Monday, December 04, 2017

China: Hunan Province Reports An H9N2 Case

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With fewer than 3 dozen human infections reported over the past 2 decades (see FluTrackers Global Cumulative H9N2 Partial Case List 1998-2017), LPAI H9N2 - which is ubiquitous in Asian & Middle Eastern poultry - is nonetheless an important player in the avian flu world.
H9N2 is considered to have at least some pandemic potential of its own (see CDC IRAT score), but by far its greatest impact has been as a driver of novel influenza's evolution in Asia and the Middle East (see 2014 The Lancet report Poultry carrying H9N2 act as incubators for novel human avian influenza viruses).
Three years ago, in PLoS Path: Genetics, Receptor Binding, and Transmissibility Of Avian H9N2 researchers found evidence of Chinese H9N2 viruses binding preferentially to alpha 2,6 receptor cells -  the type commonly found in the human upper respiratory tract - rather than to alpha 2,3 receptor cells which are found in the gastrointestinal tract of birds.

While earlier this year, in Vet. Microb.: Analysis Of Korea Lineage Of Avian H9N2 viruses, we saw evidence presented that  the South Korean lineage of H9N2 may be making strides towards better mammalian adaptationA topic we looked at again last August in That Touch Of Mink Flu (H9N2) - Revisited.
These mammalian adaptations are not only a concern for the future threat from H9N2, but also from any new reassortants that receive some of their internal genes from this evolving H9N2 virus. 
For these reasons, and because surveillance in the parts of the world where this virus circulates is spotty at best, we take note whenever we see a reported human infection.

Today we received word of the 4th reported case of 2017, that of a 20-month old child in Hunan province.  The details come from the following Macao Government release which recounts both this H9N2 case, and the H7N9 case reported in this blog on Saturday. 

1 new case of human infection of H7N9 and H9N2 case of human infection of bird flu cases Mainland 
 
2017-12-03 20:32:00

Source: Health Bureau

Health Bureau said, according to the latest bulletin of the Mainland health authorities, Yunnan new case of human infection of H7N9 avian influenza. Data refer to the patient was 64-year-old man, farmer, living in Kunming, before the onset of contact with dead poultry, on November 21 developed symptoms November 26 hospitalized, diagnosed with severe pneumonia.

According to the health department informed the Mainland, Hunan Province new case of human infection of H9N2 avian influenza virus, the patient was a 20-month-old girl, now lives in Changsha City. November 27 symptoms, are less severe, before the onset of the live poultry market.

Since September 2017, the Mainland H7N9 infection cases emergence of the local area, including Jiangsu, Liaoning, Hunan and Yunnan.

Health Bureau will continue and the country and neighboring areas in the health sector, World Health Organization keep in close contact, monitor activity around and Macao, and through cross-sectoral cooperation and public and private institutions, as soon as the Macau neighborhood or bird flu preventive measures appear and preparation.

Macao Health Bureau called on the public:

    Avoid visiting recently there have been influenza A H7N9 bird flu in the downtown area, there are farms where the sale or display of birds;
    Avoid contact birds and secretions, excretions; if contact should wash their hands;
    Do not buy, carry without quarantine of birds;
    Do not eat undercooked poultry meat, offal, blood products and eggs;
    Note Gerenweisheng, frequent hand washing;
    Such as fever, cough, shortness of breath and other symptoms should wear a mask and seek medical advice as soon as possible, and detailed travel history doctors and animal contact history.

For more information on Influenza A H7N9 bird flu can be found at Health Department website (www.ssm.gov.mo) or call the hotline 28700800 Health Department infectious disease in the Bangongshijian.