easytraveler

This is high alert! If you're planning a trip to China, especially to Shanghai, this is necessary information. Please read the article! The breakout is in Shanghai and environs.

http://vitals.nbcnews.com/_news/2013...id=msnhp&pos=1

Please take lots of hand sanitizer in those small 3-oz bottles and use often.

Please be very careful what you touch in China. And DON'T EAT RAW CHICKEN! Maybe just stay away from chicken dishes as much as possible, since half-raw chicken with the blood still showing is considered a delicacy sometimes.

Take all necessary preventive shots, especially those for tetanus and whatever the CDC recommends for China.

Here's the CDC site on preventative shots for China:

http://wwwnc.cdc.gov/travel/destinations/china.htm

Take as many preventative shots as you can, even the malaria ones if your hospital/clinic agrees with the CDC list. Some of the preventative measures have to start months ahead of time. I always took as many preventative shots as possible, which is why I could travel so much throughout Asia for business.

So, one ounce of prevention is worth a pound of trouble. You can't be careful enough, even if the current cases don't seem to have anything to do with already dead chickens. The cost of the preventative shots are minimum compared with the illnesses that could be contracted.

Take care! We need you back on Fodors!



Don't know if this topic has been posted before, as I'm not often on the Asia Forum these days. If it has, my apologies.

Kathie

The new strain of svian flu is of interest, but no traveler should be on "nigh alert" because of it. You may wish to forgo any visits to live poultry markets or chicken farms, but there is not really much more you might want to revise in your itinerary.

Don't eat raw chicken is good advice world-wide. Not because of a new strain of avain flu, but because of pathogens like samonella.

Shots for things like tetanus are wise even if you are staying at home. It is wise to get all of the recommended immunizations before traveling, but those won't keep you from getting the avian flu. Hand washing and hand sanitizers can help.

Also, there is no immunization for malaria.

easytraveler

Hi, Kathie,

Thanks for your valuable input from the medical side.

Sorry if my use of "High Alert" was confusing. I didn't mean it in any medical or scientific way, just as a way to warn travelers to China.

Hygiene in China is still an iffy matter, so taking all precautions is still a priority. Now that there's a deadly virus beginning to raise its head, that priority is a "high" one for someone like me.

The virus has now spread to Beijing and does have some virologists around the world worried. To chicken, therefore, the following article also has some adding eggs and pork to avoid.

http://behindthewall.nbcnews.com/_ne...id=msnhp&pos=4

I would also add any salads, peeled fruit, or other raw, uncooked food. Also don't get non-boiled water into your mouth, such as opening your mouth in the shower or using tap water to brush your teeth. Even in the best of hotels, the staff may not be always trained in good hygiene. For brushing teeth, use the thermos of boiled water that the hotel provides or bottled water.

I mean this post to be one of caution, especially to new visitors to China and, in particular, those who sign up for guided tours. Tour operators are into marketing China, not so much into health matters and will sometimes give only the minimal of precautions to take.

Hope this does not offend the sensibilities of any other Fodorites.

Kathie

Easy, I am wary of this sort of article that tends to stoke people's fears unnecessarily. Avoiding eating chicken, eggs and pork is not something recommended by any physician or scientist, but is just a quote from a "man on the street" who has decided to do this - no such advice has been given, nor is avoiding these foods likely to have any impact on the likelihood of contracting this virus.

Those who have contracted the virus have done so through close contact with live chickens, not from eating chicken.

While your advise about not eating raw or uncooked foods, using only bottled or boiled water, etc, is the standard cdc food and water precautions which one is wise to follow in all developing countries, there is no data indicating that this virus can be contracted through contaminated food and drink.

Kathie

Let me add what you, as a traveler, can do to prevent contracting the virus:

Avoid contact with birds. Do not go to the live poultry markets, or touch domesticated or wild birds.

There is currently no data to indicate that this virus can be spread from person to person. But if this virus does make that leap, careful hand-washing or use of hand sanitizer is likely your best defense.

While this is different from SARS, you may remember that with SARS, in investigating a cluster of cases in a hotel, they found that a number of people caught the virus from contaminated surfaces in their hotel, notably, elevator buttons.

easytraveler

Kathie: <i>Avoid contact with birds. Do not go to the live poultry markets, or touch domesticated or wild birds.</i>

I realize that you are a more sophisticated traveler to Asia than I am, but what you've said is not enough as a prevention:

<i>And while two of the three [who died] had had contact with poultry in the weeks before falling ill (one was a butcher, the other had been in a poultry shop), <b>one had no record of contact with birds</b>.</i>

http://www.forbes.com/sites/melanieh...urgent-report/

Forbes has labelled its article as "Urgent Warning", probably not as bad as "High Alert" but pretty serious.

