So far, avian influenza A H7N9 hasn't hit the United States, and it may never arrive. But that isn't stopping health officials from closely watching the situation and preparing for it or a similar scenario, just in case.
The U.S. government declared last week that the flu strain, which has killed 31 people and infected 130 in China, poses significant potential for a public health emergency, especially with today's lightning fast global travel.
"We've been watching it closely," said Davis County Health Department epidemiologist Brian Hatch. "Basically you get this strain from exposure to birds and poultry, but what would be concerning is if the virus mutates and begins spreading person to person."
The H7N9 strain causes severe illness in humans and is easier to catch than other bird flu strains, according to the World Health Organization. What is perplexing to health officials is the fact that it doesn't sicken chickens, making it harder to get a handle on identifying where and how widely dispersed it might be.
"Normally we aren't worrying about a lot of flu in Utah, but this is definitely on the situation watch, and we are encouraging people who have been to China and have flu-like symptoms to be tested," Hatch said. "Some of the precautions recommended to those traveling in China are to avoid exposure to animals, don't touch or pet them, and eat fully cooked foods. Practice good hygiene habits as well."
Because of the nature of this situation, Hatch said, the department is pulling out its pandemic plan, which it constantly updates all year long.
Gary House, director of Weber-Morgan Health Department, said his staff, along with the state and Centers for Disease Control, is watching the characteristics of the disease, along with the morbidity and mortality associated with it and the mode of transmission, most notably if it's circulating between and among humans.
"We maintain that vigilance whether it is H7N9 or any other virulent or dangerous strain," he said. "Once we understand that, we can educate the public regarding the characteristics of the disease and, more specifically, how to protect yourself against it."
House said the department is also looking at its past experience with H1N1 and surveying its readiness to respond if the potential for an outbreak becomes imminent.
George Chino, emergency services coordinator for Weber-Morgan Health Department, said pandemics tend to be long and more drawn out than most emergencies. Plans look at such things as a reduced workforce of health care workers who are home caring for their own sick family members or themselves."
"We have encouraged things like continuity operations at a reduced workforce, you know, like at what level can your business or school remain open with reduced absenteeism and how to keep things going while mitigating the spread of disease," Chino said. "A great benefit of pandemic planning is that it helps you prepare for that scenario, but you are also better prepared for any sudden emergencies."
H7N9 is a novel virus, meaning it hasn't infected the human population before, so there is no immunity built up, and H7 flu is poor at stimulating immunity, according to virologists speaking at the European Flu Summit in Brussels last week. That means the more virus a vaccine requires to build up immunity against it, the fewer doses can be grown in a short amount of time.
"There's a lot of education and surveillance going on right now," Hatch said. "This is what the public health department does. We watch this stuff all the time. We want to make sure the public understands how the flu is transmitted. We ask that they practice good hygiene habits all the time. If this virus does arrive in the United States, we will instruct them on what to do. There's no need to stockpile at this time. Just be aware of the situation."
Karlene Marshall, emergency preparedness coordinator at Ogden Regional Medical Center, and Shailyn Dickson, a certified infection prevention nurse at McKay-Dee Hospital, said both hospitals have a plan in place for any type of pandemic situation. If that were to happen, they would work closely with the CDC and state and local health departments to get the message out to the public as to what steps to take.