Human to Human? Mystery intensifies on how H7N9 is spreading; most had no contact with poultry

April 17, 2013BEIJINGThe World Health Organization said on Wednesday that a number of people who have tested positive for a new strain of bird flu in China have had no history of contact with poultry, adding to the mystery about the virus that has killed 17 people to date. Chinese authorities have slaughtered thousands of birds and closed some live poultry markets to try and stem the rate of human infection, but many questions remain unsolved including whether the H7N9 strain is being transmitted between people. WHO spokesman Gregory Hartl confirmed that “there are people who have no history of contact with poultry,” after a top Chinese scientist was quoted as saying about 40 percent of those with the H7N9 flu had had no poultry contact. “This is one of the puzzles still (to) be solved and therefore argues for a wide investigation net,” Hartl said in emailed comments, though he did not know the exact percentage. Several avenues should be explored by an international team of experts going to China soon, including the possibility that the virus can be spread between people, although there is “no evidence of sustained human-to-human transmission,” Hartl said. “It might be because of dust at the wet markets, it could be another animal source beside poultry, it could also be human-to-human transmission,” he added by telephone. Wendy Barclay, a flu expert at Imperial College London, said it was likely to be very difficult to determine and rule out people’s exact exposure to poultry – and to wild birds, which could also be a possible source of infection. “The incubation time might be quite long so visiting a market even 14 days before might have resulted in infection,” she said. Previously the WHO reported two suspected family “clusters,” but later said the virus was found not to have infected anyone in the first. Tests in the second were inconclusive and experts say the poor quality samples may make it impossible to know. China has warned that the number of infections could rise from the current 77. The latest victims are from the commercial capital of Shanghai, where the majority of the cases have been found, the official Xinhua news agency said on Tuesday. China reported three new bird flu outbreaks to the World Animal Health Organization (OIE) this week, bringing the total number of places to 11, the OIE said on its website. Samples have tested positive in some poultry markets that remain the focus of investigation by China and the U.N.’s Food and Agriculture Organization. Zeng Guang, the chief scientist in charge of epidemiology at the China Disease Prevention and Control Centre (CDPCC), said about 40 percent of human victims had no clear history of poultry exposure, the Beijing News reported on Wednesday. According to a Reuters analysis of the infections, based on state media reports, only 10 of the 77 cases as of Tuesday have had contact with poultry. The CDPCC declined to comment when asked by Reuters. A study published last week showed the H7N9 strain was a so-called “triple reassortant” virus with a mixture of genes from three other flu strains found in birds in Asia. [ID:nL5N0CY2ZT]One of those three strains is thought to have come from a brambling, a type of small wild bird. “We can’t rule out that this … has passed through poultry but then been reintroduced to a wild bird population from which some spread to humans might be occurring,” Barclay said. –Reuters
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3 Responses to Human to Human? Mystery intensifies on how H7N9 is spreading; most had no contact with poultry

  1. ALBIRRR says:


  2. niebo says:

    Hey, Alvin, well, I wouldn’t call it a term paper, but, it ain’t short either; I post and submit to your discretion. If nothing else, PLEASE add the last link to your own list; it is a site that tracks outbreaks worldwide.

