Comparison of Patients Hospitalized With Influenza A Subtypes H7N9, H5N1, and 2009 Pandemic H1N1

Wang, Chen; Yu, Hongjie; Horby, Peter; Cao, Bin; Wu, Peng; Yang, Shigui; Gao, Hainv; Li, Hui; Tsang, Tim K.; Liao, Qiaohong; Gao, Zhancheng; Ip, Dennis K. M.; Jia, Hongyu; Jiang, Hui; Liu, Bo; Ni, Michael Y.; Dai, Xiahong; Liu, Fengfeng; Kính, Nguyễn Văn; Liêm, Nguyễn Thanh; Hien, Tran Tinh; Liu, Yu; Yang, Juan; Wu, Joseph T.; Zheng, Yaming; Farrar, Jeremy; Cowling, Benjamin J.; Uyeki, Timothy M.; Li, Lanjuan

doi:10.1093/cid/ciu053

Cited by 118 publications

(115 citation statements)

References 34 publications

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“…While the 2009 influenza pandemic caused a significant social and economic burden, the A(H1N1)pdm09 virus was not as virulent as other influenza viruses, such as A(H5N1) or A(H7N9) (14,17,18). Compared to infections with circulating seasonal influenza A and B virus strains, infection with A(H1N1)pdm09 virus was associated with more severe disease in some human studies (19) but with comparable disease in others (20,21).…”

mentioning

confidence: 97%

Characterization of the Localized Immune Response in the Respiratory Tract of Ferrets following Infection with Influenza A and B Viruses

Carolan

Rockman

Borg

et al. 2016

J Virol

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The burden of infection with seasonal influenza viruses is significant. Each year is typically characterized by the dominance of one (sub)type or lineage of influenza A or B virus, respectively. The incidence of disease varies annually, and while this may be attributed to a particular virus strain or subtype, the impacts of prior immunity, population differences, and variations in clinical assessment are also important. To improve our understanding of the impacts of seasonal influenza viruses, we directly compared clinical symptoms, virus shedding, and expression of cytokines, chemokines, and immune mediators in the upper respiratory tract (URT) of ferrets infected with contemporary A(H1N1)pdm09, A(H3N2), or influenza B virus. Gene expression in the lower respiratory tract (LRT) was also assessed. Clinical symptoms were minimal. Overall cytokine/chemokine profiles in the URT were consistent in pattern and magnitude between animals infected with influenza A and B viruses, and peak expression levels of interleukin-1␣ (IL-1␣), IL-1␤, IL-6, IL-12p40, alpha interferon (IFN-␣), IFN-␤, and tumor necrosis factor alpha (TNF-␣) mRNAs correlated with peak levels of viral shedding. MCP1 and IFN-␥ were expressed after the virus peak. Granzymes A and B and IL-10 reached peak expression as the virus was cleared and seroconversion was detected. Cytokine/chemokine gene expression in the LRT following A(H1N1)pdm09 virus infection reflected the observations seen for the URT but was delayed 2 or 3 days, as was virus replication. These data indicate that disease severities and localized immune responses following infection with seasonal influenza A and B viruses are similar, suggesting that other factors are likely to modulate the incidence and impact of seasonal influenza. IMPORTANCEBoth influenza A and B viruses cocirculate in the human population, and annual influenza seasons are typically dominated by an influenza A virus subtype or an influenza B virus lineage. Surveillance data indicate that the burden of disease is higher in some seasons, yet it is unclear whether this is due to specific virus strains or to other factors, such as cross-reactive immunity or clinical definitions of influenza. We directly compared disease severities and localized inflammatory responses to different seasonal influenza virus strains, including the 2009 pandemic strain, in healthy naive ferrets. We found that the disease severities and the cytokine and chemokine responses were similar irrespective of the seasonal strain or the location of the infection in the respiratory tract. This suggests that factors other than the immune response to a particular virus (sub)type contribute to the variable impact of influenza virus infection in a population. Morbidity and mortality associated with human influenza virus infection are significant worldwide. Influenza is caused by three virus types (A, B, and C), among which types A and B are responsible for most of the diagnosed cases of seasonal influenza. Influenza A viruses attract the greatest attentio...

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mentioning

confidence: 97%

Characterization of the Localized Immune Response in the Respiratory Tract of Ferrets following Infection with Influenza A and B Viruses

Carolan

Rockman

Borg

et al. 2016

J Virol

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“…In addition, the INF A virus subtypes H7N9, H5N1, and H1N1 have been reported to have different LOS [18]. These varying LOS by study might be explained by different standards for admission and discharge at individual hospitals.…”

Section: Discussionmentioning

confidence: 96%

Correlation between Infection with Multiple Respiratory Viruses and Length of Hospital Stay in Patients from Cheonan, Korea

Jeon

Park

Kim

2017

Korean J Clin Lab Sci.

