Category Archives: Influenza

Avian Influenza A(H7N9) Perspectives in JIDC: Immune Status, The Elderly and Pandemics. by Stephen Huang

On 31 March 31 2013, the Chinese National Health and Family Planning Commission officially announced the emergence of novel avian influenza A(H7N9) virus infection in humans.  This virus has now caused disease in 108 people (as of 23 April 23), including severe cases and mortality.  Although the virus has not been shown to transmit from human-to-human, avian influenza A(H7N9) virus poses a pandemic threat in the human population due to the lack of pre-existing immunity and its high fatality rate, should human-to-human transmission occur.


Figure 2 from Guan et al., 2013: Typical wet market in China showing staked cages of chickens, ducks and pigeons

In this issue of JIDC, Yi and colleagues of the International Institute of Infection and Immunity, Shantou University Medical College, Shantou, Guangdong, China, published a manuscript reporting a possible route via the mixed poultry-mammals  environment in the Chinese live markets as the source of avian influenza A(H7N9) virus human infections.


Figure 3 from Guan et al., 2013: Typical wet market in China showing close proximity of multiple species including rabbits

Furthermore, based on the predominant number of severe cases in the elderly, the paper also puts forth the elderly population as at high risk for avian influenza A(H7N9) virus H7N9 human disease.


Figure 5 from Guan et al., 2013: Number of nrH7N9 human cases per age group in
China as of April 15

The manuscript describes the lack of knowledge in designing effective H7N9 vaccines and immune surveillance, as well as lack of understanding in the disease’s pathogenesis, especially in the high-risk group.  This issue requires immediate attention for assessing a possible new pandemic outbreak.  The article can be found under this link:

Stephen Huang


Filed under China, Countries, Environmental Issues, Infectious Disease, Influenza, Outbreaks

Derek: Infection and Immunity Summer Training Course in China


I am happy to present this incredibly thoughtful Postcard from Derek Ng.  Derek is from Toronto, Canada and participated in the Summer Training Course in China in 2009 focusing on Infectious Diseases.  Derek’s reflection is a striking example of how education is imperative in and out of the classroom.  I am inspired by Derek’s story and recommend international training as an essential component of science and health care instruction.  Derek is incredibly studious but he is always conscious to add heart and thoughtfulness to his work as well as daily life.  He is now a second year medical student at the University of Western Ontario.  Further questions for Derek, he is happy to help: cng2014(at)meds(dot)uwo(dot)ca.  If you have any questions or are interested in the Summer Training Courses please contact me, akelvin(at)jidc(dot)org. 


Hi there!

University of Western Ontario

My name is Derek Ng and I am currently starting my second year of medicine at the University of Western Ontario in Canada. I would like to share my international research experience that has left a positive impression on my young scientific/medical career.

Two years ago, I was a fourth year undergraduate student at McMaster University, in Hamilton, Canada, majoring in Biology. I was specifically very fond of infection and immunology, so I had focused on courses related to these topics. I selected my fourth year thesis in a mucosal immunology lab, working on a project aimed at characterizing immune homeostatic responses upon colonization of germ-free mice. The experience helped me refine both my skills and knowledge, as well as solidify my interest in immunology.

Summer Training Course in Infectious Diseases

I had a good friend who knew about my passion towards infectious diseases and she informed me about a training opportunity in Shantou, China, entitled a Summer Training Course in China Focusing on Infectious Diseases. The training course was coordinated by


Dr. David J. Kelvin of the University of Toronto. Furthermore the course is a joint collaboration between the University of Toronto, Shantou University, The University of Sassari, and Hong Kong University.  The course was open to all students of any country and university and provided financial stipends and travel support. 

I was so excited when I saw the advertisement that I prepared and submitted my application immediately without hesitation. Following a Skype interview and later confirmation of acceptance, I was well on my way to travelling to the other side of the world.

I never travelled very much before

Shantou, China Map from

and consequently the idea of pursuing research abroad – least of all in China – never occurred to me as a potential direction in which I could steer my career.

My first destination was Hong Kong, which was where I would meet the other students for our bus ride toShantou. I scheduled my flight early because this place was special to me (Hong Kong was my birth place). It was my second time meeting my relatives and it turned out to be a very pleasant time for me. Living there shortly was an easy transition since English is commonly used and I am able to speak Cantonese as well. Despite the fun with my family, I was very eager to meet the rest of the students and make the trip into the mainland. I had never visited China before and I really did not know what to expect apart from things I had heard from my family and read on the internet.


Upon our departure from Hong Kong, I was greeted by Dr. David Kelvin (our fearless leader, professor, mentor and program coordinator) as well as the other students.  Dr. D. Kelvin is a scientist at the University Health Network, Toronto Ontario, The International Institute of Infection and Immunity in Shantou, China and a Professor at the University of Sassari, Italy.  His research mostly focuses on the immune response to influenza infection.

