If you thought the coast was clear, you couldn’t be more wrong. We advise you all to remain vigilant as a spike in flu outbreaks, mainly triggered by the change of seasons and holiday travel, are on the way.

China Daily published that the next wave of flu cases are expected to occur in March, and while they won’t be as numerous as we saw in January and February, the strains are still very icky and worth avoiding at all costs.

China was recently hit by one of its worst flu outbreaks in recent years, leaving hospitals understaffed as the virus caused more than 273,000 recorded cases and 56 deaths, according to the National Health and Family Planning Commission. In January of 2016, flu cases numbered a little over 30,000, just to give a sense of how massive this outbreak was when compared to previous seasons.

While the spike in flu cases predicted for March will likely not be as fierce as our previous encounter, the Center for Disease Control and Prevention says that this new wave may coincide with the seasonal emergence of H7N9 bird flu, which is most active in March and is substantially more dangerous.

While they don’t expect a surge in bird flu cases like the 273,000 that occurred in January, more than 1,500 human cases of bird flu have been reported on the Chinese mainland since 2013, and have resulted in more than 600 deaths. So stay away from birds for the time being, and maybe wait a couple of weeks before taking up the sport of pigeon racing if that was on your Beijing bucket list.

Photo: China Daily

A second case of a new strain of avian flu has been reported in China, sparking fears of a repeat of last year’s H7N9 scare.

Details of the latest instance of the H10N8 infection remain scarce, though state news agency Xinhua reports that a 55-year-old woman was in a critical condition in a Nanchang hospital after arriving with symptoms of dizziness and a sore throat. The woman recently had “exposure to an agricultural market,” according to the Health and Family Planning Department in south east China’s Jiangxi Province. 

Reports follow the death of a 73-year-old woman, also in Jiangxi, who died in December last year after visiting a live bird market days before hospitalization. The case marked the first report of human H10N8 infection, although scientists had already detected the virus in wild and domestic birds.

Meanwhile cases of the H7N9 strain, which struck China in spring 2013 and is already responsible for over 50 deaths, continue to emerge across the east and south of the country. According to a report in yesterday’s Shanghai Daily, Zhejiang Province has seen new instances of the virus for 17 consecutive days since January 9.

Although official guidance on the new H10N8 strain is yet to emerge, it is likely to point towards avoiding contact with uncooked poultry and agricultural markets where possible. There remains no evidence of sustained human-to-human transmission with either strain at this stage.

UPDATE: The year’s first case of H7N9 in Beijing has been reported. Click here for full details over at our sister publication theBeijinger.

Photo courtesy of Padmanaba01 (Flickr)

• Mattresses
• Box springs
• Bed frames
• Headboards

• Under peeling paint and loose wallpaper
• Under carpeting near baseboards
• In upholstered furniture seams
• Under light switch plates or electrical outlets

• There are many possible signs of bed bug activity. The first would be seeing the bugs. Adult bed bugs are about the shape and size of an apple seed. A second sign would be case skins. As the juvenile bugs grow, they shed their skins, discovery of which can indicate their presence.
• After feeding, bed bugs return to their harborage to hide. They eventually defecate in these areas, which appears as black to brown stains on porous surfaces or black to brown mounds on nonporous surfaces.
• Bites also may indicate bed bug activity, but further signs will need to be found, since other sources can cause red welts on the skin, the best decision would be to hire bed bug control services to determine if you have a bed bug problem.

• Red, often with a darker red spot in the middle
• Itchy
• Arranged in a rough line or in a cluster
• Located on the face, neck, arms and hands

• When at home, follow these handy tips to help keep bed bugs at bay.
• Remove all clutter from your home, which makes finding bed bugs easier.
• Wash and dry your bed linens often using the hottest temperature allowed for the fabric.
• Closely inspect any second-hand furniture for bed bugs before you bring it into your residence.
• Inspect your residence regularly—after a move-in, a trip, when a service worker comes in or guests stay overnight.

Photo courtesy of Wikimedia commons

A 61-year-old woman from Langfang, Hebei province, is in critical condition after being infected with the H7N9 virus, the latest known case of bird flu on the mainland.

Most of those infected with the H7N9 bird flu virus have been older people with pre-existing medical problems, putting them at greater risk of getting critically ill or dying, according to China’s first comprehensive study of the new virus.

 

The analysis was led by scientists from Fudan University and was published in the latest issue of the New England Journal of Medicine.

Click here for the full story.

With this new case, it’s best to be cautious. Check Dr. Richard’s My Health Beijing blog for tips on how to avoid infection.

 Photo courtesy of wikimedia commons

A 7-year-old girl from a family of Shunyi poultry sellers is Beijing’s first confirmed case of H7N9. According to a report in the Wall Street Journal:

 The girl is in stable condition at a local hospital, it said. Officials said her parents are poultry sellers and live in Beijing’s Shunyi district. Authorities said her parents don’t appear to have the disease. Experts both inside and outside of China say the disease doesn’t appear to be contagious from person to person, which would make it considerably more dangerous.

