H7N9 International Airport Alert: Strong Indication of H7N9 Travel Out Of Hong Kong

MAXIMUM ALERT !

On December 20th a Hong Kong resident was diagnosed as having an upper respiratory infection after she

 "presented with fever, chills, rigor, sputum, sore throat, runny nose and headache" 

While still sick, on December 25 she traveled to Dubai; her traveling companion(s) were also showing upper repository symptoms.


On December 26th , while still in Dubai, she developed loose stools, a symptom common with H7N9 patients.


On December 29th she returned to Hong Kong and was admitted to the Emergency Hospital with persistent systems (her traveling companions recovered).


We see this as a clear case of a possible H7N9 infected group of people traveling overseas while actively shedding virus. It is a case which shows there are no export controls on infected air travel in Hong Kong.

Dubai is the Gateway to Europe For H7N9

View Larger Map

SOURCE:

http://www.info.gov.hk/gia/general/201312/30/P201312300595.htm

MASSIVE ALERT! HHS Forces Doomsday Prepping on ALL Medicare & Medicaid Providers

UPDATE 3/11/13:
Drudge & NYtimes finally covering this story 3 MONTHS late. Seems they waited until current H7N9 risk seemingly subsided

-----------------------------------------------------------------------------------------------------


On 12/27/13 The Department of Health & Human Services will release a 453 page list of regulations requiring ALL Medicare and Medicaid providers to engage in Doomsday prepping.

The POTRBLOG team had hoped to shut down for Christmas but we knew that such media dead periods are when most vile government regulations are attempted (the Christmas vacation creation of the Federal Reserve as an example), so we had our eyes open.

The Government's rationale for imposing these Doomsday prepping regulations on ALL Medicare and Medicaid providers is Eye Opening TOO:

"Based on our analysis of the written reports, articles, and studies, as well as on our ongoing dialogue with representatives from the federal, state, and local levels and with various stakeholders, we believe that, currently, in the event of a disaster, health care providers and suppliers across the nation would not have the necessary emergency planning and preparation in place to adequately protect the health and safety of their patients. Underlying this problem is the pressing need for a more consistent regulatory approach that would ensure that providers and suppliers nationwide are required to plan for and respond to emergencies and disasters that directly impact patients, residents, clients, participants, and their communities".

Of course this is only part of the story, just in time for H7N9 fears, the entire Public Health system is getting a C4ISR overhaul and Federal integration that will make the NSA scandals look like a kindergarten prank.

 Sources:

https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-30724.pdf

Link to 3 MONTH late story from NY times

Happy, Happy, Happy; Right, Right, Right

Phil v. Francis - Why the media ducked.

Ask any Christian.  The Bible is always right.  After all, it is the Holy Word of God.  Phil quoted it as such.  Very many people who don't like what the Bible says simply aren't content with the happiness that their un-bibilical lifestyles bring.  Happy isn't good enough, they want to be Right.  And they need everyone else to affirm their rightness.

The whirlwind of controversy swirling around the (entertainment) media's thorny relationship with the stars of Duck Dynasty reached a fever pitch recently when the real stars of the reality show about "bitter clingers" got too real.  The patriarch, Phil Robertson, quoted the Bible (1 Corinthians 6:9-11) to GQ magazine.

GQ said he then paraphrases a biblical reference: "Don't be deceived. Neither the adulterers, the idolaters, the male prostitutes, the homosexual offenders, the greedy, the drunkards, the slanderers, the swindlers — they won't inherit the kingdom of God. Don't deceive yourself. It's not right."

Now many have pointed out that the Roman Catholic Pope Francis has also talked about homosexuality (though not fornication and drunkenness)  in the public realm recently, and he was titled Person of the Year by Time magazine and the homosexual magazine The Advocate. How? Were they unaware that the Roman Catholic church considers homosexuality a sin too? Is the pope Catholic?

Nah, say the pundits.  The difference is just that the pope was nice.  He reached out, showed humility, built bridges.  He didn't use offensive language.  From Time magazines website

Francis, though he privately holds to certain doctrine which some might see as “anti-gay,” has not used any of his public speaking opportunities to share these with the world. Instead, Francis has repeatedly offered grace to the LGBT community. At one point, he even uttered what might go down as the expression of public humility that singlehandedly saved the Church: “Who am I to judge?”

So it's all about not being offensive in your speech?

There’s a way to disagree with majority opinion without coming across as disagreeable. The Pope knows how to do this. Phil does not. As a result, we respect Papa, and shame Phil.

I don't buy it.  "Niceness" has never saved anybody from the media's clutches.  They can cut right through a nicely worded comment to gut the ideas they detest.

The "judge not" angle though, was right on target.

People don't like to feel wrong.  If someone is perceived as "judging" them, they can't help but feeling that the disagreement means there is a chance they might be wrong.

The LATimes presciently published an article on this very phenomena earlier this week.

Happiness is overrated: It's better to be right, study finds.

The husband and wife were helping a trio of doctors test their theory that pride and stubbornness get in the way of good mental health. In their own medical practices in New Zealand, they had observed patients leading “unnecessarily stressful lives by wanting to be right rather than happy.” If these patients could just let go of the need to prove to others that they were right, would greater happiness be the result?

So the husband agreed with the wife on everything over the course of several days, and the wife's happiness rating went up.  (The husband's went down). 

The team was able to draw some preliminary conclusions.
“It seems that being right, however, is a cause of happiness, and agreeing with what one disagrees with is a cause of unhappiness,” they wrote.

Hence the love for Pope Francis, who didn't quite say they were right, but didn't say they were wrong either.

Hence the hatred for Phil, who believes God is right, and is himself "happy, happy, happy".

Narcolepsy, Shifting The Blame Game In Time For Forced H7N9 Vaccination

Just in time to reduce public resistance to narcoleptically tied Adjuvant laced Flu vaccines, the blame game on what exactly is responsible for vaccine induced cases of Narcolepsy is once again flip flopping.

Previously the blame was placed on adjuvants used in  H1N1 vaccines. The blame was then shifted to adjuvants made specifically in  Germany by GSK; and supposedly by some witchcraft, the same adjuvants made by the same company (GSK), but in a different country (Canada) became safe.  Now that gambit has fallen apart too as the Canadian version has also been tied to Narcolepsy. That only leaves one thing left to blame in the ever moving narcoleptic shell game, they decided to blame the H1N1 virus itself.

Now what makes this blame shell game suspicious is that whichever causation theory that meets the immediate Governmental need becomes the means to the Governmental end; and, the theory which supports that end gets the public limelight.

The narcoleptic shell game so far has played out as follows::

(1) Government wanted people to take H1N1 vaccine -> Solution: blame Narcolepsy on adjuvants as they are not approved for use in the US Flu vaccines -> RESULT: Americans take H1N1 vaccine

(2) Government "needs" to use adjuvants in H7N9 vaccine ->Solution: approve the use of Canadian adjuvants and place blame on adjunvants made in Germany (by the same company)->RESULT: Canadian adjuvants added to H7N9 vaccine

(3) Canadians shown to come down with Narcolepsy -> Solution: blame the H1N1 virus instead of the adjuvant ->RESULT:  People can't UN-take the H1N1 vaccine, and now they have no longer have a reason not to take the H7N9 vaccine.

