Scott McPherson's Web Presence

The Australian virologist Dr. Ian Mackay's blog, Virology Down Under, is a great place to go to read -- and see the visual representatio nof -- the latest on H7N9. It has become one of my "go-to" sites for updates and assumptions.

Please check this site out.  It will help you draw conclusions that you simply cannot visualize when reading the static data.

Of particluar help is his chart showing the individual cases against the backdrop of such things as the culling of poultry in the major sities reporting H7N9 cases.  If the birds were, indeed, the culprit, then we should see a decline in the number of human cases. 

Dr. Mackay's summation:

Some things we don't know...

How may are infected without obvious signs of infection

[With thanks to Dr. Katherine Arden for contributing to the questions and thoughts below]

 

• The source of the human infection
• Whether human-to-human transmission is occurring
• The scope of H7N9 genetic change in real-time (too few sequences to date)
• The nature, specificity and effectiveness of H7N9 assays
• The seroprevalence of H7N9 in humans
• The range of signs and symptoms attributable to H7N9
• How may are infected without obvious signs of infection

 

In a conference call this afternoon with clinicians, the U.S. Centers for Disease Control and Prevention has officially asked hospitals and doctors to begin looking for signs of human infection with H7N9 avian flu.

Some takeaways from the 2PM EDT conference call:

Persons exhibiting influenza-like illness and/or severe respiratory distress, and who have either traveled to China or have had close contact with someone who has traveled to China, need to be considered in a separate category and closely monitored.

Any Influenza-Like Illness within this subset that cannot be conclusively diagnosed as seasonal influenza needs to be considered suspected H7N9, and samples are to be sent to the CDC immediately.

Suspected patients should be put into isolation, preferably in an appropriate environment, negative-air-pressure room (AIIR).

It is unknown whether rapid office tests could detect avian influenza.  Therefore, all commercially available influenza tests should be disregarded when testing for H7N9. It should be assumed they are inaccurate.

The CDC is currently the only testing facility in the United States that can test reliably for H7N9.  This will change as the CDC certifies states with the ability to detect H7N9.

The CDC is advising organizations to review and revise their pandemic plans.

International airports with frequent travel to and from China have begun listing H7N9 information on their electronic signs, particularly in Customs areas.

Limited human-to-human transmission has occurred in China. Which is a) not surprising and b) probably expected.

Put people on Tamiflu immediately upon suspicion of H7N9, even if they have presented symptoms for more than 48-hours.

CDC can have test results within hours of receipt of the samples.

Clinicians need to collect specimens and notify their state health department for instructions.

There have been cases, as recently as March, where people tried to illegally smuggle Chinese poultry into the United States. 

(Of course, this was a concern back in 2007.  Recalal than in July, 2006, a Troy, Michigan warehouse was raided for suspicion of illegally-imported goose parts.  The boxes were later stolen from the Government-sealed warehouse.  )

This is getting real interesting real fast.