There have been a few signs this week that state health departments are beginning to prepare for the still unlikely event of China’s expanding outbreak of H7N9 bird flu reaching the United States. The Maine Public Health Alert Network System was used Tuesday to get the word out to local health officials, labs, emergency management officials, physicians and others about human infections with the Novel Influenza A (H7N9) viruses. Seven of the 24 victims of China’s H7N9 bird flu outbreak have already died, causing the shutdown of live poultry markets in the provinces of Shanghai and Nanjing and prompting many a restaurant to remove chicken from their menus. In addition to trying to contain the outbreak to the area, Chinese health officials are working on a vaccine for the new virus for use if it ever begins to spread from person to person. The World Health Organization (WHO) has said it wants to pay China a visit, but that has not yet happened. Both WHO and the U.S. Centers for Disease Control and Prevention sent out public health warnings about the H7N9 outbreak on April 5. So far, WHO agrees with Chinese officials who say it is NOT spread by human-to-human contact. “All 24 cases have occurred in eastern China,” says Tuesday’s alert from the Maine Center for Disease Control and Prevention. “No person-to-person transmission or epidemiologic link between any of the cases has been identified. No cases have been identified in Maine, but we wanted to provide this information as the situation in China continues to unfold.” Maine CDC reminded the state’s healthcare community that novel A influenza viruses are known for infections that cause severe respiratory illnesses in humans.  While no H7N9 cases have yet been detected in the U.S., Maine CDC advised its clinicians to consider the possibilities for anyone with severe respiratory illness and an “appropriate travel or exposure history.” A handful of other states have passed along the April 5 health advisory from the federal CDC to their local agencies. China has closed wholesale and live public poultry markets for cleaning and disinfecting. It also removed chicken from some school lunch programs. Airlines serving the area also have stopped serving chicken. Agricultural officials are also collecting tissue and blood samples from poultry in advance of a plan to slaughter any found carrying the H7N9 virus. This sampling and slaughter program will include live poultry market in all of China’s big cities. China’s poultry farms last year produced 18.23 million tons of chicken, up 6.7 percent from 2011. The outbreak has reduced daily sales by up to 50 percent. A spokesman for China’s National Poultry Industry Association says the outbreak is a “devastating blow” for the industry. The public in China is being told to avoid direct contact with poultry. The type of containment strategy China is using on the current H7N9 has been successful in the past with other novel avian influenza A viruses. The H5N1 virus was did not get any further than several Asian countries and Egypt. The H7N3 virus recently did not get out of Mexico. The WHO reported in 2011 that the H5N1 outbreak in those several Asian counties and Egypt involved 566 confirmed cases, mostly by 2007, and resulted in 332 deaths. The H7N3 virus infected ten poultry farms in Mexico last year, with no reports of human related human illnesses Influenza A virus subtype H3N2 is a subtype of the viruses that cause seasonal flu in the U.S. H3N2 viruses can infect birds and mammals and can mutate into many strains. Season influenza can kill up to 36,000 people in the U.S. during each flu season. The WHO says there is no risk of transmission of influenza viruses from eating well-cooked food, including poultry and game birds. It says to go with “piping hot” and “no pink” preparation. And avoid totally raw meat and any uncooked blood-based dishes as they are “high risk” and should be discouraged. Also eat no diseased animals or animals that died from disease.