NEED:

The Government's "need" to use adjuvants in the H7N9 vaccine is primarily based on manufacturing, logistics, and economics. Adjuvants work by revving up your immune system, its like adding Nitrous Oxide to a car engine, the engine revs like crazy and engine damage occurs easily. Adding adjuvants to a vaccine allows them to use less vaccine, and that saves time and money. Of course revving up the immune system is the last thing you want to do when you face the risk of a potential immune disorder like Narcolepsy. To tie back to the car engine Nitrous allegory, Narcolepsy is the one of the forms of "engine damage" a person's body faces with they rev the immune system with adjuvants.

LIBERTY:

Choosing whether or not to take a vaccine is a PERSONAL matter of risk mitigation. Making an informed risk mitigation decision  requires good information. Yet it seems that the information promulgate is primarily that which supports a means to end.

When weighing the available public information, it is important to remember that Public Health is about the HERD and not the individual Cow. The farmer is willing to sacrifice individual members of the herd for the perceived greater good of the herd. The exception to that rule is the Prize Heifer, it gets special treatment and dispensations, odds are that you are not a prize Heifer in the Government's eye. And when it comes to Public Health, the Government's position is that the Bill of Rights is void where prohibited by law 

The question comes down to this: are you livestock (prized heifer or not) owned by the Government's Public Health Authorities, or do you own yourself? 

Sources: 

H1N1-Triggered Narcolepsy May Stem from 'Molecular Mimicry'

[H7N9 Vaccine] New Information, Its MORE Dangerous Than Previously Thought

[ALERT!] ALL 300 Million American Citizens WILL Be Given TWO Experimental Adjuvant Laced H7N9 Vaccinations!

Complex Systems: Origin of Virulence; Chaos, & Radioactive Black Dirt

  We don't own this video, we uploaded it for YouTube's friendly controls, and because it actually features a Systems thinker working in a field of myopic bean counters, most of whom have no understanding under what boundary conditions their methods / tools produce garbage.

If your only interest is in Radiation, and why contaminated soils turn black skip to 29:28
If you want info on how black mushrooms may prevent radiation sickness skip to 34:54
If your interest is chaos and virulence skip to 37:50
If you want to understand why there are few systems thinkers in Biology and related Sciences watch the entire video.
If you want to understand why much of peer reviewed Quazi science is a scam, skip to 43:21
We use the term quazi-science because the methods used are based on self referential mathematical inference.

There are a some weakness in the presentation, the most glaring of which involves passive global warming acceptance.

Here are the video details from NIH
:
Category: Joseph J. Kinyoun
Runtime: 00:56:48
Description: The worlds inside and outside our bodies teem with microorganisms, but most don’t make us sick. Fungi in particular seem to leave mammals alone. Of the 1.5 million known fungal species, only a dozen or so are relatively common human pathogens, while insects and plants are frequent fungal targets. Why the difference? Arturo Casadevall, M.D., Ph.D., will address that question—and the intriguing possibility that the demise of dinosaurs and the rise of mammals were linked by differing susceptibility to fungal diseases—in the 2013 Joseph J. Kinyoun Memorial Lecture.

Casadevall is Professor and Chair of the Department of Microbiology and Immunology at Albert Einstein College of Medicine of Yeshiva University in New York. His research centers on the questions of how microbes cause disease and how hosts, such as humans, defend themselves. To explore this dynamic relationship, Casadevall and colleagues have long examined Cryptococcus neoformans, a common fungus that is harmless to healthy people but can cause serious disease, including lung infections and fungal meningitis, in immune-compromised people such as those with HIV/AIDS. Many of the laboratory’s projects seek to understand how hosts defend against C. neoformans and how the organism’s virulence contributes to disease.

Casadevall received doctoral and medical degrees from New York University and completed an internship and residency in internal medicine at Bellevue Hospital in New York City. He is the author of more than 570 papers and currently serves as Editor-in-Chief of the online, open-access journal mBio. Casadevall is a fellow of the American Association for the Advancement of Science, serves on the National Science Advisory Board for Biosecurity, and co-chairs the NIAID Board of Scientific Counselors.

NIAID established the Kinyoun Lecture series in 1979 to honor Dr. Joseph J. Kinyoun, who in 1887 founded the Laboratory of Hygiene, forerunner of NIH, which launched a new era of scientific study of infectious diseases.

For more information go to http://www.niaid.nih.gov/news/events/meetings/kinyounSeries/Pages/2013KinyounLecture.aspx
Author: Arturo Casadevall, M.D., Ph.D., Albert Einstein College of Medicine of Yeshiva University in New York
Download: Download Video How to download a Videocast
Caption Text: Download Caption File
CIT Live ID: 13248
Permanent link: http://videocast.nih.gov/launch.asp?18211

Conroe Texas Mystery Flu, Duck Hunting, and H7N9 Avian Influenza

The Montgomery Tx health department released an update on the four still living mystery flu patients, but no word on the results of those who died. Of the four, one has tested positive for H1N1 influenza, two have been reported to have tested negative for all flu (not sure how broad that is), and the last victim is still awaiting results. The H1N1 result should not be surprising as it is pandemic in the Caribbean; it has this kind of killing pattern, and it seemingly likes the lower latitudes. Its possible and maybe even probable that all these cases are H1N1, BUT we have noticed a few correlations that make us not rule out the possibility of avian influenza H7N9.


The first thing that jumped out at us is that this part of Texas is duck hunting country.And, that part of Texas has had an abnormally wet and cool season leading to "what has been an impressive first 30 days of duck season." We expect the odds are low that North American ducks are carrying Pandemic H7N9 in 2013, but this exact area between Houston and New Orleans is where we would expect H7N9 to show up from natural transmission.

The second thing that jumped out at us is the reports of kidney and organ failure in the afflicted individuals, similar reports were made when H7N9 was also a "mystery flu". (its also known in to happen in critically ill H1N1 patients)

The third thing that caught our attention is the negative detections for influenza.  H7N9 also seems prone to evading detection, but that might also just be a function of the antiviral and testing regimes the Chinese are using.

The fourth thing that popped out at us that the primary H7N9 outbreak locations in China are in areas surrounding river deltas; Houston certainly fits this pattern.

It is possible that this may be H7N9 avian influenza, but we still think the risk is low. However, we also know that the authorities would be dragging their feet with any such information until they felt they were in a more positive response situation. For that reason, this is an Alert worthy event, especially if you live in the Houston area, as you'll be the first to face travel restrictions.  If its not H7N9, at least its a good preparatory dry run.

FDA Directs Critical Drug Manufacturers to Prep For Massive Employee Absenteeism

"manufacturers of drug and therapeutic biological products and manufacturers of raw materials and components used in those products develop a written Emergency Plan (Plan) for maintaining an adequate supply of medically necessary drug products (MNPs) during an emergency that results in high employee absenteeism."

