H5N1

Biologists make first mouse model for MERS

Thanks to Greg Folkers for sending the link to this report in Nature News & Comment: Biologists make first mouse model for MERS. Excerpt:

A remedy for Middle East respiratory syndrome (MERS), the coronavirus outbreak from Saudi Arabia that has killed 77 of the 180 people who have contracted it, has so far eluded researchers. But they have now created the first mouse model of the disease, which could enable faster testing of drugs and vaccines. The method used to make mice susceptible to MERS might also provide a quick way to study future pandemic viruses in mice. 

The coronavirus infects humans by binding to a protein, called DPP4, that sits on the surface of cells in the lungs. But the structure of the mouse version of DPP4 is different and the virus does not bind to it. The virus does infect macaques and marmosets, which develop a mild form of the disease, and researchers have begun using them to test vaccines and drugs. Yet working with monkeys is expensive and slow. 

To create a more practical model, Stanley Perlman, a microbiologist of the University of Iowa in Iowa City, and his colleagues put the gene encoding human DPP4 into an adenovirus to which mice are susceptible. 

They exposed the mice to the adenovirus — similar to a cold virus — through inhaled droplets that entered their lungs. Once the adenovirus had invaded cells in the lungs, the cells began making the human DPP4 protein and expressing it on their surfaces. 

When the researchers then had the mice inhale droplets containing the MERS coronavirus, the coronavirus bound to the human receptor and began taking over the cells. “The animals are walking around as bags of viruses,” said Perlman, in a 29 January presentation at a meeting of the American Society for Microbiology in Washington DC. 

The animals’ immune systems responded and made antibodies to attack the MERS virus. The mice never became sick or lost weight, however, which is something of a mystery, says Perlman, although he points out that it is not unusual for human viral diseases to have milder effects in mice.

Dominican Republic worries about chikungunya

Via El Día: Chikungunya, el nuevo virus que amenaza la región caribeña.[Chikungunya, the new virus menacing the Caribbean region] Excerpt, with my translation:

Chikungunya (CHIK) es una enfermedad que rara vez causa la muerte, pero el dolor que genera en las articulaciones puede durar meses o incluso años. 

Chikungunya is rarely a fatal disease, but the pain it causes in the joints can last for months or even years.

Este virus es transmitido por la picadura de mosquitos infectados, Aedes aegypti (que también puede transmitir el dengue), según las explicaciones dada por el Ministerio de Salud y organismos internacionales. 

The virus is transmitted by the bite of infected Aedes aegypti mosquitoes (which can also transmit dengue), according to explanations given by the Ministry of Health and international agencies.

Urgen capacitación/Preparation urged  

Pese a que la alerta emitida por el ministro de Salud, Freddy Hidalgo, busca hacer prevención, algunos médicos opinan que urge capacitar a los facultativos del área de la salud. 

Although the alert was issued by Health Minister Freddy Hidalgo to promote prevention, some doctors are urging preparation for health workers. 

La representante de la Organización Panamericana de la Salud (OPS) en República Dominicana, Lilian Reneau-Vernon, manifestó ayer la necesidad de capacitar y seguir entrenando a los médicos para que puedan diferenciar los síntomas del virus Chikungunya y el del dengue, aunque aclaró que ambos guardan similitud. 

The representative of the Pan American Health Organization in the Dominican Republic, Lili Reneau-Vernon, yesterday announced the need to prepare and continue training of doctors so they can distinguish the symptoms of chikungunya and dengue, although the she explained that they are similar.

“Existen algunas diferencias entre ambas, pero en principio guardan mucho parecido”, aseguró.

"There are some difference," she said, "but in general they look alike."

Denmark: Health authorities raise guard against polio virus

Via The Copenhagen Post: Health authorities raise guard against polio virus. Excerpt:

Danes should be on heightened alert about a possible outbreak of the polio virus, according to the national association of polio and accident victims (PKU).  

