Since the initial H7N9 bird flu in China outbreak in 2013 great advances have been made by Chinese health authorities in early detection and controlling of its spread.
However, the winter of 2016, 2017 saw a big increase in the number of reported cases of bird flu in China.
Bird Flu is most prevalent in the winter months, but starts to appear in the fall and continues until the spring.
Between October 2016 and the beginning of March 2017, 460 people contracted the disease. In January and February 2017 alone, 352 cases with 140 deaths from H7N9 Bird Flu were reported in China.
Two deaths from bird flu in Hong Kong were also reported in early 2017.
Shanghai expats, therefore, should keep alert. We provide some advice on how to protect yourself from bird flu below.
Outbreak of Bird Flu in China – 2013
In the spring of 2013, Shanghai expats were exposed to a new health danger; H7N9, a strain of Bird Flu.
No Shanghai expats were reported to have been victims of this influenza, but some panic did spread throughout the Shanghai expat community.
Western bars and restaurants, along with KFC and Peking Duck restaurants, were hit hard, as both locals and expats went out to eat less and avoided poultry items.
The initial bird flu in China outbreak was centered in-and-around Shanghai, but also spread to Beijing in the North and Guangdong in the South, as well as Taiwan.
The Chinese government ordered extensive testing at live chicken farms and poultry markets around the country, and mass culling at those found to have any H7N9 virus.
Fortunately, the major danger was declared over in May 2013, with all government emergency measures stopped on May 31st.
Foreign government and health organization advisories were also ended by May 2013.
The number of confirmed infections around China from the initial outbreak in 2013 was about 130 cases, of which about 40 people died, causing more than US$ 6.5 billion in losses.
Source of Bird Flu in China
The main channel for the spread of H7N9 Bird Flu to humans was concluded to be live poultry markets, otherwise known as wet markets.
The Chinese public traditionally like to buy their poultry freshly slaughtered from wet markets rather than frozen. This increases the risk of bird flu spreading.
A study done by Chinese scientists revealed that the virus found in many of the victims had a similar genome sequence to that found in live poultry markets.
Shanghai Government Measures to Fight Bird Flu
In order to stop the initial spread of the disease, the Shanghai government ordered all of its 79 live poultry markets to close on April 6, 2013. This action brought quick results, with the spread of the virus coming under control.
But the Shanghai government realized a permanent ban would not be accepted by the general public and, therefore, gradually started to allow the markets to reopen with stricter monitoring and health and safety measures put in place.
The Sanjiaodi wet market in downtown Hongkou District, Shanghai’s largest downtown wet market, now segregates live poultry from other food sections.
Since the initial outbreak the Shanghai government requires all live poultry markets to close each year for about 10 weeks around Chinese New Year.
They also say that such live poultry markets will slowly be phased out.
With the new outbreak in 2016, 2017, national authorities have called for more measures such as further tightening control of live poultry markets and the transportation of live poultry around China.
However, health experts have again called for a total ban on wet markets around China to prevent future bird flu outbreaks.
Unique Danger of the H7N9 Bird Flu Virus
One of the major dangers of this particular bird flu strain is that H7N9 does not cause serious sickness in birds and poultry, unlike H5N1 which directly killed thousands of chickens.
So the existence of H7N9 in poultry farms and wet markets cannot be easily detected by observation alone.
H7N9 kills over 30 percent of those hospitalized, which substantially exceeds the approximate 20 percent death rate from H1N1 swine flu which quickly spread around the world in 2009, killing more than 200,000 people.
Human to Human transmission of the H7N9 Bird Flu Virus
The major risk of any virus is human-to-human infection. H1N1 Swine flu ended up killing many more people than Bird Flu strains, even though it had a lower death rate, primarily because it mutated into a form that was easily passed from human to human.
As most cases of H7N9 bird flu were easily traced back to direct contact between the infected person and live birds, scientists and doctors said the risk of immediate human to human transmission was low, but have warned that potential mutations in the virus genome could allow it to spread quickly.
One such mutant strain of H7N9 was reported in Southern China in early 2017, leading to a closure of wet markets there.
