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China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

sharon sanders

Editor-in-Chief & President
According to our case chart here 12 of the 129 known H7N9 cases are farmers by occupation:

#17 - Man, 74, onset date March 28, hospitalized March 3, farmer, died April 11 Shanghai Death note

#29 - Man, 65, hospitalized - a farmer Hangzhou, Zhejiang Province

#33 - Woman, 81, hospitalized April 4, farmer , Shanghai

#51 - Man, 65, onset date April 8, hospitalized April 9, farmer, Zhoukou City Chuanhui, Henan province

#52 - Woman, 64, farmer Huzhou, Onset date April 6, in serious condition. Zhejiang Province

#80 - Woman, 37, farmer, onset on April 11, Hangzhou, Zhejiang Province

#108 - Man, 62, farmer, onset at April 15 , in hospital for treatment. Hangzhou Zhejiang Province

#113 - Woman, 60, farmer, onset April 17, Huzhou, Zhejiang province

#114 - Woman, 50, farmer, onset April 18, Shaoxing, Zhejiang province

#115 - Man, 38, farmer, onset date April 17, Huzhou, Zhejiang province

#123 - Man, 80, farmer, onset date April 21, Nanchang County Jiangxi province

#129 - Man, 69, farmer, onset April 23, hospitalized April 27, Shaoyang City Wugang Hunan province


These 12 cases represent approximately 9.25% of the total known cases. While some of these farmers may personally participate in the wet market sales, probably not all of them do.

H7N9 influenza virus is an occupational risk for farmers. Even if 50% of the farmers sell their own products and can be counted in the group of people who have acquired the virus through wet market exposure, this leaves 4.6%, approximately, of the total cases who were exposed, most likely, on their farm.

Hence, the H7N9 virus is most likely present on farms in the affected areas of China.

 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Well what are typical influences affecting farmers more than city dwellers?

They are outdoors more often.

They work with animals.

People working in fields do not have access to water for frequent hand-washing.

Come into contact with more wild life.

Come into contact with more vermin.

Grain is an integral part of their life. That includes planting, raising and harvesting as well as feeding poultry and animals.

Come into contact with more contaminated surfaces through normal animal husband chores.

Have more minor injuries.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

http://www.eurekalert.org/pub_releases/2006-01/ajop-aiv011306.php

If we?re still looking at a possible mammalian reservoir, the increased risk farmers have is contact with vermin feces and urine and those of cats. This 2006 paper on H5N1 suggests cats and their urine as a strong possible mechanism of transmission and spread. Reported multi-organ failure in H7N9 cases does not make it a stretch to suspect infection in other systems than respiratory tract in a mammalian reservoir. I?m inclined to think as suggested in other threads that the chickens are mere victims and scapegoats.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Welcome Nox.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Welcome Nox!

What I observed in the H5N1 zoonosis is that the flu cycle progressed from a pure avian illness in wild birds ---> ducks ---> poultry ---> pigs ---> other mammals like humans, cats, dogs.

I believe pigs are an essential link in the avian to human flu development. They provide a mixing bowl to combine various flu strains and allow them to attain more human adapted genetics.

Where is this link in H7N9? The government of China continues to deny any H7N9 from any farms, including pig farms.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Where has H7N9 bird flu come from?

18:00 01 May 2013 by Debora MacKenzie
Magazine issue 2915

The new H7N9 bird flu strain continues to spread across China. Currently, more than 120 cases had been reported across 10 provinces, and 24 deaths. Yet no one knows where the virus started, which hampers efforts to contain it. But a promising new antiviral drug may help tackle flu in the future.

...They have been taking swabs on farms and live animal markets, both from birds and the surfaces they've been in contact with. Only 46 of those samples, scattered across central and eastern China, carried the H7N9 virus: 44 from markets selling live poultry, one from urban racing pigeons and one from a wild pigeon. "Not one farm tested positive," says Juan Lubroth, chief veterinary officer of the UN Food and Agriculture Organization in Rome, Italy.

Genetic differences between the samples suggest the virus has been spreading in animals for a few months. But which animals? The carriers found to date were too far apart to sustain an epidemic.

Lubroth's team has started looking for the virus in older samples from a wider range of organisms. "We're going back to our freezers and thawing samples," he says. City pigeons are also likely to come under closer scrutiny.
...

