In light of the current outbreak of H7N9 avian influenza in China, which has been confirmed in 16 individuals, resulting in six fatalities to date, the US Centers for Disease Control and Prevention (CDC) held a briefing on the situation in China today, April 5.
CDC Director Thomas Frieden and influenza medical epidemiologist, Dr. Joe Bresee briefed the press.
Dr. Frieden started by giving some basic facts about the China situation:
As of April 5th, 2013, Chinese public health officials have reported 16 cases of human infection with a novel avian influenza A, which is called the H7N9 virus, from four different provinces in China. Patients were hospitalized and six of them have died. These are the first human infections with this particular strain of H7N9 that have been identified. 15 of the cases are among adults ages 27 to 87. The one child is age 4 and apparently had mild illness. All cases had onset between February 19th and March 31st, 2013.
Based on what investigators have seen so far with close contacts of the infected patients, there has been no person-to-person transmission and no epidemiologic link between any of the cases so far, according to Frieden.
However, two family situations are being investigated by Chinese authorities to see if there was person-to-person transmission in those cases.
Frieden then went on to the situation in the United States, "At this time, no cases of human infection with avian influenza A H7N9 have been detected in the United States."
Although there is no recommendation against travel to China at this time, the CDC did issue a travel notice today with advice on how travelers can protect themselves from H7N9 avian influenza.
In addition, Frieden said that the CDC has a test available so that they can test specimens from travelers returning from China who have severe illness that might be this influenza and determine whether or not they have it. A rapid diagnostic test for the virus is in development.
He also noted that preliminary test results provided by the WHO Collaborating Centre in China suggest that the virus is susceptible to the influenza antivirals, Tamiflu and Relenza.
A candidate vaccine for this strain of bird flu is being developed; however, Frieden said, "This would only be produced if there were evidence of widespread transmission from person-to-person."
He discussed the CDC's relationship with their Chinese counterparts. "we have a very robust, long-term relationship with them. It got much stronger after SARS when China recognized that it needed to strengthen its public health system and we have an office that CDC maintains in China to collaborate."
He says that the Chinese government has posted publicly the full genetic sequence of the H7N9 strain that is affecting people in this cluster.
Frieden closes his portion of the briefing by saying, "We work to have the public's back. It's our job to be concerned and to move quickly whenever there's a potential problem, such as the one in China. And that's what we're doing. As far as should the public be concerned, there is no evidence at this point that the virus is being transmitted from one person to another or that the virus has caused any infections in the U.S. There are no specific steps that people in this country need to take to protect themselves."
Dr. Joe Bresse addressed many questions concerning surveillance of the disease, including the bird population.
Concerning China's actions concerning the bird population, Bresee said, "I will say that the animal health authorities in China have issued guidance now for surveillance for this virus among poultry population, duck populations, and any bird populations that exist in markets in that area of China. They've engaged now in a very systematic surveillance system over the next week or so that intends to figure out what the scope of this virus is and what populations it might exist in."
On the topic of "heightened surveillance" by China's neighbors, Bresee said, "What we know now is that several of the countries in Asia, especially several of the bordering countries from China have been doing extenuated surveillance either in the community where they’re testing severely old people to look for the introduction of this virus or occasionally in airports where they’re screening for fevers, for instance, of incoming passengers. I can't say that I know the exact scope of the extenuated surveillance going on, but we have heard from colleagues in Laos, Cambodia, Thiland, Taiwan and Vietnam that they’ve all heightened their surveillance in looking for this virus as have countries around the world, I might say."
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