The new strain of avian flu that has killed 23 in China and infected at least 109 has now been contracted by someone outside the country’s borders. On Wednesday, a 53-year-old Taiwanese man who had traveled to China became sick with H7N9 after returning home and has been hospitalized. The emergence of H7N9 and another new virus, a coronavirus (from the same family of viruses as SARS) in the Middle East, shows why we need to examine global readiness for new infectious diseases.
H7N9: “Serious,” “Lethal,” “Dangerous”
The Taiwanese man had been in the eastern city of Suzhou in Jiangsu province (where more than 20 cases of H7N9 have been reported) and returned to Taiwan via Shanghai (where a number of cases have also been reported). Samples from chickens, ducks and pigeons at poultry markets in Shanghai have tested positive for H7N9 but the Taiwanese man had not come into contact with birds or poultry or consumed undercooked poultry. He became ill three days after returning to Taiwan and came into contact with at least 139 people, including 110 hospital workers, according to Taiwan’s Centers for Disease Control.
The new bird flu is certainly serious; World Health Organization officials are describing it as “lethal” and “dangerous.” There are reasons to be more then concerned: birds who harbotr H7N9 appear healthy, while those who had contracted an earlier strain of bird flu, H5N1, had shown clear signs of illness. H7N9 appears to spread more easily to humans than H5N1 did. There have not yet been any reports of human-to-human transmission of H7N9, but “absence of evidence is not evidence of absence” as Ian Mackay, a professor of clinical virology at the University of Queensland in Brisbane, tells Bloomberg.
Another sign that the new bird flu could be some kind of pandemic was the discovery last month of dead pigs and dead ducks suddenly filling China’s rivers. Officials have yet to explain all those animal deaths and how they ended up in the country’s rivers, prompting speculation that these may be related to the H7N9 outbreak.
Transparency About Diseases is Key
In Taiwan alone, 346 people were sickened by SARS and an entire hospital in the capital of Taipei had to be shut down. The result of that experience is that, as Taiwan’s Minister of Health Chiu Wen-ta says to Bloomberg, “infection control [in Taiwan] … works fast.” Immediate and transparent reporting about new infectious diseases is crucial to prevent their spreading around the globe. In 2003, Chinese officials originally sought to cover-up evidence of SARS, a deceit that directly contributed to it spreading. In the case of the newest virus, the Chinese government has responded far more than quickly (though online commentators have still been dubious about Beijing’s response). Chinese officials have posted H7N9’s genetic sequence and also provided The New England Journal of Medicine with a detailed report.
The Middle Eastern coronavirus has killed eleven since it was first noticed back in September. Scientists have called on Saudi Arabia, where the disease has occurred, to be more transparent in allowing more foreign investigators.
What Can We Do To Prepare For a Pandemic?
In demanding that governments provide accurate and extensive information about new infectious diseases as quickly as possible, we need a system in place that both spots pandemic diseases and moves to stop them, the Economist underscores. In 2005, the WHO’s members agreed on new International Health Regulations, with rules for responding to outbreaks of global concern.
Members must not only create their own plans to stem outbreaks but also alert the WHO to “any risky-looking pathogen that might move beyond their borders” and take “measures to dissuade people from imposing unnecessary restrictions on travel and trade.” Countries also need to have stores of antiviral medications and vaccines and, just as importantly, resources must be allocated so scientists and pharmaceutical companies can develop these.
The ban on travel has been particularly important as, in the past, “fear of such bans discouraged governments from reporting outbreaks.” Scientists have been developing computer models to better predict how diseases travel by plane. Such models could help officials decide which routes to close to better contain a virus. Another study has shown the importance of border control in preventing the further spread of infection. According to the Economist, the U.S. is “paying scientists to patrol rapidly changing environments in Africa, Asia and Latin America, where viruses are prone to hopping from beast to man.”
So far the U.S.’s Centers for Diseases Control and Prevention is not advising people to avoid travel to China and has been reasserting “its standard advice to travelers and Americans living in China to follow good hand hygiene and food safety practices and to avoid contact with animals.” At the very least, we should take the outbreak of the new bird flu and of the coronavirus in the Middle East as grounds for being very, very aware of how a world that is globally connected can share not only information but diseases and potentially deadly ones at that.
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