Full text:
http://www.newscientist.com/article/dn23473-where-has-h7n9-bird-flu-come-from.html
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

The latest H7N9 death is a man age 54/55 who was engaged in pork "trafficking". This is another link to farms.

Out of 390,628 samples the Ministry of Agriculture says as of April 26, 2013 "also found no pigs infected with the virus."

So how did this man get infected?

More and more evidence points to H7N9 influenza virus on pig and poultry farms - despite the official proclamations of the Chinese government.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

I wonder if there has been a specific effort to study a narrow class of people for H7N9 incidence = people involved in the removal of pigs floating in the rivers earlier this year and dead pigs on farms and illegal trafficing in the dead pigs for human consumption.

I dont have much hope of getting this data, just an early christmas present request.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Hello every one. I have been reading and enjoying your posts. Excuse me if this post seems elementary. I am a retired PHN and have always been fascinated with epidemiology. I raise poultry on a very small farm in the Mississippi Flyway region. I have about 30 chickens for eggs, probably similar to Chinese small poultry farmers. I am surrounded by thousands of acres of farmland, unlike the farmers in China. We do butcher some of our own chickens. We were thinking of doing several dozen meat chickens, and now, I am not sure. I wonder about rodents in terms of a mammalian reservoir. Have they ruled out rodents? I battle rodents in the coop, the feed etc.

The other question I have, is since this is found in pigeons, and pigeon populations in cities are quite large, is it possible that it is getting into the poultry brought to wet markets, via pigeons, hence giving those in the wet markets a larger dose of the virus?

The 'urban chicken' movement has really taken off in the US. I have concerns that many people will be reluctant to cull birds. I am attempting to enact measures to keep my flock away from migratory birds, and also to be a bit more 'biosecure', not in the total sense, but, this isn't going to be easy. I don't want to cull my flock yet, as it seems little has been established in terms of reservoirs etc. At what point to I cull them?

We have several enormous chicken CAFOS in our area. Needless to say, this has me concerned as well. Is any one monitoring the chickens in the US for H7N9? There seems to be little information on how widespread H7N9 is in birds outside of China.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Welcome to FluTrackers AnnaLisa.

I'll try an answer a couple of your questions.

H7N9 has not been reported from any domesticate poultry in the western hemisphere. In fact it has not been identified in any samples outside of China. As long as you follow good hygiene practices, processing and consuming your own chickens will not be a problem.

The USDA (link) is responsible for monitoring for avian influenza in animals in the USA. Their web page is a little outdated, so I don't know how much testing is being done, but certainly they are watching for both A(H5N1) and A(H7N9).
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Welcome Anna. Yes, there are people dedicated to monitoring both wild birds and domestic flocks in the US. Keeping wild birds away from your chickens is probably a good idea on for multiple reasons but, H7N9 has not reared its ugly head in the US as of yet. There have been no cases of the dangerous emerging H7 varient outside of China. If H7 were to appear it would probably be in Alaska as part of the spring migration. While there are a few birds that do move from southeast asia to Alaska, I don't know of any that would pass over you. Therefore keeping chickens in your backyard is not a threat to you or your family. Enjoy your fresh eggs!
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

My thoughts were that we are probably in less danger from my flock than we are from human to human at this point. Yes, Alaska would be the first to have infected birds, true. The Mississippi Flyway, doesn't interact much with others. Thanks for the input. I appreciate the maps that have been put up. I have a few hysterical family members. We are moving to totally secure the flock from wild birds. It's just the smart thing to do.

I will be using masks and goggles when I care for them, or butcher them, not because of H7N9 but any avian flu, which I really hadn't thought much about before this one. We have always used masks when cleaning them, but, I didn't think much about how much things aerosolize when just filling a waterer. I suppose the jump of any avian virus to humans can happen anywhere.

I am concerned about those that live near CAFOs, myself included. I know they are kept very secure, but, they do contaminate the air, water and soil massively. If something gets in there, we are toast.

I am very concerned that this virus could be 'the one'. Looking at it's characteristics, it certainly inspires fear. The one report by Chinese agricultural scientists regarding this becoming a pandemic really knocked my socks off.

I love our sustainable lifestyle, and really hope it can continue, but, it's a minor issue in view of the chance this virus could kill so many humans, and perhaps other animals that are our food sources and collapse the world economy. I'm hoping for a fizzle out, but, I am less secure that that will happen as days wear on. I am sure there are many different scenarios this could take, and it's all conjecture at this point.

