Background The 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. Methods Field 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. Results Among 139 persons with confirmed H7N9 virus infectio...

/pdf/epidemiology-of-human-infections-with-avian-influenza-a-h7n9-3ac2l85fx0.pdf

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

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)61904-2.pdf

Effect of closure of live poultry markets on poultry-to-person transmission of avian influenza A H7N9 virus: an ecological study.

On March 31, 2013, the National Health and Family Planning Commission (NHFPC) of China announced that three fatal cases of rapidly progressive pneumonia, respiratory failure and acute respiratory distress syndrome (ARDS) were confirmed to be infected with a novel reassortant avian-origin influenza A (H7N9) virus. As of February 18, 2014, a total of 347 laboratory-confirmed cases and 109 deaths had been reported in mainland China. The novel avian influenza virus has caused global concern as a potential pandemic threat.

/pdf/human-infection-with-avian-influenza-a-h7n9-virus-1xe4itxmo7.pdf

Human infection with avian influenza a (h7n9) virus

Background Influenza A(H7N9) viruses isolated from humans show features suggesting partial adaptation to mammals To provide insights into the pathogenesis of H7N9 virus infection, we compared risk factors, clinical presentation, and progression of patients hospitalized with H7N9, H5N1, and 2009 pandemic H1N1 (pH1N1) virus infections Methods We compared individual-level data from patients hospitalized with infection by H7N9 (n=123), H5N1 (n = 119; 43 China, 76 Vietnam), and pH1N1 (n = 3486) viruses We assessed risk factors for hospitalization after adjustment for age- and sex-specific prevalence of risk factors in the general Chinese population Results The median age of patients with H7N9 virus infection was older than other patient groups (63 years; P< 001) and a higher proportion was male (71%; P< 02) After adjustment for age and sex, chronic heart disease was associated with an increased risk of hospitalization with H7N9 (relative risk, 968; 95% confidence interval, 524–179) H7N9 patients had similar patterns of leukopenia, thrombocytopenia, and elevated alanine aminotransferase, creatinine kinase, C-reactive protein, and lactate dehydrogenase to those seen in H5N1 patients, which were all significantly different from pH1N1 patients (P<005) H7N9 patients had a longer duration of hospitalization than either H5N1 or pH1N1 patients (P< 001), and the median time from onset to death was 18 days for H7N9 (P= 002) vs 11 days for H5N1 and 15 days for pH1N1 (P= 154) Conclusions The identification of known risk factors for severe seasonal infl uenza and the more protracted clinical course compared with that of H5N1 suggests that host factors are an important contributor to H7N9 severity

/pdf/comparison-of-patients-hospitalized-with-influenza-a-27ym7mmms6.pdf

Comparison of patients hospitalized with influenza A subtypes H7N9, H5N1, and 2009 pandemic H1N1.

Epidemiological, clinical and viral characteristics of fatal cases of human avian influenza A (H7N9) virus in Zhejiang Province, China

We describe a case-control study performed in Jiangsu, China, to evaluate risk factors for human infection with novel avian influenza A(H7N9) virus. Twenty-five cases and 93 controls matched by age, sex, and location were included in the study. Direct contact with poultry or birds in the two weeks before illness onset, chronic medical conditions (hypertension excluded), and environment-related exposures were significantly associated with A(H7N9) infection.

/pdf/case-control-study-of-risk-factors-for-human-infection-with-24callf1by.pdf

Case-control study of risk factors for human infection with influenza A(H7N9) virus in Jiangsu Province, China, 2013

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Case-control study of risk factors for human infection with influenza A(H7N9) virus in Jiangsu Province, China, 2013