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China- Two more H7N9 cases in Zhejiang - April 23, 2013

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  • China- Two more H7N9 cases in Zhejiang - April 23, 2013


    Zhejiang new cases of human infection of H7N9 avian influenza cases
    Date :2013 -04-23 Source: Health Department Views: 263 Font Size: [medium and small]

    Zhejiang Provincial Health Department

    April 23, 2013

    Zhejiang Provincial Health Department Bulletin, April 23 as of April 23 at 15:00, Zhejiang Province, add two cases of human infection with the H7N9 avian influenza.

    Patients, Mr. Hong, male, 84 years old, retired, Hangzhou, onset on April 15, Hangzhou, a hospital for treatment.

    Song patients, male, aged 62, farmer, Hangzhou, onset on April 15, now a hospital for treatment.

    By the provincial CDC testing, specimens of 2 patients are infected with the H7N9 avian influenza virus nucleic acid positive. My Office experts on the patient's clinical manifestations, epidemiological data and laboratory test results are discussed, and diagnosis of human infection of H7N9 avian influenza confirmed cases. Currently, two patients were seriously ill, the hospital is under active treatment.

    On the morning of April 23, critically ill patients diagnosed in the 17th Zhao (male, 86 years old, retired, Hangzhou) due to further deterioration, she died.

    At present, the province has confirmed 42 cases of human infection with the H7N9 avian influenza patients, 6 patients died of his wounds, two cases were cured, 34 patients are still hospitalized.

  • #2
    Re: China- Two more H7N9 cases in Zhejiang - April 23, 2013


    ...The Department of Health of east China's Zhejiang Province reported that an 86-year-old man surnamed Zhao, who had previously tested positive for the H7N9 virus, died on Tuesday morning after emergency treatment failed.

    The province also reported two more infection cases. An 84-year-old retired man surnamed Hong and a 62-year-old farmer surnamed Song were confirmed to be infected with the new strain of the virus. Both are in critical condition...


    • #3
      Re: China- Two more H7N9 cases in Zhejiang - April 23, 2013

      Laboratory diagnosis of avian influenza virus H7N9 infection in a renal transplant recipient
      A renal transplant recipient who had atypical clinical manifestations, unclear epidemiological exposure history and negative results from influenza virus antigen and nucleic acid amplification in throat swab specimens was admitted into our hospital on ...

      21. Source: US National Library of Medicine, full page: - Abstract on
      o Laboratory diagnosis of avian influenza virus H7N9 infection in a renal transplant recipient.
       Cheng J, Wang B, Jiang X, Cui D, Chen J, Dai Y, Sun C.
       Int J Clin Exp Med. 2014 Feb 15;7(2):451-5. eCollection 2014.
       PMID: 24600505 [PubMed]

      Case study by Cheng et al. 2014 reports the confirmation date as the 22 April 2013 matches case 108!

      Onset dates are also reported as the 15 April 2013 which matches with case #108 however an earlier cough was reported on 10 April 2013 which matches case 72's onset date!

      Most likely this new retrospective fatal case in a 62yo Renal transplant recipient is flu trackers case #108 - Man, 62, farmer, onset at April 15 , in hospital for treatment. Hangzhou Zhejiang Province

      least likely
      #72 - Man, 62, onset date April 10, hospitalized Hangzhou Zhejiang Province

      Variance: Farmer vs. no poultry exposure!

      Case report.(edited)

      On April 17, a patient infected by avian influenza H7N9 virus was admitted to our hospital. He was a renal transplant recipient with atypical clinical manifestations and negative results from multiple tests of influenza virus antigen and nucleic acid amplification of throat swab specimens. Herein, relevant medical history and laboratory test results are reported as follows in order to provide a peer reference.

      General history: the male patient (age, 62 years; from Pengbu Town of Hangzhou, Zhejiang Province, China) exhibited cough on April 15, 2013. Then he was diagnosed with the common cold and was given antitussive drug, hormone (Methylprednisolone, 8 mg, thrice daily) and antibiotics (Cefradine, 50 mg, thrice daily) in a local hospital on the same day. On April 17, he presented with fever (38.8°C) and then was diagnosed initially as lung infection after he came to our hospital.....

      On April 19, he exhibited dyspnea together with persistent low-grade fever (37.8°C-38.7°C) and was diagnosed as severe pneumonia. Then, he was transferred to the intensive care unit (immunosuppressant treatment was stopped. Meropenem and ambroxol hydrochloride were used). From 17 April to 20 April, throat swab specimens were collected repeatedly for testing relevant indicators (sputum culture, influenza A/B virus antigen typing and nucleic acid amplification for universal primer of influenza A virus). All these tests showed negative results. On April 20 and 21, he was given a consultation from a group of experts, and the sputum specimens from the lung (lower respiratory tract secretions) was collected on April 22 for influenza A/B virus antigen typing, nucleic acid amplification for universal primer of influenza A virus and the subtype of avian influenza (H7N9) virus tests, and these tests all showed a positive results, thus obtaining a definitive diagnosis.

      Previous medical history: the patient received renal transplantation (recipient) due to uremia in our hospital 18 months ago (October 2011), who suffered from diabetes for 12 years and renal hypertension for 5 years and had been taking the immunosuppressive agent Tacrohmus (sp.error in article) (FK506), hypoglycemic agents and antihypertensive drugs.

      Epidemiological history or exposure history: he had no history of exposure to the poultry and live-bird within half a month before cough, and exhibited cough caused by cold due to sweating during labor on April 10.

      Imaging examination: Chest CT scan and chest X-ray, ultrasound and ECG were performed on the day of admission, and chest CT scan or chest X-ray was given every two days to observe the progress of lung inflammation.

      No obvious abnormality was observed by ultrasound and ECG examination. The diagnostic findings from chest CT scan and chest x-ray were that the lesions of the left lung showed an apparent progressive development, but did not extend to the right lung

      Post-diagnosis outcome.

      This patient was finally diagnosed as H7N9 avian influenza virus infection after repeated laboratory examinations and expert consultation. Treatment with piperacillin sodium, sulbactam sodium, azithromycin and voriconazole was discontinued. Oral oseltamivir phosphate was administered for consecutive 5 days (150 mg, twice daily), and other symptomatic support treatment. Unfortunately, this patient died due to respiratory failure and renal failure on May 12, 2013.