I assume mice and rats are not in the avian flu loop. Mink is interesting. We used to have a lot of mink farms here, along with the dairy farms. I hear the Chinese like Midwestern mink, and there has been talk of bringing mink farming back here. Mink were linked to spongiform encephalopathy outbreaks in the 1950's.

I hope they find some answers soon.

Thanks for all your responses.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

we keep chickens. in fact i am dealing with a load of hatching chicks as we speak (loud!)

Our state ag dept comes out to us to check for H5N1 and other possible diseases (FOR FREE) - we do not have sterile conditions (is that even possible) and they free range - never had a detection of any disease here. its a small backyard flock for eggs and meat and entertainment and pest management and manure (etc)

see if your ag dept will test for you so that you can skip the hysteria. They likely wont be testing for H7N9 yet - not to worry.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

I could not find any resources to assist me when I started my flock. I started with the public health dept. which referred me to a sanitarian, who, had nothing much to say. I called my veterinarian, and she said, not to worry about any significant diseases with my flock at this time. That was 3 years ago and I was more concerned with Salmonella back then. No one has ever gotten sick on any of my eggs, and a lot of eggs have been eaten. :)

I will perhaps give them another call and see what they say.

I did sell eggs for a while, and was an LLC, but, the organic egg market is tough and our farmer's market rules are tight. I just didn't have the energy at the time to jump thru all the hoops. My flock has a fence but, they are naughty girls and they fly over it. I do have a smaller fully penned area, but they are very unhappy when locked in there. (Usually when a hawk is targeting them). Egg laying goes way down when they are locked up. So technically, they have been free-rangers most of the time. To biosecure them, I have to build much larger pens. We are doing this with 8 by 8 pods which we are attaching together as we build them, hoping to give them a big enough area. I have two 8 by 8s and an 8 by 12 all connected. I want at least 3 more before I confine them, or they will get stubborn and not lay. Plus it isn't hygeinic. I can't afford to toss up a big 40 by 60 foot area with good fencing and a roof of some type. Electric fencing hasn't worked. I'm the only one who gets shocked. For some reason, electric shocks make me curse. ;) I am also looking at sand bedding for my pods. It's a big investment for fresh eggs. :/

I live between two large riverways, and we get a lot of migratory water fowl. One morning I awoke to find 20 Sand Hill Cranes in my yard.

I will inquire again, to see if they will come and sample for free. (I have a hunch given the recent political situation in my state, that they won't. Public services here have been cut to the bone....no pun intended.)


Thanks for your response!
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

2 thoughts regarding pigs showing negative results for H7N9:

1. How do they test for the virus? H7N9 doesn't show up in throat swabs. I hardly imagine taking sputum samples from live pigs

2. Many pigs die all the time from many causes (20,000 pigs floating, anybody?). If the H7N9 affects pigs the same way as humans, without sustained transmission, it's possible that hundreds or thousands of pigs die from H7N9, but sporadically, in different farms, so nobody pays too much attention.
If this is the case, it is very dangerous, as the pigs could facilitate the required mutations for H2H transmissions.

imho, China should sample DEAD pigs sputums for the virus
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

A number of these cases are in Zhejiang province which is very mountainous. Perhaps farmers and city workers in more accessible places have early access to Tamiflu and other antivirals...? Using Tamiflu will give a negative result and also seems to give a better outcome :. Off the statistics?.?.
http://translate.google.com/transla.../content-3/detail_2013_05/03/24878837_0.shtml
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

A number of these cases are in Zhejiang province which is very mountainous. Perhaps farmers and city workers in more accessible places have early access to Tamiflu and other antivirals...? Using Tamiflu will give a negative result and also seems to give a better outcome :. Off the statistics?.?.
http://translate.google.com/transla.../content-3/detail_2013_05/03/24878837_0.shtml

Could work in either direction. Perhaps those who are aware of their isolation would be more likely to maintain a stock of anti-virals, especially those working with avian species. BioSecurity plans extend to the human on the farm as well.

Until we get clear treatment profiles in an organised format from the source for each case including home tx, we are left to speculate. No valid explanation has been provided for the sparsity of sequences and the poor annotation of the cases from the health officials in China.
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

My thoughts were that we are probably in less danger from my flock than we are from human to human at this point. Yes, Alaska would be the first to have infected birds, true. The Mississippi Flyway, doesn't interact much with others. Thanks for the input. I appreciate the maps that have been put up. I have a few hysterical family members. We are moving to totally secure the flock from wild birds. It's just the smart thing to do.

