Abstract
Since March 2013, a novel influenza A(H7N9) virus has caused 3 epidemic waves of human infection in mainland China. We analyzed data from patients with laboratory-confirmed influenza A(H7N9) virus infection to estimate the risks for severe outcomes after hospitalization across the 3 waves. We found that hospitalized patients with confirmed infections in waves 2 and 3 were younger and more likely to be residing in small cities and rural areas than were patients in wave 1; they also had a higher risk for death, after adjustment for age and underlying medical conditions. Risk for death among hospitalized patients during waves 2 and 3 was lower in Jiangxi and Fujian Provinces than in eastern and southern provinces. The variation in risk for death among hospitalized case-patients in different areas across 3 epidemic waves might be associated with differences in case ascertainment, changes in clinical management, or virus genetic diversity.
Highlights
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Emerging Infectious Diseases
Three major epidemics of human influenza A(H7N9) virus infections have occurred since the first human case was identified in March 2013: spring 2013, winter–spring of 2013–14, and winter–spring of 2014–15 (Figure 1; online Technical Appendix, http://wwwnc.cdc.gov/EID/ article/22/6/15-1752-Techapp1.pdf)
In this study, we found some evidence that the estimated risk for severe outcomes in hospitalized patients with influenza A(H7N9) virus infection may have increased in some areas across the 3 epidemic waves over time
Summary
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Emerging Infectious Diseases. LLC is accredited by the ACCME to provide continuing medical education for physicians. All other clinicians completing this activity will be issued a certificate of participation To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; (4) view/print certificate. Describe changes in laboratory-confirmed human infections with H7N9 across 3 epidemic waves in 2013–2015 in mainland China, and other epidemiologic features, based on a surveillance study. Determine possible reasons for the observed changes in laboratory-confirmed and hospitalized cases of H7N9 across 3 epidemic waves in 2013–2015 in mainland China
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