January 4th stay at home parents, their next-door neighbor has a case of keeping pigeons; hospital patients where there is a diagonally opposite the main entrance of the road with a live bird markets transactions.Dr Zhang is reported to have self medicated when the disease onset on January 11th; meaning his last known DIRECT exposure to birds was on New Year's Day.
"No history of exposure before the onset of influenza-like illness within 10 days straight".It appears he began taking antivirals on January 15th, yet was still performing appendectomies at the Emergency Room..He stopped performing surgeries and checked himself into the ER on January 17th; he died on January. Colleagues blame Dr Zhang's rapid decline on being overworked at an understaffed hospital.
Public fears are that this was a case of Human to Human transmission. And based on disease onset periods, it is more probable that it was a case of Human to Human transmission than pigeon acquired.
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We broke on Twitter that a Chinese Emergency Room doctor had died of what was suspected to be H7N9 avian influenza; that information has been confirmed in the Chinese Press today. He has been identified as Dr Zhang Xiaodong, and is reported to be a well known Internet blogger.
Key information now coming out about the situation is that Dr Zhang had performed 5 appendectomies withing recent days;. we suspect that those GI surgeries were his route of exposure. H7N9 is primarily an intestinal disease in Birds and seems to have the same effects in humans. He may have had a patient who presented with appendicitis which was really driven by an H7N9 infection.
He is reported to have had a continuous fever for 2 days, which at some point (1 day before hospitalization?)was relieved by some sort of medicine, including IV fluids for dehydration, he received from his fellow doctors. Apparently he worked tirelessly through out this entire period of illness, and then within a 1 day period developed pneumonia which traveled from his lower lobes to at least one upper lobe; killing him.
The human to human spread risks with this situation are obvious; in that regard, his Emergency Room has been shutdown and the hospital staff have been directed to take ISATIS as a preventative medicine. ISATIS is a Traditional Chinese Medicine which seemingly the entire Chinese population has been taking in massive numbers to ward off bird flu. ISATIS is starting to be difficult to obtain in the United States, a brand we use- Thorne Research (no conflict of interest)- has had to discontinue production.
Further Updates to come.
Sources:
http://www.dfdaily.com/html/3/2014/1/20/1108201.shtmlhttp://www.news365.com.cn/xwzx/gd/gdyw/201401/t20140120_1767799.html
http://www.ntdtv.com/xtr/gb/2014/01/20/a1047572.html
http://sh.eastday.com/m/20140120/u1a7898742.html
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