H7N9 Outbreak

[RenaissanceLady]

When a new strain of virus kills 20% of those it infects, it's time to sit up and pay attention. I've been watching this since the first outbreaks in March and I keep finding reason to become more alarmed, especially as we do not yet have a vaccine:

Scientists concerned at H7N9 bird flu outbreak that has killed 24 people

• Virus killing a fifth of those infected in China
• World Health Organisation considers it a serious threat

Scientists are seriously concerned about a new bird flu virus that is causing severe disease in China, killing a fifth of all those it infects.

So far, the virus, known as H7N9, is being transmitted only to humans from chickens, but there are worries that it could mutate into a form that could be passed from one person to another. Five mutations are known to be necessary for that to happen – H7N9 already has two of them. If that occurred, it could spread worldwide with lethal effect.

According to the World Health Organisation, there have been 126 cases of H7N9 bird flu, all but one of which were diagnosed in China, with the other in Taiwan in a man who had travelled from China. So far 24 people had died from the disease.

"The cases are going up daily – about 20% have died, 20% have recovered and the rest are still sick," said Prof John McCauley, director of the WHO Collaborating Centre for Influenza at the MRC National Institute for Medical Research in London. "The WHO considers this a serious threat. We're on an alert and we're developing diagnostics and vaccines specifically against the virus."

The first comprehensive genetic analysis of the virus is published in the Lancet medical journal on Wednesday. It suggests the virus might have originated from the mixing of viruses from as many as four different origins, including ducks. "Extensive global surveillance is needed," say the authors.

One of the biggest problems is that the virus does not cause illness in chickens, so it is impossible to know which are infected and which are not. In the past, China has slaughtered flocks to eradicate bird flu viruses, but H7N9 is now known to be present in chickens in all 31 provinces of China.

The first human cases were notified over the Easter weekend. "Whenever an influenza virus jumps across from its animal host to human, it is cause for concern," said Prof Jeremy Farrar, director of the Wellcome Trust major overseas programme in Vietnam. "This particular one has to be taken calmly, but seriously." There is concern about the swift rise in cases – and there may be more undetected cases if some people suffer less severe illness which does not get reported, he said, speaking by telephone from Vietnam to a scientific briefing on H7N9 in London.

The virus has not been in the human population before. Unlike swine flu, it is affecting small children and the elderly alike, so the oldest generation does not have any inherited immunity to it.

Public health experts are most concerned about the possibility of human-to-human spread. "The longer the virus is unchecked in circulation, the higher the probability that this virus will start transmitting from person to person," said Prof Colin Butte of the Avian Viral Immunology Group at the Pirbright Institute. Preparations are being made to design and manufacture a vaccine, but that could take many months.

Scientists are aware that a proportion of the public is now sceptical about the risk of a flu pandemic, following the 2009 swine flu outbreak which turned out to be less serious than was feared. As it receded, there were questions over the stockpiling of vaccines and flu drugs.

There had been many discussions about avoiding the mistakes that had been made in 2009, said Farrar. This time, he said, "I think there was a risk of cynicism and inertia [on the part of policy-makers]. I think, thankfully, we are not seeing that."

Scientists concerned at H7N9 bird flu outbreak that has killed 24 people | World news | guardian.co.uk
It should also be noted that while there isn't any solid evidence that H7N9 has been able to spread via human-to-human transmission, Forbes and other sites are indicating that as many as 40% of those infected had no direct contact with poultry. If this information is correct, it indicates one of two things: Either this virus has evolved enough to spread to other birds and animals, or it really is spreading between humans. The article states that "the virus might have originated from the mixing of viruses from as many as four different origins, including ducks."

This should be cause for alarm. We're watching evolution in action and it's making for a very dangerous virus that has already mutated from the viruses in several other species. If/when it mutates to the point it is truly being spread human-to-human (assuming this hasn't already happened), the more difficult it may be to treat or prevent.

Remember, viruses are a means of horizontal gene transfer. This means that genes between organisms can be transferred without the use of reproduction. This is why one of the reasons why we have drug-resistant diseases and also why we have genetic diversity between species. As H7N9 is already genetically diverse and may still become more diverse throughout the evolutionary process, it's going to be harder to fight or prevent. A vaccine that may initially work will become useless as the virus keeps evolving and spreading between species.

