Talk:Influenza A virus subtype H7N9

Title...

Okay. H7N9 is not helpful for its designation... nor is well... descriptive. We have a tag for what it is, but no proper name and other cases are likely to be overlapped... I don't know why we are avoiding a more descriptive time-line based one until a formal name becomes attached, but like H1N1, its a listing of type. Perhaps reclassifying the title page to be 2013 H7N9 or something might be better for the time being... ChrisGualtieri (talk) 04:13, 4 April 2013 (UTC)

Since it is the first human jump, I'm just going to leave it for now, labeled it under 2013, so if it becomes reoccurring or of major note and importance it can be handled in the same way as the other 'special' cases. ChrisGualtieri (talk) 05:08, 4 April 2013 (UTC)

These are early days, but it might be useful to compare H1N1 with the 2009 flu pandemic to get a historical perspective. Indeed, it's in part because of the swine flu pandemic that the bird flu is under such close surveillance. Antigenic shifts can be tricky things... kencf0618 (talk) 02:26, 8 April 2013 (UTC)

as 1) the CDC initiated it's emergency center on this issue on 4/9 and started antivirus research, 2) a report in the Ne Journal of Medicine on 4/12 here: H7N9 at NEJM identified the novel nature, avian source, severe symptoms, and mortality, and 3) from that article "However, limited human-to-human transmission was observed in the H7 outbreak in the Netherlands in 2003; therefore, the pandemic potential of these novel avian-origin viruses should not be underestimated.".... support that this is definitely a significant incident of novel origin and is unique to 2013 and should be renamed and elevated in importance--Anuoldman (talk) 21:28, 12 April 2013 (UTC)

====

There is no description of the form and especially the size of the virus. In the picture is no scale printed. Even more, it should be initially clear whether by using an arrow or colors, if the sticks or the mycoplasma like chains are the virus. — Preceding unsigned comment added by 90.10.31.45 (talk) 18:48, 15 August 2013 (UTC)

"Reports" section too newsy

I'd suggest promoting the subsections under the "2013 Reports" section for balance. The Reports section also is reading like a list of "breaking news" items, and should be consolidated into a summary format, naturally being updated. Otherwise the section could eventually overwhelm the article and go against avoiding news in articles. --Wikiwatcher1 (talk) 20:03, 9 April 2013 (UTC)

Wikiwatcher1 is warning against recentism and I would agree but recentism is also recruitment. Check out the page views on the other flu articles or the US fiscal cliff article. Many people got the cliff notes version and went on to greater things. So, Keep the format. Also, editors should add stronger citations to protect the integrity of the article. Geraldshields11 (talk) 20:31, 9 April 2013 (UTC)

However, the subsections under the daily list of reported cases should be promoted to their own sections. While only a new disease outbreak, still, the 2009 flu pandemic article could be used for sectioning. Note that the case reports there were incorporated into the article. Therefore, I suggest summarizing the reported cases with relevant cites.--Wikiwatcher1 (talk) 20:47, 9 April 2013 (UTC)

Okay... at the bare minimum lets keep the disproven animal links separate or something, I found them at the top of the article and they were the rumored and incorrect 'source' for the flu. The pigs could not have died or even been infected by the H7N9 because the tests done on the bodies came back negative. While 34 out of 20,000 were tested, they all came back positive for the a different and pig-only virus, which is unique and notable because it shouldn't have killed adult pigs... but that is another matter. Either way, ducks or pigs, wasn't H7N9. The source seems to be in the pigeons and that may need more emphasis. I do agree refining the 2013 section to be better, I do not believe we need to list every casualty by name or trade, but the number is low and to have the information is better then not having information at this time. I'll defer to history on whether or not it is relevant, and even if it is not important, for the time being it doesn't seem harmful. ChrisGualtieri (talk) 02:21, 10 April 2013 (UTC)

Also, in that "rejected theories" section, it seems that only a single journalist, Laurie Garrett, "speculated" on the link. Therefore, I'd remove that entire paragraph as it's almost irrelevant, as she is not a scientist and was only speculating. A single sentence at most, is all it should warrant at this point. --Wikiwatcher1 (talk) 02:30, 10 April 2013 (UTC)

