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China- Reporter interview with Zhong Nanshan on H7N9 bird flu outbreak

Pathfinder

Editor, Senior Moderator
Zhong Nanshan: H7N9 bird flu prevention is to master the key market segments

At 09:21 on February 26, 2014Source: Sohu health
  
February 22, Tenth International Conference held in Beijing collateral disease, respiratory disease known experts, the Chinese Academy of Engineering academician Zhong Nanshan attend. Meeting space, Zhong Nanshan on H7N9 bird flu outbreak accept reporter interview.
  
Reporter: H7N9 avian flu trends How? What recommendations for prevention and control?
  
Zhong Nanshan: China last year was 134, this year, probably close to 200, so this probably has more than 340 total. Just two months of this year, growing fast. This is worthy of our attention. But for the "popular", must have a clear concept. Generally popular is the ability to person to person, or is distributed, because human transmission is possible to form aggregation, in order to constitute a threat to society. For now, bird flu is essentially sporadic. Over 300 now should noteworthy is the high mortality rate, approximately 30.3% can be confirmed, it should be said that most of the patients are critically ill, and this situation is more serious. But the basic situation, now is not the existence of a positive human transmission phenomenon. Once someone successor phenomenon, it will cause a lot of burden on the social and economic instability.
  
Protection against bird flu, the agriculture sector and the long-term there are some differences in the health sector, the agricultural sector that: First, a large number of poultry farms found no H7N9 virus, keep it at home some did not. Often what kind of situation happen? Own farm or domesticated birds, once to the market, there are some exchange and interaction when it infected, chickens infected people also infected. Therefore, we have found that the infection of human and environmental markets where poultry chicken bird flu virus carrying a marked increase in the past few survey is generally 0.1%, can now be up to 8% or even 30%. So the key is to master the prevention of market segments, now in Guangdong, Zhejiang and other places have been performed temporarily closed for some time, to avoid human contact with the virus in live bird markets. In addition to H7N9, the avian virus will not get sick, sick person spread, which is contradictory. The key now is not to kill all the birds, the key is to avoid contact with the market. So since closed, many cases of Guangdong and Zhejiang new hair less, this is an immediate effect, generally there is a latent period of bird flu, the incubation period three or four days the original infection also continues to occur once in circulation will be little to stop the market. So this is the most critical protective approach.
  
Reporter: In the current research progress, the future treatment of such patients experience what can? The latest vaccine development status, will not be large-scale use?
  
I stayed in the intensive care unit for several months, because of the recent situation in Guangdong are more first-hand information from the point of view, the presence of avian influenza viruses in the past that in view of the human respiratory tract is about seven days time is not right. In the body can detect influenza viruses, even if aggressive treatment of critically ill patients but also the presence of at least two weeks, and some people have even been to death. It is a discovery.
  
The second discovery, we come out to be negative dipstick test does not mean the virus was negative. Deep cough up sputum, or suck out secretions deep is often positive, the positive dipstick test is often negative after eight days, ten days, two weeks there.
  
Third, we find a very important rule, the higher the viral load, the load is called the content reproduction or it is higher, the more severe patients.
  
Fourth, the anti-viral drugs, with five days to seven days past that on the line, now looks for critically ill patients simply can not, at least take two weeks, three weeks, we usually wait until the virus began stopping all negative two days later. As are we going to increase the dose, we have not been well explained.
  
For vaccines, and now China is fully developed, done a lot of preparatory work, but I think now is not the time to develop a vaccine into production. We know that the vaccine is universal immunization, as H1N1 is probably close to over ninety million at the end of 2009, nearly one million people vaccinated. But then H1N1 less fat, in the end due to the effect of the vaccine, or due to disease slowly declining trend throughout the world is not good to say, so the effect of the vaccine has not been very convincing show. Was developed because H1N1 vaccine is person to person, but now H7N9 is sporadic. Then distribute the vaccine at most, some people may be in contact with poultry, but as a universal vaccination, I do not think fit.
  
Sporadic cases now, China is now being developed antibodies against avian influenza because ten years ago using plasma treatment and rehabilitation of patients is very effective. China now has teams in research, preclinical been basically over, man against H7N9 humanized antibody, I think it is very promising. We hope to be able to more quickly into the clinic, the patient is for some heavy gospel. Because there are a lot of heavy presence of the virus patient with antibodies to destroy the virus is the best way.
  
Reporter: H7N9 avian bird flu as people were suffering from the disease, its prevention and control needs of the health sector and the agricultural sector to work together, your stage for cooperation between the two departments have any comments?
  
