A hospital cluster combined with a family cluster of avian influenza H7N9 infection in Anhui Province, China

Zhang, Wenyan; Zhao, Kuaile; Jin, Jing; He, Jun; Zhou, Wei; Wu, Jiawei; Tang, Renshu; Ma, Wenbo; Ding, Caiyu; Liu, Wei; Zhang, Lei; Gao, Rongbao

doi:10.1016/j.jinf.2019.05.008

Cited by 14 publications

(9 citation statements)

References 36 publications

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“…This is consistent with previous evidence that suggests that poultry might be the main origin of human H7N9 infection . In particular, limited human‐to‐human transmission of avian influenza A/H7N9 is supported by the small number of family and/or hospital clusters reported . Those patients with influenza‐like syndromes who come in close contact with poultry, confirmed patients or travel history in pandemic areas may be at high‐risk of H7N9 infection .…”

Section: Discussionmentioning

confidence: 99%

Characteristics of H7N9 avian influenza pneumonia: a retrospective analysis of 17 cases

Ding

et al. 2020

Internal Medicine Journal

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Background H7N9 avian influenza is an infection of public health concern, in part because of its high mortality rate and pandemic potential. Aims To describe the clinical features of H7N9 avian influenza and the response to treatment. Methods Clinical, radiological and histopathological data, and treatment‐related of H7N9‐infected patients hospitalised during 2014–2017 were extracted and analysed. Results A total of 17 H7N9 patients (three females; mean age, 58.4 ± 13.7 years) was identified; of these six died. All patients presented with fever and productive cough; four patients had haemoptysis and 13 had chest distress and/or shortness of breath. Early subnormal white blood cell count and elevation of serum liver enzymes were common. Multilobar patchy shadows, rapid progression to ground‐glass opacities, air bronchograms and consolidation were the most common imaging findings. Histopathological examination of lung tissue of three patients who died showed severe alveolar epithelial cell damage, with inflammatory exudation into the alveolar space and hyaline membrane formation; widened alveolar septae, prominent inflammatory cell infiltration; and hyperplasia of pneumocytes. Viral inclusions were found in the lung tissue of two patients. All patients received antiviral drugs (oseltamivir ± peramivir). Four patients carried the rs12252‐C/C interferon‐induced transmembrane protein‐3 (IFITM3) genotype, while the others had the C/T genotype. Conclusions H7N9 virus infection causes human influenza‐like symptoms, but may rapidly progress to severe pneumonia and even death. Clinicians should be alert to the possibility of H7N9 infection in high‐risk patients. The presence of the IFITM3 rs12252‐C genotype may predict severe illness.

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Section: Discussionmentioning

confidence: 99%

Characteristics of H7N9 avian influenza pneumonia: a retrospective analysis of 17 cases

Ding

et al. 2020

Internal Medicine Journal

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“…Retrospective analyses were often carried out when human infections were identified, and genetically closely related H7N9 viruses were often isolated from chickens or environmental samples, mostly from the exposed live poultry markets (Shi et al 2013a). There were also several reports of clusters of human infection cases (Ding et al 2014;Xiao et al 2014;Mao et al 2015;Yi et al 2015;Xie et al 2017;Guo et al 2018;Wang et al 2018;Zhang et al 2019), although there remains no evidence of sustained human-to-human transmission (Hu et al 2014;Dong et al 2017;Liu et al 2017;Wang et al 2019).…”

Section: Emergence and Genetic Evolutionmentioning

confidence: 99%

H7N9 Influenza Virus in China

Liu

Chen

2020

Cold Spring Harb Perspect Med

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In early 2013, human infections caused by a novel H7N9 avian influenza virus (AIV) were first reported in China; these infections caused severe disease and death. The virus was initially low pathogenic to poultry, enabling it to spread widely in different provinces, especially in live poultry markets. Importantly, the H7N9 low pathogenic AIVs (LPAIVs) evolved into highly pathogenic AIVs (HPAIVs) in the beginning of 2017, causing a greater threat to human health and devastating losses to the poultry industry. Fortunately, nationwide vaccination of chickens with an H5/H7 bivalent inactivated avian influenza vaccine since September 2017 has successfully controlled H7N9 avian influenza infections in poultry and, importantly, has also prevented human infections. In this review, we summarize the biological properties of the H7N9 viruses, specifically their genetic evolution, adaptation, pathogenesis, receptor binding, transmission, drug resistance, and antigenic variation, as well as the prevention and control measures. The information obtained from investigating and managing the H7N9 viruses could improve our ability to understand other novel AIVs and formulate effective measures to control their threat to humans and animals.

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“…There have been 5 documented H7N9 outbreaks in China from 2013 to 2017, but human-tohuman transmission was only evident to some extent in the last outbreak (32)(33)(34), consistent with a Vx that is not yet humanized and likely to cause far fewer cases than other respiratory pathogens. However, considering the estimated CFR for H7N9 patients is ~30% (30,34), even if only 10% of the COVID-19 patients in Wuhan also had H7N9 it would explain the high CFR initially reported in China.…”

Section: Empirical Evidence For a Potential Vx In The Wuhan Outbreakmentioning

confidence: 99%

The Silent Partners

Almogy¹

2020

Preprint

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Despite great advances in understanding the dynamics of viral epidemics, the emergence of rapidly spreading, highly pathogenic viruses remains a realistic and catastrophic possibility, which current health systems may not be able to fully contain. An intriguing feature in many recent zoonotic viral outbreaks is the presence of ‘superspreaders’, which are infected individuals that cause dramatically more new cases than the average. Here I study the effect of superspreaders on the early dynamics of emerging viruses that have not gained the capacity for efficient human-to-human transmission, i.e viruses with R0 < 1. I show that superspreaders have a higher chance of rapid extinction, but under ‘crowded’ conditions can lead to ‘outbreaks’, causing far more cases than regular viruses. Hence I suggest that outbreaks of highly pathogenic superspreaders are more likely when they coincide in time and space with an unrelated outbreak leading to increased hospital admission rates. These superspreader outbreaks may be difficult to detect, especially in the context of a different epidemic in progress, and can significantly affect mortality patterns observed in affected areas.

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A hospital cluster combined with a family cluster of avian influenza H7N9 infection in Anhui Province, China

Cited by 14 publications

References 36 publications

Characteristics of H7N9 avian influenza pneumonia: a retrospective analysis of 17 cases

Characteristics of H7N9 avian influenza pneumonia: a retrospective analysis of 17 cases

H7N9 Influenza Virus in China

The Silent Partners

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