"We want authorities to step in and make sewage controls and more campaigns to remind parents that their children should get a polio vaccine," the head of PKU, Holger Kallehauge, told DR Nyheder. 

While there hasn't been a case of polio in Denmark since 1983, Denmark has lately received refugees from Syria, where at least 13 cases of polio were reported last fall. 

At the same time, fewer parents are giving their children the vaccine because the risk of getting infected has been so low for years. 

"That makes the risk of getting infected higher than before," Kallehauge said. "A health minister in Denmark should not live with such a risk and neither should the population." 

May do a sewage test 

National health agency Sundhedsstyrelsen is alert to a possible outbreak, said the head of the agency's hospital services and emergency division Søren Brostrøm. 

"After the outbreaks in Syria, we have contacted the city councils and asylum centres," Brostrøm told DR Nyheder. "We also wrote doctors across the nation to make them aware of the situation. So I would definitely say we have increased focus." 

Health Minister Astrid Krag (S) said that while Denmark is generally well-protected against a polio outbreak she will also follow the developments closely. 

"That's also why we are considering testing sewage water for polio – but only if the results we get are worth the costs of the procedure," she told DR Nyheder.

Canada: When do you have a superbug "outbreak"?

Via The Globe and Mail, a report by Wendy Stueck: 'Outbreak' or not? How superbugs test a hospital's practices on informing the public. Excerpt:

In the global cast of drug-resistant bacteria, carbapenemase-producing enterobacteriaceae – more commonly known as CPE – can be thought of as the brooding villains. They are resistant to nearly all antibiotics, they can spread resistant traits to other organisms, and as many as 50 per cent of people who get a serious CPE infection die.

Yet when Fraser Health Authority detected 41 patients carrying the potentially lethal bug in its hospitals in the last half of 2013, it was under no obligation to report that to the public. The reason? In Canada, individual health facilities to determine what constitutes an outbreak. Fraser Health has called the incidents a “cluster,” saying B.C. hospitals and infection control practitioners are still discussing guidelines on what determines an outbreak. 

The question of when a cluster becomes an outbreak – and whether and when the public should be told – is pertinent not only to Fraser Health, which serves more than 1.6-million people in the Fraser Valley east of Vancouver. It highlights the challenges for Canadian hospitals when it comes to getting ahead of CPE, which began to show up in Canada around 2010. 

Health facilities are grappling with questions around the best ways to screen and test for the bacteria, the costs associated with increased testing and even whether screening can do harm. A June conference on antimicrobial-resistant organisms in Calgary, for example, includes a session that will discuss whether screening can result in patients receiving reduced care due to “leperization” and isolation. 

Fraser Health, meanwhile, is dealing with a new reality – asking patients admitted to its sites whether they have traveled outside Canada within the last six months. Those who answer yes are tested for CPE. The authority currently has about a dozen cases and expects CPE to be an ongoing issue. 

“We have not provincially decided on the definition of what an outbreak means,” Elizabeth Brodkin, Fraser Health’s medical director of infection prevention and control, said last week in discussing the cases. “So I wouldn’t use the term outbreak. We saw a cluster, which clearly we needed to respond to. And the measures we put in place were very satisfactory in bringing the numbers down.”

WHO: H7N9 update, January 31

WHO has published Human infection with avian influenza A(H7N9) virus – update. Excerpt:

On 29 January 2014, the National Health and Family Planning Commission (NHFPC) of China, and the Centre for Health Protection (CHP), Hong Kong SAR, China notified WHO of six additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus including one death. 

All of the six cases are males. The age range is 2 to 63 years old. The cases are reported from Fujian (1), Guangdong (1), Hong Kong SAR (1), and Zhejiang (3). Four of the cases are currently in critical or serious condition. Four of the cases are reported to have had exposure to poultry or a live poultry market. 

