Hui Jiang1, Peng Wu2, Timothy M Uyeki3, Jianfeng He4, Zhihong Deng5, Wen Xu6, Qiang Lv7, Jin Zhang8, Yang Wu9, Tim K Tsang2, Min Kang4, Jiandong Zheng1, Lili Wang10, Bingyi Yang2, Ying Qin1, Luzhao Feng1, Vicky J Fang2, George F Gao11,12, Gabriel M Leung2, Hongjie Yu13, Benjamin J Cowling2. 1. Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing. 2. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China. 3. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Guangdong Provincial Centre for Disease Control and Prevention, Guangzhou. 5. Hunan Provincial Centre for Disease Control and Prevention, Changsha. 6. Yunnan Provincial Centre for Disease Control and Prevention, Kunming. 7. Sichuan Provincial Centre for Disease Control and Prevention, Chengdu. 8. Anhui Provincial Centre for Disease Control and Prevention, Hefei. 9. Hubei Provincial Centre for Disease Control and Prevention, Wuhan. 10. Institut Pasteur of Shanghai, Chinese Academy of Sciences. 11. CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences. 12. Chinese Center for Disease Control and Prevention, Beijing. 13. School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Xuhui District, Shanghai, China.
Abstract
BACKGROUND: Since 2014, 17 human cases of infection with the newly emerged highly pathogenic avian influenza A(H5N6) virus have been identified in China to date. The epidemiologic characteristics of laboratory-confirmed A(H5N6) cases were compared to A(H5N1) and A(H7N9) cases in mainland China. METHODS: Data on laboratory-confirmed H5N6, H5N1, and H7N9 cases identified in mainland China were analyzed to compare epidemiologic characteristics and clinical severity. Severity of confirmed H5N6, H5N1 and H7N9 cases was estimated based on the risk of severe outcomes in hospitalized cases. RESULTS: H5N6 cases were older than H5N1 cases with a higher prevalence of underlying medical conditions but younger than H7N9 cases. Epidemiological time-to-event distributions were similar among cases infected with the 3 viruses. In comparison to a fatality risk of 70% (30/43) for hospitalized H5N1 cases and 41% (319/782) for hospitalized H7N9 cases, 12 (75%) out of the 16 hospitalized H5N6 cases were fatal, and 15 (94%) required mechanical ventilation. CONCLUSION: Similar epidemiologic characteristics and high severity were observed in cases of H5N6 and H5N1 virus infection, whereas severity of H7N9 virus infections appeared lower. Continued surveillance of human infections with avian influenza A viruses remains an essential component of pandemic influenza preparedness.
BACKGROUND: Since 2014, 17 human cases of infection with the newly emerged highly pathogenic avian influenza A(H5N6) virus have been identified in China to date. The epidemiologic characteristics of laboratory-confirmed A(H5N6) cases were compared to A(H5N1) and A(H7N9) cases in mainland China. METHODS: Data on laboratory-confirmed H5N6, H5N1, and H7N9 cases identified in mainland China were analyzed to compare epidemiologic characteristics and clinical severity. Severity of confirmed H5N6, H5N1 and H7N9 cases was estimated based on the risk of severe outcomes in hospitalized cases. RESULTS: H5N6 cases were older than H5N1 cases with a higher prevalence of underlying medical conditions but younger than H7N9 cases. Epidemiological time-to-event distributions were similar among cases infected with the 3 viruses. In comparison to a fatality risk of 70% (30/43) for hospitalized H5N1 cases and 41% (319/782) for hospitalized H7N9 cases, 12 (75%) out of the 16 hospitalized H5N6 cases were fatal, and 15 (94%) required mechanical ventilation. CONCLUSION: Similar epidemiologic characteristics and high severity were observed in cases of H5N6 and H5N1 virus infection, whereas severity of H7N9 virus infections appeared lower. Continued surveillance of human infections with avian influenza A viruses remains an essential component of pandemic influenza preparedness.
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