Abstract
Novel avian influenza A(H7N9) virus was isolated in fatal patients in Yangtze River Delta of China in March 2013. We aimed to screen the virus in febrile patients in a tertiary hospital in an area with confirmed cases. Throat-swab specimens collected from consecutive patients with fever (≥38°C) and flu-like symptoms from April 15 to April 25, 2013 were subjected to detect novel avian influenza A(H7N9) virus with real-time PCR. The clinical outcomes in the patients and close contacts were followed up. Of total 200 patients screened, one (0.5%) was positive for avian influenza A(H7N9) virus and 199 others were negative. The infected patient experienced respiratory failure and had diffuse infiltrates in the right lower lobe in chest CT images. He received symptomatic and antibacterial treatments as well as oseltamivir. His condition was substantially improved within three days after admission; avian influenza A(H7N9) virus was not detected after 5 days' antiviral therapy. The hemagglutinin inhibition test showed that the serum titers against avian influenza A(H7N9) virus increased from <1∶20 at the early phase to 1∶80 at the convalescent phase. Follow-up of 23 close contacts showed that none of them developed fever and other symptoms within two weeks. Our findings suggest that although the infection rate of avian influenza A(H7N9) virus in patients with fever and flu-like symptoms is rare, the screening is valuable to rapidly define the infection, which will be critical to improve the clinical outcomes.
Highlights
During March 2013, a novel influenza virus of avian origin, influenza A(H7N9), was isolated from three patients with fatal severe respiratory disease in Shanghai and Anhui, both located in the Yangtze River Delta Region, east part of China [1]
A total of 200 febrile patients, who presented flulike symptoms, were recruited in this study to have their throatswab specimens tested for the presence of avian influenza A(H7N9) virus with fluorescence reverse transcription (RT)-PCR
The results that none of the 23 close contacts of the patient with influenza A(H7N9) developed flu-like symptoms suggest that the virus is not to transmit from human to human, which is in agreement with the other reports [10,11,12]
Summary
During March 2013, a novel influenza virus of avian origin, influenza A(H7N9), was isolated from three patients with fatal severe respiratory disease in Shanghai and Anhui, both located in the Yangtze River Delta Region, east part of China [1]. During late March and early April 2013, five patients who attended to our hospital were confirmed to have caught avian influenza A(H7N9) [3]. This had us to assess the incidence of avian influenza A(H7N9) virus in patients with fever flu-like symptoms, who attended the fever clinic of our hospital, a major general hospital in areas with confirmed cases of avian influenza A(H7N9)
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