The journal Nature published an editorial and opinion piece on the emergence of the H7N9 avian influenza strain.

• Editorial: “China deserves credit for its rapid response to the outbreaks of H7N9 avian influenza, and its early openness in the reporting and sharing of data,” the editorial states. Unlike its response to severe acute respiratory syndrome (SARS) a decade ago, when “China failed to report early cases … and fumbled its initial response to the threat,” the country’s response to H7N9 “is next to exemplary,” according to Nature. The editorial details some of China’s responses to the novel virus, continuing, “China has made a good start, but it is crucial for the country to continue its openness over the H7N9 outbreaks. In particular, it must promptly report any evidence of human-to-human spread,” share detailed data on human cases, and publish case reports as soon as possible. In addition, “[j]ournals must be ready and willing … to fast-track peer review of H7N9 papers,” the editorial states, concluding, “Meanwhile, observers should continue to scrutinize China’s response to H7N9, but they should also give credit where credit is due. It is time to recognize that China has changed” (4/25).
• Peter Horby: Horby, director of the Oxford University Clinical Research Unit in Hanoi, Vietnam, reviews the pathogenicity of several influenza viruses, including H5N1, H7N7, and H1N1, and asks, “So will H7N9 prove to be controllable? Will it remain entrenched in animals? Or will it, like the H1N1 virus, stably adapt to humans and cause a pandemic?” He states, “[M]y colleagues and I consider that H7N9 has many of the traits that make a new flu virus worrisome.” He continues, “If H7N9 were to stably adapt to humans, it would probably meet with little or no human immunity” and “it could easily spread nationally and internationally.” “Hopefully H7N9 will remain an animal virus, and maybe the fact that it has circulated for at least two months without stably adapting to humans indicates that the species barrier is too great for it; but maybe not,” Horby states, concluding, “The first human case of H7N9 outside mainland China is perhaps only a matter of time. Then the public health and clinical community will need to assess, carefully and quickly, whether it represents a single imported case of animal-to-human transmission, an animal epidemic that has spread abroad, or the international spread of a partially or fully human-adapted virus” (4/25).