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Eight more H7N9 cases reported in China

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leungchopan / iStockphoto

Eight more H7N9 influenza cases have been reported from four of China’s provinces over the past 3 days, signaling that cases may be leveling off from a burst of infections that appeared to coincide with Lunar New Year activity.

The cases are from four Chinese provinces, according to official notices from Hong Kong’s Centre for Health Protection (CHP) and provincial health department notices translated and posted by the FluTrackers infectious disease news message board.

Provincial health ministry reports

Three of the newly confirmed infections involve patients from Guangdong province, one of the main H7N9 hot spots during the second wave of infections. They include a 4-year-old girl, a 79-year-old man, and a 44-year-old man.

Hunan and Anhui provinces each reported two cases. Hunan’s two case-patients include a 46-year-old man whose infection was first reported on Feb 15 and a 64-year-old man whose illness was reported today. The patients from Anhui are a 14-year-old girl whose infection was reported on Feb 15 and a 63-year-old man whose positive H7N9 test was reported the following day.

The eighth case-patient is an 84-year-old man from Jiangsu province whose infection was reported yesterday.

The CHP, which issued statements today and yesterday announcing seven of the new cases, said the patients are receiving treatment in hospitals.

Reports of eight more cases from China lift the number of cases reported in the outbreak’s second wave to 221, compared with 136 reported during the first wave. Also, the new reports boost the overall outbreak total to 357, according to FluTrackers’ running total.

WHO details latest confirmations

In other developments, the World Health Organization (WHO) today posted two updates on H7N9 cases in China, one on seven reports it received from the country on Feb 13 and one on an infection in a Chinese traveler to Malaysia, the first to be detected outside China.

In the report on the seven cases on the mainland, the WHO said all of the patients are male, ranging in age from 8 to 84 years. All of them have a history of exposure to live poultry. Three are hospitalized in critical condition, three are listed as severe, and one patient—an 8-year-old boy—has a mild infection.

Illness onset dates ranged from Jan 28 to Feb 6, according to the WHO.

The WHO’s report on the visitor to Malaysia contained some new details but confirmed other reports. Based on information it received from Malaysia’s health ministry, the WHO said the 67-year-old woman was treated in Guangdong for fever, cough, flu, fatigue, and joint pain 4 days before she traveled to Malaysia. The timing of symptom onset and her travel dates suggest that she was probably exposed to the virus before she arrived in Malaysia.

She and her tour group, which included family members, stayed overnight in Kuala Lumpur upon their Feb 3 arrival in Malaysia and then visited Sabah from Feb 4 to 6.

Malaysia’s health ministry is investigating the woman’s illness, tracing her contacts, and sharing information with Chinese health officials, the report said.

The WHO reiterated its assessment that community spread of the virus from exported H7N9 cases in travelers is unlikely, given that H7N9 so far doesn’t transmit easily among humans. It said more sporadic cases are expected in China and possibly neighboring countries, and it urged travelers to countries with known outbreaks to avoid live poultry settings.

Officials institute more poultry controls

In poultry developments, Guangzhou, capital of Guangdong province, on Feb 15 temporarily closed poultry markets for 2 weeks to control the spread of H7N9, according to a Feb 14 Associated Press (AP) report. The announcement appeared on provincial government microblog.

The province, along with Zhejiang province, has been among the hardest-hit areas, especially in the second wave of infections.

In other developments, Vietnam’s government is stepping up efforts to prevent the spread of the virus to its poultry, according to recent media reports. The country’s agriculture ministry, after a meeting with officials on Feb 13, announced a ban on Chinese poultry, Than Nien News, a Vietnamese media outlet, reported on Feb 14. During the meeting authorities aired concerns about H7N9 detections in people and poultry in China’s Guangxi province, which borders northern Vietnam.

Local officials have been ordered to boost surveillance and test birds in poultry markets in Vietnam’s northern region, according to the report.

via Eight more H7N9 cases reported in China | CIDRAP.

Bird Flu’s Return in China Seen Sped by New Year Chicken

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A health worker sprays disinfectant at a poultry farm on April 11, 2013 in Huaibei, China. Human cases of H7N9 were first reported in China in March and spiked in April before agriculture authorities closed live poultry markets to limit human exposure. Photo: ChinaFotoPress via Getty Images

 

The avian flu strain that killed 45 people in Asia last spring is poised to return as poultry flocks swell before Chinese New Year, amplifying the virus that hides undetected in birds.

