A family cluster of three confirmed cases infected with avian influenza A (H7N9) virus in Zhejiang Province of China

BMC Infectious Diseases

Hongjie Yu⁴  Enfu Chen¹  Shelan Liu³  Chengliang Chai³  Shuwen Qin³  Haiyan Mao³  Xuhui Yang⁷  Jingfeng Hu⁵  Fenjuan Wang⁶  Peter W Horby²  Zhao Yu³  Yin Chen³  Hua Ding⁷ 

[1] Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou 310051, Zhejiang, China;Singapore Infectious Disease Initiative, Singapore City, Singapore;Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China;Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, No. 155 Changbai Road, Changping District, Beijing, China;ShangCheng District Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China;XiaoShan District Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China;Hangzhou Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China

关键词: Epidemiological investigation;    Death;    Live bird market;    Family cluster;    H7N9 subtype;   

Others  :  1090085
DOI  :  10.1186/s12879-014-0698-6

 received in 2014-06-30, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

A total of 453 laboratory-confirmed cases infected with avian influenza A (H7N9) virus (including 175 deaths) have been reported till October 2,2014, of which 30.68% (139/453) of the cases were identified from Zhejiang Province. We describe the largest reported cluster of virologically confirmed H7N9 cases, comprised by a fatal Index case and two mild secondary cases.

Methods

A retrospective investigation was conducted in January of 2014. Three confirmed cases, their close contacts, and relevant environments samples were tested by real-time reverse transcriptase-polymerase chain reaction (RT-PCR), viral culture, and sequencing. Serum samples were tested by haemagglutination inhibition (HI) assay.

Results

The Index case, a 49-year-old farmer with type II diabetes, who lived with his daughter (Case 2, aged 24) and wife (Case 3, aged 43) and his son-in-law (H7N9 negative). The Index case and Case 3 worked daily in a live bird market. Onset of illness in Index case occurred in January 13, 2014 and subsequently, he died of multi-organ failure on January 20. Case 2 presented with mild symptoms on January 20 following frequent unprotected bed-side care of the Index case between January 14 to 19, and exposed to live bird market on January 17. Case 3 became unwell on January 23 after providing bedside care to the Index case on January 17 to 18, and following the contact with Case 2 during January 21 to 22 at the funeral of the Index case. The two secondary cases were discharged on February 2 and 5 separately after early treatment with antiviral medication. Four virus strains were isolated and genome analyses showed 99.6 ~100% genetic homology, with two amino mutations (V192I in NS and V280A in NP). 42% (11/26) of environmental samples collected in January were H7N9 positive. Twenty-five close contacts remained well and were negative for H7N9 infection by RT-PCR and HI assay.

Conclusions

In the present study, the Index case was infected from a live bird market while the two secondary cases were infected by the Index case during unprotected exposure. This family cluster is, therefore, compatible with non-sustained person-to-person transmission of avian influenza A/H7N9.

【 授权许可】

   
2014 Ding et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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