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Unique reassortant of influenza a(H7N9) virus associated with severe disease emerging in Hong Kong

Available online 24 February 2014

In Press, Accepted Manuscript — Note to users

 

Summary

Objective

Human infections caused by avian influenza virus A(H7N9) re-emerged in late 2013. We reported the first Hong Kong patient without risk factors for severe A(H7N9) disease.

Methods

Direct sequencing was performed on the endotracheal aspirate collected from a 36-year-old female with history of poultry contact. Bioinformatic analysis was performed to compare the current strain and previous A(H7N9) isolates.

Results

The influenza A/Hong Kong/470129/2013 virus strain was detected in a patient with acute respiratory distress syndrome, deranged liver function and coagulation profile, cytopenia, and rhabdomyolysis, The HA, NA and MP genes of A/Hong Kong/470129/2013 cluster with those of other human A(H7N9) strains. The PB1, PB2 and NS genes are most closely related to those of A/Guangdong/1/2013 strain identified in August 2013, but are distinct from those of other human and avian A(H7N9) strains. The other internal genes NP and PA genes are more closely related to those of non-A(H7N9) avian influenza A viruses. A unique PA L336M mutation, associated with increased polymerase activity, was found. The patient required salvage by extracorporeal membrane oxygenation.

Conclusions

The A/Hong Kong/470129/2013 virus is a novel reassortant derived from A/Guangdong/1/2013 virus. The unique mutation PA L336M may enhance viral replication and therefore disease severity.

http://www.sciencedirect.com/science/article/pii/S0163445314000498 

Camels Linked to Spread of #MERS Virus in People

By DENISE GRADYFEB. 25, 2014

A new study suggests that camels are the major source of the Middle East Respiratory Syndrome, or MERS, a viral disease that has sickened 182 people and killed 79 of them since it was first detected in Saudi Arabia in 2012.

The animals are most likely to infect people through respiratory secretions — from coughing, sneezing, snorting or spitting — that travel through the air or cling to surfaces.

People with chronic illnesses like diabetes, lung disease or kidney failure, or other conditions that weaken their immunity, seem to be most susceptible, and should avoid close contact with camels, researchers say.

Continued:  http://www.nytimes.com/2014/02/25/health/camels-linked-to-spread-of-deadly-virus-in-people.html?_r=0

Fujian Reports #H7N9 1 Case Cured - No New Cases in February

Translation
2/25/14

  Health and Family Planning Commission of Fujian Province 2 months 25 days notification, Quanzhou Yongchun County 2 months 4days confirmed human infection with H7N9 avian flu Moumou, after treatment was 2 months 25 days discharged.

    As of 2 months 25 days , the province reported a total of people infected with H7N9 bird flu confirmed cases 15 cases, including the death of three patients were cured and discharged eight cases. Currently hospitalized four cases, there are twocases of H7N9 avian influenza virus nucleic acid detection has two negative. From this month, 7 days so far, no new cases occur in our province. (Emergency Management Office)

http://www.fjphb.gov.cn/show.aspx?ctlgid=246246&Id=90325 

Guangdong Province #H7N9 1 Confirmed Case, 2 Cured & 1 Death

Translation
2/25/14

 Health and Family Planning Commission of Guangdong Province on February 25 Bulletin, Foshan new confirmed cases of H7N9 avian influenza case of human infection. 
    Case Zhu, male, 71 years old, currently residing in Nanhai District of Foshan City, coronary heart disease, hypertension history. February 23 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition, were treated at a local hospital sentinel. 
    Another Shenzhen January 20 confirmed cases Jeong, February 4 confirmed cases were cured in Dengmou February 25 discharged; Foshan City, January 8 cases diagnosed cure Choi was discharged on February 25, 2 May 4 confirmed cases cure a strict discharged on February 22. 
    Jiangmen City, February 20 confirmed cases of labor due to respiratory failure in a February 24 died.

http://www.gdwst.gov.cn/a/zwxw/2014022511359.html

Guangdong Province 4 new confirmed cases of with #H7N9 avian influenza & 1 Death

Translation
2/24/14
Health and Family Planning Commission of Guangdong Province on February 24 Bulletin, Guangzhou, Foshan new confirmed cases of H7N9 avian influenza four cases of human infection.
    Case 1 Yemou, male, 76 years old, currently residing in Haizhu District of Guangzhou City, suffering from chronic obstructive pulmonary disease, tuberculosis and other chronic diseases 30 years. February 21 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition, were treated at a local hospital sentinel. 
    Case 2 Lee, female, 55 years old, currently residing in Liwan District of Guangzhou City, suffering from high blood pressure, diabetes and other chronic diseases for 10 years, on February 21 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition, were treated at a local spot hospital.    
    Case 3 Jimmy A, F, 75 years old, currently residing in Tianhe District, Guangzhou City, February 21 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition, were treated at a local hospital sentinel.    
    Case 4 Hwang, male, 33 years old, currently residing in Shunde District of Foshan City, February 23 confirmed cases of human infection of H7N9 avian influenza, the patient is currently in critical condition at Zhongshan Hospital Wards hospitalized.    
    Also, Zhaoqing City, February 20 confirmed cases in a certain way because of respiratory failure in February 23 died.
http://www.gdwst.gov.cn/a/zwxw/2014022411350.html 

WHO Human infection with avian influenza A(H7N9) virus – update February 24, 2014

24 February 2014 - On 20 and 21 February 2014, the National Health and Family Planning Commission (NHFPC) of China notified WHO of nine additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus.
Seven of the nine cases are males. The age range is 29 to 81 years. Cases were reported from Anhui (1), Hunan (2), Jilin (1) and Guangdong (5). One case died, six cases are in a critical condition, one case is in a severe condition and one case is in a stable condition. Six cases are reported to have had a history of exposure to live poultry. Investigations are ongoing.

Details of the cases notified on 20 February are as follows:

• A 64 year-old farmer from Shaoyang City, Hunan Province. He became ill on 9 February, was admitted to a hospital on 15 February and is currently in a critical condition. The patient has a history of exposure to poultry.
• A 29 year-old resident from Changsha City, Hunan Province. She became ill on 8 February, was admitted to a hospital on 16 February and is currently in a critical condition. The patient has a history of exposure to poultry.
• A 79 year-old man from Foshan City, Guangdong Province. He became ill on 10 February, was admitted to a hospital on 14 February and is currently in a severe condition.
• A 60 year-old food handler from Xuancheng City, Anhui Province. He became ill on 13 February, was admitted to a hospital on 19 February and is currently in a critical condition. The patient has a history of exposure to poultry.
• An 81 year-old man who lives in Guangzhou City, Guangdong Province. He became ill on 7 February, was admitted to a hospital on 16 February and is currently in a critical condition. The patient has a history of exposure to poultry.

Details of the cases notified on 21 February are as follows:

• A 46 year-old woman from Zhaoqing City, Guangdong Province,. She became ill on 13 February, was admitted to a hospital on 19 February and is currently in a critical condition. The patient has a history of exposure to poultry.
• A 64 year-old man from Guangzhou City, Guangdong Province. He became ill on 9 February, was admitted to a hospital on 15 February and died on 18 February.
• A 69 year-old man from Jiangmen City, Guangdong Province. He became ill on 10 February, was admitted to a hospital on 18 February and is currently in a critical condition. The patient has a history of exposure to poultry.
• A 50 year- old chicken farm keeper from Jilin Province. He became ill on 15 February, was admitted to a hospital on 19 February and is currently in a stable condition. 

Continued:  http://www.who.int/csr/don/2014_02_24/en/