It was not isolated... but she is a noted journalist and sci-fi author and was simply the best and most prominent person associated in a major magazine that has received coverage on it. But is it really relevant 'now', no. So I agree with removal. ChrisGualtieri (talk) 18:39, 12 April 2013 (UTC)

I did some consolidation in this section and only some very minor deletion. Obviously, if this strain continues to spread this section will need to again be cut back. In the meantime, I hope that an editor does not come along and slash it down to next to nothing. For now it is interesting to watch the cases grow with info on ages, occupations, etc. left in place. There is still plenty of time for further editing. Gandydancer (talk) 15:24, 25 April 2013 (UTC)

Neuraminidase inhibitors

Previously, I noted that neuraminidase inhibitors are effective in the treatment of H7N9 this has been replaced with the well-known, and trade name Tamiflu which is really Oseltamivir. Though four such neuraminidase inhibitors exist with Peramivir being used in H1N1 back in 2009. I think cutting to a specific drug might be good for the layman's terms, but by all means, Tamiflu is not the sole drug, and the class of drugs DO show use. Because the original WHO report I previously cited specifically denotes this class of drugs, I believe that a link to neuraminidase inhibitors (with the source) be noted with the most common drug of that type (as the other source), preferably in the same sentence. As this article contains medical information, I believe in doing our best to maintain the utmost accuracy whenever possible, and doing so by listing the class of drug and a leading drug used to treat it. Also... for U.S. centric readers, they will get 'Tamiflu' easier, but not all drugs bear the same trade name and is not chemically identical. For the swine flu, Peramivir, is the only IV drug and it is noted on its page, but Oseltamivir may already be in use in China to treat it. Right now its like stating its treated by Tylenol and not acetaminophen, but worse because if you want the pain reliever class of drugs... ChrisGualtieri (talk) 02:35, 10 April 2013 (UTC)

I just merged the two sections... Treatment is better term then vaccine at this time anyways. ChrisGualtieri (talk) 02:45, 10 April 2013 (UTC)

Summary table

To have big picture, what do you think about a summary table? New worl (talk)

Date	New confirmed case	New death	Total confirmed case	Total death
31/3	3 (in Hong Kong)	0	3	0
2/4	4 (Jiangsu)	0	7	0

Too soon for a table, IMO. --Wikiwatcher1 (talk) 17:52, 11 April 2013 (UTC)

And we should avoid 'new death' and such. If it got out of hand maybe provinces with cases and deaths reported, but let's not be morbid or dramatic. ChrisGualtieri (talk) 18:37, 12 April 2013 (UTC)

Removed the 1988 'case'

There are 29 records in the H7N9 taxo, but for some reason a 'case' from 1988 was listed here.[1] I have removed it, as it wasn't backed up properly, it just read as a sequencing of a piece of the virus and lacked context, much less a human case. ChrisGualtieri (talk) 15:45, 24 April 2013 (UTC)

---

I know what you want to say. the H7n9 virus has changed from 1988 turkeys to 2013 other birds and even human. but they are also the same H7N9 type virus , we can not call them two different viurs type. H7n9 virus article is not only talk about human but also anmial . thanks ---goodfoak --- — Preceding unsigned comment added by Goodforak (talk • contribs) 16:23, 24 April 2013 (UTC)

The case is just the first recorded on that database, it is not the first virus and it is commonly found in avian populations. Therefore, while it may be worth a mention, it is not a reliable source about a HUMAN transmission and the H7N9 is a type, not a specific virus. It is like the common cold which is a diverse group, one type of H7N9 is not the same as another. Which brings me to the matter of the flu as a whole, it changes and that is why it cannot be vaccinated against with a singular type, it mutates and changes so even the vaccine you get may be ineffective at the strain you will ultimately pick up. That H7N9 source which existed wrote a check its source could not cash.ChrisGualtieri (talk) 23:23, 24 April 2013 (UTC)

haha blablabla. you are so weirdy ---goodforak — Preceding unsigned comment added by Goodforak (talk • contribs) 03:00, 25 April 2013 (UTC)