Zhong Nanshan: there is still much room for improvement in cooperation at this stage. At first there were a lot of people not suspected of H7N9 from birds to, but over time, we observed more than 90% are in contact with live poultry in markets after infection, so it is an indisputable fact that the agricultural sector is now beginning to accept this view. In other countries, is now basically concentrated poultry breeding farms, live bird in the market and there was little trading in Hong Kong 90% chilled listing, centralized slaughtering, leaving only 10% passed strict inspection traded in the market. I think we should go our way, Guangdong now has developed a plan to prepare for centralized slaughtering chilled market. But to overcome these two problems, one is now in the whole chain is not perfect, centralized slaughter, chilled listed in a transition process. Centralized slaughtering sector has a lot of facilities, including refrigerators, freezers are not yet done. After still closed, dozens of million compensation for chicken farmers have not been resolved. So these issues should have government support to complete, so I think now is a concentrated feeding direction, but the agenda should focus on slaughter, in fact, now come on the agenda. I know that Guangdong has already begun to do that. Also like chilled seafood for Taiwanese food culture, centralized slaughtering chilled listed only one way to go. The emergence of H7N9, has greatly promoted the government's determination to focus on slaughter. That future is gradually concentrated breeding, slaughter chilled concentrated in big cities listed, has entered a specific substantive process. So I think now gradually ease the contradiction between the two departments.

zhttp://health.sohu.com/20140226/n395665752.shtml
 
Re: China- Reporter interview with Zhong Nanshan on H7N9 bird flu outbreak

Translation Google


Zhong Nanshan: H7N9 avian virus inductive therapy does not appear sequelae

At 9:06 on February 27, 2014 Source: Sohu health
  
February 22, Tenth International Conference held in Beijing collateral disease, respiratory disease known experts, the Chinese Academy of Engineering academician Zhong Nanshan attend. Meeting space, Zhong Nanshan on haze and flu-related matters to accept a reporter interview.

Reporter: Beijing heavy haze, influenza is relatively heavy, in this case, how to protect the public, who should be the hospital how to monitor and improve? For Integrative Medicine, is the concept of Chinese medicine diagnosis and treatment of Western medicine to penetrate them, but not all will use Western medicine approach, that we should be how to safer, more effective treatment to complete it?
  
Zhong Nanshan: Last night I came out on the sore throat, and you have a cold , do this with Beijing haze quite serious. But the relationship between haze and the flu has not yet convincing research, because PM2.5 is actually a carrier, it affects the human body itself, but whether it will be something attached to the viral particles have not yet been clear research, it is not possible to prove that the data can be increased haze days influenza occur.
  
Another synergistic effect of influenza occur once the patient has the flu, or the patient due to respiratory haze, respiratory defense system being under the influence cases, it may be more susceptible to the flu. Now a lot of research data on the presence of haze effects on the respiratory system and heart, and may in the future be more research. I am glad that now pay close attention from the central haze pollution began, and use it as leaders at all levels to measure performance, I very much agree.
  
You talk about the second question, it should be said that more and more of Western medicine began to believe, and I believe it is an alternative type of treatment, and in some ways better than Western medicine. This is not a Western change their thinking, the most important thing is to change the methods of traditional Chinese medicine, technology, as well as its way of thinking. Methods of modern medicine now use more medicine, more and more confirmed a lot of drugs are very valuable, and is very good. Doctors who engage in the most important is to look at the result, in the words of an effective medicine, Western medicine why not? My research institutes, as well as the National Key Laboratory of Clinical Research Center has a dedicated group of TCM, and why? I tasted it benefits. I think medicine will always be someone to speak, but it will be more and more people accept the premise is to use modern methods and techniques to illustrate the problem, which can not be subject to any exceptions.
  
Reporter: H7N9 avian influenza antiviral therapy will not be the same as the year SARS treatment of severe sequelae?
  
Zhong Nanshan: Until now we have used anti-viral treatment, there are three, one is oseltamivir, peramivir one is, and the third is zanamivir, these three are all anti-neuraminidase inhibitors . The overwhelming majority of critically ill patients with a double dose, double dose of oseltamivir, peramivir double dose. Two nights ago, I attended a World Health Organization conference call, several countries together to discuss, was raised three times the dose can not be used? Triple dose we still hope to be able to do some clinical observations.
  
SARS sequelae that are two different things, SARS no antiviral drugs, when comparing critically ill patients when, in order to rescue the use of corticosteroids to treat, and corticosteroids and later abused, all high fever, SARS gave him the use of those who have not targeted . The second is what? With large doses. Lecture than when I was in Beijing five times the recommended dose to ten times that many patients had this case osteonecrosis sequelae, which is caused by corticosteroids, antiviral drugs is not caused. So for H7N9 corticosteroid medication we are very cautious, only appears shock , severe sepsis when it is available. So you just asked that question, antiviral drugs will not produce sequelae? Until now we have not found.

zhttp://health.sohu.com/20140227/n395735505.shtml
 
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