I really believe that people who are travelling to China, either for business or for pleasure, should read the above Forbes article and continue to carefully monitor the situation. My purpose is not to arouse fear in people "unnecessarily". My purpose is to alert travelers to a potentially dangerous problem and therefore to take all necessary precautions, that's all.

This virus gives no warning, mutates really fast, and can be very lethal. When scientists talk about a possible "pandemic" in the respected New England Journal of Medicine, that's pretty serious stuff - at least to me.

Kathie

I don't think we are disagreeing that this newest avian flu is one that needs to be closely monitored by health authorities worldwide. New influenza strains are always concerning and always pose the threat of a pandemic. In that way, this is not different than the last few new avian flu strains. Southern China is the incubator for new flu strains coming from both birds and from pigs.

Your best protection (other then avoiding contact with birds) is frequent and thorough hand-washing and use of hand sanitizer as appropriate.

I've also read the case-finding work on this. There is one man whose disease vector is unknown (not uncommon at this stage of the research). But at this point, there is no indication that it can be passed via person-to-person transmission, the vector that is most worrisome. If it does move to person-to-person transmission, then it becomes a danger to travelers.

crosscheck

The media is now all over this story. Not clear whether this is a human-to-chicken or a dreaded human-to-human situation. Hope it's a scare rather than a pandemic.

This piece suggests that Tamiflu works - don't leave home without it.

http://www.businessweek.com/news/201...in-north-china

And who knew that there were long distance carrier pigeon races:

http://www.guardian.co.uk/world/2013...accinate-birds

Charging

well it turns out the Bird Flu was never much of a threat and I believe the UN just announced the outbreak "under control".
To put travelers on "high alert" by the original poster is in my opinion a bit overdoing it. Even at the peak of the outbreak in the most affected areas, the risk of catching bird flu was about as high as being struck by lightening.
Sensationalist media working there...

easytraveler

It appears that Charging's "risk" and supposedly having the flu situation in hand hasn't exactly turned out the way this propagandist would have us believe:

<i>The new H7N9 bird flu virus can be transmitted between mammals not only via direct contact but also in airborne droplets, and may be capable of spreading from person to person, Chinese and American researchers have found....

The World Health Organization (WHO) has previously said it has no evidence of "sustained human to human transmission" of the virus, which has killed 36 people in China.

<b>"The findings suggest that the possibility of this virus evolving further to form the basis of a future pandemic threat cannot be excluded," said the research team, led by bird flu expert and microbiologist Yi Guan....

The findings come just days after the WHO said the H7N9 virus appeared to have been brought under control in China thanks to restrictions at bird markets.</b></i>[bolding mine]

http://news.yahoo.com/bird-flu-strai...103334429.html

I didn't even use the word "pandemic", I just used "high alert" to sound a warning to travelers that they should take extra care. The people who are actually involved on the front ranks are the ones who have used the word "pandemic" several times.

Sorry, but I stand by my warning. This virus can mutate - so say the researchers - so extra care is still needed.

Kathie

Do read the link easy offers, as it makes clear that the current situation with this virus does not warrant any kind of "high alert" for travelers. Note that "The H7N9 virus is known to have infected 131 people in mainland China and one in Taiwan since February, but no new cases have been detected since early May."

The research does indicate that the virus can be passed ferret to ferret when the ferrets were caged together. The hypothesis is that the ferrets passed the virus via airborne droplets.

All viruses mutate, and the danger of this virus (as with every other new influenza virus) is that it CAN evolve (to develop the ability to be passed easily from person to person - something that has not yet happened) which would be the basis for the possibility of a pandemic developing.

Researchers in this area are paid to think about what circumstances would raise the possibility of a pandemic. Because influenza viruses mutate quickly, researchers are always on the lookout for new influenza viruses that have the potential to become deadly. It is their job to study these viruses and develop potential vaccines.