There have been rumors all week of cases of H7N9 in Beijing, which officials had all previously denied until this case was confirmed today.  

According to the WSJ this brings the total number of H7N9 cases in China to 44, 11 of which have been fatal.

Check Dr Richard’s post on MyHealthBeijing for tips on how to avoid infection.

Hong Kong and Australia aren’t the only place that have been reeling from the surging demand for milk powder from the Chinese Mainland – the BBC reports that UK retailers, including Asda, Sainsbury’s, Tesco and Morrisons, have now also begun restricting customer purchases of such brands as Danone’s Apatamil and Cow & Gate as well as Nestle’s SMA milk powder. These measures are being spun as a "precautionary measure" to ensure supplies do not run low and manufacturers insist that "no shortages are anticipated."

Shanghai residents are on edge over the outbreak of A(H7N9) virus (a.k.a. The Bird Flu) but there is some encouraging news – a 4-year-old boy who was diagnosed with the illness has recovered, according to the WantChinaTimes (VPN needed). 

"From a clinical point of view, the boy has recovered," said Wu Fan, director of the Shanghai Disease Control and Prevention Center. His recovery proves that not every human infection of H7N9 is severe, Wu said. The boy will need to remain in the hospital for further observation, Wu added. The boy’s temperature is normal and he has no respiratory symptoms, said Yu Hui, director of the infectious disease department of the Children’s Hospital affiliated with Fudan University, where the boy is being treated.

Finally Reddit fans with kids take note: the site now has a new ChinaParenting board consisting of "Basically advice, stories and what-have-yous about being a parent in China whether foreign or Chinese.. anything goes" and including this thread on "Cross-Cultural Naming Conventions."

Shanghai’s been going through a rough patch lately – first it was tens of thousands of dead pigs found dumped in the Huangpu river and now two new cases of bird flu – it’s enough to make you feel a bit sorry for the citizens of our Great Southern Rival.

Yesterday the World Health Organization released a Global Response and Alert notice (GAR) citing Shanghai’s "two laboratory-confirmed cases of human infection with influenza A(H7N9) virus":

The first patient is a 74-year-old man, who became ill on 28 March 2013, and is now in critical condition. The other is a 66-year-old man who became ill on 29 March 2013 and is considered a mild case.

To date 18 cases (including these two new patients in Shanghai) of A(H7N9) have been confirmed in southern China, "including six deaths, ten severe cases and two mild cases," and over 500 more cases of people who have had close contact with the victims are being closely monitored. 

Alarming as this illness may seem, the encouraging news (for now) is that there has been no evidence of human-to-human transmission – the patients who have been stricken ill all worked directly with poultry – but the key question is if it’s only a matter of time before the strain mutates into a virus that can spread between people.

According to the Huffington Post, what’s got scientists particularly worried about the A(H7N9) virus, which causes pneumonia-like symptoms and difficulty breathing, is that it appears to grow more easily in the body temperature environment of mammals’ bodies than the H1N5 strain from a few years back.

Even more alarming is the possibility that in addition to humans other species, most notably pigs, may already be carrying the A(H7N9) virus as well, which has fueled speculation that Shanghai’s dead river pigs may be linked to the illness.

For now authorities have reassured the public that out of 34 randomly selected Huangpu River pig carcasses that have been tested so far, only one has tested positive for the A(H7N9) – but it remains to be seen if this sampling size is adequate enough to rule out a link.

And then there’s the matter of all the dead ducks, geese and swans found in the Nanhe River in Sichuan – Pulitzer prize winning science journalist Laurie Garrett, writing in Foreign Policy, reckons there is indeed a link between the dead birds and A(H7N9):

‘One very plausible explanation for this chain of Chinese events is that the H7N9 virus has undergone a mutation — perhaps among spring migrating birds around Lake Qinghai.

‘The mutation rendered the virus lethal for domestic ducks and swans.

‘Because many Chinese farmers raise both pigs and ducks, the animals can share water supplies and be in fighting proximity over food — the spread of flu from ducks to pigs, transforming avian flu into swine flu, has occurred many times.

‘Once influenza adapts to pig cells, it is often possible for the virus to take human-transmissible form.

‘That’s precisely what happened in 2009 with the H1N1 swine flu, which spread around the world in a massive, but thankfully not terribly virulent, pandemic.’
 

It all sounds pretty ominous, but is it time to freak out? Probably not – at this point you probably have a better chance of getting struck by lightning than coming down with A(H7N9), or even more likely one of the hundreds of other bugs that have been spreading through the city (and our office) now that the spring flu season is in full swing.

But if you think it better to be safe than sorry, the US Embassy has issued this advisory on a few precautions you can take (i.e. avoid eating runny eggs for breakfast) and over at myheathbeijing Dr Richard has a detailed post with additional tips.