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Avian influenza A (H7N9) Bird Flu – 2020 Vaccine Updated

Even though it is not as widespread as the Covid-19, avian influenza A H7N9 virus is also a threat. It is a subordinate type of influenza, observation as well as recognition of a virus were many years ago prior to its attention-grabbing impact. More so, it’s worth mentioning that there haven’s any recognition of this unique virus in either humans or animals until its discovery in March 2013 in China.

Since then, the discovery of infections in both humans and birds. The condition the infection brings is definitely a cause of concern as the majority of patients have become seriously ill.

The human infections caused by avian influenza A H7N9 virus has also been credited to live poultry exposure,  so the infections of these areas and habitats are potentially by avian influenza A H7N9 virus. Fortunately, transition of avian influenza A H7N9 virus is not easy from one person to another as there are currently no reports or studies that prove such.

Dating back to where it began, avian influenza A H7N9 virus first appeared in China and it comes back every winter and spring, also in Canada, Malaysia, and Taiwan.

In China alone, there are already four epidemics that have come and gone and a fifth one is in progress. The number of people went down with H7N9 was 1,364 individuals as of April 5, 2017, including 566 individuals of latest seasonal outbreak.  40 percent of the patients with avian influenza A H7N9 virus died during the four epidemics that were all seasonal in nature.

In addition to that, avian influenza A H7N9 virus Infection outbreak was also confirmed in Tennessee poultry[1] in March 2017, but the risk it posed to the American public from this infection was considered to be low and not alarming.

Looking further into it, it’s quite notable to say that humans are not immune to these flu viruses subtypes. Due to this, contracting this virus it can be serious and fatal, so we must not underestimate it.

Short Facts About H7N9 Flu

  • The H7N9 virus Infection is a novel zoonotic type of influenza virus that has been noted for its ability to cause human-to-human transmission which can cause a serious illness. The reservoir or host of H7N9 virus Infection is birds from different species with chickens being the most affected bird species. 
  • According to studies that included environmental samples from different locations, including live poultry markets and farms with highly pathogenic Avian or infected birds, it is easily transmitted from infected birds to humans.  
  • H7N9 virus in humans has been correlated with close interaction with birds or attending live bird markets. 
  • The majority of the reported human transmissions are from China, with a few travel-related cases of patients who had a history of visiting the mainland.
  • The human cases of the Avian influenza virus can vary from being a mild illness to a serious illness that can lead to hospital confinement. In this case, a high number of patients die. 
  • This illness had already affected more males than females with a mean age of 55 years old. .

Imaging Findings In H7N9 Influenza

According to Dr. Zhang “The distribution and very rapid progression of consolidations, ground-glass opacity, and air bronchograms, with interstitial changes, in H7N9 pneumonia help differentiate it from other causes of pneumonia,”

In all of the 12 patients participating in the test, a blurry zone in the lungs with ground-glass look and accumulation of liquid-filled as well as air-filled bronchi is also known as air bronchogra in lung tissue in 11 patients. Air bronchogram is evident for inflammation in surrounding tissue interlobular septal thickening.

“Both H1N1 pneumonia and SARS distribute more peripherally, with more changes in the spaces between tissues, and progress less rapidly than H7N9. In our study, the right lower lung was most likely to be involved, while there’s no lobar predilection in findings of H5N1 influenzam” added by Dr. Zhang.

In 10 patients undergoing computed tomography, the results revealed interval lesion progress in 3 patients with deteriorating lesions in seven patients. The overall clinical magnitude of the disorder was accurately reflected by imaging results. Throughout all cases, pulmonary lesions affected three maybe more lobes, but were mainly found in the bottom right lower lobe.

There are many variations, but these integral components are commonly present in other lung illnesses, including H1N1, H5N1 and SARS. 

How Does H7N9 Outbreak happen?

Influenza viruses, regardless of type, are constantly changing. Well, even the common flu virus, which seasonally affects vast numbers of human cases, varies significantly every year which is why the vaccine against it has to be constantly modified. Notably, the HA protein, otherwise called hemagglutinin[2], and NA enzyme, otherwise called neuraminidase inhibitors are the changing components[3]

The HA protein is responsible for the host cells to come into contact with the virus. On the other hand, the NA enzyme is the one responsible for the virus to exit, which is sometimes called shedding. The shedding then becomes the interlude to the spread of the virus.

How does it spread, then? The birds, of whatever species, may shed the infection through their mucus and poop. If this occurs, the virus may be contracted by a person who is subjected to such an infected bird without adequate protection. For instance, if an individual goes to touch the mentioned specimen where the virus is shedding, he/she can then be considered infected when he/she touches his eyes, nose, or mouth.

