Two pandemics? SARS 2 and H7N9

There are currently two viruses with apparent pandemic potential circulating in the world today – SARS 2 (nCoV) and H7N9.

Although many details are being suppressed, SARS 2 appears to be spreading human to human:

From Gulf News, May 6, 2013

The 13 cases linked to one Saudi hospital suggest the spread of nCoV may have reached a dangerous new stage in which it is spreading from one human to another, rather than infecting humans from another source such as an infected animal, according to infectious disease experts.

The virus has spread quickly: 13 people were infected between April 14 and May 1, nearly half of the 30 total cases that have been reported to the World Health Organisation. Of those 30 cases, 18 have died, giving the disease a case fatality rate similar to that of the feared H5N1 avian flu.

[snip]

Two terse emails posted on Promed over the past few days by the Saudi government suggest the virus spread multiple times from one person to another.

“It has to be person to person — I can’t imagine any other way,” said Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota.

“Animal contact doesn’t appear to play a role at all” in the latest cases, he said. Moreover, he said, the length of time between the dates of onset of disease in the 13 people-from April 14 to May 1 — suggests “multiple chains of transmission”.

From the Wall Street Journal, May 6, 2013

“People are sending messages, SMSs, saying, ‘stay home.’ That all the hospitals have the virus. All,” said one man, a cousin to one of the men who died and to two other men who have been sickened in the current outbreak and are still being treated.

The man confirmed an account from a hospital official in Hofuf that his three relatives had gone to three different hospitals in Eastern Province.

“The Ministry of Health just wants to close the books” by saying the latest outbreak is limited to one hospital, the man said, speaking on a Hofuf street lined with medical centers and pharmacies.

It is possible that the virus has infected a number of people in hospitals. This is primarily how the original SARS spread. If so, the virus can likely be contained with aggressive testing and infection control. However, if the virus is spreading easily in community settings, containment will be more difficult. We won’t know which of these possibilies to expect until the Saudi government stops hiding information.

There are now 129 reported infections and 31 deaths from H7N9 in China. The official story is that all of these cases are due to bird to human infection. This is almost certainly false because a number of clusters have been reported. Further, there are adaptive changes in the virus isolated in humans that have not been seen in birds. Release of all sequences from human cases would provide a better indication of what is going on in China, but this information has been suppressed by the government.

Both SARS 2 and H7N9 have the potential to cause pandemics. However, unless the relevant governments change their policy of data suppression, we may not know a pandemic has started until large numbers of cases have been observed in multiple countries.

And that is too late.

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