Details of the five additional cases as notified by NHFPC of China: 

• A 37-year-old farmer from Wenzhou City, Zhejiang Province, who became ill on 19 January. He was admitted to hospital on 27 January and was transferred to another hospital on 28 January. He is currently in a critical condition. The patient has a history of exposure to a live poultry market. 

• A 60-year-old man from Hangzhou City, Zhejiang Province, who became ill on 23 January. He was admitted to hospital on 28 January and is currently in a serious condition. The patient has a history of exposure to poultry. 

• A 63-year-old man from Hangzhou City, Zhejiang Province, who became ill on 24 January. He was admitted to hospital on 27 January and is currently in a serious condition. He has a history of exposure to a live poultry market. 

• A 2-year-and-8-month old boy from Xiamen City, Fujian Province, who became ill on 26 January. He was admitted to hospital on 28 January and has a mild illness. His family slaughter and sell ducks. 

• A 17-year-old man from Guangzhou City, Guangdong Province, who became ill on 22 January. He was admitted to hospital on 27 January and is currently in a serious condition. 

Details of the case as notified by the CHP, Hong Kong SAR: 

• A 75-year-old man with underlying illnesses who travelled alone to Shenzhen between 20 to 26 January became ill while in Shenzhen on 26 January. He was admitted to hospital in Hong Kong on 28 January and died on 29 January. During his stay in Shenzhen it is reported that he stayed with relatives who lived close to a live poultry market. His five home contacts in Hong Kong have remained asymptomatic but have been admitted to hospital for observation. 

Further investigations into the man’s travel and exposure histories are ongoing, in parallel with tracing of other contacts of the case, including four patients with whom he shared a hospital room, and healthcare and ambulance staff. Preliminary findings suggest that the man was infected outside of Hong Kong SAR. 

So far, there is no evidence of sustained human-to-human transmission.

South Korea: No new H5N8 cases reported in past three days

Via Yonhap News: No new bird flu cases reported in past three days.

No new cases of bird flu have been reported in the past three days but it's still possible that the highly contagious poultry disease may spread further in South Korea, the agriculture ministry said Friday. 

"Given the past experience, there could be more cases of bird flu," said a ministry official, adding the development of the animal diseases should be kept under close observation.

Hong Kong: A possible drug against MERS?

Via The Standard: Find offers hope against killer virus. Excerpt:

Hong Kong and mainland scientists said they have identified a compound that in lab-dish experiments blocks infection by the deadly SARS-like Middle East respiratory syndrome coronavirus. 

A type of small protein, also known as a peptide, prevents the spikey virus from fusing with human respiratory cells, they said. 

Fusion is a key step in replication of the MERS-CoV. It enables the virus to infiltrate a cell and hijack its cellular machinery in order to reproduce. 

The study was published yesterday in the scientific journal Nature Communications. 

The research team was jointly formed by the University of Hong Kong, Chinese Academy of Sciences and Fudan University.  

The peptide, called heptad repeat 2 or HR2P, has "good potential" for development into a future drug against MERS-CoV, the team said. So far, HR2P's effects have only been studied on cells in a lab dish and not yet on animals - the next step in a long process to validate any new drug for safety and effectiveness. 

"The reports of person-to-person transmission of MERS-CoV through close contacts have raised global concern about its pandemic potential. Therefore, the development of drugs capable of curbing the spread of MERS-CoV is of great importance," said Jasper Chan Fuk-woo, clinical assistant professor of HKU's microbiology department. 

"Fortunately, there are no cases found in Hong Kong, but seen from overseas cases, there was limited infection among humans. 

"Instances included virus spread among family members or between doctors and patients. Although it's temporarily not a pandemic, it is important to monitor the development of the virus." 

He said currently there is no specific treatment for the infection, caused by a novel coronavirus - the same virus family that caused Hong Kong's 2003 SARS outbreak.