This edit is an example of WP:OR and WP:SYN. ChrisGualtieri (talk) 03:18, 25 April 2013 (UTC)

The chart

I'll try to keep it updated. But, is the data presented in the best way. I wanted visitors to see if its spread is linear or exponential. Let me know and I can make a different one. Anna Frodesiak (talk) 23:38, 24 April 2013 (UTC)

Good work! Barnstar for you. ChrisGualtieri (talk) 00:09, 25 April 2013 (UTC)

Ah, I was just there suggesting you post here. :) Thanks again for the star, and let me know if the chart needs improving. :) Anna Frodesiak (talk) 00:23, 25 April 2013 (UTC)

That's great, Anna Frodesiak. I wonder if it is better to have another type of dots for number of death. Cheers, New worl (talk) 10:57, 25 April 2013 (UTC)

Not a bad idea because it can show if it's getting more deadly, or diverging from its relationship to total cases in any way.

But I don't know how to handle that data because the article says the first case was Mar 31 and the first death was Mar 4. Maybe the article should explain that because I'm confused, so I'm sure visitors are too. Did he die and then cause of death get identified later? Anna Frodesiak (talk) 19:19, 25 April 2013 (UTC)

I think it says they announced it on that day (Mar 31). I read somewhere that they first realized what they were dealing with in February when the first cases turned up. It seems reasonable that it would take a few days to get all their information together. Gandydancer (talk) 20:41, 25 April 2013 (UTC)

Hi Gandydancer! :) Okay, so how to do the chart? Feel free to take a crack at it if you like. There's a link to the source at the commons page. If you do change it, consider letting them know at the French Wikipedia article because they use the chart too and ought to modify the caption. Actually, maybe we should remove the x y titles and top title to make it useful in any language. Anna Frodesiak (talk) 21:46, 25 April 2013 (UTC)

I would recommend switching from dots to three lines, for cases (orange), recoveries (green), and deaths (red). http://gmggranger.wordpress.com/ has been graphing the heck out of it. I wish I had that kind of energy. EllenCT (talk) 06:21, 26 April 2013 (UTC)

Thanks, EllenCT. The recommended site has many good charts. New worl (talk) 15:50, 27 April 2013 (UTC)

124 cases

May there be an update?

http://www.blindbatnews.com/2013/04/h7n9-update-124-cases-another-human-to-human-case/20452

Thank you. (194.80.180.148 (talk) 08:15, 29 April 2013 (UTC))

Yes, there have been a couple of more cases reported by China. However, speaking just for myself, I don't think this article should attempt to provide daily updates on the number of reported cases. I think it's more useful to largely restrict ourselves to updates when either significant developments occur (e.g. spread to new provinces, the asymptomatic case, the first case outside mainland China, etc.), or when notable third parties provide updates on H7N9.

These "natural opportunities for an update" seem to happen often enough that every couple of days an interesting and informative sentence or two can be added in addition to the update to the raw totals. Of course, others might have different ideas about how the "Reported cases in 2013" section should be structured. Personally, I prefer to wait for English language articles from well-known authorities. I imagine somebody will add a new paragraph that includes an updated total shortly; if not by tomorrow, certainly when WHO releases its H7N9 update that is scheduled to be released a couple of days from now. —RP88 ^(talk) 10:36, 29 April 2013 (UTC)

I agree. The total is 124 today. It seems that this is going to be around for awhile and we obviously can't go on reporting each new case. On the other hand, I'm not quite ready to delete most of what we've got so far... For me it is informative to see the way it is jumping around and to see the ages of those that are coming down with this flu. What to do? [2] is a news release. Gandydancer (talk) 11:02, 29 April 2013 (UTC)