While interesting info, these is really no alert - let alone high alert - for travelers in this article.

easytraveler

Kathie:

I wouldn't have said anything if this strain of bird flu hadn't been characterized as "one of the most lethal" that has "baffled scientists"

http://www.foxnews.com/health/2013/0...uses-who-says/

It is not ordinary bird flu strain that costs $6.5 billion to date to "control"

http://www.reuters.com/article/2013/...94K0ZQ20130521

Had rigorous measures not been implemented and millions of chickens, etc. killed, this might well have been a pandemic.

For me, it would have been a disservice to travelers not to put them on some sort of alert, but that's just me. The health industry also finds a need to tamp down what it is afraid would cause panic, that's why the WHO came out two days ago to say that the situation is "under control".

Now there's a possibility of human-to-human transfer, which had been denied before. As far as I, a traveler, am concerned, this isn't just about not visiting chicken farms nor eating raw chicken any more. It's brings a whole new dimension to the care that needs to be taken for as long as the actual researchers say we have to be careful.

Kathie

"The health industry also finds a need to tamp down what it is afraid would cause panic,"

If you really believe that, then there is no point in me trying to explain to you what the articles you have linked to mean.

JPDeM

Been in China for several weeks now and nobody talks about this anymore over here.
With a population of only 8 million in my Canadian province, more people died from last winter's flu virus than in China with a population of 1.3 billion. And nobody canceled their trip to the Quebec city carnival.

easytraveler

Kathie: <i>If you really believe that, then there is no point in me trying to explain to you what the articles you have linked to mean.</i>

Are you saying that those in charge never feel a need to calm people down in face of a possible "pandemic"? Then the authorities are rather remiss and will be held responsible as needless panic ensues.

Or could you possibly explain why two days after the WHO announces the situation is "under control", the very researchers themselves feel a need to state that one shouldn't let one's guard down after all, because now human-to-human transmission is possible, a claim they didn't make before?

I really don't understand you. What objection do you have to warning people to stay on alert? All the time, we have warning labels on medications: "Might cause drowsiness..." Doesn't mean it will cause drowsiness, just that it might and to be alert to this situation. I suppose, by extrapolation, you don't think such warning labels are necessary.

<i>Been in China for several weeks now and nobody talks about this anymore over here.</i>

China's a big country. Were you really in the affected areas? Maybe they're not talking about it any more, because it has cost $6.5 billion to get it under even a modicum of control?

<i>With a population of only 8 million in my Canadian province, more people died from last winter's flu virus...</i>

Which Canadian province had 36 people die from the flu? Curious minds want to know.

Kathie

While I don't know the data for Canada, I expect all of the Canadian provinces had at least 36 deaths from influenza last year (and the year before and the year before...). Information on US deaths from influenza are described here: http://www.cdc.gov/flu/about/disease...ted_deaths.htm The estimates for the last 30 years in the US range from a low of 3,000 deaths to a high of 49,000. There is a high degree of variability in death rates depending on the virulence of each seasonal flu.

Easy, I think you are not accustomed to reading the scientific literature on influenza or other viral infections, so you misunderstand what these various statements mean.

- The WHO announces that the situation is under control because the original disease vectors have been interrupted and there have been no new cases in the area of China effected for more than twice as long as the incubation period.

- Researchers always work with any new virus to see under what conditions the virus might be passed from person to person. The statement made is only that it is possible (under very particular laboratory conditions), so the virus COULD mutate to enable person to person transmission. This is a VERY long way from saying that the virus is being transmitted person to person.

I think you underestimate how many people die from seasonal influenza. In comparison to deaths from seasonal influenza, the deaths from this new virus nave been miniscule. So why do researchers devote so much time and effort to researching each new virus? Because new influenza viruses have the potential to spread much more rapidly than our usual seasonal flu, as people do not have immunity (from previous flu infections) to ward off the virus. Some new viruses are more virulent than our usual seasonal viruses, so cause more deaths. A virus people do not have resistance to is thus more likely to cause a pandemic. So we want the researchers to work on this.

I have always advocated for providing people with the maximum amount of information about medical choices, about health dangers so people can make good decisions for themselves.

thursdaysd

See also:

http://www.cmaj.ca/content/168/6/761.2.full

But on the other side:

http://www.cbc.ca/news/health/story/...ths-crowe.html

Shanghainese

I have been in Shanghai and Anhui Province for the past 2 weeks, no local or foreigners talk about the chicken flu any longer. No one is eating chicken because there are no chickens for sale, we have ate hard boiled eggs and scrambled eggs with the family, at restaurants and B&B breakfasts. We believe it is not an item being discussed as a concern anymore.