A 35-year-old man from the eastern Chinese province of Zhejiang is in serious condition after being infected with the new H7N9 flu strain, health authorities said this week. It’s the first confirmed human case in two months, according to the World Health Organization in Geneva.

Human cases of H7N9 were first reported in China in March and spiked in April before agriculture authorities temporarily closed live poultry markets to limit human exposure. The WHO counts 136 laboratory-confirmed cases to date. Three patients remain hospitalized and 88 have been discharged, the United Nations health agency said in an Oct. 16 statement.

“If an H7N9 outbreak starts again now it could spread much further in China and infect a large amount of people unless intensive measures are taken to control the outbreak in birds,” said Ben Cowling, an associate professor of infectious disease epidemiology at the University of Hong Kong’s school of public health, in an interview.

The more people who get infected with H7N9, the greater the chances of the virus mutating into a form that spreads more easily among people, Cowling said.

Even though H7N9 hasn’t mutated to become as contagious as seasonal flu, strains that emerge in China are of special interest to researchers. The 1957-58 Asian Flu and 1968-69 Hong Kong Flu pandemics were first identified in the world’s most populous nation, and an earlier bird flu strain known as H5N1 is thought to have come from the southern province of Guangdong in 1996. Years later, a new seasonal flu was found in neighboring Fujian and triggered explosive epidemics worldwide.

Outside China

H7N9 has turned up outside mainland China. In late April, officials in Taiwan reported a case in a 53-year-old man who had just returned to Taiwan via Shanghai after a business trip to the eastern city of Suzhou.

The virus can circulate widely in chickens, ducks and geese without causing the mass die-offs characteristic of the H5N1 bird flu virus. Its stealth has made it difficult to track and contain a germ that’s typically more active during the colder winter months, scientists said.

New Year Threat

“We are just heading into re-emergence in November and December,” said Malik Peiris, a virologist at the University of Hong Kong, who was part of an international team of flu scientists that assisted the Chinese government in April identify how people are catching the new virus. “It will of course peak at Chinese New Year because it’s the time of maximum poultry production.”

Chinese New Year is on Jan. 31 next year.

The latest H7N9 case, a man with the surname Liu, sought medical attention on Oct. 8 and is hospitalized in Shaoxing county, the Zhejiang health bureau said on Oct. 15.

Shanghai began reopening poultry markets on June 20 to cater to residents’ demand for live ducks and chickens, the official Xinhua News Agency reported last month. The Shanghai Municipal Commission of Commerce lists 102 live-poultry markets on its website. Shanghai’s largest, the Shuidian market in Hongkou district, reopened on Aug. 30 after glass partitions and separate exhaust pipes for areas used to store and slaughter poultry were installed, Xinhuareported on Sept 10.

Call to Cull

Agriculture authorities are counting on the measures to rebuff calls from health officials for mass culling of poultry to eradicate the virus. Doctors studying disease patterns in humans found that infected poultry are the principal source of the infections in people.

When the Ministry of Agriculture tested 68,060 samples collected from poultry markets, farms and slaughterhouses, they found only 46 — or 0.07 percent — tested positive for the virus, the official Xinhua news agency reported in April.

When researchers from the University of Hong Kong conducted their own survey based on 1,341 specimens from chickens, ducks and other birds, as well as 1,006 water and fecal samples from bird markets, they found H7 viruses in 60, or 2.6 percent of them, according to a study published in the journal Nature in August.

“There’s competing interests in China between economic development and human health, and there’s continual pressure on these two essentially competing interests at all levels of government,” said Hong Kong University’s Cowling.

Poultry consumers don’t want the markets to close, said Mao Zhenjin, 70, who was buying live chickens at Shanghai’s Yinghua Market on Wednesday to boil with potatoes and taro — a local specialty and one of his granddaughter’s favorite dishes.

‘Taste the Difference’

“You can’t make this soup with frozen chicken because it’s not fresh,” Mao said as he handed over 53 yuan ($8.70) for a 1.5 kilogram (3-pound) chicken. “It’s like buying fish dead for a long time — you can taste the difference.”

Six percent of blood specimens from 396 poultry workers in China were found to have antibodies against H7N9, according to a Sept. 18 report in the Journal of Infectious Diseases. That suggests dozens of people in contact with farmed birds have been exposed to the virus without necessarily getting sick. None of the 1,129 people from the general population had H7N9 antibodies.

