Risk for worldwide pandemic of the new H7N9 influenza infection.

Dear Editor:

The recent report on the “Risk assessment on the epidemics of human infection with a novel avian influenza A (H7N9) virus” is very interesting[1]. Liu et al. concluded that “it is highly unlikely that a pandemic of human infection with avian influenza A (H7N9) virus will happen in Jiangsu Province in the near future[1].” This result is concordant with a previous report by Nishiura et al[2]. Indeed, as new cross species infection, the pandemic of the new H7N9 is widely discussed[3]. There are some concerns for the risk of H7N9 influenza. The present report by Liu et al. is based on the present data. However, in real life, the situation of viral infection is usually dynamic. The change in virus, human and environment, the triad, should be considered. A recent study noted that “under appropriate conditions human-to-human transmission of the H7N9 virus may be possible[4].” In addition, there are some new evidences indicating the change of virus. A good example is the recent emerging oseltamivir-resistant strain (http://www.bloomberg.com/news/2013-04-11/tamiflu-resistance-gene-in-h7n9-bird-flu-spurs-drug-tests.html).