I put the one in for four new provinces, just now. We should probably go by weekly updates unless it spreads to new provinces/country. We can collapse the case report later, but the data points on the graph are used to indicate it. So at the very least we should give some pause to removal of sources as the graph will be a long-time indicator of the reports, and anyone checking that graph should probably have the media for those data points be given. There is probably a way to do that as well... but the graph will be the best long term data we can show. ChrisGualtieri (talk) 13:53, 29 April 2013 (UTC)

Other charts

What do you think? Maybe better for article visitors? Anna Frodesiak (talk) 19:57, 29 April 2013 (UTC)

Those charts are nice, but I'm inclined to say we should keep using the straightforward chart that you designed for this article. In my opinion, trying to keep a more complex chart up to date would verge on WP:OR. Should the article eventually be determined to benefit from better graphs I think they can be produced after this outbreak dies down from a dataset released by the WHO, CDC, China's NHFPC, or some other researcher (or even better they'll release a public-domain graph that could be uploaded to Commons and directly included here). —RP88 ^(talk) 13:41, 30 April 2013 (UTC)

Good points all around. Let's stick with the one in the article. Thanks for the thoughtful reply. Cheers. Anna Frodesiak (talk) 14:16, 30 April 2013 (UTC)

A good resource

Hi to all. This is a source that I have been using for years for flu-related info: [3] These people live and breathe this stuff! It's really fun to be involved in the vary early stages of a possible pandemic, isn't it? Hopefully this one will peter out, but every one has the possibility to become the next world-wide killer. Anyway, this link has some interesting information. Gandydancer (talk) 19:40, 30 April 2013 (UTC)

Allegations of US bio-psychological warfare

A Chinese army official says H7N9 bird flu virus is an U.S. bio-psychological weapon. The news has been downplayed but still reported by major news agencies. Is it worth noting it?

Example article on Washington Post: Chinese army colonel says avian flu is an American plot against China — Preceding unsigned comment added by 79.21.125.83 (talk) 20:42, 30 April 2013 (UTC)

WP:FRINGE comes to mind, even if it is a notable person, but let's watch this. ChrisGualtieri (talk) 04:32, 1 May 2013 (UTC)

Casualty counts in infobox: please update refs if you change a value.

I've noticed that one or two editors who edit this page are updating the values in the infobox, but when they update the values they don't provide a source for the new values, they just leave the references to the previous values. I'd like to ask that if you change the values in the infobox that you update the reference; or at the very least delete the reference that supports the older value. It's confusing to see, for example, a value of X cases in the infobox and then read the reference for the value and see that it claims X-2 (or whatever). —RP88 ^(talk) 05:20, 3 May 2013 (UTC)

Targets old men

I've removed this mention again per WP:OR and WP:SYN. Do not re-add original claims, the flu is indiscriminate and this is a false claim because no source currently covers the age and sex of affected. While the early cases involved older males, the flu (as everyone knows) does not affect everyone equally and certainly does not pick its host by age and gender. This is equivalent of saying that elderly men as susceptible to the "regular" flu. Its a logical fallacy. ChrisGualtieri (talk) 12:50, 3 May 2013 (UTC)

I assume you are referring to the "...elderly males appear to be more susceptible" phrase added by Gandydancer to the article introduction. I agree that the inference a reader might draw from "more susceptible" is likely to be incorrect. However, your claim that "no source currently covers the age and sex of affected" is also incorrect. Experts from WHO have commented on the unusual prevalence of elderly males among those stricken with H7N9. See, for instance, (Arima 2013).

While it is, at least theoretically, possible that males are biologically vulnerable to H7N9, you are correct that no experts have made that claim. Researchers have suggested a number of theories, such as that elderly Chinese males may have more exposure to poultry or birds than other groups. One widely commented upon theory is in (Skowronski 2013). The last paragraph of the Transmission section in the main article discusses that theory a bit, using a decent reference.

I think a suitable replacement for the sentence under contention would be something like the following: "Researchers have commented on the unusual prevalence of elderly males among those stricken with H7N9, but as yet, the reason for this is not known."

Thoughts?