“The data support the conclusion that influenza A(H7N9), or a closely related virus, is circulating in live poultry markets and that infected poultry is the principal source for human infections,” wrote the authors, who included researchers from Zhejiang University’s First Affiliated Hospital.

Cooler weather will enable viral particles to remain viable for longer in the environment, such as in the air, on surfaces or in water, Cowling said.

Death by Suffocation

In its severest form, the new strain damages the lungs so badly that it causes suffocation even as other vital organs rapidly shut down, doctors in Shanghai reported in April.

While laboratory experiments using ferrets — the most-common animal model for human flu infections — showed the virus is capable of spreading from person to person, the WHO said this week that there is no evidence of sustainable human-to-human transmission so far.

Cases reported to the WHO may represent “the tip of the iceberg,” the University of Hong Kong’s Peiris said in an interview.

In 2009, a novel flu virus known as H1N1 that evolved in pigs touched off the first influenza pandemic in 41 years. The H5N1 bird flu strain, which killed at least 380 people over the past decade, hasn’t acquired the ability to spread easily among people.

If H7N9 starts spreading easily from human to human, “then it’s a different ball game,” he said. “From all the evidence we have this could be much more serious than H1N1 was: looking at human lung tissue experimental studies — seasonal flu grows on it like a weed, H5N1 really struggles, and H7N9 grows like a bomb.”

via Bird Flu’s Return in China Seen Sped by New Year Chicken – Bloomberg.

Diabetes rises in China, reaching `alert` level

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Washington: Almost 12 percent of adults in China had diabetes in 2010, with economic prosperity driving the disease to slightly higher proportions than in the United States, researchers said Tuesday.

The overall prevalence of diabetes in China in 2010 was found to be 11.6 percent of adults — 12.1 percent in men, and 11 percent in women, according to the study published in the Journal of the American Medical Association (JAMA).

In the United States, about 11.3 percent of people over 20 have diabetes according to 2011 data from the US Centres for Disease Control and Prevention.

The disease was more common in China than in the United States even though the population was slimmer — average body mass index, a ratio of height and body weight, was just 23.7 in China compared to 28.7 in the United States.

“The prevalence of diabetes has increased significantly in recent decades,” said the JAMA study.

“These data suggest that diabetes may have reached an alert level in the Chinese general population, with the potential for a major epidemic of diabetes-related complications, including cardiovascular disease, stroke, and chronic kidney disease in China in the near future without an effective national intervention.”

Only 30 percent of Chinese with diabetes were aware of their condition, it said.

Further, about half of the population has high blood sugar, or a condition known as prediabetes, according to a nationally representative sample of Chinese adults.

Diabetes has been rising in China along with the nation`s economic growth. In 1980, the prevalence of diabetes was less than one percent of the population.

The latest findings mark a more than two percentage point increase over 2007, when a national survey found a 9.7 percent prevalence of diabetes, or about 92.5 million adults.

The current data puts the total number of cases of diabetes in China at 113.9 million.

Worldwide, diabetes affects about 8.3 percent of the global population, or 371 million people.

“China is now among the countries with the highest diabetes prevalence in Asia and has the largest absolute disease burden of diabetes in the world,” said the study.

The Chinese survey included more than 98,650 people and was led by Guang Ning, head of the Shanghai Institute of Endocrine and Metabolic Diseases and colleagues with the 2010 China Non-communicable Disease Surveillance Group.

Diabetes was more common in urban areas and among young and middle aged people who were overweight or obese, and was found to be increasing along with economic development.

The research suggested that one cause for the growing trend could be poor nutrition among pregnant women and young babies, combined with overeating later in life.

Type 2 diabetes is the most common form of the disease, and can be managed with improved nutrition and exercise, as well as medication if needed.

According to an accompanying editorial in JAMA by Juliana Chan of the Chinese University of Hong Kong, “rapid modernization” has fuelled an environment that encourages diabetes “characterized by food abundance, physical inactivity, and psychosocial stress.”

The CDC says that diabetes is a top cause of blindness, kidney failure and amputations of the legs and feet, and was the seventh leading cause of death in the US in 2007.

One in three US adults will have diabetes by 2050 if current trends continue, according to the CDC.