The FDA comment period for this emergency planning ends January 2nd.  Obviously the connections with the outbreak of pandemic H7N9 avian influenza, aren't easily ignorable. There is obvious risk of a public health death spiral from a highly regulated closed system where the federally limited number of people who make the drugs are too sick to make the drugs to treat themselves. 

The obvious solution to such catastrophe is a free market system, which by its very nature has the greatest immunity to such risk. Instead, we have a top down Czarist driven system whose stability and responsiveness are legendary in the Pantheons of  Boondoggles. These systems would be laughable were they not so deadly. Exactly who won the Cold War?

Source:
https://www.federalregister.gov/articles/2013/12/02/2013-28735/agency-information-collection-activities-submission-for-office-of-management-and-budget-review

H7N9: China's Wet Market Mis-Focus and the Beltway Sniper's White Van

In 2002 the Beltway Snipers were randomly killing people;  law enforcement officials and the public were consumed with the (incorrect) hunt for a "white van" that was supposedly spotted at every shooting. Authorities even suggested that if people come under gunfire that those people should run in a zig zag pattern while simultaneously taking notes on white vans near by.

During that epidemiological hunt, apparently no one considered that white work vans were ubiquitous in the Beltway. A very similar situation may be occurring with China's focus on poultry wet markets and the "random" spread of H7N9.  The current (post wet market mitigation) efforts may bear more fruit investigating Streptococcus pneumoniae as a Sentinel of H7N9 infection in daycare centers.

There is little doubt that China's wet markets contributed to spread of #H7N9 during last Spring's outbreak. Our own take is that those markets amplified and served as a source of capacitance for relatively small population of feral propagating H7N9. In essence, the markets were like gasoline to an H7N9 spark; they allowed the disease to multiply in urban areas and spread to urban bird populations.

However, the situation in the wet markets is much less clear this winter. One thing the Chinese have done is to put in place measures that help prevent the spread spread of H7N9 from any particular day's poultry inventory to the next day's new/fresh poultry inventory, making the current situation more akin to putting damp lighter-fluid on a spark..

The wet market risk mitigation actions help reduce the markets' ability to act like an H7N9 amplifier & capacitor, moreover it pushes the FERAL transmission bottle neck back up to the poultry wholesalers and producers.  Given that the there is less massive poultry factory farming in China, there is significantly lower risk of feral H7N9 amplification at that point in the supply chain, but it does come at cost of easily tracing the outbreak back to its source.

The lesser understood risk factor is the size of the human H7N9 reservoir. The Chinese only a test a very small subset of possible Human H7N9 infections. In short, for most people, unless they have an unexplained case of  pneumonia, some proximity to poultry, and are showing flu like symptoms, they will not even get a rapid test for H7N9. If they do meet that criteria, they wont get a laboratory test unless the pneumonia turns severe. And typically, a rapid positive won't be publicly reported unless the later laboratory test comes back positive.

Give those restrictions it is possible there is a large swath of POSSIBLE missed human H7N9 cases (and deaths). The first place to look for those hidden infections might be in people with influenza like illness  (ILI) who also have Streptococcus pneumoniae. These people aren't tested because there is an explainable reason for them to have pneumonia, but that rationale white washes the fact that people with flu are 1000's of times more likely to come down with  Streptococcus pneumoniae. Unfortunately, it just so happens there is just such an ILI -Streptococcus pneumoniae outbreak going on right now in China, especially in school age children.

One thing to recognize in any war, public health or otherwise, is that the General's are always preparing to fight the previous war again; and that may be the case with the H7N9 risk mitigation efforts in China. The wet markets are important but they MAY no longer be the most efficient or cost effective target in the spread of H7N9.

The fact is that the testing and diagnosis criteria for H7N9 is self referential for wet market exposure, as such its epidemiological sleuthing significance drops off quickly once effective risk mitigation has been applied. As it stands now in China any hospital sickness or injury can be tied to the consumption of chicken or exposure to wet markets, as these are a ubiquitous cultural way of life.

Its much the same as tying any American's use of toilet paper to a particular sickness or injury; ask any American checking into a hospital  if they have recently used toilet paper and the answer will be yes. Much the same can be expected when asking someone in a Chinese hospital if they or someone they know has recently been to a wet market or eaten chicken.

None of this degrades the need for further wet market vigilance, but it does speak to the likelihood that opportunity costs of targeting other low hanging infection fruit may be have much greater return than a laser like risk mitigation focus on the wet markets.

We see the current state of H7N9 epidemiology as much akin to the hunt for the White Van the Beltway Snipers were supposedly using. Many a resource was wasted and many a van driver was dangerously inconvenienced when the real hunt should have been for a 1990 blue Caprice. To a lesser extent, this same phenomena may be occurring with Chinese wet markets today, and we'll make a wager that shutting down urban daycare and kindergartens will have a greater impact on today's spread of H7N9 than further mitigating the wet markets via shutdown.

H7N9 BIOAEROSOL: China Mirrors POTRBLOG Analysis

Our blog gets a sizable percentage of hits out of China; and it seems as if it may have done some good, as the Chinese are now recognizing Feather Epilators as a source of Aerosolized H7N9

"academics have reached consensus that hair removal machine is a risk factor, after the chicken in hot water burns, turn easily produce aerosol hair removal machine, if the virus could spread through airborne aerosols."

Source: http://news.ycwb.com/2013-12/17/content_5657871.htm
(H/T to Dave Roberts ‏@H7N9Influenza for the link thru to "H5N1" who sourced the link)

Read our detail analysis here:

Aerosolized H7N9 Bird Flu In Chinese Wet Markets

ALERT H7N9 Detected In PORTUGAL; Family Under Medical Observation

H7N9 Bird Flu has been detected on a small chicken farm in Mertola Portugal; All individuals who had interactions with the birds are under medical observation. 

The information currently being released indicates that the Portuguese strain of H7N9 has 78% commonality with the Chinese version of H7N9. It is unknown if the Mertola version is deadly to humans.

It is important to know that Portugal has strong cultural ties to China via Macau (a former coloney).
The primary air route between Macau and Portugal is Hong Kong to Dubai to Lisbon. However, given the genetic differences the infection is probably not related to human air travel. But, the infection may be related to bird migration from China.

Migratory flyways and bird habitats do make the transfer of H7N9 from China to Portugal possible. Its likely that such a conection has more than one degree of freedom, and as such would explain the drift in the strains.
If that is the case, it would mean the potential for more closely related H7N9 in migratory points between Portugal and China. As such, we consider this an Alert worthy posting.

Source Links:
http://www.ionline.pt/artigos/portugal/gripe-das-aves-virus-mertola-nova-estirpe-nivel-mundial/pag/-1

http://www.tvi24.iol.pt/503/sociedade/gripe-das-aves-mertola--tvi24/1516475-4071.html

(h/t for sparking our look into the situation)  Dave Roberts ‏@H7N9Influenza

454% Influenza Increase IMMEDIATELY PRIOR to Hong Kong H7N9 OUTBREAK !

In the week PRIOR to the December announced H7N9 outbreak in Hong Kong there was a 454% increase in people seeking Flu treatment from Chinese Medicine Practitioners. During the week the authorities announced the H7N9 cases, the doctor visits jumped another 142%.

