Entries in #H7N9; H7N9; bird flu; shandong; Zheziang; avian influenza; H5N1 (1)

China H7N9 cases climb to 106, deaths rise to 21

It was a busy weekend.  While America and Boston began its recovery from the horrible events of the preceding days, the situation in China worsened.

"Worsened" could be worse.  First, the Monday morning reset:  We have 106 confirmed human cases of H7N9 avian influenza.  We have a suspected confirmed human case in yet another province, Shandong.  And we still have no Earthly idea what (or who) the vector of transmission is.

But we still do not have the exponential growth (think of that old shampoo commercial) in cases that would signal the beginning of sustained human-to-human transmission of H7N9. 

Just one week ago, we had 72 human cases.  Friday, we had 91 cases.  And as I mentioned, today we have 106 cases.  Now the attention turns to what we don't know; namely, guessing how many unreported or undiagnosed cases there might be.

In the absence of previous testing, we are simply guessing.  As Spock said in Star Trek IV, they are making the best guess they can possibly make. From sleepless blogger Mike Coston's morning joe entry:

If, as these scientists suggest, there are really 200 cases out there, then the case fatality rate (now sitting at 20%) would be cut to (a still impressive) 10%.

We don't know when the infection started.  We don't know the carrier. We suspect wild birds have communicated the disease to poultry, but the number of positives found while testing eastern Chinese poultry probably is not that much greater than what you might find in the Netherlands or Germany.

And, believe me, they are testing poultry in Europe!  Flutrackers.com reports that H7 has been found in a turkey farm in Saxony.  27,000 birds are meeting their Maker. While low-path, as is the Chinese outbreak (if only in poultry), the Germans know the entire flock must be wiped out.

Back to China.  The virus has spread to yet another province, and Zhangzou has overtaken Shanghai as the province with the highest number of reported cases.

Veteran flu tracker laidback AL, he of the superb charts, brings us yet another gem.  The gem is flawed; it was created before Shandong came on the map. But it does show the new leader in confirmed cases, Zhegiang.

The mapo also shows the proximity of Shandong Province to the other eastern provinces.  From Wikipedia:

Shandong has emerged as one of the most populous (95,793,065 inhabitants at the 2010 Census) and most affluent provinces in the People's Republic of China (GDP of 3.94 trillion CNY in 2010).

Add another 95 million people to the mix of potential mixing vessels.