There are no known cases of H7N9 also called avian influenza in the United States, but authorities want the public to be aware and vigilant about this new strain of flu that is spreading in China and now Taiwan that poses a pandemic threat.
Dr. Lee Norman, chief medical officer for The University of Kansas Hospital in Kansas City, Kan., was briefed during a recent regional Homeland Security committee meeting.
“This is a brand new strain of flu,” Dr. Norman said. “This is not the H5N1 bird flu that we’ve known about for 15 or 16 years, nor is it associated with the SARS epidemic. This is brand new, just recently genetically typed out for the first time and there’s a whole lot we don’t know about it.”
Dr. Norman said it is most likely an airborne transmitted disease, but researchers don’t fully yet know how it spreads. Dr. Norman answered seven questions that will help the public be more vigilant.
Dr. Norman advises people traveling to and from China who experience flu-like symptoms should seek immediate health care for observation, testing and perhaps isolation.
“We are past the peak seasonal flu and so a person showing symptoms who is associated with travel should drive a higher suspicion,” Dr. Norman said.
Questions and answers with Dr. Lee Norman, chief medical officer, on H7N9 Influenza:
How is H7N9 transmitted?
“It isn’t entirely known how this is transmitted and it is thought that it probably has a poultry connection, but it is not thought to be transmitted by eating poultry. There are at least four cases in a family cluster where it’s thought that the transmission was human-to-human. That is terrifically significant because influenza doesn’t become an epidemic or globally, i.e., pandemic until there is sustained human-to-human transfer. There is no evidence of human-to-human transfer in a sustained method right now.”
How dangerous is H7N9?
“Out of 108 cases to date, there are 22 deaths – so if you just rounded it and said a 20 percent fatality rate, that’s very high for an influenza virus.”
Who is impacted the most by H7N9?
“From the deaths that have occurred so far, it is the same pattern we’ve seen in other influenza outbreaks, i.e., older patients and younger patients and patients with other concomitant disease processes or immune deficiencies who are most at risk.”
Is there a vaccine for H7N9?
“The Centers for Disease Control and Prevention (CDC) has started to grow the virus in eggs to figure out the best way to turn it into a vaccine. It is important to note that the vaccines that have been used for influenza over these last few years do not seem to have any impact at all on the H7N9 in terms of preventing it. We do know from early virus testing that it is not very immunogenic which means it doesn’t seem to stimulate a big immune response which is helpful to know in developing a vaccine.”
What do we know about the symptoms and illness of H7N9?
“It’s mostly acting like influenza of the other kind that we’re more familiar with. We know some people have gotten it (H7N9) have never sought medical care for it and have gotten over it. We know that people can have mild to moderate illness with it, receive a little bit of care and do fine. So it runs the gamut in terms of its severity, but with a 20% fatality rate as we know it today – that would be higher than you expect.
What is the medical response to someone presenting H7N9 symptoms?
“For the health care community, if someone comes in with an influenza -particularly if it involves travel- it would be recommended to go to the CDC website, look at the guidelines and to initiate the anti-viral treatment as per the recommendations of the CDC.”
What is being done to monitor the spread of H7N9?
“A large group from the World Health Organization, from the CDC in the U.S. and the Chinese Ministries of Health that are right now working on getting a better understanding of H7N9. They are doing lots of bird surveillance … up to 80,000 or 90,000 birds, mostly poultry, have been sampled. A very small percentage have had the virus and interestingly some of the birds testing positive for the virus are not ill, but are harboring the virus. In the U.S., the U.S. Department of Agriculture, the CDC and Homeland Security are monitoring and doing testing.”
Who is most likely to be affected next?
“It would be more likely, if it spreads like influenza in the past, to go next to Southeast Asia, Singapore, Indonesia and Australia, but in this day and age of global transportation anything is possible.”
- Story and Q&A by University of Kansas Hospital Media Relations office