I suppose it was inevitable that the rest of China wouldn’t forever be immune to new cases of H7N9, until now limited to our southern China citizens. But yesterday the first H7N9 case outside of the Shanghai area happened literally in our backyard — our Shunyi backyard. Fortunately, this 7 year old daughter of poultry vendors is doing well, but it was still very jarring. And today we hear of more cases spreading across China, this time with two men in central China, again far outside of the previous zone around Shanghai. This raises the total to 55 infections and 11 deaths. Here’s a bit from the article:

It’s not the case that everyone confirmed to be infected with H7N9 was “clustered in one small area with the same source of exposure,” said Michael O’Leary, head of WHO’s office in China. “So we’ve been expecting new cases to occur. … Furthermore, we still expect that there will be other cases.”

A 7-year-old girl was Beijing’s first confirmed case of H7N9. Four more cases were reported in eastern Zhejiang province on Sunday, bringing to 55 the number of people sickened from the virus. Eleven of the victims have died.

Health officials believe the virus, which was first spotted in humans last month, is spreading through direct contact with infected fowl.

O’Leary said “the good news” was that there was still no evidence that humans had passed on the virus to other humans.

“As far as we know, all the cases are individually infected in a sporadic and not connected way,” he said, adding that the source of infection was still being investigated.

The girl, whose parents are in the live poultry trade, was admitted to a hospital Thursday with symptoms of fever, sore throat, coughing and headache, the Beijing Health Bureau said.

O’Leary said early treatment can be effective, as demonstrated by the girl, who was in stable condition.

My thoughts so far:

• I am very concerned about the severity of this virus on healthy, younger persons. Even this new case in Henan has yet another healthy 34 year old man in critical condition.
• These new cases dramatically widen the infection zone, and I will be very interested to find out how the virus suddenly jumped hundreds of miles to two other spots.
• The good news remains that there still seems to be no human-to-human transmission, and all cases seem clearly linked to that person’s direct contact with poultry
• Other good news seems to be that the anti-flu medicine, usually Tamiflu, seems to be effective against H7N9.

But while this certainly makes it more real for us in Beijing, it still doesn’t change the advice we are giving to the public to avoid infection. This advice obviously involves avoiding all contact with all types of live poultry, even at a petting zoo. And let’s give three cheers for hand washing, always a public health doctor’s number one suggestion, and for good reason. Carrying around Purell-type hand sanitizer isn’t a bad idea at all, in my opinion. As for other advice, here again is the information from the U.S. CDC:

• Do not touch birds, pigs, or other animals.
  • Do not touch animals whether they are alive or dead.
  • Avoid live bird or poultry markets.
  • Avoid other markets or farms with animals (wet markets).

• Eat food that is fully cooked.
  • Eat meat and poultry that is fully cooked (not pink) and served hot.
  • Eat hard-cooked eggs (not runny).
  • Don’t eat or drink dishes that include blood from any animal.
  • Don’t eat food from street vendors.

• Practice hygiene and cleanliness:
  • Wash your hands often.
  • If soap and water aren’t available, clean your hands with hand sanitizer containing at least 60% alcohol.
  • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Try to avoid close contact, such as kissing, hugging or sharing eating utensils or cups, with people who are sick.

What If You Have Symptoms?

People get colds and flu all the time, which usually includes a low fever with coughing, runny nose and other common symptoms. A typical flu usually is like a “bad cold”, with more severe headaches, body aches and chills, and less runny nose and cough. But with this particular H7N9 flu strain, it’s the pneumonia that really stands out in severity. So anyone with a fever over 38 and unusually severe respiratory symptoms should quickly see their doctor for evaluation. This evaluation may include tests such as a CBC, chest x-ray and rapid flu screening. Shunyi residents and other Beijingers are more than welcome to see any of our doctors here at BJU, including me at our CBD clinic.

By the way, it’s important to be evaluated quickly, as Tamiflu works much more effectively if started within 48 hours of symptoms.

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