Clinical and epidemiological characteristics of a case of avian influenza A H5N6 virus infection

Zhang, Yuelun; Yang, Shigui; Li, Gang; Yuan, Jing; Ding, Hong Ming; Mao, Chen; Liu, Qu

doi:10.1016/j.jinf.2016.02.012

Cited by 8 publications

(6 citation statements)

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“…The results of previous analyses examining the impact of delayed oseltamivir treatment on outcomes of H7N9 patients are consistent with our findings. [8,26,27] The guidelines for diagnosis and treatment of H7N9 issued by the World Health Organization and the National Health and Family Planning Commission of China recommend that empirical oseltamivir therapy should be initiated as soon as possible. [15,28] In this study, we also found that the length of oseltamivir treatment in the group that died was significantly shorter than the survival group, and the group with a time from onset to oseltamivir treatment of fewer than 9.5 days, had a 27.1% fatality rate compared to 68.8% of those who started treatment more than 15.5 days after onset.…”

Section: Discussionmentioning

confidence: 99%

Clinical indices and mortality of hospitalized avian influenza A (H7N9) patients in Guangdong, China

Yang

Birkhead

et al. 2019

Chinese Medical Journal

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Background: Six epidemic waves of human infection with avian influenza A (H7N9) virus have emerged in China with high mortality. However, study on quantitative relationship between clinical indices in ill persons and H7N9 outcome (fatal and non-fatal) is still unclear. A retrospective cohort study was conducted to collect laboratory-confirmed cases with H7N9 viral infection from 2013 to 2015 in 23 hospitals across 13 cities in Guangdong Province, China. Methods: Multivariable logistic regression model and classification tree model analyses were used to detect the threshold of selected clinical indices and risk factors for H7N9 death. The receiver operating characteristic curve (ROC) and analyses were used to compare survival and death distributions and differences between indices. A total of 143 cases with 90 survivors and 53 deaths were investigated. Results: Average age (Odds Ratio (OR) = 1.036, 95% Confidence Interval (CI) = 1.016–1.057), interval days between dates of onset and confirmation (OR = 1.078, 95% CI = 1.004–1.157), interval days between onset and oseltamivir treatment (OR = 5.923, 95% CI = 1.877–18.687), body temperature (BT) (OR = 3.612, 95% CI = 1.914–6.815), white blood cell count (WBC) (OR = 1.212, 95% CI = 1.092–1.346) were significantly associated with H7N9 death after adjusting for confounders. The chance of death from H7N9 infection was 80.0% if BT was over 38.1 °C, and chance of death is 67.4% if WBC count was higher than 9.5 (10 9 /L). Only 27.1% of patients who began oseltamivir treatment less than 9.5 days after disease onset died, compared to 68.8% of those who started treatment more than 15.5 days after onset. Conclusions: The intervals between date of onset and confirmation of diagnosis, between date of onset to oseltamivir treatment, age, BT and WBC are found to be the best predictors of H7N9 mortality.

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Section: Discussionmentioning

confidence: 99%

Clinical indices and mortality of hospitalized avian influenza A (H7N9) patients in Guangdong, China

Yang

Birkhead

et al. 2019

Chinese Medical Journal

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“…These continued zoonotic events pose a major threat to public health since an avian influenza A virus may be able to acquire mutations that allow for efficient and sustained human-to-human transmission and lead Table 1 to the next influenza pandemic [23]. Avian influenza A viruses including HPAI H5N6 have been detected in free-range poultry and wild birds [24] and more frequently in live poultry markets [24,25]. The newly emerged HPAI H5N6 virus belonging to the genetic clade 2.3.4.4 of H5 virus subtypes has acquired receptor binding affinity to the human-like SAα2,6Gal-linked receptor, suggesting increased pandemic potential, although HPAI H5N6 virus did not exhibit aerosol transmission and demonstrated relatively lower pathogenicity compared with HPAI H5N1 virus in the ferret model [26].…”

Section: Discussionmentioning

confidence: 99%

Preliminary Epidemiologic Assessment of Human Infections With Highly Pathogenic Avian Influenza A(H5N6) Virus, China

Jiang

Uyeki

et al. 2017

Clinical Infectious Diseases

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“…According to the self‐reported exposure history of people infected with HPAI A(H5N6) virus, 19 of 23 had exposure to poultry, which therefore suggested that contact with poultry or contaminated poultry market environments was the source of infection. 100 , 103 , 104 , 105 , 106 , 107 , 108 The hospitalized patients initially showed influenza‐like symptoms including fever, sore throat, headache, chills, cough, and myalgia, then developed into shortness of breath due to severe pneumonia and progressed to acute respiratory distress syndrome (ARDS) and multiple organ failure (MOF) in the deceased patients. 99 , 100 , 101 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 Bi et al indicated that A(H5N6) patients were observed to have significantly higher levels of 11 cytokines and 5 chemokines among the 48 markers tested, compared to individuals with A(H7N9) or A(H1N1)pdm09 infections.…”

Section: Human Infections With Clade 2344 A(h5n6) Virusmentioning

confidence: 99%

Pandemic potential of highly pathogenic avian influenza clade 2.3.4.4 A(H5) viruses

Yamaji

Saad

Davis

et al. 2020

Reviews in Medical Virology

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Summary The panzootic caused by A/goose/Guangdong/1/96‐lineage highly pathogenic avian influenza (HPAI) A(H5) viruses has occurred in multiple waves since 1996. From 2013 onwards, clade 2.3.4.4 viruses of subtypes A(H5N2), A(H5N6), and A(H5N8) emerged to cause panzootic waves of unprecedented magnitude among avian species accompanied by severe losses to the poultry industry around the world. Clade 2.3.4.4 A(H5) viruses have expanded in distinct geographical and evolutionary pathways likely via long distance migratory bird dispersal onto several continents and by poultry trade among neighboring countries. Coupled with regional circulation, the viruses have evolved further by reassorting with local viruses. As of February 2019, there have been 23 cases of humans infected with clade 2.3.4.4 H5N6 viruses, 16 (70%) of which had fatal outcomes. To date, no HPAI A(H5) virus has caused sustainable human‐to‐human transmission. However, due to the lack of population immunity in humans and ongoing evolution of the virus, there is a continuing risk that clade 2.3.4.4 A(H5) viruses could cause an influenza pandemic if the ability to transmit efficiently among humans was gained. Therefore, multisectoral collaborations among the animal, environmental, and public health sectors are essential to conduct risk assessments and develop countermeasures to prevent disease and to control spread. In this article, we describe an assessment of the likelihood of clade 2.3.4.4 A(H5) viruses gaining human‐to‐human transmissibility and impact on human health should such human‐to‐human transmission occur. This structured analysis assessed properties of the virus, attributes of the human population, and ecology and epidemiology of these viruses in animal hosts.

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Clinical and epidemiological characteristics of a case of avian influenza A H5N6 virus infection

Cited by 8 publications

References 1 publication

Clinical indices and mortality of hospitalized avian influenza A (H7N9) patients in Guangdong, China

Clinical indices and mortality of hospitalized avian influenza A (H7N9) patients in Guangdong, China

Preliminary Epidemiologic Assessment of Human Infections With Highly Pathogenic Avian Influenza A(H5N6) Virus, China

Pandemic potential of highly pathogenic avian influenza clade 2.3.4.4 A(H5) viruses

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