File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome

TitleHuman infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome
Authors
Issue Date2013
PublisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet
Citation
The Lancet, 2013, v. 381 n. 9881, p. 1916-1925 How to Cite?
AbstractBackground: Human infection with avian influenza A H7N9 virus emerged in eastern China in February, 2013, and has been associated with exposure to poultry. We report the clinical and microbiological features of patients infected with influenza A H7N9 virus and compare genomic features of the human virus with those of the virus in market poultry in Zhejiang, China. Methods: Between March 7 and April 8, 2013, we included hospital inpatients if they had new-onset respiratory symptoms, unexplained radiographic infiltrate, and laboratory-confirmed H7N9 virus infection. We recorded histories and results of haematological, biochemical, radiological, and microbiological investigations. We took throat and sputum samples, used RT-PCR to detect M, H7, and N9 genes, and cultured samples in Madin-Darby canine kidney cells. We tested for co-infections and monitored serum concentrations of six cytokines and chemokines. We collected cloacal swabs from 86 birds from epidemiologically linked wet markets and inoculated embryonated chicken eggs with the samples. We identified and subtyped isolates by RT-PCR sequencing. RNA extraction, complementary DNA synthesis, and PCR sequencing were done for one human and one chicken isolate. We characterised and phylogenetically analysed the eight gene segments of the viruses in the patient's and the chicken's isolates, and constructed phylogenetic trees of H, N, PB2, and NS genes. Findings: We identified four patients (mean age 56 years), all of whom had contact with poultry 3–8 days before disease onset. They presented with fever and rapidly progressive pneumonia that did not respond to antibiotics. Patients were leucopenic and lymphopenic, and had impaired liver or renal function, substantially increased serum cytokine or chemokine concentrations, and disseminated intravascular coagulation with disease progression. Two patients died. Sputum specimens were more likely to test positive for the H7N9 virus than were samples from throat swabs. The viral isolate from the patient was closely similar to that from an epidemiologically linked market chicken. All viral gene segments were of avian origin. The H7 of the isolated viruses was closest to that of the H7N3 virus from domestic ducks in Zhejiang, whereas the N9 was closest to that of the wild bird H7N9 virus in South Korea. We noted Gln226Leu and Gly186Val substitutions in human virus H7 (associated with increased affinity for α-2,6-linked sialic acid receptors) and the PB2 Asp701Asn mutation (associated with mammalian adaptation). Ser31Asn mutation, which is associated with adamantane resistance, was noted in viral M2. Interpretation: Cross species poultry-to-person transmission of this new reassortant H7N9 virus is associated with severe pneumonia and multiorgan dysfunction in human beings. Monitoring of the viral evolution and further study of disease pathogenesis will improve disease management, epidemic control, and pandemic preparedness.
Persistent Identifierhttp://hdl.handle.net/10722/192488
ISSN
2015 Impact Factor: 44.002
2015 SCImago Journal Rankings: 14.638
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChen, Yen_US
dc.contributor.authorLiang, Wen_US
dc.contributor.authorYang, Sen_US
dc.contributor.authorWu, Nen_US
dc.contributor.authorGao, Hen_US
dc.contributor.authorSheng, Jen_US
dc.contributor.authorYao, Hen_US
dc.contributor.authorWo, Jen_US
dc.contributor.authorFang, Qen_US
dc.contributor.authorCui, Den_US
dc.contributor.authorLi, Y-
dc.contributor.authorYao, X-
dc.contributor.authorZhang, Y-
dc.contributor.authorWu, H-
dc.contributor.authorZheng, S-
dc.contributor.authorDiao, H-
dc.contributor.authorXia, S-
dc.contributor.authorZhang, Y-
dc.contributor.authorChan, KH-
dc.contributor.authorTsoi, HW-
dc.contributor.authorTeng, LL-
dc.contributor.authorSong, W-
dc.contributor.authorWang, P-
dc.contributor.authorLau, SY-
dc.contributor.authorZheng, M-
dc.contributor.authorChan, JFW-
dc.contributor.authorTo, KKW-
dc.contributor.authorChen, H-
dc.contributor.authorLi, L-
dc.contributor.authorYuen, KY-
dc.date.accessioned2013-11-15T02:17:44Z-
dc.date.available2013-11-15T02:17:44Z-
dc.date.issued2013en_US