The total increase in Flu treatment seekers has jumped a total of 644% from the week ending November 23 to the week ending December 7th. Such a massive increase has not been seen in the 3 prior years for which we have seen data. That same data also indicates that there was also unusual Flu symptom activity over the Summer months.  

UPDATED chart for week the ending December 14th:

Aerosolized H7N9 Bird Flu In Chinese Wet Markets

UPDATE 12/16/13: Our blog gets a sizable percentage of hits out of China; and it seems as if it may have done some good, as the Chinese are now recognizing Feather Epliators as a source of Aerosolized H7N9

"academics have reached consensus that hair removal machine is a risk factor, after the chicken in hot water burns, turn easily produce aerosol hair removal machine, if the virus could spread through airborne aerosols."

Source: http://news.ycwb.com/2013-12/17/content_5657871.htm
(H/T to Dave Roberts ‏@H7N9Influenza for the link thru to "H5N1" who sourced the link)

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The Mainland Chinese have used very sensitive tests and discovered three positive H7N9 samples in surface swipes taken from Chinese wet markets. The positive samples came from a cutting board, fecal droppings, and an epilator.

The epliator is a device better known as a mechanical chicken plucker. Rather than describe the device, at the bottom of this post we have embedded a Youtube video of a Chinese Plucker. When watching the video, note the exhaust at the bottom front of the device where the feathers are expelled. There are many homemade versions of this device, the most aerosolizing  versions have rotating drums.

Given the H7N9 detection, the epilators in use in markets likely are the greatest threat to those who do not have direct contact with the birds as they serve to make the virus airborne, especially if the bird is still bleeding from slaughter.

The winner in all of this is Tyson foods, as will it will corprotatize chicken production in China and thereby concentrate the infection potential to the factory floor. Those methods will potentially reduce sporadic small scale infections, however they increase the risk of large scale infection when escaped defects in the system occur.

Currently the Chinese have a reasonable approach to wet market risk mitigation. They close the markets daily for disinfection, and they make sure that bird inventory does not carry over from one day to the next. And they are encouraging people to have the dirty work done at the market, as opposed to taking live chicken home as shown in the 2nd graphic video below.  Together, those steps help to discretize the infection potential, and reduce the risk of creating large urban virus reservoirs.

However, the Chinese could significantly further improve the situation by ensuring that chicken slaughtering, epilating, and butchering (followed by disinfection) occurred before the market opened. Furthermore, they could stabilize supply by freezing excess inventory for use during higher demand periods.

Chinese Chicken Epliator in Action:

 GRAPHIC: Live Chickens Brought Home For Slaughter

H7N9: CDC Contracting Emergency Delivery Of Strategic National Medical Stockpile to the Pacific

The Centers of Disease Control is readying to make emergency air deliveries of the Strategic National Medical Stockpile (SNS) to US Pacific Island Protectorates and Allies. The CDC is contracting with air cargo carrier ASIA Pacific Airlines for three B727's  to make these emergency deliveries

Of course, Pacific Islands are likely to be the first to see H7N9 bird flu as high wealth Chinese flee Hong Kong. In fact the US Government war gamed pandemic influenza in the Pacific on August 27-30th, 2013 during OPERATION LIGHTNING RESCUE 2013

Lightning Rescue 2013 (LR13) was led by the National Emergency Management Office (NEMO) of the Republic of Palau and supported by the United States Army Pacific (USARPAC), which was the lead agency for this activity in earlier years. The three-day tabletop exercise, held August 27-29, focused on multi-agency coordination during the response and recovery phases of a major Pandemic Influenza/Infectious Disease (PI/ID) emergency

Video Coming Soon:

REMEMBER: The Government believes that a Public Health excuse trumps the Bill Of Rights

  

Sources:

Air Charter Transporation Services (ACTS) for the DSNS

Infectious Disease Exercise Strengthens Partnerships and Coordination

200000 Doctors Scrubs in 48hrs

Surge Delivery to the Pacific

[Breaking] Hangzou H7N9 Outbreak Also Likely Hospital Acquired

The truth, the whole truth, and nothing but the truth, seems to be a system foreign to the Chinese public health outlets, as we never get all three facets of the truth from them at the same time. It seems to us that Chinese have been molding information releases, possibly to control societal angst  

The case of the Zhejiang cluster also seems to fit that disclosure pattern. On December 1st  we noted that there were possibly two H7N9 cases in  Zhejiang, on December 6 the Chinese announced that there was a 2nd case and that he was a relative of the first case.

At that time, the authorities played down the human to human transmission aspect and pointed towards the 6 chickens owned by the "family". Today we find out that the 2nd H7N9 patient was the stepson of the 1st H7N9 patient and did NOT live with him. But rather, the stepson only had direct contact with the stepfather AFTER he started looking after him at the hospital. 

Frankly its not surprising that this would be another hospital acquired case, as we have seen poor infection control procedures in several videos and pictures released by the media. The Chinese seem to have a great reluctance to release any information pointing at human to human spread of H7N9; hopefully that means they see the fear of H7N9 as being a greater risk than the actual H7N9 infection itself. 


Alternatively, it could mean the authorities fear the loss of control greater than the loss of life. Certainly that was the case in their early years when they disarmed and slaughtered more than 20 million of their own people.  Hopefully it is not the latter, as that would not bode well for a global pandemic.


Source Links:
http://english.cntv.cn/program/china24/20131210/101387.shtml

[Explosion] NRC Activiates Incidence Response At Russellville Arkansas Nuclear Plant

 Initial radioactive releases (IF ANY) would have been local and moving Southward, any radioactive materials pushed upwards into the Jetstream via the fire and explosion would be well on to their way to Memphis and points northward to New Madrid, Missouri (see Jetstream Map below)

The situation is supposedly "safe" but that is always the initial claim. Moreover, the NRC's definition of "Safe" means you won't die of radiation posioning in the next week or so. Whether or not you get cancer 1-10 years down the road is not something that enters their definition of safe.

Source: http://www.nrc.gov/reading-rm/doc-collections/news/2013/13-037.iv.pdf

The US Government is ordering 14,000,000 doses of radiation thyroid blocker, but if you needed it now you and your loved ones would not have it. Buy it now, and give iOSAT out as Christmas stocking stuffers its relatively inexpensive at $6 for fourteen adult doses.

ALERT! US GOV Stockpiling 14 Million CHILDREN's Doses of Potassium Iodide "ThyroSafe"

The Department of Health and Human Services has an order out for 14,000,000 children's doses of Potassium Iodide, "ThyroSafe" brand, for February 1st delivery; price quotes are due by 12/23/13. Based on other Government possibly jointly related to H7N9 pandemic preparations, it appears that this stockpile is being readied for emergency delivery to Pacific Rim Island locations (more on that in a follow-up post)

Potassium Iodide (PI) is a thyroid blocker. It is used to prevent the thyroid from absorbing radioactive iodine. PI works by filling up the thyroid with iodine, thereby preventing any further absorption of iodine.

