Get ready for H7N9

Taiwan has geared up for combating H7N9. During his visit to the Central Epidemic Command Center (CECC) for H7N9 influenza today, Taiwanese Premier Jiang Yi-huah said that Taiwan’s health department is geared up to fight the spread of the new bird flu virus.

Referring to the nation’s first imported case of H7N9 infection confirmed yesterday, Jiang noted that it was the only confirmed case among the 133 people being tracked by the Centers for Disease Control (CDC). But as more cases are likely to surface in the near future, Taiwan cannot let its guard down, he added.

Jiang thanked Health Minister Chiu Wen-ta, CDC Director-General Chang Feng-yee and their teams for responding promptly during the initial outbreak and taking measures to keep the virus from entering Taiwan. However, as the outbreak continues to spread in mainland China, Taiwan may see more cases of imported infections given the frequent movement of people across the strait.

Whether the infections come from home or abroad, the CECC must follow the standard operating procedures that have been set up over many years, said the premier. He also reminded the Department of Health (DOH) and other agencies to review and improve such procedures as appropriate.

In yesterday’s case, the patient initially underwent several throat swab tests at local clinics and hospitals, all of which came back negative for H7N9. The infection was not confirmed until a sputum specimen collected later tested positive. Health workers should be aware that symptoms may not appear in the upper respiratory tract even after the virus has been in the body for some time, Jiang said. Hospitals and clinics must be on the alert to patients presenting fever and inflammation.

Since bird flu cases are mainly arising outside of Taiwan’s borders currently, Jiang asked the Ministry of Transportation and Communications, Mainland Affairs Council, Ministry of Foreign Affairs and the Ministry of the Interior to step up exchange of H7N9 information with mainland China, and to weigh public health versus economic interests when assessing whether to adopt travel restrictions. Authorities should also carefully evaluate new developments or response measures before announcing such information to the public. In order to win the war against H7N9, Cabinet members must take an active role in CECC’s operations and decision-making process, report important information under their jurisdiction, and carry out CECC policies in their respective agencies, the premier added.

To reduce the risk of virus transmission, the Council of Agriculture (COA) had planned to ban the slaughter of live poultry at traditional markets starting from June 17. But as the first case has already surfaced in Taiwan, the COA will monitor the situation closely and move the ban to an earlier date if possible and necessary.

Since this policy could affect sales at traditional markets, the COA will step up communication with poultry vendors. The DOH was also asked to support the policy by banning the sale of live birds as well, announcing the ban clearly and at the proper time. To eliminate the threat of avian-borne viruses in the long run, Jiang said the COA should amend the Animal Industry Act and the Infectious Animal Disease Prevention and Control Act to consolidate the legal basis for prohibiting the sale and slaughter of live poultry.

The CECC is taking active steps to stem the virus, paying special attention to:

1. Surveillance of the spread of H7N9

2. Border screening and controls

3. Fever detection and flu diagnosis

4. Case confirmation procedures, isolation and treatment

5. Vaccine development by the DOH

6. Antiviral drugs: If necessary, the DOH may ask the government to activate a special reserve fund.

Jiang said the development of a vaccine cannot wait. The DOH should speed up the work or purchase vaccines if necessary, and the Executive Yuan will provide full support.

It is natural that the public would feel shocked by news of the first case of H7N9 inTaiwan, noted Premier Jiang. However, citizens should not panic because experts do not believe this to be an instance of human-to-human infection. He advised the public to remain on the alert, maintain proper hygiene and avoid contact with live poultry and birds.

“People with flu-like symptoms such as fever and coughing should seek medical attention, and medical institutions must report suspected case in accordance with standard procedures,” he said.

The government plans to invite experts to study whether H7N9 virus will eventually become capable of human transmission. Taiwan will comply with all disease control measures recommended by the World Health Organization, indicated Premier Jiang.

“Because migratory birds fly south for the winter, disease control work will likely continue throughout the year into the winter as well,” remarked the premier. He instructed the CECC to gather opinions from medical experts and provide the information to the government as reference for policy-making.



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