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The length of hospital stay (LOS) for patients with respiratory virus infections has been reported to depend the virus type and infection severity. However, the impact of co-infections remains unclear. Patients with suspected respiratory virus infections, who visited Dankook University Hospital between December 2006 and February 2014, were included to examine the relationship between co-infections and LOS. Multiplex reverse transcriptase-polymerase chain reactions were used to identify the causative viruses. LOS was analyzed with respect to sex, age, virus, and co-infection. During this period, 5,310 out of the 8,860 patients (59.9%; median age, 1.5 years) were respiratory virus-positive. In respiratory virus-positive patients with single, double, and three-or-more infections, the average LOS was 7.3, 6.7, and 6.6 days, respectively. Longer LOS was observed for older patients and those with human coronavirus OC43 infections compared with adenovirus or respiratory syncytial virus A infections. LOS differed significantly according to age, virus type, and co-infection, but not between double and three or more infections.

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“…It was shown that wild bird IAVs can directly infect mammals with minimal or no clinical symptoms. Yet diff erent magnitude of seroconversion makes the monitoring of the mammalian infections caused by avian IAV diffi cult (Yamazaki et al, 2009;Yang et al, 2012;Reed et al, 2014;Wang et al, 2014;Yang et al, 2014;Huang et al, 2015). On the other hand, the risk of avian and human IAV reassortants formation in susceptible wild and domestic mammalian species attracted the attention of many investigators.…”

Section: Discussionmentioning

confidence: 99%

Immune response of mice to non-adapted avian influenza A virus

Stropkovská¹,

Mikušková²,

Bobišová³

et al. 2015

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Summary. -Human infections with avian infl uenza A viruses (IAVs) without or with clinical symptoms of disease were recently reported from several continents, mainly in high risk groups of people, who came into the contact with infected domestic birds or poultry. It was shown that avian IAVs are able to infect humans directly without previous adaptation, however, their ability to replicate and to cause a disease in this new host can diff er. No spread of these avian IAVs among humans has been documented until now, except for one case described in Netherlands in the February of 2003 in people directly involved in handling IAV (H7N7)-infected poultry. Th e aim of our work was to examine whether a low pathogenic avian IAV can induce a virus-specifi c immune response of biological relevancy, in spite of its restricted replication in mammals. As a model we used a low pathogenic virus A/Duck/Czechoslovakia/1956 (H4N6) (A/Duck), which replicated well in MDCK cells and produced plaques on cell monolayers, but was unable to replicate productively in mouse lungs. We examined how the immune system of mice responds to the intranasal application of this non-adapted avian virus. Th ough we did not prove the infectious virus in lungs of mice following A/Duck application even aft er its multiple passaging in mice, we detected virus-specifi c vRNA till day 8 post infection. Moreover, we detected virus-specifi c mRNA and de novo synthesized viral nucleoprotein (NP) and membrane protein (M1) in lungs of mice on day 2 and 4 aft er exposure to A/Duck. Virus-specifi c antibodies in sera of these mice were detectable by ELISA already aft er a single intranasal dose of A/Duck virus. Not only antibodies specifi c to the surface glycoprotein hemagglutinin (HA) were induced, but also antibodies specifi c to the NP and M1 of IAV were detected by Western blot and their titers increased aft er the second exposure of mice to this virus. Importantly, antibodies neutralizing virus A/Duck were proved in mouse immune sera aft er the second dose of virus and a slight increase of mRNA expression of immune mediators tumor necrosis factor alpha (TNF-α) and IP10 has been observed in lungs of these mice 48 hr aft er the infection. Th ese observations correspond to the limited replication ability of the virus in mice and provided an important information about its ability to induce virusspecifi c antibodies, including those neutralizing virus, even without the previous virus adaptation to the new mammalian host. Such antibodies could consequently infl uence the immune potential of exposed individuals and their defensive capability against the newly emerged, even more virulent IAV.

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Comparison of Patients Hospitalized With Influenza A Subtypes H7N9, H5N1, and 2009 Pandemic H1N1

Abstract: Hospitalization with H7N9 virus infection is associated with older age and chronic heart disease, and patients have a longer duration of hospitalization than patients with H5N1 or pH1N1. This suggests that host factors are an important contributor to H7N9 severity.

Cited by 118 publications

References 34 publications

Characterization of the Localized Immune Response in the Respiratory Tract of Ferrets following Infection with Influenza A and B Viruses

Characterization of the Localized Immune Response in the Respiratory Tract of Ferrets following Infection with Influenza A and B Viruses

Correlation between Infection with Multiple Respiratory Viruses and Length of Hospital Stay in Patients from Cheonan, Korea

Immune response of mice to non-adapted avian influenza A virus

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