New bird flu strand could be linked to dead pigs in Shanghai river

WantChinaTimes.com ^ | 04/01/13 | Staff

[Brian Kopp DPM]

New bird flu strand could be linked to dead pigs in Shanghai river: expert

• Staff Reporter
• 2013-04-01
• 15:37 (GMT+8)

A worker cleaning up dead pigs out of the river. (Photo/Xinhua)

The new strand of the bird flu that has already killed two people and left another critically ill in eastern China could be linked to the thousands of dead pigs found floating in a Shanghai river last month, according to a Hong Kong infectious disease expert.

China's Ministry of Health and the National Health and Family Planning Commission announced on Sunday the world's first reported cases of the H7N9 virus, a new subtype of the avian influenza. The virus has already killed two men, aged 87 and 27, from Shanghai, while a 35-year-old woman from Anhui province remains in critical condition.

Health authorities said there is currently insufficient data to suggest that the new strand could spread among humans, especially as 88 close contacts of the three had tested negative for the virus. As of now there is no vaccine available.

Ho Pak-leung, director of the Infectious Disease Center at the University of Hong Kong, told reporters that the H7N9 cases could be related to the 10,000-plus pig carcasses that were pulled out of Shanghai's Huangpu River since early March. Local media reports attributed the mass dumping to a swine epidemic earlier in the year.

While there is no concrete evidence to suggest a definitive link between the two, the fact that the 27-year-old victim was a pork seller means health departments should collect samples of the dead pigs to see if they have been affected by the same virus, Ho said.

The previous outbreak of the highly pathogenic bird flu that first struck China in 2003 belonged to the H5 subtype, Ho said. This time the human infection appears to be different and suggests that this strand of the avian influenza might be evolving.

Ho is not the only person to draw a link between the new bird flu and the pig carcasses. Yuen Kwok-yung, a professor in the microbiology department at the University of Hong Kong, told reporters that while the H7N9 subtype should be low pathogenic, the virus could have mutated after infecting the pigs. However, Yuen urged the public not to panic until all necessary tests have been carried out.

Many of China's internet users have also drawn a direct relationship between the flu and the pigs, with some saying it is obvious that birds passed the virus to pigs, which were then consumed by humans.

Huang Li-min, the director of infection in children at National Taiwan University Hospital, said the recent deaths in China are not a coincidence and that the fatality rate could be high if the virus turns out to be highly pathogenic. The virus does not necessarily have to go from bird to pig to human; it is possible that the virus could be transmitted directly from birds to humans, Huang said, adding that at this stage, the disease should be controllable as long as it is not spread from human to human.

[Brian Kopp DPM]

Something to keep an eye on: new H7N9 avian flu with genetic mutations to infect humans.

Commentary

H7 Q226L In Shanghai and Anhui H7N9 Cases
Recombinomics Commentary 20:15
April 1, 2013 The recent H7N9 cases in China have caused considerable concern.  This serotype had never been found in humans previously and only one fatal bird flu case that was not H5N1 had been reported (H7N7 in The Netherlands in 2003.  Two of the H7N9 cases were fatal (87M and 27M), while one was critical (35F).

The WHO Chinese Influenza Research Center released a full set of sequences for all three cases.  Each had PB2 E627K, as well as a 15 BP deletion In N9.  PB2 E627K is a mammalian adaptation and was present in both H5N1 transmission experiments (CDC and EMC) which used an avian PB2.

All three of the H5N1 transmission studies introduced the receptor bind domain change Q226L to increase affinity for mammalian receptors. 

Q226L has never been reported in natural H5N1 isolates.

Two of the H7N9 cases, A/Shanghai/2/2013 and A/Anhui/1/2013 have Q226L, raising serious pandemic concerns.

[null and void]

Bring Out Your Dead

Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.

The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.

So far the false positive rate is 100%.

At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.

*sigh* Such is life, and death...

[Safetgiver]

Ho Hum

[nitzy]

However, Yuen urged the public not to panic until all necessary tests have been carried out.

So we are supposed to panic, just not yet.

