Blog 10: Unanswered Questions Regarding Outbreak of H7N9 Influenza

China's Action's in Flu Cases Draw Critics
By: Keith Bradsher
April 10, 2013
New York Times

http://www.nytimes.com/2013/04/11/world/asia/delay-on-china-avian-flu-announcement-questioned.html?pagewanted=all&_r=0

The recent outbreaks of H7N9 avian influenza in China have some questioning whether Chinese officials deliberately concealed their presence and scope or simply overlooked the particular strain in question. Flu surveillance among poultry populations is common in Asia and across the globe. New strains are routinely identified and tracked. The first cases of the H7N9 strain showed up in humans in southern China, in and around Shanghai, February 19, 2013 but were not reported until nearly six weeks later, March 31. It is possible that scientists and government officials purposefully withheld the information. It is also possible that the strain was misidentified as H1N1 or overlooked during routine surveillance testing. Nonetheless, most agree that a six week delay in reporting new, confirmed cases of human infections with a novel avian influenza strain is excessive. In addition, the new strain shows genetic adaptations that help it infect and invade mammalian cells and tissues, including humans. The American Centers for Disease Control have activated preliminary emergency measures for dealing with a global flu pandemic, should it appear to be evolving.

Analysis

This report highlights the crucial roles that disease surveillance systems, public health infrastructure and international cooperation play when dealing with disease outbreaks. Although not confirmed in this instance, political motivations, system inefficiencies, social and economic factors are all integral to the means by which emerging infectious diseases establish themselves in the contemporary world. China's opaque, oligarchical government, along with a history of media censorship and information suppression allow for significant concerns when dealing with infection outbreaks within Chinese territory - pointing out the need for transparency, collaboration and rapid information dissemination when dealing with emergent public health threats. Also, the fact that so many new disease outbreaks seem to occur in China's Guangdong and neighboring provinces is not surprising. The area is the most densely human-populated region on earth. When coupled with the ubiquitous presence of "wet markets" where food animals, poultry and livestock are often traded, the risks of disease emergence and transmission are exponentially compounded.

Antony Lynn Cochran
SOC 202-02
April 12, 2013 20:20