Thursday, December 12, 2013

H7N9: Roundup of Reports From Hong Kong & Shenzhen

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# 8063

 

 

While follow up reports from Hong Kong’s CHP continue to indicate no additional cases of H7N9 infection have been detected (see 12 December 2013 update Epidemiological investigation and follow-up actions by CHP on two confirmed human cases of avian influenza A(H7N9)), experts remain concerned over the possibility of seeing more human cases in neighboring Guangdong Province, particularly since the trade in live birds continues (see SCMP report below), at least at some of the markets in Shenzhen.

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A tour then of recent comments by Hong Kong’s SFH, Dr. Ko Wing-man, virologist Dr. Guan Yi from the University of Hong Kong, and infectious disease specialist  Ho Pak-leung – also of the University of Hong Kong, and a curious change in China’s 2014 Holiday Schedule. 

 

First, this exchange between reporters and Dr. Ko Wing-man on the importation of chickens from Guangdong Province.

SFH on avian influenza A(H7N9)


Following is the transcript of remarks made by the Secretary for Food and Health, Dr Ko Wing-man, after attending a public function this morning (December 12):


Secretary for Food and Health: The Centre for Health Protection has received notification that (three) specimens from two live poultry markets in Shenzhen were tested positive for the avian influenza A(H7N9) virus. I think this is an evidence further supporting experts' opinion that part of the live poultry in Shenzhen has already been infected with the virus. But up to this stage, there is no concrete evidence to substantiate the direct relationship between these positive specimens and the source of infection of the two human cases of avian influenza A(H7N9) in Hong Kong. Therefore, we will maintain the arrangement to suspend live poultry import from Shenzhen farms for the time being.

Serology test is a more sensitive test (used to) detect the antibodies of the poultry, which gives us an idea of how wide the virus is spreading among the poultry population. The test, however, has its own limitation as well. Because even there are specimens tested positive (for the virus) in the serology (test), we cannot draw a direct conclusion that the live poultry (in question) would be infectious.


Reporter: (On avian influenza A(H7N9).)


Secretary for Food and Health: I think experts have pointed out that the positive finding of the (avian influenza A)H7N9 virus in the environmental specimens from two Shenzhen markets actually highlighted the possibility that sporadic human cases (of infection) after contacting poultry will continue. However, up to this moment, there is no evidence showing that the virus is being transformed into a shape that it can be sustainably transmitted among humans.

 


Dr. Guan Yi, who played a huge role in the identification of the SARS virus a decade ago, is featured in The Hong Kong Standard report entitled (H7N9 found in Shenzhen markets by Eddie Luk and Mary Ann Benitez), where he warns:

 

Hong Kong bird flu experts warned that H7N9 remains "the biggest threat to public health" as it has a high chance of becoming endemic if not eradicated early.

"The virus is suddenly spreading out [in parts of the mainland]," said professor Guan Yi, director of the State Key Laboratory of Emerging Infectious Diseases at the University of Hong Kong.

"There is a high chance that the virus will become endemic. It must have been circulating for a long time in this region."

Guan said the discovery of samples of H7N9 in chicken markets in Shenzhen is "not surprising because we have human cases."

 

Also in the same article, Dr. Ho Pak-leung urged the Hong Kong government to consider asking   `local poultry stalls to suspend business until after the Lunar New Year’.   Ho warned they could see a `second wave’  of cases this winter sometime around the Lunar New Year.


Whether these concerns will translate into the closure of live markets in Shenzhen remains to be seen.


You may recall that earlier this month we saw reports (see Shanghai To Close Poultry Markets Over Lunar New Years To Curtail H7N9) that the sale of live poultry would be suspended from the end of January until the end of April.

 

In what could turn out to be a related story, Reuters is reporting this morning on a controversial change in China’s 2014 official holiday schedule which will impact next year’s Lunar New Year’s celebrations, which involves the largest single migration of humans on the planet each year.

 

Chunyun, or the Spring Festival travel season, begins about 15 days before the Lunar New Year and runs for about 40 days total, during which time more than 2 billion passenger journeys will be made (mostly via crowded rail and bus) across Asia.

 

This year’s revised schedule (released only yesterday)  makes the Lunar New Year’s Eve a workday, putting a major crimp in the travel plans of millions of people who plan to return home for their traditional New Year’s Dinner. 

 

China's revised 2014 holiday schedule sparks public ire

SHANGHAI Thu Dec 12, 2013 2:30pm IST

(Reuters) - China has designated the eve of Lunar New Year as a working day in 2014, triggering an outcry over the disruption of plans to celebrate the year's most important traditional holiday.

Each year in mid-December, the government announces public holidays for the following year.

They often follow a similar pattern, but next year's schedule, announced late on Wednesday, has surprised and angered many, as the Spring Festival holiday is when millions travel home to be reunited with families, many for the only time in the year.

(Continue . . . )

 

I’ve no idea if this abrupt decision has anything to do with China’s concerns over the spread of H7N9, but it has the potential to affect the amount of travel during a perennial period of elevated concern by infectious disease specialists (see The Impact Of Mass Gatherings & Travel On Flu Epidemics).

 

Unfortunately, what may seem like reasonable preventative steps to us - like the closing live bird markets - carries with it tremendous societal, political, and economic costs in China. 

 

So we may continue to see reluctance on the part of local officials to act decisively as long as human infections remain sporadic and under control.