New pandemic threats

Not only are we looking at bird flu in China: we are now looking at swine flu and a new form of SARS.

Rising threat of a pandemic: flu infections rising among pigs in southern China, says study

Risk of spillover to humans is 'constant or growing', says the author of the study

South China Morning Post,

9 May, 2013

Scientists said on Wednesday that flu infections were rising among pigs raised for slaughter on farms in south and southeastern China, also plagued by bird flu.

And the risk of spillover to humans was “constant or growing”, according to one of the authors of a study published in Proceedings of the Royal Society B.

Pigs are an important source of new human strains of influenza A, such as the 2009-10 H1N1 pandemic that emerged in Mexico and infected an estimated fifth of the world’s population.

Pigs can act as a “mixing vessel” in a process known as re-assortment, brewing new flu strains from swine, poultry and human viruses in areas where they live in close proximity.

Such new hybrids can be deadly – tens of millions of people died in flu pandemics in 1918, 1957 and 1968.

Luckily, the 2009 strain was about as lethal as the ordinary seasonal flu, though highly infectious.

China is currently in the grips of a deadly H7N9 bird flu virus that has killed 27 people since March, mainly in the country’s east – overlapping with the study area.

H7N9 has not been traced to pigs and has not been shown to jump from person to person, but is being closely watched for genetic changes that may make this possible.

An article in the science journal Nature last month highlighted that H7N9 seems to be circulating in areas of China that have large populations of pigs and humans “providing opportunities for further adaptation to mammals and for re-assortment with human- or pig-adapted viruses”.

For the new study, an international team of disease experts analysed data collected at an abattoir in Hong Kong over a 12-year period from 1998 to 2010, to learn more about the spread of flu among pigs.

Such information may be useful to prevent future pandemic jumps from animals to humans.

The team analysed the results of tests for virus infection at time of slaughter, as well as tests for antibodies which would indicate the pig had previously been infected and was now immune.

They observed a drop in positive virus tests by the time the pigs reached the abattoir but, worryingly, concluded this did not mean there was less infection.

“Instead, it reflects higher rates of influenza circulation on the farms where pigs are raised, so that they have already been infected [and so they’re immune] by the time they’re going to slaughter,” co-author James Lloyd-Smith of the University of California in Los Angeles said by e-mail.

The conclusion was derived from a corresponding rise in positive antibody tests.

“The prevalence of infection in swine has not decreased and so the risk of spillover to humans or birds is constant or growing,” added Lloyd-Smith.

China is a priority for flu surveillance given the high densities of humans, swine and fowl in the region, the team wrote.

“Currently, China produces and consumes almost 50 per cent of the world’s pork, requiring an enormous swine population.”

The authors stressed their findings did not mean that flu was more prevalent in pigs in China than in other countries for which data mostly did not exist.

The Chinese data was a rare example of long-term, systematic surveillance of influenza in swine, and should be commended, they said.

But important lessons can be extrapolated for application worldwide – mainly to boost surveillance.

A case in point – the team said elements of the H1N1 pandemic strain had been circulating undetected in swine for more than 10 years before the 2009 outbreak started in Mexico.

Keeping an eye on influenza spread among pigs could “help us to avoid such nasty surprises in the future”, said Lloyd-Smith.

Last week, a study in the journal Science showed it was possible for H1N1 to swap genes with H5N1 bird flu, which is deadly for humans but not transmissible from person to person, to create a hybrid that can spread in the air between mammals – in that case guinea pigs.

“Saudi Arabia has had 13 cases in a recent outbreak of a new strain of coronavirus that has emerged from the Gulf and spread as far as Britain and France, the World Health Organization (WHO) said on Wednesday, and seven of those have died”.

http://www.reuters.com/article/2013/05/08/saudi-coronavirus-idUSL6N0DP1V720130508

France confirms first case of new SARS-related coronavirus

A 65-year-old Frenchman is hospitalized after contracting France's first case of a deadly new respiratory virus related to SARS, and French health authorities said Wednesday they are trying to find anyone who might have been in contact with him to prevent it from spreading.

CTV

8 May, 2013

It's unclear how or where the man was infected with the novel coronavirus, which has killed 18 people in four countries and raised new public health concerns since being identified last year in the Middle East. It can cause acute pneumonia and kidney failure.

The Frenchman fell ill after returning from a trip to the United Arab Emirates, the Health Ministry said. He has been under isolation and medical surveillance at a hospital in Douai in northern France since April 23, and is receiving respiratory assistance and blood transfusions, said Jean-Yves Grall, the government health director.

SARS: Memories of global health crisis still fresh in minds of key players

Paris' Pasteur Institute analyzed the man's virus and confirmed that it is a novel coronavirus, the ministry announced Wednesday.

Since September 2012, the World Health Organization has been informed of 30 confirmed cases of the virus, and 18 of the patients have died. Cases have been emerged in Saudi Arabia, Jordan, the UAE, Qatar, Britain and Germany, and health officials have said the virus has likely already spread between people in some circumstances.

France's health minister, Marisol Touraine, said "this is an isolated case" in France but said authorities are "fully mobilized" to prevent it from spreading. Authorities are trying to reach anyone who was in contact with the patient before he was hospitalized, and a national hotline was established Wednesday for the public to call about the virus.

WHO has advised countries to test any people with unexplained pneumonia.

"Any virus that has the potential to develop into something that is highly transmissible between people, including the coronavirus, is a major concern," WHO spokesman Gregory Hartl said.

"We need to follow up on all possible routes of infection, i.e. animal to human, whether it's being spread in hospitals or from human-to-human," he said.

Health authorities are trying to determine how humans are contracting and spreading the virus and how best to treat it. It does not appear to be as contagious as SARS or the flu, but it has probably spread between people who had close contact. It seems to have spread among family members in Britain and in health workers in Jordan who were caring for patients, for example.

The new coronavirus is most closely related to a bat virus and scientists are considering whether bats or other animals like goats or camels are a possible source of infection.

"We still don't know the animal reservoir of this virus or the source of exposure," Hartl said. "We need a solid epidemiological investigation to nail down a common behaviour between patients...All we can tell people at the moment is they should be very vigilant about their basic hygiene practices."

He said it's unclear whether there is something specific in the environment in the Middle Eastern countries where cases have been confirmed.

Several cases have been reported in Saudi Arabia. In the most recent Saudi outbreak, the Health Ministry has said five people have died and at least five others are hospitalized with confirmed cases of the virus.

SARS, or severe acute respiratory syndrome, killed some 800 people in a 2003 epidemic.

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