The quantity being ordered is 700,000 packages of 20 tablets each. Each tablet contains 65mg of Potassium Iodide. 65mg is a child's dose, the adult dose is double that amount. These specifications clearly indicate that this stockpile is for civilian purposes.  Last year the military had an order out for approximately 1 million doses of "iOSAT" (the adult dosage)

The quantity and dosage being order is sufficient to offer US Pacific Island protectorates (but not Hawaii)  roughly 20 days protection from radioactive iodine produced from a Fukushima fuel pool failure. In a nuclear war scenario 10 days protection is called for as the majority of radioIodines will have decayed within 10days after the blast. However, the Fukushima catastrophe is a continuously producing source of radioIodides; and as such, a fuel pool failure can produce massive amounts of radioactive Iodine for weeks, months, and years.


iOSAT and ThyroSafe make good Christmas stocking stuffers they are relatively cheap at $6 for 14 adult doses of iOSAT and $13 for 20 children's doses of ThyroSafe.  Both should last indefinitely if stored well, their printed shelf lives are 6 years. Amazon seems to have the best prices on both items, alternatively direct order from the manufacturer is advisable for the longest shelf life. But be aware that, the massive order from HHS may make ThyroSafe unattainable for some time period.

Source information

Potassum Iodide Solicitation Number: 14-284-SOL-0015A

FDA Q&A on Taking Potasium Iodide (MUST READ)

Healthcare and Public Health (Federal) Threat Operations Center (HTOC)

"Healthcare and Public Health Threat Operations Center (HTOC)",  Google it. You won't find anything, yet the organization exists.

Time and circumstances permitting we'll have more on this soon. In the mean time, if you know something feel free to share it in the comments below.

ALERT! Hong Kong: Tuen Muen Hospital Likely H7N9 Infection Point

Update 12/12/13:
Today two new cases of symptomatic individuals were reported at the Tuen Muen Hospital, these are individuals who shared the same room with the 80 year old male. Its unclear exactly how many person from the hospital show symptoms; some are patients and some are healthcare workers. All are on (and have been on) antivirals. Asymptomatic individuals are being held in quarantine else where.  So far it has been reported that all these individuals test negative; frankly thats not very reassuring. It appears they are only using rapid tests.  
Source: http://www.info.gov.hk/gia/general/201312/12/P201312120541.htm
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On December 6th we broke the news (on Twitter),  that an 80 year old male H7N9 patient had likely picked up a HOSPITAL ACQUIRED  H7N9 INFECTION  at the Tuen Muen Hospital in Hong Kong.  The Hong Kong authorities are dead set against acknowledging that likelihood.  We find this obfustication concerning because the MATH  (see below) of the situation clearly points towards the hospital as the likely infection source .  Assuming that the authorities are not incompetent, the situation likely means the authorities are hiding something, and that is what we find concerning.



 Based on  previously known  H7N9 infections, it has been reported in The Lancet:

(1)The MOST LIKELY time to H7N9 symptom onset is 2.4 days.
(2) The mean time to symptom onset is 3.1 days, with a Standard deviation of 1.4 days.
(watch the video above for more detail on the math, expressed in straightforward terminology)

 Here is what we know about the Tuen Muen Hospital (TMH):

(1)  3 days after entering TMH the 80 year old male tested positive for H7N9
(2)  TMH is currently having infection control difficulties as evidence by a Vancomycin Resistant Enterococci outbreak. 
(3) From Nov 27 to Nov 30th , TMH was treating a 36 year old female H7N9 patient
(4) On Dec 3rd the 80 year old male went to TMH for weakness related to heart problems and diabetes
he had no flu symptoms or fever, moreover he had no exposure to live chickens or other H7N9 sources.
(5) Another exposed patient at TMH has developed flu symptoms and fever
(6) A health care worker at TMH has developed flu like symptoms

Sources:

Comparative epidemiology of human infections with avian influenza A H7N9

[H7N9 TRIAGE DEATH PANEL] ONE Day delay in Hospital Admission may Significantly reduce ICU Loads & Costs

http://news.sina.com.hk/news/20131204/-7-3132734/1.html

Vancomycin Resistant Enterococci outbreak. 

http://www.info.gov.hk/gia/general/201312/08/P201312080610.htm

#H7N9 ALERT! 2nd #HongKong Victim! Infection timeline suggests HOSPITAL ACQUIRED #Infection @ 1st victim's hospital http://t.co/4fCCQxlB1W
— Potrblog.com (@Potrblog) December 6, 2013

Inflection Point Hong Kong: Hunker Down or Run While You Still Can?

We approach the th H7N9 situation in Hong Kong purely from a risk mitigation stand point; what's happening there now is a good primer for what could happen here in the USA later.

In an island state like Hong Kong there is always a quarantine risk to either keep people out or keep people in, one cannot expect the State to tip its hand on what its plans are, as it might make the lemmings run into the sea and exacerbate the situation. The key is to be able to recognize the risk potential and impact BEFORE the herd mentality takes over;  that point is probably neigh right now in Hong Kong.

As we see it now, there is prima facia evidence of human to human spread of H7N9 inside of Hong Kong, likely via primary schools and hospitals.

Given sufficient economic resources, the most risk avoiding action to take would be to take an extended vacation to a warm weather climate in the Southen Hemisphere (hello Australia).

The likely most cost effective risk avoiding action would be to shelter in place, and stock up on non perishable food supplies, medicines, infection control items, and water while you still can. Of course this assumes that H7N9 is not the end of the world as we know it; currently we think that that is a reasonable assumption to make, but it has a high price tag for being wrong.

If there is one simple preventative measure to take, it would be to purchase Chlorhexidine Gluconate surgical scrub; in the USA the brandname is Hibiclens. see this link for details:
BUY IT NOW! H7N9 FLU Pandemic Will Spark Run On CHG

We make no money from the sale of Hibiclens / CHG, but if it ends up saving your life feel, free to donate to our website in hindsight:

Hidden H7N9 Human to Human Spread In Hong Kong via Primary School Children

We strongly suspect Human to Human spread of H7N9 in Hong Kong, via Kowloon school children, tied to common bus routes. Currently the Creative Primary School is under intense scrutiny and testing from public health authorities as the 10 year old son of the H7N9 maid's employer attends there. We suspect the maid was actually infected by the children.

There has been a strange combination and concentration of  Influenza Like Illness, Pneumonia, and Gastrointestinal symptoms in primary school children in the Kowloon section of Hong Kong; There was a resultant death on November 17th, with symptom onset around November 11th.. The pneumonia was identified as Streptococcus, and we suspect it was a coinfection with H7N9.  Gastrointestinal symptoms are also strongly associated with H7N9.

Coinfection is suggested as Streptococcus Pneumonia rates and deaths have been unusually high in this group for the last few months, such an increase in amplitude would be expected with an H7N9 coinfection. Such coinfection would  likely preclude H7N9 testing and make symptomatic diagnosis of H7N9 highly unlikely.

If H7N9 does become a deadly pandemic, it may be called the Orphan's Flu, as the children will infect the adults and leave themselves orphans.

