WASHINGTON - There is no evidence that the deadly H7N9 bird flu has yet spread between humans in China but health authorities must be ready for the virus to mutate at any time, a top US virologist has warned.
Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases (NIAID), said officials in China had studied more than 1,000 close contacts of confirmed cases and not found any evidence of human-to-human transmission.
"That is powerful evidence because if you had a thousand contacts with someone with the flu you would be pretty sure some of them would have been infected," Fauci said in an interview with AFP.
Nevertheless, Fauci cautioned that authorities needed to be ready for the possibility of the virus mutating and spreading between humans.
"It's unpredictable as are all the influenza. One of the things we need to be concerned about is this might gain the capability of going human-to-human which up to this point has not happened and is somewhat encouraging news," Fauci said.
"But we still need to be very prepared for the eventuality of that happening."
Researchers are already developing a diagnostic test to identify H7N9, along with a vaccine, with clinical trials due in July or August.
"Work is under way on making a diagnostic test to be able to pick it up quickly," Fauci said.
"We have already started on an early development of a vaccine as we did with H5N1 years ago... Hopefully, we will never have to use it."
More than 110 people in mainland China have been confirmed to be infected with H7N9, with 23 deaths, since Beijing announced on March 31 that the virus had been found in humans.
Most of the cases have been located in eastern China, although Taiwan has reported one case. Another case has been found in southern China, while Chinese officials confirmed a further outbreak in the central province of Hunan.
Chinese authorities have identified poultry as the source of the virus and have confirmed that patients became sick from contact with infected live fowl.
A visiting team from the World Health Organization, which wrapped up a week-long visit to China on Wednesday, said there had been no human-to-human transmission but warned H7N9 was "one of the most lethal" influenza viruses ever seen.
Fauci praised Beijing for its handling of the current crisis, contrasting it to the response of the outbreak of severe acute respiratory syndrome in 2002-2003, when China stood accused of covering-up the scale of the crisis.
"It was not the case with SARS in 2003 but the transparency has been excellent," Fauci said. "I am quite satisfied with the Chinese response."
Fauci likened the current H7N9 strain of bird flu "in some respects" to the H5N1 bird flu strain of several years ago.
"The similarities are that it is fundamentally a chicken or bird flu that jumps from chicken to humans and is quite severe when it infects humans," he said.
However, Fauci added: "The difference between H7N9 and H5N1, is that H5N1 kills chickens very rapidly so it is easy to identify where the infected flocks of chickens are. H7N9 doesn't make the chicken sick, so it has been difficult to pinpoint where the infected chickens are."
There have been 566 confirmed cases of the H5N1 strain of bird flu, which killed 332 people in the world -- a mortality rate of 58 percent, compared to 20 percent for the H7N9 bird flu strain.
The H1N1 "swine flu" pandemic o 2009, which appeared in Mexico at the same time of year as the H7N9, eventually infected 60 million people throughout the world and killed more than 12,000.
The 1918 Spanish flu, which has been called one of the deadliest plagues in human history, had a mortality rate of only two percent.
Sunday, April 28, 2013
Saturday, April 13, 2013
Bird Flu Prompts Panic Buying of Herbal Remedy in China (Beijing) Tuesday, April 9, 2013 WILLIAM WAN
(c) 2013, The Washington Post.
BEIJING — Amid growing panic over a new strain of bird flu in China, some officials have prescribed a surprising solution: hot brews of a root called ban lan gen.
With more Chinese cities closing their poultry markets, U.S. scientists rushing to produce a vaccine and the death toll reaching eight on Tuesday, the herb has flown off pharmacy shelves during the past week. Many stores from Shanghai to Guangzhou are sold out. Prices have shot up.
The suggestion from several provincial authorities that people turn to the herb has garnered ridicule online and sparked debate among China's scientific community.
It has also generated some reflection here about the Chinese tendency toward panic buys, which have become an almost-standard reaction to disaster. The easy sway of suggestion and rumor, some say, shows how much is uncertain in modern society and how little — from tainted milk powder to copycat Apple stores — can be trusted.
