World Health Organization director- general Margaret Chan Fung Fu-chun warns bird flu H7N9 is particularly worrying as it could be a flu pandemic strain. This is because H7N9 is unique as it does not make chickens sick but is deadly in humans. Sick birds could usually provide early warning for imminent outbreaks, Chan told The Standard. This comes as Macau reported its first human case of H7N9 yesterday. "The biggest challenge for the world is the next influenza pandemic," Chan said.

1. WHO warns of H7N9 pandemic
Published at 15 December 2016 in The
Standard Hong Kong, Mary Ann Benitez and
Carain Yeung.
World Health Organization director- general
Margaret Chan Fung Fu-chun warns bird flu
H7N9 is particularly worrying as it could be a
flu pandemic strain. This is because H7N9 is
unique as it does not make chickens sick but is
deadly in humans. Sick birds could usually provide early warning for imminent
outbreaks, Chan told The Standard. This comes as Macau reported its first human
case of H7N9 yesterday. "The biggest challenge for the world is the next influenza
pandemic," Chan said.
The last flu pandemic was the human swine flu H1N1 which originated in Mexico in
2009, but was considered milder than most pandemics. Chan, who was the first to
notify the WHO of a new bird flu H5N1 when she was Hong Kong's director of health
in 1997, said that of the various bird flu viruses, she has paid attention the most to
H7N9.
"H7N9 is unique as compared to H5N1. Why? Because when it affects the poultry
population, it does not kill the bird. So we lost one early warning signal. We only see
human morbidity and mortality," she said. "In other words this is not causing disease
in birds, it is only causing disease when it jumps to humans. So we need to watch it. We
have been blindsided (by H7N9) as we don't have early warning signs in animals as we
do in H5N1."
Chan said the world could not get complacent with flu as the viruses are "highly
unpredictable and always full of surprises, starting from H5N1, H1N1 to H7N9,
H5N6." The H7N9 victim, a 58-year-old stall owner at Sociedade do Mercado
Abastecedor de Macau Nam Yue, a wholesale poultry market in Macau, has not
shown symptoms but has been quarantined along with his wife at Centro Hospitalar
Conde de Sao Januario.
Macau has culled 10,000 live poultry and the wholesale market has been closed for
sterilization. A three- day ban was imposed on live poultry trade. This followed the
discovery of H7N9 in the batch of 500 samples taken from imported silky fowls from
the mainland on Tuesday. Investigation by the Health Bureau of Macao said the man
handled the cages containing the infected chickens. He was sent to hospital and his
test results came back positive for H7N9 at night.
The male truck driver who delivered the batch of chicken had returned to the
mainland and Macau health officials said they have notified mainland counterparts.

2. "At this point in time, we see a wide spread of these viruses in both northern and
southern countries in different continents," Chan said. "They are still primarily
affecting the bird population. It has not gained sustained human- to-human
transmission. We still see sporadic human cases due to close contact with poultry,"
Chan said.
On Tuesday, Hong Kong's Centre for Health Protection said five men in the mainland
were in serious condition from H7N9. One man, 59, is from Fujian while the four
others are from Jiangsu, aged 32 to 64. All have poultry market exposure. A
spokesman for the center said bird flu virus activity increases in winter in the
mainland.
"The public should avoid contact with poultry, birds and their droppings and should
not visit live poultry markets and farms to prevent avian influenza, particularly during
travel in the Christmas and New Year holidays," the spokesman said. Mainland health
authorities have reported 783 human cases of H7N9 since 2013.