Avian influenza A H7N9 in Zhejiang, China

摘要

On March 31, 2013, the China Health and Planning Commission notified WHO of three human infections in Shanghai and Anhui with a novel influenza virus characterised as avian influenza A H7N9 (illness onset between Feb 19 and March 15, 2013).1 Genetic characterisation2 showed that this virus resulted from recombination of genes between three parent viruses noted in Asia in poultry and wild birds. The severity of disease was remarkable, as was the fact that patients were from towns located 400 km apart, and had no epidemiological connection. In The Lancet, Yu Chen and colleagues3 report details of their first H7N9-infected patient from Zhejiang province, and three additional cases who were identified by retrospectively testing 486 patients admitted to hospital with pneumonia between March 7 and April 9, 2013. Combined with those described by Gao and coworkers,2 Chen and colleagues' findings show a disease profile characterised by bilateral pneumonia progressing to acute respiratory distress syndrome, and multiorgan dysfunction that resembles human infections with highly pathogenic avian influenza A H5N1 virus or severe seasonal or pandemic influenza.45 These detailed descriptions of the first patients with a newly emerging infection are crucial to increase the clinical awareness needed for early recognition, and might provide clues about pathogenesis and strategies for clinical management.