Understanding the New Avian Flu H7N9

Released: 17 April, 2013

avian fluA new strain of bird flu virus has quickly grabbed the attention worldwide earlier this month, when the World Health Organization (WHO) announced that influenza A (H7N9) has been identified in a number of people in China. As of 17 April, according to the state-run Shanghai Daily Newspaper, there have been 77 cases of human infection, resulting in 16 deaths.

Chinese health authorities are conducting investigations and coordinating with international partners to monitor the situation. Much about the virus still remains unknown, but thus far scientists have confirmed that it contains genetic markers that could help infect humans.

Most cases of infection apparently got the virus from direct contact with live birds. The good news is that there is not enough evidence that the virus can spread from person to person. However, influenza viruses constantly change and it is possible that this virus could gain that ability.

Unlike the earlier avian flu, this virus is considered "low pathogenic", meaning that the infected birds can seem perfectly healthy, making it harder to identify and take elimination measures.

Symptoms of the new flu include fever, cough, shortness of breath, respiratory problems and severe pneumonia.

Laboratory testing conducted in China has shown that the H7N9 virus are sensitive to certain anti-influenza drugs, however, there is no experience with the use of these drugs for the treatment of H7N9 infection.

Avoiding Infection

Both the WHO and the Center for Disease Control and Prevention (CDC) in the United States gave similar advices to prevent H7N9 infection:

1. Avoid contact with bird and other animals

  • Do not touch birds, pigs, or other animals whether they are alive or dead.
  • Avoid direct contact with surfaces in contact with animals in live markets.

2. Eat food that is fully cooked

  • Eat meat and poultry that is fully cooked (not pink) and served hot.
  • Eat hard-cooked eggs (not runny).
  • Don't eat dishes that include blood from any animal.

3. Practice hygiene and cleanliness

  • Wash your hands often with soap and running water.
  • Use hand sanitizer containing at least 60% alcohol.
  • Don't touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
  • Cover your mouth and nose with a tissue or your sleeve when coughing or sneezing.
  • Throw used tissue into a closed bin immediately after use.
  • Try to avoid close contact, such as kissing, hugging or sharing eating utensils or cups with people who are sick.

There is no recommendation against travel to China at this time.

Boosting Your Immune System

Of all the cases thus far, many of the infected are persons aged 50 or above.

The sample size is not large enough to conclude that the elderlies are particularly susceptible. However, based on previous experience with other influenza viruses, the elderly and children are indeed more susceptible to infection due to weakened immunity.

"It is important to give our immunity a boost whenever a flu strikes," advises Graeme Bradshaw, Founding Director of IMI.

For influenza to infect your cells, the virus has to enter them. The hemagglutinin protein on the virus binds to a receptor on the cell, causing the cell to undergo endocytosis. Once inside, the virus "hi-jack" the host cell to replicate its own genetic material. This mechanism is mostly the same amongst all types influenza virus.

Your immune system has the innate ability to fight influenza infections by manufacturing antibodies to the hemagglutinin on the virus. When antibodies attach to hemagglutinin, they keep the virus from attaching to the receptors on your healthy cells. Additionally, your immune system cells can also destroy pathogens before a disease develop.

When you have an optimal immune system, you are less likely to be infected by influenza or other virus. The strength of our immune system is what makes the difference.

For more information on how to give your immune system a boost, see these articles:

Beat the Cold and Flu Season

Children's Health: Improving Immunity

Improving Your Children's Immunity

Best Immune Supplements when Stressed or Chronically Ill

Elderberry Extract and Influenza

Dr Zichria Zakay-Rones, Professor of Virology at the Hebrew University of Jerusalem and a leading influenza virologist conducted a number of studies on elderberry extract's efficacy in the treatment of influenza A and B infections. She has tested H1N1, H3N2, Influenza A from several swine and turkey viruses, as well as many Influenza type B strains.

In a paper she published in The Journal of Alternative and Complementary Medicine in 1995, a standardized elderberry extract, Sambucol, was shown to reduced hemagglutination and inhibit replication of human influenza viruses, during an outbreak of influenza B Panama.1

Later, during the flu season of 1999-2000 in Norway, Dr Zakay-Rones and her team conducted a study of sixty patients, aged 18-54, suffering from influenza-like symptoms for 48 hours or less. Results again showed that elderberry syrup seemed to offer an efficient treatment to both influenza A and B.2

Dr Zakay-Rones is quoted as saying in one interview that elderberry extract has proven effective at "inhibiting all Influenza stains tested so far."

"There has been no study using elderberry extract specifically for the treatment of the novel influenza A (N7N9)," says Graeme, "but in my experience, products like Sambucus, which is an elderberry syrup, have been very effective as a natural antiviral agent against many types of influenza."


1. Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, et al: Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract during an outbreak of influenza B panama. J Altern Complement Med 1995; 1: 361-369.

2. Zakay-Rones Z, Thom E, Wollan T, Wadstein J: Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 2004; 32: 132-140