H7N9 avian influenza and novel coronavirus: Is there a pandemic potential?
With the recent emergence of two viruses not seen in human infections before, experts and the general public wonder, how serious could these infectious diseases be?
Since April 2012, the novel (new) coronavirus (nCoV) has been confirmed in 17 people on the Arabian Peninsula and the United Kingdom, with 11 cases resulting in death (about a 65 percent mortality rate).
Coronaviruses are a large family of viruses that includes viruses that may cause a range of illnesses in humans, from the common cold to SARS.
It is not clear if it is transmitted person-to-person, though some clusters of cases suggest that it may. There is circumstantial evidence that one nCoV patient may have become infected through contact with a camel.
The China H7N9 avian influenza outbreak has been grabbing headlines most recently with 21 confirmed cases and six fatalities in a short period of time (about a 29 percent mortality). No human infections with H7N9 viruses have been reported until recent reports from China. The transmission of this virus is still being investigated.
So the question is, do either of these pathogens have the potential to cause a pandemic?
“Both the new coronavirus and H7N9 have the potential to cause a pandemic”, says David J. Dausey, PhD, FACE, Dean, School of Health Professions and Public Health at Mercyhurst University.
Dr. Dausey told The Global Dispatch that virus mutation over time could allow the spread of the viruses from person-to-person giving it the potential to become a pandemic.
If these new viruses have pandemic potential, how prepared is health agencies (World Health Organization, Centers for Disease Control and Prevention, etc)?
“Both the WHO and CDC have made significant progress in the last decade with regards to pandemic influenza preparedness. We saw a swift global response to H5N1 that helped to mitigate the spread of disease, Dausey said.
“Unfortunately the economic downturn has resulted in a lot of the money that was invested in pandemic influenza preparedness (in particular in the US) to be taken away. Thus, I don’t feel that the US is as prepared as it could be to deal with a pandemic especially one that results in a large loss of human life.”
Dausey said that although Global surveillance systems for pandemic influenza have improved dramatically in recent years and Regional and subregional disease surveillance networks have collaborated to develop strategies for early detection, there are areas that could be improved.
“One large area for improvement is with the coordination of response from the many agencies and organizations that will be needed to detect the novel disease and to respond to it. Once a disease starts spreading quickly from person to person, it is very difficult to contain it, he notes.
“In most instances, efforts to contain the disease at best, just slow it down. We have global strategies for “ring vaccinations” to try to stop a pandemic before it occurs but the odds are against us. We need to have real plans in place to quickly respond to novel infectious disease outbreaks to limit the impact on human lives.”
Dr. Dausey summed it up by saying, “there is always the potential for another pandemic that results in a large loss of human life.”
“Every century in recorded history has been marked by at least one pandemic (with many of them involving influenza). I have no reason to believe that the 21st century will be any different.
“People have become too overconfident in the modern health care system and believe that public health agencies are more prepared than they actually are. The reality is that we are always at risk for a novel infectious disease with a high case fatality rate to spread in the population.”
David J. Dausey is a professor, researcher and epidemiologist who is a well known public health scholar. Dausey was one of the first researchers to develop and quantitatively test measures to assess the performance of US public health agencies. His research on disease surveillance in US public health agencies gained international attention and sparked an ongoing debate about what should be expected of public health agencies when responding to infectious disease outbreaks.
Dausey has worked on the ground with senior health officials in more than 20 countries including Mexico, Jordan, Israel, Palestine, Cambodia, Thailand, Lao PDR, China, Kenya, and Tanzania. His work has encompassed a full array of public health topics from behavioral health to bioterrorism. He is an internationally recognized leader on the use of exercises to evaluate public health preparedness.
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