dc.identifier.citationThe Lancet, 2013, v. 381 n. 9881, p. 1916-1925en_US
dc.identifier.issn0140-6736-
dc.identifier.urihttp://hdl.handle.net/10722/192488-
dc.description.abstractBackground: Human infection with avian influenza A H7N9 virus emerged in eastern China in February, 2013, and has been associated with exposure to poultry. We report the clinical and microbiological features of patients infected with influenza A H7N9 virus and compare genomic features of the human virus with those of the virus in market poultry in Zhejiang, China. Methods: Between March 7 and April 8, 2013, we included hospital inpatients if they had new-onset respiratory symptoms, unexplained radiographic infiltrate, and laboratory-confirmed H7N9 virus infection. We recorded histories and results of haematological, biochemical, radiological, and microbiological investigations. We took throat and sputum samples, used RT-PCR to detect M, H7, and N9 genes, and cultured samples in Madin-Darby canine kidney cells. We tested for co-infections and monitored serum concentrations of six cytokines and chemokines. We collected cloacal swabs from 86 birds from epidemiologically linked wet markets and inoculated embryonated chicken eggs with the samples. We identified and subtyped isolates by RT-PCR sequencing. RNA extraction, complementary DNA synthesis, and PCR sequencing were done for one human and one chicken isolate. We characterised and phylogenetically analysed the eight gene segments of the viruses in the patient's and the chicken's isolates, and constructed phylogenetic trees of H, N, PB2, and NS genes. Findings: We identified four patients (mean age 56 years), all of whom had contact with poultry 3–8 days before disease onset. They presented with fever and rapidly progressive pneumonia that did not respond to antibiotics. Patients were leucopenic and lymphopenic, and had impaired liver or renal function, substantially increased serum cytokine or chemokine concentrations, and disseminated intravascular coagulation with disease progression. Two patients died. Sputum specimens were more likely to test positive for the H7N9 virus than were samples from throat swabs. The viral isolate from the patient was closely similar to that from an epidemiologically linked market chicken. All viral gene segments were of avian origin. The H7 of the isolated viruses was closest to that of the H7N3 virus from domestic ducks in Zhejiang, whereas the N9 was closest to that of the wild bird H7N9 virus in South Korea. We noted Gln226Leu and Gly186Val substitutions in human virus H7 (associated with increased affinity for α-2,6-linked sialic acid receptors) and the PB2 Asp701Asn mutation (associated with mammalian adaptation). Ser31Asn mutation, which is associated with adamantane resistance, was noted in viral M2. Interpretation: Cross species poultry-to-person transmission of this new reassortant H7N9 virus is associated with severe pneumonia and multiorgan dysfunction in human beings. Monitoring of the viral evolution and further study of disease pathogenesis will improve disease management, epidemic control, and pandemic preparedness.-
dc.languageengen_US
dc.publisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet-
dc.relation.ispartofThe Lanceten_US
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in The Lancet. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Lancet, [VOL 381, ISSUE 9881, 2013] DOI 10.1016/S0140-6736(13)60903-4-
dc.titleHuman infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genomeen_US
dc.typeArticleen_US
dc.identifier.emailChan, KH: chankh2@hkucc.hku.hk-
dc.identifier.emailTsoi, HW: hwtsoi@hkucc.hku.hk-
dc.identifier.emailTeng, LL: jadeteng@swissmail.net, llteng@hkusua.hku.hk-
dc.identifier.emailSong, W: wjsong@hkucc.hku.hk-
dc.identifier.emailWang, P: puiwang@hkucc.hku.hk-
dc.identifier.emailLau, SY: lausiuying@hotmail.com-
dc.identifier.emailChan, JFW: jfwchan@hku.hk-
dc.identifier.emailTo, KKW: kelvinto@HKUCC.hku.hk-
dc.identifier.emailChen, H: hlchen@hku.hk-
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hk-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0140-6736(13)60903-4-
dc.identifier.pmid23623390-
dc.identifier.scopuseid_2-s2.0-84878336274-
dc.identifier.hkuros224885en_US
dc.identifier.volume381en_US
dc.identifier.issue9881-
dc.identifier.spage1916en_US
dc.identifier.epage1925en_US
dc.identifier.isiWOS:000320319500032-
dc.publisher.placeUnited Kingdom-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats