Title: CAS’s Zhong Nanshan said the finding of two H7N9 flu virus resistant to antivirals is matter of concern.
Subject: Avian Influenza, H7N9 subtype, a highly pathogenic variant virus found to be also resistant to neuraminidase inhibitors drugs.
Source: Local Media, full page: (LINK). Article in Chinese, edited.
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Zhong Nanshan: H7N9 virus mutant showed drug resistance, urged people do not buy live birds
"Two H7N9 avian influenza viruses found in Guangdong were resistant to antiviral drugs."
At the 13th International Symposium … held yesterday, Zhong Nanshan, an academician, told reporters that the two strains found recently Poultry showed highly pathogenicity trait for birds, and according to the present situation, the most critical step is to prevent and control from the source to solve. Do not do be involved live poultry trade, but also to persuade the public not to buy live birds.
Death rate of more than 40%? "Not necessarily"
According to data released by the State Inspector General's Bureau of Disease Control and Prevention on February 14, as of January this year, 17 provinces and cities in China have reported H7N9 human cases of avian influenza infection with a total of 192 people infected with the disease, of which 79 People died.
The high incidence of the epidemic this year scattered in the Yangtze River Delta and the Pearl River Delta region. As of the current public report (February 25), Jiangsu Province, the largest number of infections, up to 124 people, of which 35 were killed. Zhejiang, Guangdong is also the hardest hit, in January this year, our province reported a total of 21 cases of H 7N 9 cases, 10 cases of death cases.
It is noteworthy that in January this year, Guangdong Province CDC from two cases of human infection, H7N9 virus have been isolated and sequenced. In the two isolates the hemagglutinin showed a multi-aminoacids residue at the cleavage site, and on February 19, the test results have been confirmed by the National Center for Disease Control and Prevention of the National Influenza Center.
Zhong Nanshan said that the transition of the virus to a more pathogenic variant for birds does not mean the same is true for humans. So far the virus does not seem to be more infectious, but a firm conclusion could not be made.
But it is worth noting that this year's epidemic has two characteristics: First, the number of patients in January is far more higher than in January last year, and the infection is more widespread that before.
Statistics show that this year H 7N 9 epidemic mortality rate is more than 40%, disease control experts believe that this is due to missed the best treatment time. However, for this figure, Zhong Nanshan said: "Because the current number of the total population affected can not be known for sure, confirmed cases are generally the most severe, this does not mean that the overall case-fatality rate is actually so high."
"Most of the virus isolated so far showed no variation"
Zhong Nanshan revealed that this mutation has two characteristics: First, the original H7N9 virus is low pathogenicity strain for birds, so that infected poultry does not develop any symptoms, mainly to cause human disease. The mutation of the virus will now make the infection in poultry evident, since the virus acquired a highly pathogenic trait. Second, there are cases of resistance to Tamiflu, recently found in Guangdong 2 cases with viremia and spread of the virus into the upper and lower respiratory tract, and resistance to Tamiflu.
"Now, there are a lot of unknown." First, there is no mean to know whether the drug-resistant strains will become later widespread and dominant.
‘’Second, whether these resistant strains are widely circulating is not presently known, so there is need for an increased surveillance.’’
Zhong Nanshan stressed that even if this would be the case, the public do not need to panic, and until now in many cases treated, Tamiflu showed to be effective, because the mutant Has not become a widespread, a considerable part of the virus had no variation.
Guangdong Provincial Center for Disease Control and Prevention of infectious diseases prevention and control of the chief expert He Jianfeng also said that these two cases is caused by drug resistance or virus mutation caused by the impact is not yet determined, but this is indeed a matter of concern.
If there is resistance to mutant virus strains, treatment options will be adjusted? Zhong Nanshan explained that mutant virus strains have just been found soon, the adjustment program is too early. There is also a combination of methods, and H7N9 virus treatment is the most critical or supportive therapy.
"From our experience, the avian flu virus on the patient's lung injury is the largest, severe patients will harden the entire lung, and finally respiratory failure, while the heart, kidneys have different degrees of harm.Therefore we in the anti-virus treatment At the same time, to support these important organs of the therapy, if these important organs can support live, you can survive the dangerous period.
"Not to say that after the mutation on the patient mortality rate is higher, and now also not the conclusion, the current case data is too small, is closely observed." Zhong Nanshan that even Guangdong has taken a very strong measure, but Guangdong Like the habit of eating chicken is difficult to change, so I hope the media appeal, the public do not contact live chickens, because most of the live chickens are backyard.
"Although there is no obvious phenomenon of people coming, but there is fever, soon to medication, because the effect of drug is the first 5 days more effective, behind the effect is not very good, we must increase the dose. At the same time, after scientific demonstration, in response to influenza, such as … and other proprietary Chinese medicines for improving physical resistance, reduce inflammation is indeed effective, the relevant research results will be announced.
H7N9 Avian flu into the high incidence of the national death toll has increased to 87 people
According to the latest statistics of the State Health Commission, February 6 to 12, the national report H7N9 cases 69 cases, 8 people died! January people infected with death 79 people! 19, Guangdong H7N9 infected cases found in the virus mutant strains.
Yangtze River Delta Pearl River Delta is the highest incidence of H7N9 epidemic in Jiangsu
The high incidence of the epidemic this year scattered in the Yangtze River Delta and the Pearl River Delta region. Up to now the public report, Jiangsu Province, the largest number of infections, up to 124 people, of which 35 were killed. The remaining provinces of Zhejiang, Guangdong, Anhui, Jiangxi, Fujian, Hunan, Hubei and other provinces have reported H7N9 avian influenza virus infection cases and deaths. According to Xinhua News Agency, China CDC virus disease deputy director, director of the National Center for Influenza Shu Yuelong said that since last winter, due to climate and other factors, the global animal avian flu epidemic was high trend, spread to Asia, Europe , The Middle East nearly 40 countries and regions. This year, China's H7N9 not only distributed in the region than ever before, the number of cases of infection and death are the largest number of four years, the current situation, the mortality rate of about 40%.
Keywords: China; H7N9; Avian Influenza; Human; Antivirals; Drugs Resistance; Oseltamivir.