1. Arima, Yuzo; Zu, Rongqiang; Murhekar, Manoj; Vong, Sirenda; Shimada, Tomoe (2013). "Human infections with avian influenza A(H7N9) virus in China: preliminary assessments of the age and sex distribution". Western Pacific Surveillance and Response Journal. 4 (2). WHO. doi:10.5365/wpsar.2013.4.2.005. Retrieved 3 May 2013.
2. Skowronski, DM; Janjua, NZ; Kwindt, TL; De Serres, G (25 April, 2013). "Virus-host interactions and the unusual age and sex distribution of human cases of influenza A(H7N9) in China, April 2013". Eurosurveillance. 18 (17). European Centre for Disease Prevention and Control. Retrieved 3 May 2013. {{cite journal}}: Check date values in: |date= (help)

—RP88 ^(talk) 14:59, 3 May 2013 (UTC)

Thanks RP88, I really appreciate your input. Since the age of people affected is important for our article, it would be good to find some sort of wording that we can agree on. Since it has been reported that males seem to be more affected, it does help in the puzzle of the strange case where it is the live bird markets that seem to be the breeding ground rather than a poultry farm. If in that country it is the men that work in these areas rather than women, that would be a clue about the origin. I believe that your wording is very good. Gandydancer (talk) 19:12, 3 May 2013 (UTC)

Good points, but if you note that Arima only describes 63 cases, less than half of the known cases... but at face value it brings an interpretation that is confusing from the actual.According to Arima, "Three main reasons may be considered for the current case distribution: (1) differential exposure between males and females due to gender-associated practices and norms; (2) biological differences between males and females in the clinical course post exposure/infection; and (3) differential healthcare-seeking/access behaviour between male and females, leading to surveillance/detection bias." With the way it was worded the issue would be option #2 as the reason (WP:SYN) We overlook that the information is unclear and hasn't been given. Elderly Chinese males are more likely to have caged bird pets and congregate together in parks. Let's not confuse behavior issues with biological or clinical treatment differences, this topic is important to have as accurate as possible. If we are going to cite the elderly male connection, include the suggestions of Arima as possible factors and note the publication date as well, much has happened since April 2nd. ChrisGualtieri (talk) 20:59, 3 May 2013 (UTC)

Oh... and Eurosurveillance, from 25 April 2013 is actually a decent one to use for citing, but I'd use Arima's clear cut explanations, Euro brings up a different type of connection as well... but I do not know how to explain it in layman terms. ChrisGualtieri (talk) 21:05, 3 May 2013 (UTC)

I do not care to spend any more time attempting to satisfy you. Will you agree to this recent (May 2) source: According to The Lancet, "Most H7N9-infected patients are older (approximate median age 62 years) urban men who reported exposure to chickens or captive-bred pigeons either professionally or through visits to live poultry markets." Gandydancer (talk) 22:50, 3 May 2013 (UTC)

Yes, don't need the approx median age. Just trying to keep biological targeting and weakness out. The actual fatality rate is the weird one between men and women in that age group, but outside it is similar as a whole. The care must matter, but given I've heard of accounts from Chinese natives, the fear of H7N9 is why I will be extremely picky about information. We are also missing information about the Chinese response to this... their actions have been a bit drastic about the culling of birds, but I do not have a good source to back that up. Always the river crabs they say. ChrisGualtieri (talk) 23:23, 3 May 2013 (UTC)

With regards to the culling of birds, I'd certainly welcome any contributions you might want to make to the existing "Culling of birds" section in the main article. It's not very complete at this point.

With regards to Skowronski's Eurosurveillance article, it is actually already discussed a bit in the last paragraph of the "Transmission" section in the main article, although that paragraph cites CIDRAP's article that attempts to summarize Skowronski for the layman. I agree that conflating the possible contributions of behavior, biology, and treatment on this issue would be a problem, but I think we should find a way to mention the unusual prevalence of elderly males.

