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Qi X, Qian Y, Bao C, et al. 2013 Probable person to person transmission of novel avian influenza A (H7N9) virus in Eastern China, 2013: epidemiological investigation. BMJ 2013;347:f4752 doi.org/10.1136/bmj.f4752 (Published 6 August 2013) open access
Probable person to person transmission of novel avian influenza A (H7N9) virus in Eastern China, 2013: epidemiological investigation | BMJ
Clip
The index patient was a retired man aged 60 with a history of
hypertension for more than 10 years. He developed a fever,
cough, and shortness of breath on 8 March 2013 and was
admitted to a Chinese hospital (hospital A) on March 11 with
a left upper lobe inflammation. Initial blood routine testing
identified no abnormality, except for increased hypersensitive
C reactive protein (28.5 mg/L). He was treated with
azithromycin and piperacillin-sulbactam. Because of progressive
respiratory distress, persistent hyperpyrexia, and hypoxemia,
he was transferred to the hospital’s intensive care unit in the
afternoon of 15 March with a diagnosis of viral pneumonitis
and type I acute respiratory distress syndrome. He was again
transferred to another tertiary hospital’s (hospital B) intensive
care unit because of deterioration on 18 March and began to
treatment with oseltamivir the next day. He did not develop
diarrhoea during the course of the disease. He died of
disseminated intravascular coagulation and multi-organ failure
on 4 May.
The index patient’s daughter, an unemployed woman aged 32,
was otherwise healthy without any underlying illnesses. She
provided bedside care for her father until he was admitted to
the second hospital’s intensive care unit. She developed fever
with body temperature 39.6°C and cough on 21 March. On 24
March, she was admitted to the pneumology department of the
same hospital (hospital B) with pneumonia in the left upper
lobe. Initial testing showed leucocytopenia (2.0×109/L),
lymphopenia (0.7×109/L), and slight hypoxia. She was treated
with antibiotics (azithromycin and piperacillin-sulbactam).
Oseltamivir (75 mg twice a day) was administered on 24 March.
She was transferred to intensive care on 28 March because of
persistent hyperpyrexia, respiratory failure, and acute respiratory
distress syndrome. Although treated with mechanical ventilation,
broad spectrum antibiotics, oseltamivir, immunological therapy,
and fluid resuscitation, she died of multi-organ failure and
cardiac arrest on 24 April. Table A in appendix 1 summarises
the clinical characteristics of the two patients.
see supplements:
Web Extra
Extra material supplied by the author
Files in this Data Supplement:
Data Supplement - Appendix 1: Supplementary tables and definitions of cases and close contacts
Data Supplement - Appendix 2: Phylogenetic trees for eight gene segments
Web Extra | BMJ
Full genome sequences of
the viruses were deposited in GenBank (accession number:
KF034916-KF034923 for the father (index case),
KF034908-KF034915 for the daughter, and
KF150605-KF150612 for the environment).
Most likely Flu tracker cases #7 and #119:
#7 - Woman, 32, onset date March 21 - hospitalized March 28 - Binhu district of Wuxi City, Jiangsu province Death Note
(probable hospital transmission while caring for father, A/Wuxi/1/2013**)
FluTrackers - View Single Post - China - 4 cases of H7N9 + some suspected cases hospitalized? - Jiangsu province - Updated April 4, 2013
and
#119 - Man, 60, Binhu District Jiangsu province
(Index Father of FT case #7 !,A/Wuxi/2/2013**)
Also see:
First probable person to person transmission of new bird flu virus in China | BMJ Editorial
H/T Tetano ( Yesterday 04:55 PM)
BMJ: First probable person to person transmission of new bird flu virus in China - H7N9 - FluTrackers
and
CIDRAP (RSS)
Study reports person-to-person spread of H7N9 in family | CIDRAP
Probable person to person transmission of novel avian influenza A (H7N9) virus in Eastern China, 2013: epidemiological investigation | BMJ
Clip
The index patient was a retired man aged 60 with a history of
hypertension for more than 10 years. He developed a fever,
cough, and shortness of breath on 8 March 2013 and was
admitted to a Chinese hospital (hospital A) on March 11 with
a left upper lobe inflammation. Initial blood routine testing
identified no abnormality, except for increased hypersensitive
C reactive protein (28.5 mg/L). He was treated with
azithromycin and piperacillin-sulbactam. Because of progressive
respiratory distress, persistent hyperpyrexia, and hypoxemia,
he was transferred to the hospital’s intensive care unit in the
afternoon of 15 March with a diagnosis of viral pneumonitis
and type I acute respiratory distress syndrome. He was again
transferred to another tertiary hospital’s (hospital B) intensive
care unit because of deterioration on 18 March and began to
treatment with oseltamivir the next day. He did not develop
diarrhoea during the course of the disease. He died of
disseminated intravascular coagulation and multi-organ failure
on 4 May.
The index patient’s daughter, an unemployed woman aged 32,
was otherwise healthy without any underlying illnesses. She
provided bedside care for her father until he was admitted to
the second hospital’s intensive care unit. She developed fever
with body temperature 39.6°C and cough on 21 March. On 24
March, she was admitted to the pneumology department of the
same hospital (hospital B) with pneumonia in the left upper
lobe. Initial testing showed leucocytopenia (2.0×109/L),
lymphopenia (0.7×109/L), and slight hypoxia. She was treated
with antibiotics (azithromycin and piperacillin-sulbactam).
Oseltamivir (75 mg twice a day) was administered on 24 March.
She was transferred to intensive care on 28 March because of
persistent hyperpyrexia, respiratory failure, and acute respiratory
distress syndrome. Although treated with mechanical ventilation,
broad spectrum antibiotics, oseltamivir, immunological therapy,
and fluid resuscitation, she died of multi-organ failure and
cardiac arrest on 24 April. Table A in appendix 1 summarises
the clinical characteristics of the two patients.
see supplements:
Web Extra
Extra material supplied by the author
Files in this Data Supplement:
Data Supplement - Appendix 1: Supplementary tables and definitions of cases and close contacts
Data Supplement - Appendix 2: Phylogenetic trees for eight gene segments
Web Extra | BMJ
Full genome sequences of
the viruses were deposited in GenBank (accession number:
KF034916-KF034923 for the father (index case),
KF034908-KF034915 for the daughter, and
KF150605-KF150612 for the environment).
Most likely Flu tracker cases #7 and #119:
#7 - Woman, 32, onset date March 21 - hospitalized March 28 - Binhu district of Wuxi City, Jiangsu province Death Note
(probable hospital transmission while caring for father, A/Wuxi/1/2013**)
FluTrackers - View Single Post - China - 4 cases of H7N9 + some suspected cases hospitalized? - Jiangsu province - Updated April 4, 2013
and
#119 - Man, 60, Binhu District Jiangsu province
(Index Father of FT case #7 !,A/Wuxi/2/2013**)
Also see:
First probable person to person transmission of new bird flu virus in China | BMJ Editorial
H/T Tetano ( Yesterday 04:55 PM)
BMJ: First probable person to person transmission of new bird flu virus in China - H7N9 - FluTrackers
and
CIDRAP (RSS)
Study reports person-to-person spread of H7N9 in family | CIDRAP
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