NDLI: Human infection with a novel avian-origin influenza A (H7N9) virus.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yang, Weizhong Xiang, Nijuan Bai, Tian Wang, Shiwen Li, Xiaodan Zhang, Zhiyong Xu, Xuewei Dong, Libo Zhu, Wenfei He, Zebao Yu, Hongjie Gao, George F. Wang, Dayan Zhang, Ye Jie, Zhijun Guo, Junfeng Han, Jun Hu, Wanfu Gu, Yong Yuan, Zhenghong Lu, Hongzhou Hu, Yunwen Zhu, Yun Xu, Ke Wang, Yu Gao, Rongbao Qiu, Haibo Li, Xiyan Zhang, Yanping Feng, Zijian Chen, Jian Li, Dexin Shen, Yinzhong Cao, Bin Dong, Jie Yang, Lei Wu, Guizhen Zou, Shumei Zhou, Lei Zhao, Xiang Li, Qun Hao, Pei Gao, Zhancheng Yang, Yi Shu, Yuelong
Spatial Coverage	China
Description	Author Affiliation: Gao R ( National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.)
Abstract	BACKGROUND: Infection of poultry with influenza A subtype H7 viruses occurs worldwide, but the introduction of this subtype to humans in Asia has not been observed previously. In March 2013, three urban residents of Shanghai or Anhui, China, presented with rapidly progressing lower respiratory tract infections and were found to be infected with a novel reassortant avian-origin influenza A (H7N9) virus. METHODS: We obtained and analyzed clinical, epidemiologic, and virologic data from these patients. Respiratory specimens were tested for influenza and other respiratory viruses by means of real-time reverse-transcriptase-polymerase-chain-reaction assays, viral culturing, and sequence analyses. RESULTS: A novel reassortant avian-origin influenza A (H7N9) virus was isolated from respiratory specimens obtained from all three patients and was identified as H7N9. Sequencing analyses revealed that all the genes from these three viruses were of avian origin, with six internal genes from avian influenza A (H9N2) viruses. Substitution Q226L (H3 numbering) at the 210-loop in the hemagglutinin (HA) gene was found in the A/Anhui/1/2013 and A/Shanghai/2/2013 virus but not in the A/Shanghai/1/2013 virus. A T160A mutation was identified at the 150-loop in the HA gene of all three viruses. A deletion of five amino acids in the neuraminidase (NA) stalk region was found in all three viruses. All three patients presented with fever, cough, and dyspnea. Two of the patients had a history of recent exposure to poultry. Chest radiography revealed diffuse opacities and consolidation. Complications included acute respiratory distress syndrome and multiorgan failure. All three patients died. CONCLUSIONS: Novel reassortant H7N9 viruses were associated with severe and fatal respiratory disease in three patients. (Funded by the National Basic Research Program of China and others.).
ISSN	00284793
Issue Number	20
Volume Number	368
e-ISSN	15334406
Journal	New England Journal of Medicine
Language	English
Publisher	Massachusetts Medical Society (United States)
Publisher Date	2013-05-16
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Influenza A Virus Genetics Influenza In Birds Virology Influenza, Human Adult Aged, 80 And Over Animals China Fatal Outcome Female Genome, Viral Humans Classification Isolation & Purification Transmission Male Phylogeny Poultry Real-Time Polymerase Chain Reaction Reassortant Viruses Respiratory Distress Syndrome, Adult Etiology Reverse Transcriptase Polymerase Chain Reaction Sequence Analysis, DNA Case Reports Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Medicine
Content Type	Text
Resource Type	Article
Subject	Medicine

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