It sounds like we all agree that researchers think the prevalence of elderly males in the cases of H7N9 is a phenomenon worth investigating. How about the following for a sentence in the intro paragraph: "Researchers have commented on the unusual prevalence of older males among H7N9-infected patients. While several environmental, behavioral, and biological explanations for this pattern have been proposed, as yet, the reason for this is not known." Also, maybe the part of the Transmission section that discusses the age/sex profile of H7N9 could then be expanded with Arima's possible explanations, in addition to the already existing bit derived from Skowronski's Eurosurveillance article. —RP88 ^(talk) 06:55, 4 May 2013 (UTC)

OK, in the spirt of WP:BOLD, in the process of updating and clarifying the introduction, symptoms, transmission and treatment I went ahead and added a section to the article on the age/sex distribution of H7N9. In addition to adding some new content, I also moved the last paragraph of the "Transmission" section to the new age/sex distribution section. Please feel free to edit the new section or the sentence about it in the introduction. —RP88 ^(talk) 12:05, 4 May 2013 (UTC)

Nice work! Gandydancer (talk) 15:54, 4 May 2013 (UTC)

References

Feedback please

I question an entire paragraph on this information:

The fact that no evidence of sustained human-to-human transmission for the current H7N9 outbreak has yet been found suggests that the virus is undergoing “stuttering transmission” in which a virus that normally circulates in an animal reservoir infects a person, but further human-to-human transmission does not occur. In general, viruses capable of stuttering transmission have acquired novel sequence variations that allow them to infect humans, but have yet to acquire sequence variations that allow them to sustain efficient transmission between humans. Comparative genomics analysis is now being performed at the Influenza Research Database to identify candidate sequence variations that might be involved in human adaptation.[48]

It seems too in-depth and complicated to me. I have not seen similar info in other flu articles. It should be telling that "stuttering transmission" cannot be blue-linked. Thoughts? Gandydancer (talk) 20:53, 4 May 2013 (UTC)

I dunno, but it wasn't the WP:FRINGE material I just removed, though this section is speculation on the part of the researcher. Just because it is in a RS doesn't mean it can be used in an article. I'm going with the axe and maybe look at the RS to explain that research into its genome is being studied by the labs. ChrisGualtieri (talk) 03:26, 5 May 2013 (UTC)

The phrase "stuttering transmission" in that report from the Influenza Research Database project is pretty niche jargon, short for "self-limited stuttering transmission chain" or "self-limited stuttering chain of human-to-human transmission". I think that particular phraseology originates with Dr. Lloyd-Smith. He's not really a big name, but I hear he is one of the ones to pay attention to in the study of emerging pathogens and the evolution of infectious diseases. If you want to read more about it, I think his Epidemic Dynamics at the Human-Animal Interface (2009) is a good introduction. I agree that the paragraph in question probably needs to be rewritten. I'll give it some thought. —RP88 ^(talk) 14:37, 5 May 2013 (UTC)

Perhaps better to not have any "niche jargon" in the transmission section? If you do continue to work with this info, perhaps it would fit in the virus section better? Gandydancer (talk) 20:12, 6 May 2013 (UTC)

I have done some copy edit to the transmission section to make it more readable. How would it be if we'd move the more technical info re the virus to that section? Gandydancer (talk) 13:36, 7 May 2013 (UTC)

OK, in the process of some general editing for clarity, I've edited the bit on the virus lacking the genes necessary to for efficient transmission between humans, and moved it to the section about the virus. —RP88 ^(talk) 16:40, 7 May 2013 (UTC)

Great edits...great photo too! Gandydancer (talk) 17:59, 7 May 2013 (UTC)

Thanks, and to you as well. Your edits to Transmission section of the article gave it some much needed polish. —RP88 ^(talk) 18:28, 7 May 2013 (UTC)

Breakdown by province?

Is it necessary to have a tabulated breakdown of total number of cases in each provincial-level areas in China? I may do it but an inconsistency problem may exist for the data provided by the websites of the health departments of each affected province do not match with that of Xinhua. Roadrunner272008 (talk) 16:47, 6 May 2013 (UTC)

I think it would make sense to wait. After the outbreak dies down it will be easier to find a single trustworthy and reliable source that provides the necessary data. As it stands currently we'd probably have to to assemble the data ourselves (verging on WP:OR). I also think it would be difficult to keep up to date (we have trouble as it is just keeping the counts for total cases and deaths up date, accurate, and well-sourced). —RP88 ^(talk) 12:43, 7 May 2013 (UTC)

in China from March 4 to April 28 (participating hospitals), of 20,739 persons with influenza-like illnesses who are tested, only 6 test positive for H7N9.

