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Article: Clinical, Virological and Immunological Features from Patients Infected with Re-Emergent Avian-Origin Human H7N9 Influenza Disease of Varying Severity in Guangdong Province

TitleClinical, Virological and Immunological Features from Patients Infected with Re-Emergent Avian-Origin Human H7N9 Influenza Disease of Varying Severity in Guangdong Province
Authors
Issue Date2015
Citation
PLoS One, 2015, v. 10 n. 2, p. e0117846 How to Cite?
AbstractThe second wave of avian influenza H7N9 virus outbreak in humans spread to the Guangdong province of China by August of 2013 and this virus is now endemic in poultry in this region.
Background The second wave of avian influenza H7N9 virus outbreak in humans spread to the Guangdong province of China by August of 2013 and this virus is now endemic in poultry in this region. Methods Five patients with H7N9 virus infection admitted to our hospital during August 2013 to February 2014 were intensively investigated. Viral load in the respiratory tract was determined by quantitative polymerase chain reaction (Q-PCR) and cytokine levels were measured by bead-based flow cytometery. Results Four patients survived and one died. Viral load in different clinical specimens was correlated with cytokine levels in plasma and broncho-alveolar fluid (BALF), therapeutic modalities used and clinical outcome. Intravenous zanamivir appeared to be better than peramivir as salvage therapy in patients who failed to respond to oseltamivir. Higher and more prolonged viral load was found in the sputum or endotracheal aspirates compared to throat swabs. Upregulation of proinflammatory cytokines IP-10, MCP-1, MIG, MIP-1α/β, IL-1β and IL-8 was found in the plasma and BALF samples. The levels of cytokines in the plasma and viral load were correlated with disease severity. Reactivation of herpes simplex virus type 1(HSV-1) was found in three out of five patients (60%). Conclusion Expectorated sputum or endotracheal aspirate specimens are preferable to throat swabs for detecting and monitoring H7N9 virus. Severity of the disease was correlated to the viral load in the respiratory tract as well as the extents of cytokinemia. Reactivation of HSV-1 may contribute to clinical outcome.
Persistent Identifierhttp://hdl.handle.net/10722/208767
ISSN
2015 Impact Factor: 3.057
2015 SCImago Journal Rankings: 1.395
ISI Accession Number ID
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DC FieldValueLanguage
dc.contributor.authorYang, ZFen_US
dc.contributor.authorMok, KPen_US
dc.contributor.authorLiu, XQen_US
dc.contributor.authorLi, XBen_US
dc.contributor.authorHe, JFen_US
dc.contributor.authorGuan, WDen_US
dc.contributor.authorXu, YHen_US
dc.contributor.authorPan, WQen_US
dc.contributor.authorChen, LY-
dc.contributor.authorLin, YP-
dc.contributor.authorWu, SG-
dc.contributor.authorPan, SH-
dc.contributor.authorHuang, JC-
dc.contributor.authorDing, GY-
dc.contributor.authorZheng, K-
dc.contributor.authorKe, CW-
dc.contributor.authorLin, JY-
dc.contributor.authorZhang, YH-
dc.contributor.authorLee, HHY-
dc.contributor.authorLiu, WK-
dc.contributor.authorYang, CG-
dc.contributor.authorZhou, R-
dc.contributor.authorPeiris, JSM-
dc.contributor.authorLi, YM-
dc.contributor.authorChen, RC-
dc.contributor.authorChen, L-
dc.contributor.authorZhong, NS-
dc.date.accessioned2015-03-18T09:12:17Z-
dc.date.available2015-03-18T09:12:17Z-
dc.date.issued2015en_US
dc.identifier.citationPLoS One, 2015, v. 10 n. 2, p. e0117846en_US
dc.identifier.issn1932-6203-
dc.identifier.urihttp://hdl.handle.net/10722/208767-
dc.description.abstractThe second wave of avian influenza H7N9 virus outbreak in humans spread to the Guangdong province of China by August of 2013 and this virus is now endemic in poultry in this region.en_US
dc.description.abstractBackground The second wave of avian influenza H7N9 virus outbreak in humans spread to the Guangdong province of China by August of 2013 and this virus is now endemic in poultry in this region. Methods Five patients with H7N9 virus infection admitted to our hospital during August 2013 to February 2014 were intensively investigated. Viral load in the respiratory tract was determined by quantitative polymerase chain reaction (Q-PCR) and cytokine levels were measured by bead-based flow cytometery. Results Four patients survived and one died. Viral load in different clinical specimens was correlated with cytokine levels in plasma and broncho-alveolar fluid (BALF), therapeutic modalities used and clinical outcome. Intravenous zanamivir appeared to be better than peramivir as salvage therapy in patients who failed to respond to oseltamivir. Higher and more prolonged viral load was found in the sputum or endotracheal aspirates compared to throat swabs. Upregulation of proinflammatory cytokines IP-10, MCP-1, MIG, MIP-1α/β, IL-1β and IL-8 was found in the plasma and BALF samples. The levels of cytokines in the plasma and viral load were correlated with disease severity. Reactivation of herpes simplex virus type 1(HSV-1) was found in three out of five patients (60%). Conclusion Expectorated sputum or endotracheal aspirate specimens are preferable to throat swabs for detecting and monitoring H7N9 virus. Severity of the disease was correlated to the viral load in the respiratory tract as well as the extents of cytokinemia. Reactivation of HSV-1 may contribute to clinical outcome.-
dc.languageengen_US
dc.relation.ispartofPLoS Oneen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleClinical, Virological and Immunological Features from Patients Infected with Re-Emergent Avian-Origin Human H7N9 Influenza Disease of Varying Severity in Guangdong Provinceen_US
dc.typeArticleen_US
dc.identifier.emailMok, KP: ch02mkp@hkucc.hku.hken_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0117846en_US
dc.identifier.pmid25723593-
dc.identifier.hkuros242659en_US
dc.identifier.volume10en_US
dc.identifier.issue2en_US
dc.identifier.spagee0117846en_US
dc.identifier.epagee0117846en_US
dc.identifier.isiWOS:000350251200040-
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza-

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