I will be using masks and goggles when I care for them, or butcher them, not because of H7N9 but any avian flu, which I really hadn't thought much about before this one. We have always used masks when cleaning them, but, I didn't think much about how much things aerosolize when just filling a waterer. I suppose the jump of any avian virus to humans can happen anywhere.

I am concerned about those that live near CAFOs, myself included. I know they are kept very secure, but, they do contaminate the air, water and soil massively. If something gets in there, we are toast.

I am very concerned that this virus could be 'the one'. Looking at it's characteristics, it certainly inspires fear. The one report by Chinese agricultural scientists regarding this becoming a pandemic really knocked my socks off.

I love our sustainable lifestyle, and really hope it can continue, but, it's a minor issue in view of the chance this virus could kill so many humans, and perhaps other animals that are our food sources and collapse the world economy. I'm hoping for a fizzle out, but, I am less secure that that will happen as days wear on. I am sure there are many different scenarios this could take, and it's all conjecture at this point.

I assume mice and rats are not in the avian flu loop. Mink is interesting. We used to have a lot of mink farms here, along with the dairy farms. I hear the Chinese like Midwestern mink, and there has been talk of bringing mink farming back here. Mink were linked to spongiform encephalopathy outbreaks in the 1950's.

I hope they find some answers soon.

Thanks for all your responses.

Welcome AnnaLisa!

As you've seen, FluTrackers is the right place to find answers.

We commend you on your pursuit of a sustainable living style. If you manage a flock, more information will always be better in this type of potential crisis. As each day passes, we, like you, grow more concerned that improper surveillance depth is actively closing doors to public health solutions.

You'll be well-informed by taking an hour to overview our discussion on the genetic sequence thread because higher-level topics are covered related to the potential emergence in the United States. From detail reviews of the genetic database, our analytics show that emergent H7N9 or a precursor is currently influencing human influenza genetics in the United States and other countries identified on the GISAID thread.

If you have children or grandchildren under 5 who have access to your home, your additional vigilance of gathering a wide spectrum of information now will prepare you to offer a safer haven.

 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Welcome AnnaLisa!

As you've seen, FluTrackers is the right place to find answers.

We commend you on your pursuit of a sustainable living style. If you manage a flock, more information will always be better in this type of potential crisis. As each day passes, we, like you, grow more concerned that improper surveillance depth is actively closing doors to public health solutions.

You'll be well-informed by taking an hour to overview our discussion on the genetic sequence thread because higher-level topics are covered related to the potential emergence in the United States. From detail reviews of the genetic database, our analytics show that emergent H7N9 or a precursor is currently influencing human influenza genetics in the United States and other countries identified on the GISAID thread.

If you have children or grandchildren under 5 who have access to your home, your additional vigilance of gathering a wide spectrum of information now will prepare you to offer a safer haven.


Thanks for the welcome. I will read as much as I can and endeavor to understand some of the genetics of this, which is a bit over my head.

I DO have children under the age of 5. I am 60 and my husband is 62 but we are raising a child of 3. Our grandson is living with us, so we are active seniors, lol. I also have other grandchildren who are under the age of 5 who come to our home. I care for one other grandchild on a regular basis at her home one day per week as well. They don't have a lot of access to the chickens or their area, and once we confine them, they should have no contact other than to look at them from afar. We do have some biosecurity measures in place. Because we have a little one, I think I have been more cautious than many due to a fear of salmonella. At times tho, lol, I would love to know what antibodies we already have!!
 
Re: China - 9.25% of Known H7N9 Cases are Farmers by Profession Suggesting Extensive Spread on Farms in Affected Areas

Thanks for the welcome. I will read as much as I can and endeavor to understand some of the genetics of this, which is a bit over my head.

I DO have children under the age of 5. I am 60 and my husband is 62 but we are raising a child of 3. Our grandson is living with us, so we are active seniors, lol. I also have other grandchildren who are under the age of 5 who come to our home. I care for one other grandchild on a regular basis at her home one day per week as well. They don't have a lot of access to the chickens or their area, and once we confine them, they should have no contact other than to look at them from afar. We do have some biosecurity measures in place. Because we have a little one, I think I have been more cautious than many due to a fear of salmonella. At times tho, lol, I would love to know what antibodies we already have!!

You do have substantial priorities on this matter then, don't you!
 
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