Map of Kowloon schools were these combination of symptoms have been reported:

Location "A" is the Palatial Coast Estate where the maid worked
Location "D" is where one of the children attended school
Location "B"&"C" are other schools on the same route where public health authorities conducted outbreak investigations just prior to public H7N9 notification.


View Larger Map

Source Information:

Students are disinfected contact Creative school
Influenza-like illness outbreak under CHP investigation
Outbreak of acute gastroenteritis in primary school under CHP investigation
3-year-old boy killed Streptococcus pneumoniae
Pui Ching Young Park and burst flu
Girl, 5, confirmed with fatal bug as lawmakers slam vaccine plans

HONG KONG: Eight Hundred New H7N9 INFECTIONS by 12/12/13, with 4 New DETECTIONS by 12/9

UPDATE 7: 12/18/13
A 26 hour emergency room wait is now being reported for patients who were triaged as "Semi-Urgent".  Previously the wait time we saw was 15 hours for any patient
Source:

http://www.info.gov.hk/gia/general/201312/18/P201312180602.htm


UPDATE 6: 12/14/13

Our rough estimate is being substantiated by Hong Kong's tracking of people seeking flu treatment Chinese Medicine Practitioners; there was a 644% increase in people seeking Flu treatment from the week ending November 23 to the week ending December 7th. See the chart here:
http://pissinontheroses.blogspot.com/2013/12/454-influenza-increase-immediately.htm
Prophylactic use of Antivirals is also affecting testing results, as there are multiple cases of symptomatic H7N9 in close contacts who are still testing negative.
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We estimate that by 12/12 there will be at least 800 cases of new H7N9 infections in Hong Kong, of this number we expect there will be 4 clinical H7N9 detections by 12/9 and 8 clinical H7N9 detections by 12/16

 Ours is a back of envelope calculation, it is based on reports that the H7N9 infected Indonesian maid has been coughing since 11/21 and reports that her employer's family are also coughing. We took a look at the infection timeline, and the potential numbers of people exposed during that time frame and ASSUMED NO AGGRESSIVE  ANTIVIRAL campaign for symptomatic persons, and  continued cold weather for the region.

Update #1.

Seven health care workers are reported to have symptoms, this is in addition to the 4 house hold members who also have symptoms, these 11 people are reported to have tested negative in a rapid H7 test.
And, in an interesting testing distinction an additional 6 individuals are waiting for laboratory testing to return results.  All 17 of these individuals are under quarantine and are undergoing antiviral treatment, an additional 200+ individuals are under observation and have been offered antiviral treatment.

It is important to note that patient zero tested negative 2 times before finally testing positive, and obvious H7N9 patients with full blown ARDS have also previously tested negative.


UPDATE #2 12/4

The situation is being called "EXPLOSIVE".  Emergency rooms in Hong Kong are bursting with patients with Influenza Like Illness (ILI), there is a 15 hour wait to see patients.  The Queen Elizabeth hospital was packed with more than 150 patients. Hospitals are starting to use temporary beds (meaning people are being admitted).

Source Link:
H7N9 scare forced burst QEH  flu Everyone crowded emergency room on the ward for more than 15 hours, etc. 

BREAKING UPDATE #3 12/4

Internal Hospital emails show that the #H7N9 infected Indonesian maid actually tested H7N9 positive on November 28th, FIVE FULL DAYS BEFORE THE PUBLIC WAS NOTIFIED OR QUARANTINE ACTION WAS TAKEN.
Source Link http://news.sina.com.hk/news/20131204/-7-3132734/1.html

Breaking Update #4  12/6
As we Tweeted earlier this morning, A 2nd victim has been confirmed in Hong Kong (we expect at least 2 more by Monday). This 2nd victim's time line suggests that he has a HOSPITAL ACQUIRED H7N9 infection which he picked up when he entered the EMERGENCY ROOM of the 1st victim's hospital. see: Inflection Point Hong Kong: Hunker Down or Run While You Still Can?

UPDATE 5:  12/10/13

Additional medical staff and 48 beds are being added to the Emergency Room in Kowloon. As we have previously reported, we suspect Kowloon Primary Schools are the current Hong Kong outbreak source. 
(see) http://pissinontheroses.blogspot.com/2013/12/hidden-h7n9-human-to-human-spread-in.html

The Hospital authority is also pledging to improve H7N9 diagnoistics.
Source: http://hkm.appledaily.com/detail.php?guid=18545945&category_guid=4104&category&issue=20131211

ALERT: Report of Hong Kong Conducting H7N9 Quarantine Raids And Search For Mystery Travel Companion

Update #3 12/3 :  Reports that over 200 people are being monitored for H7N9. The afflicted family lived on the 15th floor of  Palatial Coast Block #5, retail value roughly $7,000,000. Reports indicate that 'heavily armed' cleaners are disinfecting the entire property.  

We estimate that by 12/12/13 approximately 800 people will be infected with H7N9 as a result of this outbreak. more details at this link:
http://pissinontheroses.blogspot.com/2013/12/hong-kong-eight-hundred-new-h7n9.html


Update #2:  The 36yr old maid worked for a family of six: A 40 year old couple with two sons 10 and 13 years old, plus their elderly parents aged 78 and 80 years old. The age range is concerning as it connotes the potential spread to all age groups in Hong Kong, especially given the long exposure period.

Update: Confirmed reports of at least 10 people in Quarantine, expect this number to grow quickly.
Source: http://hk.news.yahoo.com/
---------------------------------------------
There is an unconfirmed report of Hong Kong Health authorities rounding up suspected contacts of the 36 year old H7N9 infected Indonesian maid.

Ambulances and masked health authorities were reported to have made a 1 am raid at the  Palatial Coast housing estate in Hong Kong, where a number of masked men and women were been seen taken to the Princess Margret Hospital. Targets also included patients and persons who may have come into contact with the 36yr old female victim at a private health clinic.

A full blown search is also underway for a mystery traveling companion who accompanied the H7N9 victim in the Mainland. Reportedly scant information on the traveling companion is available. We do not discount the possibility this person returned to Indonesia.


Palatial Coast Housing Estate (courtesy wiki)

Google Map of the Palatial Coast Housing Estate


View Larger Map

Two New H7N9 Cases in China? Reporting Delays and Discrepancies of Concern

UPDATE 12/6
It seems as if we called this one right on the money, the son of the Zhejiang patient is also #H7N9 positive, reports indicate he came down with high fever around the same time his father's case was being confirmed.
We suspect the son tested positive on a rapid test, and that announcement was delayed until labratory confirmation occurred.  This same pattern of not notifying on rapid  test results was also reported in the recent case of the 36 year old Hong Kong maid. That delay is likely responsible for what appear to be a large outbreak in the making in Hong Kong.
Source:(h/t "A biologist")  http://news.xinhuanet.com/politics/2013-12/07/c_125822263.htm

----------- ---------------------------------------------------------------------------------------------
What we know so far:

Patient Name:XX (Moumou)  Age 57; Sex: Male residing in Zhejiang
Fell ill on November 20th and hospitalized on November 22nd
As reported by the Hong Kong health authorities on November 28th
Source: http://archive.news.gov.hk/tc/categories/health/html/2013/11/20131128_154441.shtml


Patient Name: Zhang  Age? Sex Male? residing in Anji (Zhejaing)
Went from his HOME to the emergency room on November 26th with respiratory failure
As reported by Mainland Media on November 29th
Source: http://finance.chinanews.com/jk/2013/11-29/5561832.shtml

Given how slow and secretive the Chinese were about the previous two reported H7N9 cases, it is possible that these are two separate H7N9 cases.

