Seems like only 365 days ago I wrote about H7N9 being 1 year old.
Now - it's another year later.
While we have studied, written, read and learned much, much more about this emerging respiratory virus than we have about the Middle East respiratory syndrome coronavirus - even after its 3 years among us - we are still watching a new outbreak of human H7N9 cases spread across China.
Each year more provinces are added to the list to report human infections - more infections likely go unnoticed, unrecorded and/or unreported. Gaps in the reporting is not unexpected and not unusual.
Each outbreak with its accompanying economic damage, financial losses, human illness and death is because of the desire to maintain a tradition, namely the consumption of freshly extinguished poultry.
We're really good at getting ourselves into pickles. And we seem to be doomed to repeat the patterns, playing catchup and never getting in front of our new and emerging infectious diseases problems. And each time we seem amazed at what we learn, but really, we learn the same thing over, and over and over again. Eventually we'll run out of infectious threats I guess.
Or they'll run out of hosts in which to incubate in and spread from.
Happy Lunar New Year.
Its been 2-years since Prof. Ali Mohamed Zaki sent his email to ProMED notifying them of a novel coronavirus. That email was published 20-Sept 2012.[1]
A year ago we had 138 cases and 58 deaths. Today we have 856 cases with perhaps 306 fatal (36%).
I won't rehash what I said a year ago - I invite you to check that out over at the 1st birthday post.[2]
Suffice to say the past year has been, to my mind anyway, mostly about:
- Camels
- High level job "shuffling"
- Controversial parallel publications
- Very problematic infection prevention and control issues.
The latter leading to the relatively huge number of MERS-CoV detections and deaths in Saudi Arabia and to some exported detections and cases. The one constant over both years has been that the MERS-CoV is a pitiful spreader among humans. MERS-CoV is nonetheless a virus that is very capable of inducing fatal outcomes, especially among older males with underlying diseases.
Has MERS-CoV gone away? No. Of course it hasn't. MERS has, mostly. That's the disease, not the virus. For now anyway MERS cases are sporadic, although still geographically widespread.
MERS cases fell to zero cases per week for a number of weeks this year following containment of the Jeddah-2014 outbreak. Nonetheless, this is a virus of camels that seems to spread, rarely, to humans and when in us, it has not been in any rush to mutate into the pandemic SARS-like threat many once worried about.
Camels are where this virus likely remains. And there have been no signs that that has in any way changed. The latest information suggests camels have been harbouring MERS-CoV for at least 30-years.[3] This, as with a great deal of the research to date, is knowledge gained mostly thanks to the efforts of international research teams and their funding
So Happy 2nd Birthday you opportunistic, spiky little killer. I'm once again wishing Dr Zaki well and congratulating him on co-parenting the birth of this novel coronavirus. This year I also wish Prof. Ziad Memish well and congratulate him on seeing the infant virus through to toddler age.
Oh, and 2-years on, I still see no sign that the contentious patenting issues were any sort of hindrance to diagnostics or actual research. Just sayin'.
References...
- http://www.promedmail.org/direct.php?id=20120920.1302733
- Happy 1st birthday Middle East respiratory syndrome coronavirus (MERS-CoV)http://virologydownunder.blogspot.com.au/2013/09/happy-1st-birthday-middle-east.html
- MERS Coronavirus Neutralizing Antibodies in Camels, Eastern Africa, 1983–1997
http://wwwnc.cdc.gov/eid/article/20/12/14-1026_article
A year ago, on the 18-Feb-2013, the first human case of avian influenza A(H7N9) virus infection started showing signs of an illness; coughing with sputum.
That person was an 87-year old retired male with hypertension and chronic obstructive pulmonary disease (COPD). By the time he presented a week later he had fever and shortness of breath. He sadly died of acute respiratory distress syndrome (ARDS).
No other cases of infection were noted to have resulted.
He was treated with oseltamivir, an antiviral flu drug to which H7N9 is generally susceptible, 7-days after he became ill. He was in hospital for 6-days.
His infection, along with those of 2 others, were reported to the World Health Organization on 31-March (2)
- NEJM Article on First 3 human cases of H7N9.
http://www.nejm.org/doi/full/10.1056/NEJMoa1304459
- WHO Overview. 31-05-2013.
http://www.who.int/influenza/human_animal_interface/influenza_h7n9/WHO_H7N9_review_31May13.pdf?ua=1
