Q: When the public hears about bird flu and the link to poultry, they might be worried about their food. Should they be?
Dr. Goel: There is certainly no reason to be avoiding poultry as a result as this. In fact, the interesting thing about H7N9 is the birds don’t seem to be getting sick. It’s one of the reasons that has the microbiology community concerned. This virus has adapted so it can be carried by birds but only cause illness in humans. You’re not going to getting bird flu from eating birds or chicken, but from breathing the same air as birds carrying the virus.
Q: In a word, what’s the risk now: Is it moderate? Is it negligible?
Dr. Goel: That’s the Holy Grail for influenza people: How do we communicate the level of risk? Remember during H1N1, the WHO had its pandemic alerts and people were treating those like hurricane-strength warnings? It’s very hard to really put a single indices on it: The number of people infected is very small, the transmissibility between humans has still not been documented and, aside from one case in Taiwan, it remains localized in one region of China. So, on a global scale, it’s not a huge issue. But, within that region of China, it is a grave concern because it seems to be transmitting among birds and poultry and, because there is no illness, it’s hard for a poultry farmer or someone selling birds in a market to know if the birds are diseased and a risk to humans. It’s adapted in a way that makes it hard to pick up but it hasn’t moved much beyond that immediate setting. I wouldn’t consider this on the same scale as pandemic H1N1 or SARS, at least not right now.
Q: Samples of the virus are being sent to the National Microbiology Lab in Winnipeg. Why is Canada getting involved like this?
Dr. Goel: That is a federal lab with world-class expertise but I only know what I’ve read in public reports, that H7N9 has been shared with reference laboratories around the world. Above all, I think that’s a really good sign. You will recall that during SARS the Chinese were accused of being secretive, and they’re being much more open now, both in terms of information on infections and sharing the virus with international laboratories. What I imagine these labs will be doing is trying to determine what antivirals the virus is sensitive to so there can be better treatments and I imagine they will also start work on a vaccine. This openness is giving the rest of the world a real head start in case this virus does spread – which I would say seems highly unlikely right now. The other more general more theoretical research is looking at the sequences and comparing how they changed in different settings and, through that research, they should be able to determine the genesis of this virus – what birds and swine elements came together and formed this virus.
Q: Is it too early to be talking about a vaccine?
Dr. Goel: For humans, yes, because we have a very limited problem. But I suspect the Chinese are looking for a veterinary vaccine. They’re going to need to inoculate birds to control the spread of this virus, otherwise there will have to be a massive culling of poultry which will have immense economic consequences. The large-scale manufacturing of a human vaccine is not necessary at this point but having this virus being studied in labs accelerates the process should it become necessary.
Q: How do you balance the concern with H7N9 but not wanting to over-react?
Dr. Goel: That’s a very good question. It’s something we struggle with every day in public health because there are so many pressing challenges in both the infectious diseases area and in non-communicable diseases. We have to ensure that we do not lose sight of our most pressing challenges. We have to maintain our vigilance. We have to make sure our systems are ready for H7N9. But we should not be going overboard on this because we have many more public health challenges. We still have to worry about childhood obesity and mental health and so on. I wish the media would pay as much attention to those everyday challenges as to the bird flu.