April 13, 2013
China: 44 H7N9 Flu Cases, One In Beijing

A 7 year old girl in Beijing has H7N9 influenza. Her parents sell poultry. So probably still transmission from birds. 11 dead so far. The scary part:

Genetic sequence data indicate that the H7N9 virus may bind more easily to human receptors than avian receptors and that the virus may also be transmitted by air.

Scarier still: H7N9 causes brain damage and damages other organs. See this NEJM about the potential for a global pandemic written by Timothy M. Uyeki, M.D., M.P.H., M.P.P., and Nancy J. Cox, Ph.D.

We might still dodge this one. Hasn't shown up yet outside China. H7N9 might not mutate into a form easily transmitted between humans. But if it mutates into a form easily transmitted by humans then we'd better all prepare for how to live our lives for many months in relative isolation. See my 2005 proposal for workplace cocooning for ideas on how to do that while still enabling the economy to function.

If an especially lethal pandemic ever arises do not panic. Just find a way to restructure your life to reduce your exposure to other people. Figure out whether you can put together a trustworthy group you can isolate with, preferably a work group. Reduce your frequency of contact outside of that group to a very bare minimum. Then wait for a vaccine or for the disease to burn itself out.

Share |      Randall Parker, 2013 April 13 01:44 PM 

Kudzu Bob said at April 14, 2013 4:15 PM:

Forget Bird Flu. XDRTB (Extensively Drug Resistant Tuberculosis) is already Going Greyhound. The post-antibiotic era will be...interesting. I wonder how rich people will like living in Manhattan then?

Randall Parker said at April 14, 2013 7:32 PM:

Kudzu Bob,

We might need to move to West Virginia. Though I'm thinking farm areas will have low rates in general. Alaska has the highest TB rate in the United States:

Reports of new TB cases were statistically lowest in West Virginia in 2012 with an incidence rate of 0.4 compared with Alaska where the incidence rate was 9.0. The median incidence rate among the states was 2.3.

TB has been declining in the US for the last 20 years. XDR-TB is still very rare in the United States:

In the United States, 63 cases of XDR TB have been reported between 1993 and 2011*.

Will it spread in the United States? How fast?

What would help: extremely fast diagnosis so that XDR TB patients can be isolated.

James Bowery said at April 14, 2013 10:04 PM:

"very rare"? Sheesh.... Once you get beyond a few dozen, the only thing that really matters is the R0 among the various populations because you're just about guaranteed you haven't located them all. That's one reason I don't really buy the SARS narrative, that the public health measures taken were what stopped it.

Phillep Harding said at April 17, 2013 12:15 PM:

AIDS only took one in the wrong place.

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