Hong Kong, January 31: CHP notified of seven additional human cases of H7N9, 1 death, in Mainland

The Centre for Health Protection has issued a news release: CHP notified of seven additional human cases of avian influenza A(H7N9) in Mainland. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health (DH) received notification yesterday (January 30) of seven additional human cases of avian influenza A(H7N9) respectively in Jiangmen (one case) from the Health and Family Planning Commission of Guangdong Province, and in Zhejiang (four cases), Jiangsu (one case) and Guangxi (one case) from the National Health and Family Planning Commission.      

The case in Jiangmen involves a woman aged 67. She passed away on January 28.      

The four cases in Zhejiang involve four men aged 64, 75, 76 and 78 who are all under treatment in hospital.      

The case in Jiangsu involves a woman aged 75. She is now hospitalised for treatment.      

The case in Guangxi involves a woman aged 56 who is now hospitalised for treatment.      

As of yesterday, a total of 266 human cases of avian influenza A(H7N9) have been confirmed in the Mainland, including Zhejiang (111 cases), Shanghai (41 cases), Jiangsu (36 cases), Guangdong (37 cases), Fujian (16 cases), Jiangxi (six cases), Anhui (four cases), Henan (four cases), Beijing (three cases), Hunan (three cases), Shandong (two cases), Hebei (one case), Guizhou (one case, imported from Zhejiang) and Guangxi (one case).      

"Locally, enhanced disease surveillance, port health measures and health education against avian influenza are ongoing. We will remain vigilant and maintain liaison with the World Health Organization (WHO) and relevant health authorities. Local surveillance activities will be modified upon the WHO's recommendations," a spokesman for the DH said.      

"In view of human cases of avian influenza A(H7N9) confirmed in Hong Kong and multiple cases reported in the Mainland, the activity of the virus is expected to be higher in the winter season. Those planning to travel outside Hong Kong during the Lunar New Year should maintain good personal, environmental and food hygiene at all times," the spokesman urged.

China: Happy New Year from the folks fighting H7N9

Via Shanghaiist.com: Photo of the Day: Happy New Year from the folks fighting H7N9.

Happy New Year to our beloved readers and our hostile commenters! Out of the many 'Year of the Horse' images making the rounds today, we're promoting this one: to the tireless men and women of Zhejiang No. 1 Hospital, saving us from flumageddon.

China confirms new human H7N9 case

Credit: Reuters

Via Xinhua, a January 31 report: China confirms new human H7N9 case. Excerpt and then a comment:

One new human H7N9 case has been confirmed in east China's Jiangsu Province, the provincial health department said on Friday. 

The patient. a 75-year-old woman from the provincial capital of Nanjing, is in critical condition, the department said in a statement. 

The new case brought the number of infections in the province this year to 8 this year. 

H7N9 bird flu has killed 19 in China this year, and the total number of human infections had reached 96 as of Monday, according to the Chinese Center for Disease Control and Prevention. 

Li Lanjuan, researcher at the Chinese Academy of Engineering and a specialist in H7N9 prevention, said so far there have not been any cases in which one person transmits the flu to another, and the latter transmits the virus to a third person. 

Her team has identified H7N9 virus mutations this year, but the mutations are not large-scale. 

"Inter-human transmission is very unlikely," said Li, who added that the virus has not evolved to be extensively drug resistant.

Thanks to just under 100 cases of a new strain of influenza, identified in one month, a nation comprising one-seventh of all the human beings on the planet faces a serious medical, economic, and political crisis.

Countless young, well-trained medical experts are trying to understand this latest variation on an old scourge. Scores of millions of households that depend on the poultry trade are facing ruin. A government that emerged from war and more revolutions than it wants to think about, and lifted untold millions out of poverty, must must now confront a virus that tends to kill old people who have survived all the upheavals of the past 70 years. 

 

Let us hope that the billionaires now ruling the People's Republic have the brains and political wisdom to deal with this stupid little virus. What happens in China now happens to all of us.