Even worse, if a particular bird flaps its wings, then the virus can circulate through the air which leads to potential infection, confirmed by the Centers for Disease Control and Prevention (CDC).

Furthermore, a sickly-looking bird is not an exclusive sign of an infected bird. There are some birds that look normal but have the novel avian influenza virus. Human transmission of avian influenza can occur during an unprotected encounter of this kind of poultry.

What Are The H7N9 Symptoms?

In human cases, high fever and cough are the first symptoms of H7N9 human infection. What’s even worse is the fact that the virus may lead to fatal respiratory symptoms like severe pneumonia conditions.     

Moreover, instantaneous protein changes within the virus can surprise the immune system of humans. This occurrence is usually the reason behind severe types of diseases; and because humans have not experienced any of this before, then immunity becomes a huge question.

The symptoms are also grouped according to the phases of the disease that a patient may experience. Check them out below.

Critical stage symptoms

  • Reduced platelet count or thrombocytopenia
  • Low level of lymphocytes or lymphopenia

Early-stage symptoms

  • Wheezing and breathing concerns
  • Headache
  • Cough that produces mucus or sputum
  • Muscle pain or myalgia
  • Fever
  • General malaise[4]

Later stage symptoms

  • Abrupt progression to acute respiratory distress syndrome (ARDS)[5]
  • Multi-organ dysfunction, e.g. kidney dysfunction and impaired liver
  • Muscle breakdown or rhabdomyolysis
  • Brain disease or encephalopathy
  • Blood infection and septic shock
  • A severe respiratory infection such as pneumonia

Is there a treatment for H7N9? 

h7n9

Patients who are infected with H7N9 avian flu are given existing antiviral drugs that are also used to treat the common flu viruses.

As soon as an individual is surmised to have an H7N9 infection, he/she will be given a specific class of drugs called neuraminidase inhibitors. The provision of this drug to an infected patient should be done even prior to laboratory confirmation, according to the World Health Organization (WHO). 

In the treatment against H7N9 infection, two neuraminidase inhibitor drugs are often prescribed –  Oseltamivir (Roche-made Tamiflu)[6] and Zanamivir (GlaxoSmithKline-made Relenza)[7]. Take note, however, that these drugs are not effective in all H7N9 patients. In some cases, though, the patients have experienced improved symptoms of the disease instead of a cure. Currently, new drugs are being studied and developed against H7N9; and hopefully, they will be successful in terms of treatment.

Is there a vaccine for H7N9?

As of now, there is no specific vaccine for H7N9 avian flu. However, when tough times call for it i.e., an influenza pandemic, then the CDC along with WHO and other health entities have three existing vaccines that could potentially be adapted to deal with it.

Why is there still no H7N9 vaccine? Simply because it is hard to develop and produce one since the virus is continually evolving.

Alternative treatments for bird flu

To treat H7N9 and other types of bird flu, many antiviral drugs are already being used. In fact, there is no vaccine for humans against H7N9 or other bird flu strains. With this being said, you may consider alternative choices such asexisting antiviral drugs.

Patients may pursue natural remedies that can aid in relieving the bird flu symptoms and in boosting the immune system in order to fight off infection. Here are several herbal remedies that you can try to protect yourself from bird flu infection and to speed up the recovery process when you’ve already contracted the  disease:

Turmeric

Turmeric, as a known cold and flu remedy is considered to be effective against the flu. What makes it potent? Turmeric has a significant compound called curcumin[8] which has antifungal, antiviral, antibacterial, and anticancer properties. More so, curcumin is considered to be a high-powered antioxidant that has the ability to fight off free radicals that are known to defile the immune system.

Green Tea

For bird flu, green tea serves as a potent natural remedy. What’s remarkable about this is its antioxidant and antiviral properties that are robust enough. It can even limit the release of neuraminidase or the enzyme that is responsible for the reproduction of the bird flu virus.

Olive leaf extract

Olive leaf extract is an amazing choice because it is a potent enhancer for the immune system. It supports the lymphatic systems and the blood to make them strong enough to combat bird flu viruses. Of course, not to mention its antiviral and antibacterial properties.

Garlic

Another effective natural remedy that can successfully defend against infections is garlic. It has been incorporated in several colds and flu treatments for centuries now because of its antibiotic and antiviral features.

Astragalus

This unusual herb called Astragalus helps in boosting the immune system, thereby improving the body and making you less susceptible to influenza. Even better, it has antiviral properties and has been used to treat flu and common colds for a long time. Moreover, it is a type of herb that is known for its ability to stimulate the white blood cells, which is a necessary bodily occurrence to help you fightdangerous invaders.

Prevention

Please pay attention to this prevention and control of the risk of H7N9 avian influenza.

