Kelvin K-W To1, Jasper F-W Chan, Kwok-Yung Yuen. 1. State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Research Centre of Infection and Immunology, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Abstract
PURPOSE OF REVIEW: The avian influenza A(H7N9) virus has jumped species barrier and caused severe human infections. Here, we present the virological features relevant to clinical practice, and summarize the epidemiology, clinical findings, diagnosis, treatment, and preventive strategies of A(H7N9) infection. RECENT FINDINGS: As of 18 February 2014, A(H7N9) virus has caused 354 infections in mainland China, Taiwan, and Hong Kong with a case-fatality rate of 32%. Elderly men were most affected. Most patients acquired the infection from direct contact with poultry or from a contaminated environment, although person-to-person transmission has likely occurred. A(H7N9) infection has usually presented with severe pneumonia, often complicated by acute respiratory distress syndrome and multiorgan failure. Mild infections have been reported in children and young adults. Nasopharyngeal aspirate and sputum samples should be collected for diagnosis, preferably using reverse transcriptase-PCR. Early treatment with neuraminidase inhibitors improved survival, but the efficacy of antivirals was hampered by resistant mutants. The closure of live poultry markets in affected areas has significantly contributed to the decline in the incidence of human cases. SUMMARY: The emergence of A(H7N9) virus represents a significant health threat. High vigilance is necessary so that appropriate treatment can be instituted for the patient and preventive measures can be implemented.
PURPOSE OF REVIEW: The avian influenza A(H7N9) virus has jumped species barrier and caused severe humaninfections. Here, we present the virological features relevant to clinical practice, and summarize the epidemiology, clinical findings, diagnosis, treatment, and preventive strategies of A(H7N9) infection. RECENT FINDINGS: As of 18 February 2014, A(H7N9) virus has caused 354 infections in mainland China, Taiwan, and Hong Kong with a case-fatality rate of 32%. Elderly men were most affected. Most patients acquired the infection from direct contact with poultry or from a contaminated environment, although person-to-person transmission has likely occurred. A(H7N9) infection has usually presented with severe pneumonia, often complicated by acute respiratory distress syndrome and multiorgan failure. Mild infections have been reported in children and young adults. Nasopharyngeal aspirate and sputum samples should be collected for diagnosis, preferably using reverse transcriptase-PCR. Early treatment with neuraminidase inhibitors improved survival, but the efficacy of antivirals was hampered by resistant mutants. The closure of live poultry markets in affected areas has significantly contributed to the decline in the incidence of human cases. SUMMARY: The emergence of A(H7N9) virus represents a significant health threat. High vigilance is necessary so that appropriate treatment can be instituted for the patient and preventive measures can be implemented.
Authors: Jasper F W Chan; Susanna K P Lau; Kelvin K W To; Vincent C C Cheng; Patrick C Y Woo; Kwok-Yung Yuen Journal: Clin Microbiol Rev Date: 2015-04 Impact factor: 26.132
Authors: Andrew C Y Lee; Houshun Zhu; Anna J X Zhang; Can Li; Pui Wang; Chuangen Li; Honglin Chen; Ivan F N Hung; Kelvin K W To; Kwok-Yung Yuen Journal: Clin Vaccine Immunol Date: 2015-10-07
Authors: Can Li; Chuangen Li; Anna J X Zhang; Kelvin K W To; Andrew C Y Lee; Houshun Zhu; Hazel W L Wu; Jasper F W Chan; Honglin Chen; Ivan F N Hung; Lanjuan Li; Kwok-Yung Yuen Journal: PLoS One Date: 2014-09-18 Impact factor: 3.240
Authors: Kelvin K W To; Candy C Y Lau; Patrick C Y Woo; Susanna K P Lau; Jasper F W Chan; Kwok-Hung Chan; Anna J X Zhang; Honglin Chen; Kwok-Yung Yuen Journal: Virol J Date: 2016-03-15 Impact factor: 4.099