In August 2013, a study done by Chinese scientists and published in the British Medical Journal for the first time concluded that at least one victim of the disease more than likely contracted it from her sick father who she was caring for, as she herself had no contact with live birds or poultry.
Moreover, samples taken from both victims showed such a genetic similarity that the virus was most likely to have spread directly from father to daughter.
As very few other such cases were detected, however, the risk of human to human transmission for H7N9 is still considered quite low.
Symptoms of H7N9 Bird Flu in China
Otherwise known as Avian Flu, bird flu is a virus that primarily affects birds and poultry, but some strains, such as H7N9 have jumped to humans, causing devastating effects.
According to the World Health Organization (WHO), initial symptoms of Bird Flu include sore throat, running nose and muscle aches.
More severe infection will lead to severe pneumonia, respiratory illness, difficulty breathing, nausea, abdominal pain, diarrhea, vomiting, and dizziness.
Cures for Bird Flu
The antiviral drugs Tamiflu and Relenza have shown some effectiveness in curing H7N9 when taken within five days of the infection.
However, it has also shown that resistance to these drugs is easily developed.
Bird Flu Vaccine
Many research bodies began working on a vaccine for bird flu in 2013. Several of these R&D projects did produce good results including:
- Beijing-based Sinovac Biotech Ltd produced a vaccine which showed effectiveness in animal tests.
- US National Institutes of Health funded several projects across the US which entered Phase 2 testing on humans.
- A joint project which included Hong Kong University, the Chinese Center for Disease Control and Prevention, the Chinese Academy of Medical Sciences, and others produced the first influenza vaccine virus strain in China, facilitating the production of a vaccine.
- US based Novavax & Swiss pharmaceutical company Novartis said they had successfully developed the ability to produce vaccines for the H7N9 virus.
Person to Person Transmission Risk Low
As mentioned, the source for most cases of H7N9 in 2013 was traced to direct transmission from animal to human. This affects manufacturers’ willingness to manufacture the vaccine. With little to no human to human transmission mass inoculation is not necessary.
There is, therefore, no H7N9 bird flu vaccine available for purchase by the general public.
Human to human transmission of the 2019 Novel Coronavirus, aka SARS-CoV-2, which causes COVID-19 has proven to be much more prevalent. So bigger efforts to produce a vaccine for COVID-19 are crucial.
Bird Flu Virus Mutating
The new breakout of H7N9 in 2017 also showed that the this strain of bird flu was mutating into new variants. This reduces if not eliminates the effectiveness of earlier developed vaccines.
US health authorities admit the vaccine they initially began to stockpile in case of an H7N9 bird flu outbreak would probably not be effective against the new strain which appeared in 2017.
Protecting Yourself From Bird Flu in China
For anyone coming into contact with infected patients it is recommended by the American CDC (Centers for Disease Control) to wear a N95 face mask respirator.
Other channels to stay informed about Bird Flu in China include:
- Consulate/Embassy Advisories and Health Warnings: make sure you are registered with your Consulate to receive these warnings.
- Foreign clinics and health care providers: Sign up for their newsletters.
- Your own company’s Human Resources Department
- National and International health organizations:
- Centers for Disease Control and Prevention,
- World Health Organization,
- Public Health Agency of Canada,
- Health Map
Reduce the Risk of Contracting Bird Flu in China
Some advice from the International SOS:
- Avoid contact with sick animals, including cats and dogs.
- Do not go to live animal markets, poultry farms or pig farms.
- Do not handle sick or dead birds. Prevent children from doing so.
- Avoid touching any surfaces that may be contaminated by bird droppings. Do not swim in any body of water that is used by birds.
- Always maintain high levels of personal hygiene. Frequent hand washing is very important. Wash hands before and after food preparation and before eating.
- Thoroughly cook all poultry products, including eggs.
Other Strains of Bird Flu in China
Apart from the more prevalent H7N9 strain of bird flu, other strains have also caused casualties in China.
In March 2015 one person in Sichuan died from H5N1 bird flu. In January 2016 another man in Chengdu, Sichuan became critically ill from this strain.
In 2015 a person in Yunnan province died after contracting the H5N6 strain of avian flu. This strain of bird flu also appeared in Taiwan in 2017.