  • If your daily undertaking does not require you to handle birds, then the CDC advises you to not contact any species of birds, whether alive or dead. More so, they recommend that you avoid poultry markets and other areas where bird droppings may be present.
  • Total cooking should be done for poultry products and meat. Avoid having the pink-colored meat parts, which indicate the blood of the animal. Eggs, on the other hand, should be hard-boiled.
  • Frequent hand washing, use both soap and water and wash your hands thoroughly. You may also use hand sanitizers and 60-percent solution alcohols if washing with soap and water is not possible.
  • If you are someone who is involved in poultry for whatever purpose, or if you are traveling to China, you should be extra careful when dealing with birds.
  • It’s crucial that when people sneeze or cough, they should do so into a tissue or their arms when tissue is not available.
  • If you are a traveler and you feel sick upon returning home, then it’s highly recommended that you immediately consult a doctor, most especially if you are having a fever and/or cough, and even shortness of breath.
  • There is currently no H7N9 vaccine reported to be accessible for the protection of poultry influenza A (H7N9) infections in cases of humans. Flu viruses, nevertheless, already have been both isolated and characterized. The first step in the development of a vaccine is the selection of candidate viruses that could go into a vaccine. The WHO and its partners continue to isolate available avian influenza A (H7N9) viruses to identify the best candidate viruses. These candidate viruses can be used to develop vaccines.

Conclusion

There is fear that H7N9 might worsen, but the good thing is, the WHO continuously tracks its progress and the development of other zoonotic influenza viruses. Close monitoring is made possible by its Global Influenza Surveillance and Response System (GISRS)[9].

In cooperation with the Food and Agriculture Organization (FAO)]and World Organization for Animal Health (OIE), the WHO performs human-animal interface surveillance, evaluates the related risks, and eventually coordinates the outbreak response to zoonotic influenza and its threat to the public.

Frequently Asked Questions

What are the other kinds of Human avian influenza viruses?

Other subtypes of avian influenza viruses that have caused human infections are H5, H7, and H9 viruses.

What is a novel influenza?

A novel influenza A virus is one that has caused human infections but is different from seasonal human viruses that circulate among people. Seasonal influenza is an acute respiratory infection caused by influenza viruses. Novel influenza A viruses are usually influenza A viruses that circulate among animals.

What happened on March and April 2013 in China? 

H7N9 virus was found in March 2013 in China in poultry. But the first human infection of  avian H7N9 virus was reported on April 2013. This virus has not reported to acquired the ability of sustained human transmission of H7N9 infections.

Does H7N9 transmit easily? 

human infections with avian influenza or H7N9 viruses do not transmit easily through person-to-person transmission or direct contact to humans.  It is primarily linked to close contacts or exposure to infected poultry or contaminated environments.

When was the pandemic in the US?

H7N9 viruses were detected in the United States in December 2014. The Centre for Disease Control and Prevention works together with clinical and public health laboratories in the United States to control and monitor the human infections of seasonal and novel influenza viruses in humans.

What is H7N9 flu?

According to the world Health Organization, H7N9 flu is one of the infectious diseases that cause a pandemic around the globe especially in China. It is caused by  H7N9 virus which is one of the highly pathogenic flu viruses. This flu virus causes fear to public health because it undergoes human transmission. This Avian influenza A(H7N9) is a subtype of influenza viruses that have been reported  in live poultry markets in China.

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  1. Centers for Disease Control and Prevention. (2017). CDC: Outbreak of North American avian influenza A(H7N9) in poultry poses low risk to people. Available from: https://www.cdc.gov/media/releases/2017/s0308-h7n9.html
  2. Kara Rogers. (2020). Hemagglutinin. Available from: https://www.britannica.com/science/hemagglutinin
  3. Kara Rogers. (2020). Neuraminidase. Available from: https://www.britannica.com/science/neuraminidase
  4. Krista O’Connell. (2019). What Causes Malaise?. Available from: https://www.healthline.com/health/malaise#see-your-doctor
  5. Mayo Clinic. (2020). ARDS. Available from: https://www.mayoclinic.org/diseases-conditions/ards/symptoms-causes/syc-20355576
  6. WebMD. (2020). Oseltamivir PHOSPHATE. Available from: https://www.webmd.com/drugs/2/drug-17762-5294/oseltamivir-oral/oseltamivir-oral/details
  7. WebMD. (2020). Zanamivir Miscellaneous. Available from: https://www.webmd.com/drugs/2/drug-17453/zanamivir-inhalation/details
  8. Susan J. Hewlings & Douglas S. Kal. Foods. (2019). 6(10): 92. Curcumin: A Review of Its Effects on Human Health. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/
  9. World Health Organization (WHO). (2020). Global Influenza Surveillance and Response System (GISRS). Available from: https://www.who.int/influenza/gisrs_laboratory/en/
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