[vetvetdoug]

This strain would be a kick in the tail...our vaccines are geared to H1N1 strains. I watched H3N8 jump species and it was a over a year before anyone got a handle on the disease.

[Gaffer]

I wonder how involved our CDC is involved. If so, treat information from this like the plague. They are incompetent poltical functionaries.

[Boogieman]

I think when you live in a country where thousands of dead pigs can be found floating in the river, you should always be prepared to panic at a moment’s notice.

[tet68]

The virus does not necessarily have to go from bird to pig to human; it is possible that the virus could be transmitted directly from birds to humans, Huang said, adding that at this stage, the disease should be controllable as long as it is not spread from human to human.

Should be controllable...I somehow find no solace in
that statement.

[DCBryan1]

I think when you live in a country where thousands of dead pigs can be found floating in the river, you should always be prepared to panic at a moment’s notice.

This is how World War Z starts.

[ZX12R]

I think when you live in a country where thousands of dead pigs can be found floating in the river, you should always be prepared to panic at a moment’s notice.

It does make it look like a filthy and disease ridden place, doesn't it? Do they get drinking water from that river? Sounds like a disgusting place.

[Boogieman]

I guess it’s still slightly better than the Ganges, where they regularly dump HUMAN bodies in the main water source for millions of people.

[American in Israel]

Local media reports attributed the mass dumping to a swine epidemic earlier in the year.

Imagine someone selfish enough to throw thousands of pigs into a river to float his problems on everyone downstream.

Imagine people drinking water from that river.

Communism is the most selfish of governments in history, with the most hypocritical history of being "for the people".

[informavoracious]

Angry Birds!

[ZX12R]

I guess it’s still slightly better than the Ganges, where they regularly dump HUMAN bodies in the main water source for millions of people.

I've seen pictures of what you speak. And people still go swimming, washing and drinking among the carcasses. India is another filthy hellhole.

[Brian Kopp DPM]

Shanghai H7N9 Familial Cluster Chronology Supports H2H [human to human transmission]
Recombinomics Commentary 23:00
April 1, 2013

in the third case, he hadn’t left his home for two weeks before he started to get a fever. So based on what we have now, we still don’t know what the source of the infection was.”
 
According to Shanghai No. 5 People's Hospital, the three members of the Li family were admitted between February 14 and 24 for symptoms including a high fever and coughing. All three were diagnosed as having pneumonia. The 69-year-old son recovered and was discharged but the 55-year-old died from severe pneumonia and respiratory failure in late February. The father died of multi-organ failure.

The above comments indicate that the confirmed case (87M) in the above cluster has no exposure to birds or people outside of his house.  Media reports and the April 1 WHO update indicate disease onset was February 19.  This one or both of his sons (see blue above) were hospitalized prior to his disease onset, strongly suggesting that one or both were the source of his infection.  Both sons had similar systems and one (55M) died (as did the father, 87M).
 
These dates and contacts signal human to human transmission in this family, as expected from the sequences from the three confirmed cases, which include the 87M.  All three have PB2 E627K as well as a 15 BP deletion in N9.  Two of the confirmed cases, A/Shanghai/2/2013 and A/Anhui/1/2013 were most closely related to each other and had the receptor binding domain change Q226L, (added to all  three H5s in transmiison studies) which would likely increase human to human (H2H) transmission.  The age and collection dates for the two male confirmed cases (87M and 27M) were withheld.  However samples as usually number chronologically, so it is likely that A/Shanghai/1/2013 is from the 87M, since his disease onset was more than a week earlier than the unrelated case (27M).

Regardless of the assignment, the above bird flu H7N9 cluster strongly suggests that all three family members were infected and one or both sons infected their father. 

Although WHO maintains there is no evidence of  H2H based on confirmed cases, the above cluster has disease onset dates that support H2H transmission, as expected due to the genetic changes in these sequences.

[Brian Kopp DPM]

[Brian Kopp DPM]

[Safetgiver]

Abortions cause $55 of all breast cancer. Studies are there, I’m not going back to look for them. Ever hear the CDC say crap about that? NOOOO, of course not.

[Safetgiver]

55%, asshat.