 

[exo_doc]

This scares the hell out of me.

 

[pixelsmith]

You can bet Baxter already has a vaccine because they probably created this virus. Problem, Reaction, Solution.

 

[RenaissanceLady]

This scares the hell out of me.

There are definitely things to be concerned about in this virus. If you remember from the old "Be Afraid" thread, I had written:

There are 16 different hemagglutinin sub-types and 9 different neuraminidase sub-types, any combination of which can occur though not necessarily affect humans. At this time, only H1, H2, H3, H5, H7 and H9 as well as N1, N2 and N7 can affect humans. Even then, only H1, H2, H3, N1 and N2 affect humans to any extent - though it should be noted that H5 is entering the scene and has the potential to become a serious pandemic. A study of H5N1 is a study on how easily an extremely fatal pandemic could occur under the right circumstances, as well as a lesson in the dynamics of evolution.

It was fortuitous that I wrote about this at that time, as my information was correct at that time. This is something new that has entered the scene. N9 viruses had never been found in humans until H7N9, which is why H7N9 has never been seen in humans until now. This means we have little, if any immunity to this virus. It also means that vaccines might not work as well as we would hope. According to NPR:

Since no humans had ever been known to be infected with an H7N9 virus before now, scientists worry that a vaccine might not induce as strong an immune response as, say, a vaccine against an H1 strain, where people are already primed to respond.

I also referenced how H5N1 might become a pandemic under the right circumstances. A scientist commented in an article published April 14th:

Webby thinks H7N9 poses a greater threat of becoming transmissible among humans than the H5N1 virus that has caused such prolonged anxiety among researchers. "My gut feeling, at this point in time, is that this guy [H7N9] is probably closer to doing it," he says.

Cox notes the virus already has two genetic changes that enable it to infect human cells and reproduce at human's body temperature, which is lower than birds'.

That means, she says, "these viruses may already be partially adapted not totally adapted, but partially adapted towards the type of virus that might efficiently transmit from human to human."

She says the coming weeks may tell whether H7N9 is only a bird disease that occasionally spills over into humans, the potential seed of a dangerous global flu pandemic, or something in between.

It should be noted that at this time, there isn't any solid evidence that the virus is spreading between humans. If this doesn't change, the outbreak will be almost entirely limited to large swaths of China, with a few individuals getting sick after they traveled to China. Definitely sad for the Chinese, but good for the rest of the planet. It should also be noted that it's entirely possible that there are scores of other people who have been infected with the disease but have not experienced severe symptoms, therefore they haven't been to the doctor and their numbers counted among the percentages of those who get the disease and survive. The unfortunate part is that H7N9 already has some of the characteristics needed for human-to-human transmission.

The next thing to do is watch how this evolves. *Most* of the articles I've read, including the NPR one cited above, indicate that this disease has not been seen in swine. This is also good news, as pigs can simultaneously be infected with swine, avian and human flu. If all three of these things were to infect and mutate in one animal, we'd see some radical horizontal gene transfers, resulting in some radically new viral strains. At that point, we'll have a pandemic.

Or...maybe... nothing else happens. It might be we haven't seen N9 viruses among humans in the past because these viruses aren't contagious between humans. Outbreaks would therefore be limited. We'll just have to wait and see - and hope the scientists doing "reverse engineering" are able to manage a good vaccine and keep H7N9 under control.

(If you haven't, I'd definitely encourage you to read all of the articles I've cited in these posts. It's also rather easy following how this virus has spread - and been reported - as the earliest cases only happened about 6 weeks ago.)

 

[RenaissanceLady]

A little bit of interesting info: Even the Wiki site about neuraminidase doesn't (yet) mention N9. They say this:

Nine subtypes of influenza neuraminidase are known; many occur only in various species of duck and chicken. Subtypes N1 and N2 have been positively linked to epidemics in man, and strains with N3 or N7 subtypes have been identified in a number of isolated deaths.

- Yet they don't provide a citation - nor an update that N9 is now causing deaths in China.

It's a new virus, folks. We're all still learning about it.

 

[mike]

We are well overdue for a pandemic, and when it hits modern international transport will make the spanish flu look like a sniffle.

I remember watching this as a kid and ive been worried about it ever since

One of the side effects of my medical condition is a superpowered immune system, so i will likely be ok
When i get a cold it lasts for hours not days, typically i will feel the effects one afternoon, and wake up fit as a fiddle the next day.