The disease is characterized by the body`s shortage of insulin, or an inability to use the hormone efficiently for converting glucose into energy.

AFP

via Diabetes rises in China, reaching `alert` level.

Bribery ‘routine’ for foreign pharmaceutical firms in China

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Chinese drug salesmen admit paying bribes. Martin Patience reports

Bribes are routinely paid by major foreign pharmaceutical firms operating in China, the BBC has learned.

Five drugs salesmen for foreign companies told the BBC their firms paid bribes in order to increase sales of their products.

None of them wanted to be identified, fearing they would lose their jobs.

The revelations come as Beijing widens its investigation into drugs-price fixing amid a bribery scandal engulfing drugs giant GlaxoSmithKline.

‘Inflated prices’

One of the salesmen said his company paid about $1,000 (£647) to get its product back on the shelves at one hospital.

 

It may cost us more if we have not paid the bribe. It will be a lot of money and energy”

Salesman

China drug costs: The human price

“I don’t deny [giving money to doctors] happens in foreign companies,” the sales representative said. “It is rare though and only very few people get it,” he added.

But he described an incident where a product had been cleared from a hospital’s shelves, which proved to be “an embarrassment” for him and his company.

“If we follow the normal procedure to recover it, it is very complicated. It will cost a lot of money and energy. We looked for a quick way.”

He admitted that strictly speaking, the money paid out to ensure the product returned to shelves was probably a bribe and that his manager signed it off. He said it would have cost a lot more to achieve the same result through official routes.

“It may cost us more if we have not paid the bribe. It will be a lot of money and energy,” he said.

Such revelations follow last month’s allegations by the Chinese police that the British drugs giant GlaxoSmithKline had engaged in “mafia-style behaviour”. GSK was accused of directing up to £320m through travel agencies to facilitate bribes to doctors and officials.

A detained Chinese executive from the firm told state television that bribes paid by his company had inflated prices of its products by a third.

GSK has said that it is co-operating with the Chinese investigation.

China’s health care spending is expected to more than double by the end of this decade.

By investigating possible drugs price fixing the authorities are hoping to tackle the rising costs.

via BBC News – Bribery ‘routine’ for foreign pharmaceutical firms in China.

Two die from H1N1 flu in China

Two Chinese women have died from the H1N1 flu strain in Beijing in the past 10 days
Two Chinese women have died from the H1N1 flu strain in Beijing in the past 10 days

Two Chinese women have died from the H1N1 flu strain in Beijing in the past ten days, the first reported deaths from the virus in China’s capital since 2010.

A 65-year-old cancer patient died on Friday and a 22-year-old migrant worker died on 27 December, the Beijing Daily said on its website.

Flu cases in Beijing are at their highest level in five years and the H1N1 strain has become the most dominant, the centre’s director Deng Ying said.

The rise in cases corresponds with weeks of record low temperatures in Beijing and across much of China.

H1N1 is a swine flu virus responsible for a pandemic that broke out in 2009, starting in the United States and Mexico and spreading around the world in six weeks.

Initial World Health Organisation estimates put the number of deaths from that global outbreak at around 18,500, but a study published last June said the death toll was likely to have been between 284,500 and 579,000 people.

RTE

Inflation Heats Up In China

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BEIJING (Reuters) – China’s annual consumer inflation sped to 2 percent in November from 33-month lows, data showed on Sunday, dampening the chance for further policy easing as the economy recovers.

 

Economists polled by Reuters had forecast November inflation to climb to five-month highs of 2.1 percent, compared with October’s 1.7 percent.

The National Bureau of Statistics said in the same release China’s producer price index dropped 2.2 percent in November from a year ago, narrowing from October’s 2.8 percent annual fall but sharper than forecasts for a 2 percent decline.

A recovery in factory-gate prices bodes well for China’s corporate sector, which has been battling falling profits.

Sunday’s price data support earlier indications that China’s economy is finally stirring from a slump stretched over seven straight quarters, thanks in part to the central bank’s policy loosening.

To reinvigorate economic growth, the central bank cut interest rates twice this year, lowered banks’ reserve requirements by a 100 basis points, and pumped cash into the banking system.

(Reporting by Koh Gui Qing and Aileen Wang; Editing by Paul Tait)

Copyright (2012) Thomson Reuters

Read more: http://www.businessinsider.com/3767c850054269d8039e0373c0f587b9#ixzz2EYjl2hJb

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