Experts urge action after H7N9 shows Tamiflu resistance

South China Morning Post, March 1, 2017. Experts said signs of resistance in a new strain of the deadly H7N9 bird flu virus against a drug used to treat people with the infection needs swift investigation to clarify how to handle the mutation.

Two patients in Guangdong province with a new and more virulent strain of the virus have shown signs of failing to respond to the drug Tamiflu, the Nanfang Daily reported this week, citing Zhong Nanhsan, an expert in respiratory diseases.
Virologists said the finding did not mean the drug was ineffective against bird flu, but a swift investigation was needed to assess how to handle the situation. There have been over 1,200 laboratory confirmed cases of human infection for bird flu in mainland China since the first was reported in 2013.
As of Sunday, 94 people have died from the illness on the mainland this year. The number of deaths so far this year have already surpassed the total number of H7N9 fatalities last year, which was 73.
Mutation of H7N9 bird flu strain found in Guangdong patients

The drug resistance was found in two patients found to have the mutation of the virus, the report said. The new strain was identified by the China Centre for Disease Control.
Taiwan’s Centre for Disease Control announced earlier this month that gene sequence analysis of a H7N9 bird flu patient, who fell ill after visiting Guangdong, found the virus had a mutation that was resistant to antiviral drugs such as Tamiflu and Relenza. The patient, a 69-year-old businessman, died earlier this week.

Zhong was quoted in the Nanfang Daily as saying most patients on the mainland were responding to Tamiflu treatment, suggesting the mutated strain of H7N9 was not the dominant virus, or “a considerable amount of viruses” did not mutate.

He Jianfeng, chief expert in infectious diseases at the Guangdong Provincial Centre for Disease Control and Prevention, told the newspaper both patients with the new strain had taken Tamiflu before and it was not clear whether the drug resistance was caused by previous use of the treatment or the virus mutation.
Professor Malik Peiris, a virologist at the University of Hong Kong who published a paper in the medical journal The Lancet four years ago saying H7N9 patients in Shanghai had previously shown antiviral resistance, said Tamiflu resistance occurred occasionally in bird flu patients treated with the drug before.

China’s H7N9 bird flu measures came too late, experts say

His further work showed these patients can be treated with alternative antiviral drugs. Professor Peiris called for a quick investigation into the latest H7N9 virus mutation.
“We need more information on how widespread this resistance is in recent viruses, especially those with the high pathogenic mutation,” he said.

Tamiflu can still be useful for treatment and early use of the drug will reduce the chance of resistance developing and increase the chance of a cure, he added. Patients who have begun antiviral treatment need to be monitored to see whether there was a good response and to change to alternative drugs if there was no improvement, he said.

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Korea’s response to birdflu outbreaks complete fail: Disaster for poultry industry

sanatizing-rivers [at the picture – Large mobile sprayers spew sanitizers into Seongho Reservoir in Icheon, Gyeonggi, on Thursday, to prevent highly pathogenic avian influenza from spreading in the region.] Published at December 15, 2016 in the Korean Joonang Daily.

Avian Influenza in Korea

It’s official – the H5N6 avian influenza (AI) virus that touched down in Korea one month ago. It has caused the largest amount of damage the domestic poultry industry has ever experienced with bird flus. That’s 284 farms hit, nearly 15 million ducks, chickens and quails culled, and more to go. No other AI virus in the past has killed this many birds. Egg prices are soaring, now fixed at around 6,580 won ($5.63) per tray of 30 at the largest discount retail chain, E-Mart. Paris Baguette raised prices by an average of 6.6 percent earlier this month, their first hike in almost three years.

According to local experts, the crisis will last through April 2017 unless the government dramatically reforms current measures, which have been criticized for being far too weak. In an article published Tuesday, the Korea JoongAng Daily wrote that the first major government meeting discussing the outbreak was not held until one month after the virus was discovered on Oct. 28 in Cheonan, South Chungcheong, in the feces of migratory birds. By then, it had been a week since it reached nearby farms.

Measurements

On Wednesday, the Ministry of Agriculture, Food and Rural Affairs announced that it would “negotiate” whether to raise the national AI crisis level to the highest of the four-tier system, from the current level 3. On Thursday it was upgraded. “Things can really get worse unless the central government closely collaborates with regional governments and farms,” said Seo Sang-heui, a veterinary medicine professor at Chungnam National University in Daejeon.

Kim Jae-hong, dean of the College of Veterinary Medicine at Seoul National University, warned that for the domestic poultry farming industry the next one to two weeks will be a matter of “life or death.” One problem is that regional governments are not doing enough to quarantine areas, due to a lack of human resources and money. In a recent investigation by the Ministry of Public Safety and Security, there were 20 cases in which a government office wrote on official documents they set up an AI control team for their communities, but did not actually do so.

In Sejong City, a farmer was caught shipping off 100,000 chickens to his retailers last month and reporting to the government the next day that his farm appeared to be hit by AI. It later tested positive and authorities are now investigating whether he had known about the infection ahead of time. In a country where the government relies on farmers to report viruses on their own, and punishes those who turn out to have failed to take proper quarantine measures in the first place, many farmers hesitate to report their circumstances. Moreover, movement bans are imposed on poultry farmers and their vehicles at locations where the virus has tested positive, but rarely are these restrictions taken seriously.

Choe Nong-hoon, a veterinary medicine professor at Konkuk University in Seoul, thinks it is time for Korea to reform its entire poultry farming industry as current circumstances will only attract more forms of AI in the future. In Korea, chickens are normally raised in a closed, artificial setting, Choe said, as opposed to European countries and Japan, where free-range farming is more common. Free-range farming is more expensive, but cheap goods can be replenished by foreign imports, said the professor. “It’s about time to negotiate changes in related policies not just for Korea’s poultry industry,” Choe said, “but for the sake of public health.”

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WHO warns of H7N9 pandemic

birds-in-container

H7N9 Pandemic?

Published at 15 December 2016 in The Standard Hong Kong, by Mary Ann Benitez and Carain Yeung.

World Health Organization director- general Margaret Chan Fung Fu-chun warns bird flu H7N9 is particularly worrying as it could be a flu pandemic strain. This is because H7N9 is unique as it does not make chickens sick but is deadly in humans. Sick birds could usually provide early warning for imminent outbreaks, Chan told The Standard. This comes as Macau reported its first human case of H7N9 yesterday. “The biggest challenge for the world is the next influenza pandemic,” Chan said.

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