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Article: Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus

TitleClinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus
Authors
Issue Date1998
PublisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet
Citation
Lancet, 1998, v. 351 n. 9101, p. 467-471 How to Cite?
AbstractBackground. Human infection with an avian influenza A virus (subtype H5N1) was reported recently in Hong Kong. We describe the clinical presentation of the first 12 patients and options for rapid viral diagnosis. Methods. Case notes of 12 patients with virus-culture-confirmed influenza A H5N1 infection were analysed. The clinical presentation and risk factors associated with severe disease were defined and the results of methods for rapid virus diagnosis were compared. Findings. Patients ranged from 1 to 60 years of age. Clinical presentation was that of an influenza-like illness with evidence of pneumonia in seven patients. All seven patients older than 13 years had severe disease (four deaths), whereas children 5 years or younger had mild symptoms with the exception of one who died with Reye's syndrome associated with intake of aspirin. Gastrointestinal manifestations, raised liver enzymes, renal failure unrelated to rhabdomyolysis, and pancytopenia were unusually prominent. Factors associated with severe disease included older age, delay in hospitalisation, lower-respiratory-tract involvement, and a low total peripheral white blood cell count or lymphopenia at admission. An H5-specific reverse-transcription PCR assay (RT-PCR) was useful for rapid detection of virus directly in respiratory specimens. A commercially available enzyme immunoassay was more sensitive than direct immunofluorescence for rapid viral diagnosis. Direct immunofluorescence with an H5-specific monoclonal antibody pool was useful for rapid exclusion of H5-subtype infection. Interpretation. Avian Influenza A H5N1 virus causes human influenza-like illness with a high rate of complications in adults admitted to hospital. Rapid H5-subtype-specific laboratory diagnosis can be made by RT-PCR applied directly to clinical specimens.
Persistent Identifierhttp://hdl.handle.net/10722/157290
ISSN
2015 Impact Factor: 44.002
2015 SCImago Journal Rankings: 14.638
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, KYen_HK
dc.contributor.authorChan, PKSen_HK
dc.contributor.authorPeiris, Men_HK
dc.contributor.authorTsang, DNCen_HK
dc.contributor.authorQue, TLen_HK
dc.contributor.authorShortridge, Ken_HK
dc.contributor.authorCheung, PTen_HK
dc.contributor.authorTo, WKen_HK
dc.contributor.authorHo, ETFen_HK
dc.contributor.authorSung, Ren_HK
dc.contributor.authorCheng, AFBen_HK
dc.date.accessioned2012-08-08T08:48:41Z-
dc.date.available2012-08-08T08:48:41Z-
dc.date.issued1998en_HK
dc.identifier.citationLancet, 1998, v. 351 n. 9101, p. 467-471en_HK
dc.identifier.issn0140-6736en_HK
dc.identifier.urihttp://hdl.handle.net/10722/157290-
dc.description.abstractBackground. Human infection with an avian influenza A virus (subtype H5N1) was reported recently in Hong Kong. We describe the clinical presentation of the first 12 patients and options for rapid viral diagnosis. Methods. Case notes of 12 patients with virus-culture-confirmed influenza A H5N1 infection were analysed. The clinical presentation and risk factors associated with severe disease were defined and the results of methods for rapid virus diagnosis were compared. Findings. Patients ranged from 1 to 60 years of age. Clinical presentation was that of an influenza-like illness with evidence of pneumonia in seven patients. All seven patients older than 13 years had severe disease (four deaths), whereas children 5 years or younger had mild symptoms with the exception of one who died with Reye's syndrome associated with intake of aspirin. Gastrointestinal manifestations, raised liver enzymes, renal failure unrelated to rhabdomyolysis, and pancytopenia were unusually prominent. Factors associated with severe disease included older age, delay in hospitalisation, lower-respiratory-tract involvement, and a low total peripheral white blood cell count or lymphopenia at admission. An H5-specific reverse-transcription PCR assay (RT-PCR) was useful for rapid detection of virus directly in respiratory specimens. A commercially available enzyme immunoassay was more sensitive than direct immunofluorescence for rapid viral diagnosis. Direct immunofluorescence with an H5-specific monoclonal antibody pool was useful for rapid exclusion of H5-subtype infection. Interpretation. Avian Influenza A H5N1 virus causes human influenza-like illness with a high rate of complications in adults admitted to hospital. Rapid H5-subtype-specific laboratory diagnosis can be made by RT-PCR applied directly to clinical specimens.en_HK
dc.languageengen_US
dc.publisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lanceten_HK
dc.relation.ispartofLanceten_HK
dc.subject.meshAdulten_US
dc.subject.meshAnimalsen_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshDisease Outbreaksen_US
dc.subject.meshFemaleen_US
dc.subject.meshFluorescent Antibody Technique, Directen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunoenzyme Techniquesen_US
dc.subject.meshInfanten_US
dc.subject.meshInfluenza A Virus, H5n1 Subtype - Isolation & Purificationen_US
dc.subject.meshInfluenza, Human - Diagnosis - Epidemiology - Transmission - Virologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPolymerase Chain Reaction - Methodsen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshTime Factorsen_US
dc.titleClinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virusen_HK
dc.typeArticleen_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.emailPeiris, M: malik@hkucc.hku.hken_HK
dc.identifier.emailCheung, PT: ptcheung@hku.hken_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.identifier.authorityPeiris, M=rp00410en_HK
dc.identifier.authorityCheung, PT=rp00351en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0140-6736(98)01182-9en_HK
dc.identifier.pmid9482437-
dc.identifier.scopuseid_2-s2.0-0032515589en_HK
dc.identifier.hkuros36206-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032515589&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume351en_HK
dc.identifier.issue9101en_HK
dc.identifier.spage467en_HK
dc.identifier.epage471en_HK
dc.identifier.isiWOS:000072097700009-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.scopusauthoridChan, PKS=7403497792en_HK
dc.identifier.scopusauthoridPeiris, M=7005486823en_HK
dc.identifier.scopusauthoridTsang, DNC=7005609132en_HK
dc.identifier.scopusauthoridQue, TL=7003786628en_HK
dc.identifier.scopusauthoridShortridge, K=7005677034en_HK
dc.identifier.scopusauthoridCheung, PT=7202595465en_HK
dc.identifier.scopusauthoridTo, WK=7004294514en_HK
dc.identifier.scopusauthoridHo, ETF=18335076000en_HK
dc.identifier.scopusauthoridSung, R=7101684314en_HK
dc.identifier.scopusauthoridCheng, AFB=7402075035en_HK

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