must be present to determine human to human infection has occurred? Does anyone know of a standard or guideline for this?
We are all looking for (and have found some) items that suggest H2H spread, but are there any 'pertinent negatives' we are missing that would suggest H2H spread is NOT occuring?
I imagine the media is being excessively scrutinized in the affected areas and will not be printing articles about increased respiratory infections at hospitals or overcrowded ERs.
Re: Is H7N9 Spreading from Human to Human in China?
Clustering of cases between close familiy, friends and co-workers. And a large number of health care workers coming down with the disease. Later swamped emergency rooms.
Please do not ask me for medical advice, I am not a medical doctor.
Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
Thank you,
Shannon Bennett
Clustering of cases between close familiy, friends and co-workers. And a large number of health care workers coming down with the disease. Later swamped emergency rooms.
Shannon is correct. Unfortunately, we don't know if China will release such information in a timely manner. Remember that what lead to the reporting of the first case was a cluster of illnesses in a Shanghai hospital in early March. However, only one of the individuals was reported to have contracted H7N9.
There is an additional possibility that springs to mind: vermin. Again, H7N9 infected pigs or other dead animals that had washed ashore would have been fed upon, and vermin are pervasive in cities and buildings and could be a spread vector.
...shades of early H5N1!
A post by IOH states that the M segment has the S31N change. An H9N2 2012 Brambling M segment sample also has that change. They are sometimes kept as pets (shades of early H5N1 also).
.
"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
Re: Is H7N9 Spreading from Human to Human in China?
This is a copy of excerpts of an article that I put in the H7N9 discussion thread earlier today.
... "We speculate that when this virus is maintained in poultry the disease will not appear, and similar in pigs, if they are infected, so nobody recognizes the infection in animals around them, then the transmission from animal to human may occur," said Dr. Masato Tashiro, director of the World Health Organization's influenza research centre in Tokyo and one of the specialists who studied the genetic data. "In terms of this phenomenon, it's more problematic."
This behaviour is unlike the virus's more established relative, the virulent H5N1 strain, which set off warnings when it began ravaging poultry across Asia in 2003. H5N1 has since killed 360 people worldwide, mostly after close contact with infected birds.
"In that sense, if this continues to spread throughout China and beyond China, it would be an even bigger problem than with H5N1 in some sense, because with H5N1 you can see evidence of poultry dying, but here you can see this would be more or less a silent virus in poultry species that will occasionally infect humans," said University of Hong Kong microbiologist Malik Peiris, who also examined the information.
...
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