Tjandra Yoga Aditama

WHO SEARO
• “Here, we report on an influenza virus surveillance of pigs from 2011 to 2018 in
China, and identify a recently emerged genotype 4 (G4) reassortant Eurasian
avian-like (EA) H1N1 virus, which bears 2009 pandemic (pdm/09) and triple-
reassortant (TR)-derived internal genes and has been predominant in swine
populations since 2016. Similar to pdm/09 virus, G4 viruses bind to human-type
receptors, produce much higher progeny virus in human airway epithelial cells,
and show efficient infectivity and aerosol transmission in ferrets.”

• “Further serological surveillance among occupational exposure population showed

that 10.4% (35/338) of swine workers were positive for G4 EA H1N1 virus,
especially for participants 18 y to 35 y old, who had 20.5% (9/44) seropositive
rates, indicating that the predominant G4 EA H1N1 virus has acquired increased
human infectivity. Such infectivity greatly enhances the opportunity for virus
adaptation in humans and raises concerns for the possible generation of
pandemic viruses.”
• A World Health Organization (WHO) expert said Wednesday that the
recently publicized swine flu in China was not new and that it's under close
surveillance.

• "It's important, I think, to reassure people that this is not a new virus – this
is a virus that is under surveillance," said Dr Michael Ryan, executive
director of the WHO Health Emergencies Program, at a press conference
Wednesday, adding "this is a finding from surveillance that's been carried out
over many years."

• The Eurasian avian-like H1N1 swine influenza virus has "been under
surveillance by Chinese authorities and by the global influenza surveillance
network around the world, and the WHO collaborating centers," Ryan said.

• "It's been under surveillance since 2011 and in fact, the most recent
publication is a publication of all of that surveillance data over that time and
obviously reporting both on the evolution of this virus within the swine
population but also in terms of occupational exposures to workers over that
time," he explained.
• The article described swine influenza viruses detected through swine
surveillance from 2011 to 2018 in China – the viruses with genes from
Eurasian avian-like A(H1N1) lineages and internal genes from the human,
seasonal A(H1N1)pdm09 virus and swine influenza triple reassortant
viruses. These swine influenza viruses were classified based on their
genetic make-up and termed genotypes G1-G6.

• The paper focuses on the zoonotic potential of the genotype G4 which emerged
in 2013 and became predominant in swine population since 2016.

• The paper reported elevated seroprevalence rate (10.4%) of the G4 viruses

identified in some swine workers, and efficient direct contact and respiratory
droplet transmission of the viruses in a ferret model.
• The viruses discussed in paper are not new. Viruses with similar gene
combinations including G4 genotype were reported previously in swine in China
by the Harbin Veterinary Research Institute, China in a 2016 publication, and G4
genotype viruses have been the dominant genotype in swine population in
China since 2016.

• similar also reported already in the Feb 2020 :

https://www.who.int/influenza/vaccines/virus/202002_zoonotic_vaccinevirusup
date.pdf?ua=1
https://www.who.int/influenza/vaccines/virus/candidates_reagents/summary_a
_h1v_cvv_nh2020_21_20200228.pdf
• Sporadic zoonotic infections in humans with G4 genotype swine influenza
viruses have been reported. The WHO Collaborating Center (CC) at China CDC
has previously reported human infections by Eurasian avian-like A(H1N1) variant
viruses, including two recent cases with the G4 genotype with the most recent
human case reported in Nov 2019.

• In line with the findings of this paper which shows evidence of transmissibility of
G4 genotype swine viruses in ferrets , the US CDC Influenza Division has
performed risk assessments of related viruses in 2019 and confirmed that they
are transmissible in a ferret model of infection by both direct contact and
respiratory droplet transmission.
• The G4 genotype and other swine, and avian influenza viruses are
continuously evolving. WHO, in collaboration with partners from the
animal health sector, will continue monitoring their evolution and assess
the associated risks for a potential influenza pandemic.

• Animal influenza viruses continue to challenge human public health;

surveillance of swine influenza viruses is as equally important as avian
influenza viruses. Effective surveillance of these viruses improves
pandemic preparedness significantly.

• It also highlights that we cannot let guard on influenza and need to be

vigilant and continue surveillance even in coronavirus pandemic!
• The 2009 swine flu pandemic was an influenza
pandemic that lasted for about 19 months, from
January 2009 to August 2010
• Estimated that the actual number of cases including
asymptomatic and mild cases could be 700 million to
1.4 billion people—or 11 to 21 percent of the global
population
• The number of lab-confirmed deaths reported to
the WHO is 18,449, but it is estimated to have actually
caused about 284,000
• For comparison, the WHO estimates that 250,000 to
500,000 people die of seasonal flu annually.
• As we enter the post-pandemic period, this does not mean
that the H1N1 virus has gone away. Based on experience with
past pandemics, we expect the H1N1 virus to take on the
behaviour of a seasonal influenza virus and continue to
circulate for some years to come

• Pandemics, like the viruses that cause them, are

unpredictable. So is the immediate post-pandemic period.
There will be many questions, and we will have clear
answers for only some

• Continued vigilance is extremely important, and WHO has

issued advice on recommended surveillance, vaccination, and
clinical management during the post-pandemic period
Light at the end of the tunnel
•Perkembangan pandemi

•Penemuan obat dan vaksin

•“New normal” sekarang dan masa datang

•Evaluasi pandemi COVID-19

•“Persiapan” menghadapi pandemi mendatang

• https://www.unenvironme
nt.org/resources/report/pr
eventing-future-zoonotic-
disease-outbreaks-
protecting-environment-
animals-and
TerImakasIh

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