Institute of Infection and Immunity

This was my first time meeting the students and David, although we had previously communicated a bit over the internet. There were only ten of us, but we brought with us a very diverse background of experience. Collectively our previous knowledge spanned across biochemistry, biology, engineering science, health science, immunology, medicine and microbiology. We were a very well-balanced group and bonded quickly. One interesting anecdote I have here is that we were traveling in the midst of the 2009 H1N1 influenza outbreak.  When we were crossing the border fromHong Kong into China, our bus was boarded by officials with temperature sensors. We had all passed the initial screen, but when we entered the checkpoint building we had our temperatures taken again. Some of my colleagues were separated for even further screening (this time it was an axillary temperature). When we emerged from the other side of the border, there were only nine of us. One of the students was taken from us for an overnight quarantine at the hospital (he was fine and would meet up with us the next morning). This experience had undoubtedly set the tone for the course.

Chaozhou Group

Shortly after reaching Shantou, it had sunk in that I was definitely not in Toronto anymore. I was in a beautiful place surrounded by lush green mountains with a river running out towards the open ocean. I was surrounded by throngs of motorcycles, cars, people and a way of life that, although seemed foreign to me, was normal for the citizens. Also, the main language spoken here was Mandarin although a local Chaozhou dialect was in use as well. The language barrier made my stay more interesting because I was often trying to communicate with people by figuring out the Mandarin equivalent of words that I already knew in Cantonese.

We stayed at the international student residences at ShantouUniversity, the campus of which was quite stunning and picturesque. We were introduced to the staff and scientists that worked at the International Institute of Infection and Immunology, located at a separate medical campus in the city. As stated by the Institute:  The mission of the institute is to increase our understanding of human infectious diseases through the use of genomics, proteomics and molecular epidemiology. Frieda Law, the representative of the Li Ka Shing Foundation at Shantou, gave us a tour of the medical building, explained some of the history of the medical school and what the facilities had to offer. She also introduced to us the philanthropist activities of Li Ka Shing, which ranged from rural health projects to even funding activities such as our trip. The staff working there were a group of exceptional people and well-versed in their knowledge and ability to teach. Everyone involved was friendly and very accommodating to us during our time in Shantou.

We were given daily lectures on various topics infectious diseases in the mornings such as . Professors included David Kelvin, Michael Ratcliffe, Salvatore Rubino, Piero Cappuccinelli, Giacamo Spissu, Honglin Chen, Jiang Gu,  Guan Yi, Liqun Jin, Yong Xiao, Krystal Lee, Alberto Joseph Leon, Amber Farooqui.  In the afternoons we would learn how to apply our knowledge in a lab setting.  We were assigned various tasks to complete during our one-month excursion. For example, we were taken to see traditional Chinese medical doctors and collect herbs known to be prescribed for flu-like symptoms. Each student was then

Mackenzie Howatt and I in our shantou university medical college lab coats

assigned an herb to investigate in terms of its properties, usage, and extraction of active ingredients. Following lectures on influenza, we were given the opportunity to grade histological slides as well as grow virus in chicken eggs. I personally enjoyed the way we learned because the design of the course created a very interactive learning experience that helped solidify concepts.

There is undoubtedly a difference between knowledge acquired in a classroom and that gained from real experiences. For a student to sit in the comfort of a lecture hall and learn about how pandemic influenza and recombination occur is undoubtedly important. However, what complements this textbook knowledge is to be in a place where you can see these concepts in action. For example, Dr. D. Kelvin specifically wanted us to see Shantou’s live poultry markets, in which ducks, geese and other birds were kept together in close proximity to each other and people. Upon further inquiry, we were told that unsold birds were brought back to a common, large farm at the end of the day. This helped me appreciate the complexity for public health officials or scientists in assessing the origins and spread of an infectious outbreak.

There are many things that come to my mind when I think about what I learned inShantou. For one, it reinforces the idea that science is not only being conducted in developed countries. I also better understand part of the rationale behind open access scientific journals in helping to provide fair access to information for scientists in resource-limited situations. By promoting science in places like this, it helps to secure the future of scientific progress on a global stage where the vast majority of today’s youth is situated. On

an example of a poultry market where different breeds of birds are housed together for sale

a personal level, I had gone to China without any international experience and came back to Canada as a more passionate individual towards issues in global health. We had met scientists from around the world and even officials such as the former President of Sardinia, Mr. Giacomo Spissu. Our conversations on health policy allowed me to gain a better understanding of how an outbreak is dealt with on the government level. By the end of the course, I could associate all the levels of collaboration during an outbreak in terms of basic scientific research, epidemiology, health policy, economics and even the psychosocial or cultural aspects.

I hope this offers you a sufficient glimpse into my one month spent in paradise. There is so much more I could say about this experience, because it opened my eyes to the world and changed my life for the better. I would like to express my deepest appreciation to Dr. D. Kelvin, his staff, colleagues and friends for making this all possible by organizing and participating in such an incredible course.

JoAnne, Mackenzie, myself, volunteers from HKU *hong knog university* and STU *shantou university*, and children from a rural area in China


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Filed under Infectious Disease, Influenza, Open Access, Uncategorized