None the less my plan includes multivitamins on a regular basis, good home grown food where possible. And a large bulk store of non perishable foods in the garage, im currently holding about 60 kilos of rice for example.

In a pandemic scenario i can impose a long quarantine here if needed.

 

[pixelsmith]

You can bet Baxter will not make the same mistake as their H1N1 debacle when they patented their vaccine over a year before the virus outbreak... Instead of Problem, Reaction, Solution they gave us Solution, Problem, Reaction. oops!

 

[Angel of Ioren]

Not everything is a conspiracy. This is a real problem. At least we can all agree that the vaccine will not give you autism.

 

[pixelsmith]

The jury is still out on the autism/vaccine thing. And how do you explain a vaccine patent before the H1N1 outbreak? They made the virus AND the vaccine.

 

[Pegusta]

This is certainly disconcerting, but we have been warned before of pandemics and the catastrophic consequenses they may have. Thus far, fortunately, we have not seen such a scenario come to pass.

Hope for the best and prepare for the worst seems like a pretty good outlook in most situations i guess. And while the possible implications are disturbing enough, I see no nedd to live in fear of them.

Sure, medical companies ultimately are about profit, but I am nontheless happy for the medicine they provide. As Angelo says, not everything is a conspiracy.

 

[pixelsmith]

again... how did baxter know to patent the H1N1 vaccine over a year before the virus was known to exist? maybe the patent office made it all up?

 

[Pegusta]

Purely circumstancial...........

Seriuosly though I am not ruling out the possibility that there are some real conspiracies, and some of them might even involve major medical companies. My main point is that I do not think that it is fair to assume that the medical industry per definition an evil thing setting out to pave the way for some sinister agenda. Rather we should aknowledge the fact that modern medicine probably has helped us more than it has hurt us.

And to make things clear: I am not saying you think that modern medicine is a bad thing per say. My point was more reflecting on the fact that some parties such as medical companies, intelligence/security agencies, government institutions etc most often get to be blamed for a lot of bad stuff, including conspiracies. And regardless of what they do - even if they provide good services - they are regarded as shady. I dont think that is fair.

 

[exo_doc]

Baxter International doesn't seem to have a clean record I'll grant you that Pixel.

2008 Chinese heparin adulteration
Main article: 2008 Chinese heparin adulteration
In 2008, the quality of blood thinning products produced by Baxter was brought into question when they were linked to 19 deaths in the United States.[20] Upon inspection one of the raw ingredients used by Baxter were found to be contaminated – between 5 and 20 percent – with a substance that was similar, but not identical, to the ingredient itself. The company initiated a voluntary recall, temporarily suspended the manufacture of heparin, and launched an investigation.
Investigation into the contamination has focused on raw heparin produced by Changzhou Scientific Protein Laboratories, a China based branch of Scientific Protein Laboratories, based in Waunakee, Wisconsin. Due to procedural errors Changzhou SPL's facilities was never subject to an inspection by US FDA official, as required by FDA rules. The factory's products were also never certified as safe for use in pharmaceutical products by Chinese FDA officials as Changzhou SPL was itself registered as a chemical company and not a drugs manufacturer.[21][22][23] Though Baxter was first to recall heparin because of increased adverse reactions, after the contaminant was identified and testing protocols were shared with other manufacturers globally, over a dozen other companies in nearly a dozen countries issued recalls, which linked back to certain supply points in China.
2009 avian flu contamination


In early 2009, samples of viral material supplied by Baxter International to a series of European laboratories were found to be contaminated with live Avian flu virus (Influenza A virus subtype H5N1).[24] Samples of the less harmful seasonal flu virus (subtype H3N2) were found to be mixed with the deadly H5N1 strain after a vaccine made from the material killed test animals in a lab in the Czech Republic. Though the serious consequences were avoided by the lab in the Czech Republic,[25] Baxter claimed the failed controls over the distribution of the virus were 'stringent' and there was 'little chance' of the lethal virus harming humans.[26]
2009 drug cost inflation

On July 2, 2009, Kentucky Attorney General Jack Conway announced a settlement between the state and Baxter Healthcare Corporation, a subsidiary of Baxter International, worth $2 million. The company had been inflating the cost of the intravenous drugs sold to Kentucky Medicaid, at times as much as 1300%.[27]
2010 hepatitis C infections

