Maryn McKenna

Journalist and Author

H7N9 Flu, Year Two: What Is Going On?

By Leave a Comment

Live-poultry market, Shandong, China, 2009. Jonas_in-China (CC), Flickr

Live-poultry market, Shandong, China, 2009. Jonas_in-China, Flickr

Cast your mind back to about this time a year ago. A novel strain of flu, influenza A (H7N9), had emerged in China, in the provinces around Shanghai. International health authorities were deeply concerned, because any new strain of flu bears careful watching — and also because, on the 10th anniversary of the SARS epidemic, no one knew how candid China would be about its cases.

By the time peak season for flu ended in China, there had been 132 cases and 37 deaths from that newest flu strain. But, confounding expectations, the Chinese government was notably open about the new disease’s occurrence, and scientists worldwide were able to ramp up to study it. Still, no one could say whether that flu would be the one to make the always-feared leap to a pandemic strain that might sweep the globe. As with other, earlier, worrisome strains of flu, science could only wait and see whether it might return.

And now it has.
[Read more…]

The "Road Not (Yet) Taken" On H7N9 Flu — And How Far We've Gotten

By Leave a Comment

Last week’s New England Journal of Medicine included a thoughtful meditation on the possibility that the new bird flu out of China, H7N9, could become a globe-spanning pandemic — and on how much knowledge is needed before we’ll be able to predict whether it will or not. The authors, all from the US National Institutes of Health, know a fair amount about pandemics: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. David Morens, Fauci’s senior advisor and a medical historian; and Dr. Jeffery Taubenberger, a physician and microbiologist who brought back to the world the viral cause of the worst pandemic: the influenza of 1918, which killed 100 million people.

In various combinations over the past 10 or so years, the three have written a number of papers looking back at the record fro 1918, interrogating its impact, and particularly examining the causes of its extraordinary death toll. So they are probably the perfect authors to write about gaps in knowledge about H7N9.

But aside from its useful examination of the virology, what struck me as most interesting about their paper is how soon it is to be able to write something like this. After all, H7N9 only emerged to public knowledge in late February, and so far has caused 132 cases and 37 deaths, all in eastern China. That these authors could write this paper now is yet another marker, I think, of how different this outbreak is from SARS 10 years ago, as well as how rapidly international public health science can move, if everyone cooperates.

[Read more…]

The New Bird Flu, and How to Read the News About It

By Leave a Comment

By now you’ve no doubt heard that international health authorities are deeply concerned about a new flu strain that has surfaced in China: H7N9, which so far has sickened at least 16 people and killed six of them. The outbreak has a number of features that are troubling. It emerged rapidly; the first cases were announced five days ago, and the first death apparently occurred on Feb. 27. It is widely distributed: Confirmed cases have been found in three adjoining provinces that wrap around Shanghai, and also in Shanghai municipality itself. And it is novel: H7N9 has never been recorded in humans before.

For infectious-disease geeks, it’s that last aspect that raises a particular nervous thrill. Most of the time, most people take flu for granted, to the point of not bothering to be vaccinated against it because they assume it will not make them very sick. But every once in a while, flu defies expectations, and roars up into a pandemic: worldwide spread, high numbers of cases, high rates of death. When a pandemic occurs, almost definitionally, it is because of a new strain to which humans have no prior immunity. In human terms, H7N9 is a new strain.

[Read more…]

WCSJ: Maybe The Biggest Disease Threat Isn't Infectious At All

By Leave a Comment

I’ve been away the past week at the World Conference of Science Journalists, a biannual gathering that brought 726 writers and broadcasters from 87 countries to Doha, Qatar. I was there to give a presentation about blogging, and also because I organized two panels on under-reported epidemics and on food and farming issues in the developing world. My panelists’ testimony was so powerful that I wanted to share some of the details.

Going into the conference, the epidemics panel was my favorite. That’s not because I cheated and made myself one of the speakers, but because it brought into public view so many of the disease-control issues that we talk about here. When I say hidden epidemics, what I mean is this: The diseases that routinely grab headlines are almost never the ones that cost society the most in illness and deaths, and also in money to control and repair them.

Think of Ebola, for instance. There has never been a case of human Ebola in the United States. And as I’ve written before, viral hemorrhagic fevers repeatedly have been imported to North America without ever starting an outbreak. Yet whenever Ebola sparks in Africa, it earns scare-font headlines here, as though it were about to rampage across the continent — even though, in all its known engagements with humans, Ebola has killed less than one-tenth of the 19,000 that MRSA, for instance, kills in the US in a single year.

I asked a set of distinguished health journalists, all friends, to come to Doha to talk about diseases that deserve headlines, but never get them. Here’s what they said:

[Read more…]