After the 2011 meltdown of a nuclear plant in nearby Japan, hordes of Chinese rushed to buy personal mountains of salt, on the mistaken belief that it would help mitigate radiation. (It might have eventually, experts later pointed out, but one would die first from the amount required.)
Bottles of vinegar were must-haves in Guangdong during the 2003 SARS epidemic, for its supposed ability to prevent respiratory illness. Then came last year's Beijing floods, in which a man drowned after being trapped in his car. A sudden run on emergency hammers to smash car windows ensued, followed just months later with a run on candles amid worries of darkness during an approaching doomsday prediction.
The most recent run began with a public advisory issued by Jiangsu province, just north of Shanghai, where most cases of the new H7N9 strain have appeared.
The memo, published April 3 on the local government's website, carried a tinge of nationalism, urging experts to "explore and develop the role of Chinese medicine" in treating the new bird flu. It suggested a long list of Chinese herbs for treating infected patients, including ginseng, bamboo, licorice and powder made from bear bile.
But what caught most people's attention was the claim, unsupported by scientific evidence, that ban lan gen could prevent infection in the first place.
The next day, after Shanghai authorities made their own plug for the root at a news conference, shop owners in the region sold out almost instantly. China's equivalent of eBay lit up with orders.
Authorities in nearby Nanjing were so incensed at the bedlam in stores there that they issued two advisories last weekend banning increases in ban lan gen prices and forbidding public suggestions that it can prevent bird flu.
Curiously, on the same day of the Jiangsu memo, the western province of Gansu issued a memo as well, suggesting facial massages of key acupuncture pressure points could also prevent H7N9. (Alas, no panicked runs on facial massages have been reported — perhaps because Gansu health officials have been dinged before for their medical advice, notably pushing pig's feet in recent years as a cure-all.)
Ban lan gen, however, has been a particular favorite for China's panic buyers. It caught public attention during the 2003 SARS epidemic, then resurfaced during the H1N1 swine flu and the previous H5N1 strain of avian flu.
Derived from the root of a flowering plant called woad, or Isatis tinctoria, ban lan gen's reputation as a cure-all has a certain logical appeal for many in China, where it is widely used to combat the common cold.
In the parlance of traditional Chinese medicine — focused on balancing yin and yang, hot and cold, in the body — ban lan gen is valued for its antiviral properties as a "clear heat," said Yang Liteng of Southern Medical University in Guangzhou.
The view of Yang, an expert in integrating Chinese and Western medicine for respiratory diseases, reflects the vast majority of China's medical community — that ban lag gen may have proved helpful for viruses in the past, but lacks proof for treating H7N9.
"In the first 24 hours of the common cold, ban lan gen can restrain the virus and is helpful," Yang said. In the case of H7N9, however, Yang said it's too soon to tell, calling the Jiangsu advisory irresponsible because "there is no scientific evidence showing that it is helpful."
But with relatively mild side effects, ban lan gen would be harmful only to those with already weak constitutions, Yang said.
For the most part, central health authorities have avoided weighing in on the ban lan gen debate.
The World Health Organization, the lead international agency in the crisis, has been similarly diplomatic. "The main recommendation in our clinical guidelines for treatment is the prompt administration of neuraminidase inhibitors," a type of anti-influenza drug, WHO spokesman Gregory Hartl said in an email. "We do not have enough evidence to comment on the efficacy of traditional medicines, although we know there have been reports of their efficacy."
But some people have had a field day with the conflicting government advisories on the root remedy, especially online, one of the rare places where criticism of Chinese officials is possible. In one especially popular Internet meme, bloggers have been sarcastically tweeting traditional poems but replacing key words with "ban lan gen" in mock praise of its good-for-any-situation properties.
While skepticism abounds, there are many other steps Chinese as well a WHO experts agree that the public should be taking, such as only eating fully cooked poultry, avoiding contact with birds and washing hands frequently.