In 2010, a jury in Las Vegas, Nevada ordered Baxter to pay $144 million to patients who had been infected with Hepatitis C after doctors wrongly reused dirty medical supplies to administer propofol to patients. The jury granted the award, despite the fact that the label for propofol clearly states that it is for single-patient use only and that aseptic procedures should be used at all times.[28]
2008–2010 tax dodging

In December 2011, the non-partisan organization Public Campaign criticized Baxter for spending $10.45 million on lobbying and not paying any taxes during 2008–2010, instead getting $66 million in tax rebates, despite making a profit of $926 million.[29]

 

[exo_doc]

Purely circumstancial...........

Seriuosly though I am not ruling out the possibility that there are some real conspiracies, and some of them might even involve major medical companies. My main point is that I do not think that it is fair to assume that the medical industry per definition an evil thing setting out to pave the way for some sinister agenda. Rather we should aknowledge the fact that modern medicine probably has helped us more than it has hurt us.

And to make things clear: I am not saying you think that modern medicine is a bad thing per say. My point was more reflecting on the fact that some parties such as medical companies, intelligence/security agencies, government institutions etc most often get to be blamed for a lot of bad stuff, including conspiracies. And regardless of what they do - even if they provide good services - they are regarded as shady. I dont think that is fair.

You're giving companies and governments too much credit Pegusta.
Entities like this should always be treated with suspicion and skepticism.
Big Pharma's are out for one thing, and only one thing....profits. And they do not search for cures. They search for treatments.
Cures are a one time deal.
Treatments go on forever. A cash cow that keeps on giving.

And Governments should never, under any circumstances, be fully trusted and given carte blanc to do as they please.
Absolute power corrupts absolutley........history has shown this time after time after time.
Governments should function in fear of their citizens.......not the other way around.

 

[Pegusta]

You bring up some very good points. A skeptic outlook is certainly a sound thing to have in life. My point precisely is that we should not live in fear, not of the government nor any such structures - just because it empowers them.


However, I am pretty certain that even though medical companies do not provide cures for every illness or condition, there are a lot of people in the world that are happy for medicines that counter symptoms, making their lives easier. What I am opposed to is an overly polarised black/white picture. Not every action taken by a particular entity is motivated entirely by malicious intent, nor is every action taken necessarily a universally beneficial one.

I would argue that as long as there is a people, the government fears it, becuase it is accountable to it. And the power of the people is a powerful thing indeed.

 

[Angel of Ioren]

The jury is still out on the autism/vaccine thing. And how do you explain a vaccine patent before the H1N1 outbreak? They made the virus AND the vaccine.

Nope, they're not - vaccines don't cause autism.

 

[pixelsmith]

Nope, they're not - vaccines don't cause autism.

depends on who you listen to. my back door neighbor would punch you in the face for your statement because they know different. they live a very very stressful life because of what vaccines did to their daughter.

 

[Angel of Ioren]

depends on who you listen to. my back door neighbor would punch you in the face for your statement because they know different. they live a very very stressful life because of what vaccines did to their daughter.

Vaccines didn't do that. As much as they are looking for an explanation, vaccines do not cause autism.

 

[pixelsmith]

Vaccines didn't do that. As much as they are looking for an explanation, vaccines do not cause autism.

Inject a normal happy baby with a bunch mercury and other crap and couple days later it starts very unusual behavior that turns into autism ...it's a magical coincidence! A coincidence that thousands of other healthy babies have gone thru..

It has been proven that it is scientifically possible that vaccines can cause autism. An Error Occurred Setting Your User Cookie

The "error" message above does in fact lead to the 2011 study.

 

[exo_doc]

From Wikipedia in the Vaccine section;
..........."Some parents believe vaccinations cause autism, although the scientific consensus has rejected this idea.[32] In 2011, Andrew Wakefield, leading proponent of one of the main controversies regarding a purported link between autism and vaccines was found to have falsified research data and was stripped of his medical license.

IF vaccines contain mercury, and I'm pretty sure they do, mercury is a toxic heavy metal that cannot be normally discharged through bodily waste, it just stays in the body.
After a few vaccines, just how much mercury does that equal? At what level does mercury become clinically detrimental to the mind and body?