However if they are the same case, the large time delay from hospitalization on the 22nd to H7N9 confirmation on the 27th indicates that all is not as it seems in China when it comes to detecting and reporting H7N9.

Toss in to the mix the recent French quarantine of a jet returning from Asia because passengers were showing flu symptoms, and it may be inferred that the Global authorities have greater concerns than are currently being publicly let on.

Details on Paul Walker's Death Car

We looked at this because of rumors that Fast & Furious actor Paul Walker died in lithium fire from a "green energy" Porsche. The reported difficulty in putting out the fire led some credence to the rumor, as burning lithium is not something that is readily "put out".

We dug a little deeper and found the 2005 Porsche Carrera GT listed on Walker's dealership site, its pretty clear to us that it's apparently not another green energy death.


Here are the details on the car listed at Walker's Dealership:

VIN#  WP0CA29815L001131
 2005 Porsche Carrera GT
Engine: 5.7 liter V10


The car

The passenger (Walker) seat in the car

Driver's seat

The Engine

ALERT: Unusual Increase In Airborne Radioactivity, Saint Louis

There is an unusual 20-30% increase in Airborne radioactivity blowing into the Saint Louis area, tied to the Fukushima jetstream moving into the area.  We can not say with certainty that the increase is Fukushima related; given the high surface winds, we don't don't discount the possibility that the radiation increase may be from Weldon Spring Ordnance Works Nuclear Superfund Site:

If the increase in radiation is related to Fukushima we would expect elevated readings to soon be reported from other reporting locations.

  A screen capture of our Live Indoor and Outdoor Radiation monitors {link}

Weather Conditions at the time:

Sunshine (no rain)
79F
High Winds from the South and West, @ 20-40 mph with Gusts 30-60 mph
Jetstream blowing in from Fukushima

CDC's Secret Security Force, Not Very Secret, But Definitely Scary

The Drudge Report had a headline today informing people about ObamaCare setting up a Secret Security Force. For those aware of what is going on with the Government's H7N9 pandemic planning, it is not very secret. But it is something the media does not cover much, likely because of the concern it would cause if the citizenry knew that- yes the CDC believes it has the authority to put a gun to your head and force you to take that shot of experimental H7N9 vaccine. And, oh by the way, they just did order 600 million syringes to give every person in the USA two shots.

Moreover, not only does the CDC have the 600 million syringes on the way, they just created a new Division, and are staffing a that Division, for the primary purpose of nationalizing state and local health departments by embedding their own people in these health departments and by moving the locals onto the Federal payroll.  Of course you need not take our word for it they are very forthright about the situation and plans in their announcements in the Federal Register and their orders of FedBizOpps. see the source links below





Source Documents:
https://www.federalregister.gov/articles/2013/10/25/2013-24941/statement-of-organization-functions-and-delegations-of-authority

https://www.federalregister.gov/articles/2013/10/01/2013-23834/guidance-for-temporary-reassignment-of-state-and-local-personnel-during-a-public-health-emergency

https://www.federalregister.gov/articles/2013/10/25/2013-25184/agency-information-collection-activities-submission-to-omb-for-review-and-approval-public-comment

U.S. Public Health Service Commissioned Corps  MEDICAL OFFICERS BEST KEPT SECRETS U.S. Public Health Service Commissioned Corps Opportunities


ONE Day delay in Hospital Admission may Significantly reduce ICU Loads & Costs

CDC Says: "the US health care system is likely to be overwhelmed" from a Fall 2013 H7N9 Outbreak

CDC Plans Live EMERGENCY ALERT SYSTEM Pandemic Flu Broadcast

[FEMA] 48 Hour Delivery Order: 100,000 "Doctor Scrubs"; 1000 (100 Person) Shelters; + Fuel, Showers, Bathrooms, and Hygine Equipment; Apparent Mobilization of the National Disaster Medical System

[ALERT!] ALL 300 Million American Citizens WILL Be Given TWO Experimental Adjuvant Laced H7N9 Vaccinations!

Chris Farely Faked His Death, Changed His Name To Rob Ford, and Became Mayor of Toronto

Saturday Night Live actor Chris Farely supposedly died in 1997,
but the video evidence shows him as being alive, not well, and working in his new job as mayor of Toronto, Ontario, Canada, under the assumed name of Rob Ford.

See the videos below for the unmistakable evidence.

Toronto Mayor "Rob Ford" (aka Chris Farely aka Matt Foley)

Chris Farely (aka Matt Foley, aka Rob Ford):

Apparently Mr Farely took  Mr Ford's identity after discovering him dead at the scene of a DUI accident in Miami in 1999. Mr Farely had been secretly living in Cuba between 1997 and 1999, and managed to return to Miami in a boat flotilla that same year. Sadly, both Jim Morrison and Jimi Hendrix died at sea on the same attempted return trip.

ALERT! Airborne Radioactive "YELLOWCAKE" Leak In Richland, Washington

There was a airborne Yellowcake release in Richland Washington, it had the makings of a catastrophic failure in both their primary and secondary filtering systems, it is the 2nd time we know that it has happened.

EMERGENCY OVERVIEW: Very toxic: danger of very serious irreversible effects if swallowed. May also have serious irreversible effects through skin contact or inhalation.

Based on NRC Event Reports  #49524 and #45402

Once again the NRC reports that AREVA's Yellowcake is flying into the air in Richland Washington. Albeit, its supposedly below the point where you'll be legally able to prove they caused your cancer, or as they put it in their own terms  "Potential dose to a member of the public and the effect on the environment are essentially negligible."  Unfortunately there is no good way to know how long they have been spewing out the  ammonium diuranate this time, but we do know they have learned anything since the last time they did it in 2009.

AREVA seems rather lackadaisical about the whole thing, after all they claim  its "still below required administrative action levels". But don't worry, because 

"A Corrective Action Report, 2013-8809, was written on November 8, 2013. The cause of the apparent deterioration is under active investigation. Steps to prevent recurrence will be developed as appropriate."

Of course that is the exact same thing they said back in 2009 the last time AREVA spewed Yellowcake over Richland.

"A Corrective Action Report was written on October 1, 2009. The cause of the apparent deterioration is under active investigation. Steps to prevent recurrence will be developed as appropriate."

It certainly seems their so called corrective action is to boiler plate the same report over and over again. Beyond that, they seem more than satisfied to rely on multiple catastrophic filter failures as their primary  means of system maintenance.

In the end, anyone living down wind or down river of this location should expect to have fewer birthday cakes as a result of this recent Yellowcake release. But if the NRC lets this kind of tight rope walking incompetence continue at AREVA, a large scale nuclear catastrophe is just waiting to befall on the public.