Perhaps sensing a rare opening for unsolicited public health advice, Yang, the medical professor, did not hesitate to tack on a few precautions that never hurt anyone: "Adopt a clean living style and a healthier diet. And do some physical exercise."
bc-china-herbal (TPN)
BEIJING — Amid growing panic over a new strain of bird flu in China, some officials have prescribed a surprising solution: hot brews of a root called ban lan gen.
With more Chinese cities closing their poultry markets, U.S. scientists rushing to produce a vaccine and the death toll reaching eight on Tuesday, the herb has flown off pharmacy shelves during the past week. Many stores from Shanghai to Guangzhou are sold out. Prices have shot up.
The suggestion from several provincial authorities that people turn to the herb has garnered ridicule online and sparked debate among China's scientific community.
It has also generated some reflection here about the Chinese tendency toward panic buys, which have become an almost-standard reaction to disaster. The easy sway of suggestion and rumor, some say, shows how much is uncertain in modern society and how little — from tainted milk powder to copycat Apple stores — can be trusted.
After the 2011 meltdown of a nuclear plant in nearby Japan, hordes of Chinese rushed to buy personal mountains of salt, on the mistaken belief that it would help mitigate radiation. (It might have eventually, experts later pointed out, but one would die first from the amount required.)
Bottles of vinegar were must-haves in Guangdong during the 2003 SARS epidemic, for its supposed ability to prevent respiratory illness. Then came last year's Beijing floods, in which a man drowned after being trapped in his car. A sudden run on emergency hammers to smash car windows ensued, followed just months later with a run on candles amid worries of darkness during an approaching doomsday prediction.
The most recent run began with a public advisory issued by Jiangsu province, just north of Shanghai, where most cases of the new H7N9 strain have appeared.
The memo, published April 3 on the local government's website, carried a tinge of nationalism, urging experts to "explore and develop the role of Chinese medicine" in treating the new bird flu. It suggested a long list of Chinese herbs for treating infected patients, including ginseng, bamboo, licorice and powder made from bear bile.
But what caught most people's attention was the claim, unsupported by scientific evidence, that ban lan gen could prevent infection in the first place.
The next day, after Shanghai authorities made their own plug for the root at a news conference, shop owners in the region sold out almost instantly. China's equivalent of eBay lit up with orders.
Authorities in nearby Nanjing were so incensed at the bedlam in stores there that they issued two advisories last weekend banning increases in ban lan gen prices and forbidding public suggestions that it can prevent bird flu.
Curiously, on the same day of the Jiangsu memo, the western province of Gansu issued a memo as well, suggesting facial massages of key acupuncture pressure points could also prevent H7N9. (Alas, no panicked runs on facial massages have been reported — perhaps because Gansu health officials have been dinged before for their medical advice, notably pushing pig's feet in recent years as a cure-all.)
Ban lan gen, however, has been a particular favorite for China's panic buyers. It caught public attention during the 2003 SARS epidemic, then resurfaced during the H1N1 swine flu and the previous H5N1 strain of avian flu.
Derived from the root of a flowering plant called woad, or Isatis tinctoria, ban lan gen's reputation as a cure-all has a certain logical appeal for many in China, where it is widely used to combat the common cold.
In the parlance of traditional Chinese medicine — focused on balancing yin and yang, hot and cold, in the body — ban lan gen is valued for its antiviral properties as a "clear heat," said Yang Liteng of Southern Medical University in Guangzhou.
The view of Yang, an expert in integrating Chinese and Western medicine for respiratory diseases, reflects the vast majority of China's medical community — that ban lag gen may have proved helpful for viruses in the past, but lacks proof for treating H7N9.
"In the first 24 hours of the common cold, ban lan gen can restrain the virus and is helpful," Yang said. In the case of H7N9, however, Yang said it's too soon to tell, calling the Jiangsu advisory irresponsible because "there is no scientific evidence showing that it is helpful."
But with relatively mild side effects, ban lan gen would be harmful only to those with already weak constitutions, Yang said.
