Epidemiology of Human Infections with Avian Influenza A(H7N9) Virus in China

被引：557

作者：

Li, Qun ^{[1
]}

Zhou, Lei ^{[1
]}

Zhou, Minghao ^{[6
]}

Chen, Zhiping ^{[8
]}

Li, Furong ^{[9
]}

Wu, Huanyu ^{[10
]}

Xiang, Nijuan ^{[1
]}

Chen, Enfu ^{[8
]}

Tang, Fenyang ^{[6
]}

Wang, Dayan ^{[2
]}

Meng, Ling ^{[1
]}

Hong, Zhiheng ^{[1
]}

Tu, Wenxiao ^{[1
]}

Cao, Yang ^{[1
]}

Li, Leilei ^{[1
]}

Ding, Fan ^{[1
]}

Liu, Bo ^{[1
]}

Wang, Mei ^{[1
]}

Xie, Rongheng ^{[4
]}

Gao, Rongbao ^{[2
]}

Li, Xiaodan ^{[2
]}

Bai, Tian ^{[2
]}

Zou, Shumei ^{[2
]}

He, Jun ^{[9
]}

Hu, Jiayu ^{[10
]}

Xu, Yangting ^{[7
]}

Chai, Chengliang ^{[8
]}

Wang, Shiwen ^{[2
]}

Gao, Yongjun ^{[1
]}

Jin, Lianmei ^{[1
]}

Zhang, Yanping ^{[1
]}

Luo, Huiming ^{[3
]}

Yu, Hongjie ^{[3
]}

He, Jianfeng ^{[11
]}

Li, Qi ^{[12
]}

Wang, Xianjun ^{[13
]}

Gao, Lidong ^{[14
]}

Pang, Xinghuo ^{[5
]}

Liu, Guohua ^{[15
]}

Yan, Yansheng ^{[16
]}

Yuan, Hui ^{[17
]}

Shu, Yuelong ^{[2
]}

Yang, Weizhong ^{[3
]}

Wang, Yu ^{[3
]}

Wu, Fan ^{[10
]}

Uyeki, Timothy M. ^{[18
]}

Feng, Zijian ^{[1
]}

机构：

[1] Publ Hlth Emergency Ctr, Beijing, Peoples R China

[2] Natl Inst Viral Dis Control & Prevent, Beijing, Peoples R China

[3] Chinese Ctr Dis Control & Prevent, Beijing 102206, Peoples R China

[4] Chinese Field Epidemiol Training Program, Beijing, Peoples R China

[5] Beijing Municipal Ctr Dis Control & Prevent, Beijing, Peoples R China

[6] Jiangsu Prov Ctr Dis Control & Prevent, Nanjing, Jiangsu, Peoples R China

[7] Nanjing Prefecture Ctr Dis Control & Prevent, Nanjing, Jiangsu, Peoples R China

[8] Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Zhejiang, Peoples R China

[9] Anhui Prov Ctr Dis Control & Prevent, Hefei, Peoples R China

[10] Shanghai Municipal Ctr Dis Control & Prevent, Shanghai, Peoples R China

[11] Guangdong Prov Ctr Dis Control & Prevent, Guangzhou, Guangdong, Peoples R China

[12] Hebei Prov Ctr Dis Control & Prevent, Shijiazhuang, Peoples R China

[13] Shandong Prov Ctr Dis Control & Prevent, Jinan, Peoples R China

[14] Hunan Prov Ctr Dis Control & Prevent, Changsha, Hunan, Peoples R China

[15] Henan Prov Ctr Dis Control & Prevent, Zhengzhou, Peoples R China

[16] Fujian Prov Ctr Dis Control & Prevent, Fuzhou, Peoples R China

[17] Jiangxi Prov Ctr Dis Control & Prevent, Nanchang, Peoples R China

[18] Ctr Dis Control & Prevent, Influenza Div, Atlanta, GA USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2014年 / 370卷 / 06期

关键词：

A H7N9 VIRUS; TO-PERSON TRANSMISSION; RISK-FACTORS; H5N1; VIRUS; HUMAN ILLNESS; SURVEILLANCE; PROVINCE; DISEASE; FERRETS; MARKET;

D O I：

10.1056/NEJMoa1304617

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundThe first identified cases of avian influenza A(H7N9) virus infection in humans occurred in China during February and March 2013. We analyzed data obtained from field investigations to describe the epidemiologic characteristics of H7N9 cases in China identified as of December 1, 2013. MethodsField investigations were conducted for each confirmed case of H7N9 virus infection. A patient was considered to have a confirmed case if the presence of the H7N9 virus was verified by means of real-time reverse-transcriptase-polymerase-chain-reaction assay (RT-PCR), viral isolation, or serologic testing. Information on demographic characteristics, exposure history, and illness timelines was obtained from patients with confirmed cases. Close contacts were monitored for 7 days for symptoms of illness. Throat swabs were obtained from contacts in whom symptoms developed and were tested for the presence of the H7N9 virus by means of real-time RT-PCR. ResultsAmong 139 persons with confirmed H7N9 virus infection, the median age was 61 years (range, 2 to 91), 71% were male, and 73% were urban residents. Confirmed cases occurred in 12 areas of China. Nine persons were poultry workers, and of 131 persons with available data, 82% had a history of exposure to live animals, including chickens (82%). A total of 137 persons (99%) were hospitalized, 125 (90%) had pneumonia or respiratory failure, and 65 of 103 with available data (63%) were admitted to an intensive care unit. A total of 47 persons (34%) died in the hospital after a median duration of illness of 21 days, 88 were discharged from the hospital, and 2 remain hospitalized in critical condition; 2 patients were not admitted to a hospital. In four family clusters, human-to-human transmission of H7N9 virus could not be ruled out. Excluding secondary cases in clusters, 2675 close contacts of case patients completed the monitoring period; respiratory symptoms developed in 28 of them (1%); all tested negative for H7N9 virus. ConclusionsMost persons with confirmed H7N9 virus infection had severe lower respiratory tract illness, were epidemiologically unrelated, and had a history of recent exposure to poultry. However, limited, nonsustained human-to-human H7N9 virus transmission could not be ruled out in four families. The first cases of human infection with the avian influenza A(H7N9) virus were identified in China in early 2013. This report describes findings for 139 persons with confirmed H7N9 virus infection through December 1, 2013. The first identified cases of human infection with a novel influenza A(H7N9) virus occurred in eastern China during February and March 2013 and were characterized by rapidly progressive pneumonia, respiratory failure, the acute respiratory distress syndrome (ARDS), and fatal outcomes.(1) We analyzed available data from field investigations to characterize the descriptive epidemiology of laboratory-confirmed cases of avian influenza A(H7N9) virus infection in humans that were reported to the Chinese Center for Disease Control and Prevention (China CDC) as of December 1, 2013. In this report, we summarize the epidemiologic findings of case investigations and follow-up monitoring of close contacts of ...

引用

页码：520 / 532

页数：13

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