View Larger Map

BREAKING! Possible / Likely H7N9 Outbreak In Hong Kong

Update 11/12:

The outbreak location has been identified as the Hong Kong Ling Liang Church Kindergarten @ Causeway Bay . From all reports the school has a very good reputation.

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Note that the suspected outbreak is in Wan Chai, HK;  a geographic hotspot for H7N9 coming in from mainland China (see map below)

From the Hong Kong department of Public Health:

"

Influenza-like illness outbreak under CHP investigation

11 November 2013

The Centre for Health Protection (CHP) of the Department of Health is today (November 11) investigating an influenza-like illness outbreak at a kindergarten in Wan Chai affecting 20 pupils, and hence reminded members of the public and staff of institutions to maintain good personal and environmental hygiene against influenza.

The affected pupils, comprising 14 boys and 6 girls aged between 3 and 6, developed symptoms of upper respiratory tract infection, including fever, coughing and sore throat, since October 31.

One of the girls aged 5 required hospitalisation and has been discharged. The respiratory specimens of the girl and another 6-year-old boy both tested positive for Influenza A upon laboratory testing.

All the affected pupils are in a stable condition.

Officers of the CHP have visited the school and advised the management to adopt measures against respiratory tract infection.

"

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Source Links:

http://www.dh.gov.hk/english/press/2013/131111-2.html

http://news.sina.com.tw/article/20131112/11096314.html

H7N9 CLUSTER ALERT! 63 People in Quarantine After Contact With Infected 3yr Old

A new report out of Hong Kong states that 63 people are under a one week quarantine after coming in contact with "Andy" the 3 year old boy who was reported as being H7N9 positive yesterday. See the known time-line of his infection here: The quarantine number is up from the 7 to 9 people who were originally stated as being under quarantine.

We have marked this as an Alert because the high number of people being quarantined; we suspect this is actually indicative of a cluster.  Given claimed poultry transmission route, it certainly seems strange that they would quarantine persons supposedly associated with ANDY rather than the supposed infection source. Especially since the first photos of Andy in isolation show him and his visitor not wearing masks PPE.

So far, two health care workers and Andy's father are reported to have the flu, but are supposedly not testing positive for H7N9. It seems there is more to this case than is being let on; we'll wager that were this case not in close proximity to Hong Kong, there would be a near information blackout on this case similar to what is occurring in Jiaxing with the 64yr old infect female farmer. That case may be tied to its own cluster, see that report here.

UPDATE: 28 of the quarantined individuals are school children all of whom are reported to be asymptomatic. More troubling however is that medical personnel are also in quarantine.

Other factors of concern are:

(1) None of the market chickens have tested positive
(2) There are a large number of people with Influenza Like Illnesses in the area,
BUT THERE IS ONLY A LIMITED CAPACITY TO TEST THESE INDIVIDUALS FOR H7N9.

Under these conditions, and given the long time it took to diagnose "Andy", a large quarantine group looks like a stop gap measure. We seek a significant risk of spread from this situation. On the positive side, there is no large reported death count yet; hold your breath for worse news within the next 10 days.

Expect a very strong push in the USA for Seasonal Flu vaccination.

Source Information:
http://www.scmp.com/news/china/article/1349382/fourth-case-h7n9-bird-flu-confirmed-china-3-weeks
http://news.cqnews.net/html/2013-11/07/content_28547605.htm

UPDATE 11/8: Cluster Alert! Additional H7N9 Case in Jiaxing City, China

On October 25th we reported via Twitter that there were UNCONFIRMED reports of an H7N9 cluster in Jiaxing City China, related to the case of a 67 year old male farmer whose infection was announced on October 23rd.

Today (11/5/13) we have confirmation, via Macau, that a 64 year old female farmer from Jiaxing was reported as being H7N9 positive on November 4th.  In a giant warning sign, the Chinese have only reported minimal information on this situation. 

We suspect that situation is related to the rumored cluster in Jiaxing; bear in mind that the Zhenhang province is a disaster area from Typhoon Flooding in October. 



UPDATE 11/7:  As we suspected, the Jiaxing is a cluster, the 64 yr old female lives across the river from another H7N9 victim, likely the 67 yr old male farmer. The Chinese authorities are looking for further cases and have the area under strict qurantine and are taking disinfection actions.

Here is the direct machine translated quote:

"the emergence of cases it makes sense. The patient at home, chicken, close contact with poultry, and her home and family on one case in Jiaxing patients are separated by only a river. "An indication that the area may have a virus spread, the need for strict quarantine disinfection measures do, and pay close attention to whether there will be a third cases."

One thing to note is that things the rest of the world call rivers are typically referred to as creeks here in the USA.  Shown below is a Google map of the general location where we believe the infected area is located.


UPDATE 11/8
While information is still scarce, the mainland Chinese media are now reporting on this case publicly.

So what ever happened in this cluster, it took 2 weeks for the Chinese to either clear it up, clean it up, or otherwise feel comfortable about the outcome.

Based on the news black out time period  length (Oct 25-Nov 8th) and the known  H7N9 incubation periods, the Chinese likely suspected that this cluster could be explosive (no doubt the typhoon flooding did not help matters).  Our SWAG is that there was a concurrent outbreak of Influenza Like Illness [ILI] in this location, and that the Chinese believed it was H7N9 related.

It is plausible that such a ILI outbreak was actually H7N9; the Chinese reaching such a conclusion would be the obvious cause of their apparent policy shift that the food shortages from an H7N9 cull / market shutdown would have a greater impact than the spread of H7N9.

If this conjecture holds true, expect the Chinese media to dial back any hysteria or panic causing reports related to H7N9.  The question still remains though, how different will the impact and spread of H7N9 be once it gains a foot hold outside of the Chinese population.

A different H7N9 pandemic expression in the rest of the world's population is a wild card that should not be underestimated as the Chinese public as a whole has taken preventative Traditional Chinese Medicine "self help" countermeasures. Moreover, the Spring 2013 H7N9 outbreak may have served to inoculate many Chinese against the ravages of a otherwise more severe Fall 2013 outbreak. In that regard, the rest of the world may still be a sitting duck. The next few weeks will tell us just how dangerous this current incarnation of H7N9 really ends up being.






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Source links:

http://www.gcs.gov.mo/showCNNews.php?PageLang=C&DataUcn=73755

http://news.qoos.com/%E7%97%85%E6%AF%92%E6%B4%BB%E8%BA%8D%E8%A1%9B%E5%B1%80%E7%B1%B2%E9%98%B2%E7%A6%BD%E7%96%AB-1568807.html

http://news.qoos.com/%E8%A1%9B%E7%94%9F%E5%B1%80%E6%8E%A5%E7%8D%B2%E5%85%A7%E5%9C%B0%E5%85%A9%E4%BE%8B%E4%BA%BA%E6%84%9F%E6%9F%93H7N9%E7%A6%BD%E6%B5%81%E6%84%9F%E7%97%85%E4%BE%8B%E7%9A%84%E9%80%9A%E5%A0%B1-1568909.html

http://hznews.hangzhou.com.cn/kejiao/content/2013-11/08/content_4958015.htm