For the most part, central health authorities have avoided weighing in on the ban lan gen debate.
The World Health Organization, the lead international agency in the crisis, has been similarly diplomatic. "The main recommendation in our clinical guidelines for treatment is the prompt administration of neuraminidase inhibitors," a type of anti-influenza drug, WHO spokesman Gregory Hartl said in an email. "We do not have enough evidence to comment on the efficacy of traditional medicines, although we know there have been reports of their efficacy."
But some people have had a field day with the conflicting government advisories on the root remedy, especially online, one of the rare places where criticism of Chinese officials is possible. In one especially popular Internet meme, bloggers have been sarcastically tweeting traditional poems but replacing key words with "ban lan gen" in mock praise of its good-for-any-situation properties.
While skepticism abounds, there are many other steps Chinese as well a WHO experts agree that the public should be taking, such as only eating fully cooked poultry, avoiding contact with birds and washing hands frequently.
Perhaps sensing a rare opening for unsolicited public health advice, Yang, the medical professor, did not hesitate to tack on a few precautions that never hurt anyone: "Adopt a clean living style and a healthier diet. And do some physical exercise."
bc-china-herbal (TPN)
Friday, April 5, 2013
H7N9 bird flu strain has worrying traits
PARIS: A mutated bird flu virus that has killed five people in China displays worrying traits that warrant high vigilance, experts say, though the true extent of the threat is unclear.
Most concerning is the virus' wide geographical spread, and the fact that it seems to be spreading unseen among its host animals, possibly chickens or ducks.
"I am cautiously worried," virologist John Oxford of the Queen Mary University of London told AFP.
"If there were four cases in Shanghai, I would be much less concerned, but because it is so geographically widespread I think it is trying to tell us something.
"It is not a deadly virus for chickens so it could spread in chickens without anyone knowing it. I suspect it's probably wider than we think."
Having made its jump from animals to humans, which required a series of genetic mutations, the influenza A(H7N9) strain has now been diagnosed in four Chinese provinces: Jiangsu, Zhejiang, Anhui and the business capital Shanghai.
Of 11 people confirmed infected, five have died since February. Patients suffer from severe pneumonia with a fever, cough and shortness of breath.
The better-known H5N1 bird flu, which has infected 622 people since 2003 of whom 371 died, is highly fatal in birds, making it easier to identify than the new strain.
According to the World Health Organisation (WHO), the animal source of the new infection and its mode of transmission was not yet clear.
"We do not yet know enough about these infections to determine whether there is a significant risk of community spread," the UN's health agency stated in an online H7N9 update.
No cases of human-to-human transmission have yet been found, and no infections beyond China.
"Any influenza that jumps from an animal species to a human has pandemic potential," Alan Hampson, chairman of the Australian Influenza Specialist Group, said in a statement issued by the Science Media Centre.
"If it learns to spread in humans, if it actually acquires that ability, then it's a high likelihood that it will become pandemic."
Chinese authorities are monitoring about 400 people who had been in contact with those taken ill, but have found no one with symptoms.
Since humans had not been exposed to this particular strain of flu until now, we have no immunity and would be highly susceptible.
There is no preventive vaccine.
Preliminary tests have shown the virus would react to existing antiviral drugs like Tamiflu, according to the WHO.
The UN agency has advised against airport screening and any Chinese travel or trade restrictions for now, recommending good hygiene as the best course of action - regular and thorough hand washing, avoiding diseased animals and properly cooking all meat.
It has started work on developing a vaccine, which must be strain specific, but observers fear it would be too late to deal with a potential H7N9 outbreak.
The experts and the WHO all point to the unpredictability of influenza viruses, saying this strain could fizzle out just as easily as it could kickstart an epidemic.
It is common for flu viruses to mutate, but only once in about five years do they cross the species barrier, and rarely with grave effects for humans.
"This one looks bigger because so many people have died," said Oxford.
"We just have to wait and see. We will know within the next couple of weeks whether anything serious is going to happen." -AFP
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