    A virus, from the Latin for “poison”, is not considered an actual life-form, because all viruses lack cellular structure (the standard to meet in order to be considered “life”), their own metabolism, the ability to self-reproduce, and cannot survive (for long) outside of a host organism, which means that they are primitve parasites. Though the range of hosts is limited for each type of virus, as an order, viruses are able to infect everything, bacteria, fungi, worms, sponges, catfish, lizards, oak trees, etc. They are adaptable and hardy; while science recognizes the existence of millions of them, only five thousand or so are known in detail. Of all life-forms/sub-life-forms, the classification system for viruses is the most complex in science, complicated to understand (my head would explode) and even harder to explain with brevity (your head would explode, at least if I tried), so I’m skipping that part. Influenza viruses, specifically, are “negative-sense single-strand RNA” [(-)ss-RNA] viruses; the ss-RNA is the important part, because these guys are extra-primitive. Upon infection, they begin to replicate in the cytoplasm (the goo inside all cells wherein the other parts float); they borrow some proteins from the ribosome and start spitting out copies, a process which (unlike other classes of virus) is unchecked and unregulated; in the process, they often glean pieces and parts from other viruses, and by this “random” nature of reproduction, they create mutations more often than any other form/sub-form of life, almost by design.
    The published information contained in the study by Chinese officials represents just seven (7) isolate samples that were collected from three connected provinces. Two came from avian donors, one chicken and one pigeon (both from Shanghai), another was an environmental sample, collected from a marketplace in Shanghai, and the other four were taken from victims of the disease. Of them, the first (Shanghai1) is from an 87 year old man who died on 4 March; the second (Shanghai2), collected from a 27 year-old pork seller who died 10 March; sample three (Anhui1) is from a 35 year-old woman from Anhui province (west of Shanghai) who became ill on 15 March and remains hospitalized in critical condition; the fourth isolate (Hangzhou1) was taken from a 38 year-old man who died on 27 March in Zhejiang province, south of Shanghai.
    According to genetic analysis, this H7N9 virus shares (H) genes with the low-pathogenic H7N3, (N) genes with the low-pathogenic H11N9 (isolated in the Czech Republic, 2010), and remaining sequences with H9N2, which circulated recently in Shanghai, Zhejang, and Jiangsu. This suggests that the viruses are reassortants; their H7 and N9 genes are derived from avian viruses and the remaining genes from poultry viruses. Of the four human isolates, all are similar at the amino-acid and nucleotide level, which suggests a common ancestor, BUT, where Shanghai2, Anhui1, and Hangzhou1 share 99% identity and differ by no more than 3 nucleotides per gene (though they were gathered from 3 different provinces, several hundred kilometers apart); Shanghai1 differs from Shanghai2 by 52 nucleotides, even though these cases were identified in the same city around the same time. In combination with the other three samples, the findings suggest that Shanghai2, Anhui1, Hangzhou1, Chicken, and Environment share a closely related source of infection while Shanghai1 and Pigeon are likely to have originated from other SOURCES. (For a total of THREE)
    Similarities/differences of note:
    The amino-acid sequence of the receptor-binding site (H) determines preference for human/avian type receptors; Shanghai1 contains an H3 mutation, while Shanghai2, Anhui1, Pigeon, Chicken, Environment show two other mutations; any of the three could increase binding to human receptors. More alarming is the finding in regards to Hangzhou1, which contains the same amino-acid as SEASONAL H3N2.
    In another position that contributes to binding, all seven samples share a mutation, an H3 trait, of increased binding to human receptors.
    In a position that is responsible for replication of avian influenza in humans, Lysine is essential; it is present in all four human cases, while it is absent from the avian and environmental samples.
    All seven isolates share resistence to ion-channel inhibitors (amantadine and rimantadine), but six show sensitivity to neuramindase inhibitors (tamiflu). The exception is Shanghai1, which registers resistance, thus the newly-discovered Shanghai1 is already treatment-resistant.
    While the low-pathogenic viruses have not devastated bird populations, the viruses have had time to intermix, recombine, and mutate; evidence supports THREE sources for seven samples, in an outbreak (for humans) that is less than 90 days old. And none of the information herein answers the question that got me started on this: if the avian samples do not contain the amino-acid that is critical for replication in humans (Lysine, so at least I did learn the name of the responsible compound), where did the human isolates get it?
    From another source, one that provides the missing link that allows the virus to cross species (and flourish), a source that is not isolated here. Which means . . . there may be four sources for seven samples. Also, if the resistance of Shanghai1 resurfaces, or if the H3N2 component of Hangzhou1 spreads, the chances of it crossing species greatly increases. And one more thing: of over 1000 close-contacts to victims who are being monitored by the Chinese none have shown any signs of illness. Which means that it is not contagious, person-to-person. Yet. Just don’t let a pigeon sneeze on you.

    EXCELLENT SITE that tracks outbreaks worldwide:

  3. Michele Lewis says:

    Finally… (just in the last few hours) they are acknowledging the possibility, which has been obvious for some time now…
    “H7N9 Flu: China Investigating Possible Human-To-Human Spread”
    Chinese Government Suspects Human-to-Human Transmission of H7N9 Bird Flu
    If you are really curious about the possibilities of this, read about the 1918 pandemic, otherwise known as the Spanish Flu. Starts small, but can then explode.
    On April 4, Recombinomics wrote, “Q226L Signals Recent H7N9 Human Adaptation”
    “[In 2003, I think] When new H5N1 bird flu cases were reported, agencies would claim that the H5N1 couldn’t transmit human to human (H2H) because the two key changes, Q226L and G228S, were not present… The recent appearance [in H7N9] of Q226L, as well as D225G on H7 and E627K on PB2, raises concerns that the number of severe and fatal cases will spike higher…The presence of Q226L in most recent cases is expected, and the appearance of additional receptor binding domain changes, such as G228S would be catastrophic.” This change relates to its ability to transmit more easily.

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