Chinese study finds very few mild H7N9 cases, Center for Infectious Disease Research & Policy (CIDRAP), University of Minnesota, May 9, 2013.

“ . . . Writing in Emerging Infectious Diseases, a team of Chinese and US researchers said that testing of samples from 20,739 patients who had ILIs [influenza-like illnesses] revealed only six cases of H7N9 infection, a rate of .03%. . . ”

“ . . . The H7N9 surveillance study involved testing of patients at hospitals throughout China that participate in the Chinese National Influenza-Like Illness Surveillance Network. Patients who sought care for an ILI between Mar 4 and Apr 28 were tested, the report says.

“The 20,739 samples that were tested came from 141 sentinel hospitals in 10 provinces and cities. . . ”

“ . . . The researchers note several limitations of the study, including that the sentinel hospitals are in cities and therefore may not detect H7N9 cases in rural areas. . . ”

I am not a doctor, and I want to be clear about that. But I am pretty good at researching things. Cool Nerd (talk) 17:14, 13 May 2013 (UTC)

Hi there Cool Nerd! It is so good to work with you again. I agree that the info you suggest is important because it helps to show that the mortality rate is accurate rather than missing some or many cases that present with less severe symptoms or have not been tested--though it is possible that some people are not sick enough to be admitted... For a start I just copied info from the lead to open a mortality section. As I said in my edit summary, it can be edited and expanded. Your suggestion will fit there as well. Gandydancer (talk) 12:44, 26 May 2013 (UTC)

The end of Influenza A virus subtype H7N9

The last reported case was May 28th. Should we adjust the lede and infobox to reflect its apparent end? Has it really ended? Anna Frodesiak (talk) 12:07, 7 July 2013 (UTC)

I think we shall wait for the next monthly update of MOH China on July 10. It's been almost a month ago, we don't know if there were new cases or none. JoeCo0327 (talk) 19:09, 7 July 2013 (UTC)

Okay. :) Anna Frodesiak (talk) 03:14, 11 July 2013 (UTC)

Time to trim and update?

While things have quieted down this summer, the news about the virus is still coming in, with much of it not yet covered in the article. For example, there are fears that it could become a panedemic this autumn; there are continual reports that it is resistant to drugs; and that it could mutate and become transmittable in the air.

Also, the most widely used title I've seen for news stories is "H7N9 Bird Flu," so we should consider simplifying the article title for general readership.

As for revising the article, I'd vote to dramatically trim sections covering "reported cases" as loaded with useless trivial details. I'd also ask we decide who we expect to read and benefit from the article: medical experts or average persons. I'd hope that doctors would have better sources and assume that 99% of readers would be common folk. That makes me, at least, read the section on Vaccine, for instance, and feel that it would scare off most casual readers very quickly. So I'd opt to make sure the first parts of all sections are easy to understand and put the minutia following it.

In fact, the very first sentence in the body, which is describing what the virus is, states:

Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: hemagglutinin (HA) and neuraminidase (NA). The avian influenza A(H7N9) virus designation of H7N9 identifies it as having HA of the H7 subtype and NA of the N9 subtype.[16]

That kind of wiki link-loaded jargon will not help most readers, IMO. Thoughts? --Light show (talk) 21:26, 21 July 2013 (UTC)

