Friday, April 12, 2013


The new "bird flu" (H7N9) virus in eastern China is claiming more victims. Official statistics now estimate the number of illnesses at 43 and deaths at 11. China, and other countries, particularly the neighboring ones, continue to worry that this might be turning into the next big pandemic. In fact these days it seems to be a toss-up as to whether North Korea's threats or H7N9 is creating more jitters among governments and the public.

There are several disturbing aspects of this new virus, even apart from the fact that this virus has crossed the species barrier from animals to humans. One is that we can't really place much confidence in the numbers reported for at least two reasons - maybe three (the third one being politics, but I am not going to discuss that).

In such situations, many more illnesses always occur than ever get into the official statistics. It is the same in the United States, Britain, Canada, Europe, and elsewhere. People don't always go to the doctor, and the doctor doesn't always get around to reporting right away, even if he or she is alert for H7N9 symptoms. Or, reports get delayed in the bureacracy.

Also, we don't have much information on the nature of H7N9 symptoms. In worst human cases - those that get diagnosed - victims have reportedly have severe respiratory symptoms, high fever, tend to cough and have shortness of breath. Think of a bad case of pneumonia.

A second reason for underestimation of numbers - and for concern - is that the disease seems to be very severe in humans, even though it appears mild and almost without symptoms in birds. At the same time, we can't be sure at this point as to whether there are also milder human cases occurring which are not reported, or, a-symptomatic carriers, who could be spreading the virus - that is, if it turns out to be spread by person-to-person contact.

And of course, a major reason for concern is that we don't really know how to avoid getting ill since there is still no certainty among the experts on how you catch it. The World Health Organization's advice is currently very broad, and focuses on personal hygiene, respiratory hygiene, avoiding direct physical contact with live animals in markets or farms where there have been illnesses, being careful about how you prepare (handle) raw meat, and making sure your meat is well cooked.

Here is WHO's food safety advice as it currently stands (note by the way, that "diseased aninmals" in the case of this virus will be very difficult to identify as they usually don't show symptoms):

Influenza viruses are not transmitted through consuming well-cooked food. Because influenza viruses are inactivated by normal temperatures used for cooking (so that food reaches 70°C in all parts— "piping" hot — no "pink" parts), it is safe to eat properly prepared and cooked meat, including from poultry and game birds.

Diseased animals and animals that have died of diseases should not be eaten.

In areas experiencing outbreaks, meat products can be safely consumed provided that these items are properly cooked and properly handled during food preparation. The consumption of raw meat and uncooked blood-based dishes is a high-risk practice and should be discouraged.

Remember too, that in the case of the previous "bird flu" the evidence suggested that many people who became ill caught the virus through handling (as in preparation for cooking) of diseased birds.

The good news is that, according to Shanghai authorities,the H7N9 virus remained sensitive to the drug Tamiflu. But, to get effective treatment, you would have to be diagnosed early. That's yet another reason to be alert.

All this advice is still rather premature for much of the world, but it is better to be prepared, in case. After all, with so much travel these days, including to Shanghai, which is an important financial center, diseases travel too.

To your good health,


UPDATE: April 14 - The virus has now spread to Beijing. A case of a young girl was reported today. This is the first case outside eastern China.
UPDATE: April 16: As this post speculated, there may be milder versions of the disease in humans, or a-symptomatic carriers. This has now been discovered to be true. A 4-year old child near Beijing was declared an a-symptomatic carrier today.
UPDATE: April 16: Latest numbers are 77 confirmed illnesses and 16 deaths.

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