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.

The name may conjure images of Medieval plagues or equestrian illnesses, but annual outbreaks of Hand, Foot and Mouth Disease have become very much a routine reality in Beijing.

Not to be confused with "Foot (or Hoof) and Mouth Disease" (which afflicts livestock), this viral born ailment is common in small children and infants and causes "fever and blister-like eruptions in the mouth and/or a skin rash." Late spring/early summer outbreaks are a common occurrence in the capital, and though it is generally not considered a very serious illness, a few deaths have been reported in Beijing in the past few years, including a one-year-old baby in April of this year.

Varying degrees of severity notwithstanding, Beijing municipal regulations stipulate that if two or more cases are reported in a single class within a week, the class must cease operations for ten days. Likewise, if ten cases are reported in a single kindergarten within a week, the entire school will be ordered to shut down operations for ten days as well.

This week one student at my daughter’s school has reportedly fallen ill (with no word, yet, on any others), so it remains to be seen if we will be obliged to babysit at home for the next couple of weeks should her class get suspended. As of this past Tuesday, parents have been restricted from entering the school grounds when dropping off or picking up their children (a measure which elicits mixed reactions in my mind). For now, it seems, the most sensible measure is for everyone in the house, especially the young ones, to continually and thoroughly wash their hands upon returning from outside.