I recently updated the article and I thought that I covered the recent information re a possible fall out- brake, the ferret study, airborne transmission, and the drug resistance status has been in the article for some time. As for the vaccine, that is the norm--it takes months to develop a vaccine. Re the name, I think that for now it is what would be appropriate for the article. About the length and detail of the deaths section, I can see where some might argue to trim it. As for me, gumshoe that I am, I like it the way it is for now. I'd vote to trim it if the flu picks up again or if it dies out, but for now I think that it shows one of the unique characteristics of this particular strain of flu--why is it jumping around like that? As for who reads the article, I agree that it should be for the general public (though it would not surprise me if medical professionals read it too), and as such an effort should be made to not be too technical. If you have some ideas perhaps you could present them on the talk page and get feedback. Gandydancer (talk) 02:30, 22 July 2013 (UTC)

My overall idea is to radically simplify the article. For a section like Vaccine, or instance, where a general reader might want to quickly know whether there is a vaccine, and if not, whether anyone, or who, is working on one, they could develop a slight case of vertigo, IMO, deciphering that from the current text. I would therefore simplify to the key points and let the reader who wants more details just read it from the footnoted links. Since almost all of the citations are linked to articles, that would keep both general readers and scientists happy. As of now, after only a few months of this new virus, the article is 53K long and has 85 references, which is large by most standards. --Light show (talk) 04:32, 22 July 2013 (UTC)

Sorry--I missed your note. While I agree that it is complicated, I think that it is comparable to our other flu articles. Gandydancer (talk) 14:20, 7 August 2013 (UTC)

Person to person

First case of person to person transmition reported, [4]. I leave it to more specialised editors to include the info or not. Politis (talk) 08:00, 7 August 2013 (UTC)

Thanks, I put it in. Fortunately, this is not yet too concerning. Gandydancer (talk) 14:14, 7 August 2013 (UTC)

CDC says case detection fell abruptly since April, no travel restrictions, might re-emerge in fall

As of Sept. 14, 2013, the CDC advised on its page, Avian Influenza A (H7N9) Virus that:

The number of cases detected after April fell abruptly ...

...

... [S]ome limited human-to-human spread of this H7N9 virus would not be surprising if the virus reemerges in the fall. ...

...

... Since H7N9 is not spreading easily from person to person at this time, CDC does not recommend that people delay or cancel trips to China. The World Health Organization also is watching this situation closely and does not recommend any travel restrictions.

Updating the chart

This needs to be updated but some new cases don't have exact dates, so I don't know how to handle it. Could someone please take a crack at it? Many thanks, Anna Frodesiak (talk) 07:29, 3 December 2013 (UTC)

20 cases in China this year (2014)

[5] comp.arch (talk) 14:21, 28 January 2014 (UTC)

Thanks for the info. Wow, quite a jump here! I will try to update our article. Gandydancer (talk) 15:28, 28 January 2014 (UTC)

It is very time-consuming to try and figure out exact numbers. The WHO seems to be saying that there were six new cases in just one day, so that is a big change--though I can't find a number of total cases from them. Flutrackers, who I do trust as very reliable, put the current cases at 252. At any rate, if so many new cases keeps up, it will be hard to keep our totals up to date. For one thing, I'd like to see either the lead OR the box be used--not both as it is too much work. Thoughts?

http://edition.cnn.com/2014/01/28/health/h7n9-bird-flu-china/ 210.13.83.18 (talk) 03:38, 30 January 2014 (UTC)

Info box numbers

I have not been able to find a source that regularly updates info on the numbers of illness and deaths which includes the specific countries. IMO, it has been shown that every case so far was contacted in China, in other words, they do not represent a spread of the disease and thus offer no important information. The info in the info box is always out of date and unless someone is willing and able to keep it up I think it should be deleted. I'll wait a day or two and do that (keeping only the overall total) unless someone has a better idea. Gandydancer (talk) 15:27, 23 March 2014 (UTC)

I'll remove the numbers. Gandydancer (talk) 09:14, 26 March 2014 (UTC)

Organize by epidemic

Wouldn't it make sense to report by the numbered epidemics instead of by year, which is how the WHO, CDC, and scientific lit follows it ("During the Fifth Epidemic — China, October 1, 2016–August 7, 2017 [CDC]" - also includes cases in Hong Kong and elsewhere. A season usually runs from about October to the following summer. JuanTamad (talk) 01:17, 24 December 2017 (UTC)