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Retrospective clarification for cases from Minhang District, Shanghai Cluster

Biological

Closed. Please see Biological100
I hate seeing a linelist not complete but here it goes;
My take on the retrospective cases from Minhang District of Shanghai Cluster described by:
Shi J, Xie J, He Z, Hu Y, He Y, et al. (2013) A Detailed Epidemiological and Clinical Description of 6 Human Cases of Avian-Origin Influenza A
(H7N9) Virus Infection in Shanghai. PLoS ONE 8(10): e77651. doi:10.1371/journal.pone.0077651

http://www.plosone.org/article/fetch...esentation=PDF

#75 - No details. Retrospective cases discovered by testing samples. Shanghai 1 Death

#77 - No details. Retrospective cases discovered by testing samples. Shanghai 1 Death

#78 - No details. 1 of 4 retrospective cases identified on April 16. Shanghai

Minhang District of Shanghai Cluster

Confirmed cases of H7N9 referred to the Fifth People’s Hospital of Shanghai during the period from February to March 2013 were enrolled in this study. H7N9 infection was confirmed by the Public Health Clinical Center Affiliated with Fudan
University as well as the Chinese Center for Disease Control and Prevention

------
Shi et al.2013 case 3
Table 1. Demographic characteristics of 6 H7N9 Cases.
Case 3 [I have it as Shanghai (27th)- 13-Apr-13 PCR confirmed, Viral isolation]
Age: 74
Sex: Male
Nationality: Han
Occupation: Retired
Place of Residence: Minhang District of Shanghai
Smoking index (packyears): 30
History of alcohol intake: No
Underlying conditions: Hypertension, diabetes mellitus, coronary heart disease

See table: Table 2. Date of disease onset, admission, confirmed infection, and discharge of 6 H7N9 cases
Date of illness onset: 24-Feb-13
Date of admission: 27-Feb-13
ICU: Yes
Confirmed infection: 13-Apr-13
Method of confirmation: Viral isolation
LOS: 5
Family aggregation: No
Recent exposure to poultry: No
Date of death: 3-Mar-13

Clip:
The time course of case identification, treatment, and diagnosis
Cases 3 and 4 were admitted to the intensive care unit (ICU) because of disease progression on the first and second day of
hospitalization, respectively.

http://www.plosone.org/article/fetch...esentation=PDF

-----

Shi et al.2013 case 6
Table 1. Demographic characteristics of 6 H7N9 Cases.
Case 6 [I have it as Shanghai (28th)- 14-Apr-13 PCR confirmed, Viral isolation)]
Age: 63
Sex: Male
Nationality: Han
Occupation: Retired
Place of Residence: Minhang District of Shanghai
Smoking index (packyears): 15
History of alcohol intake: Alcoholism
Underlying conditions: COPD, hypertension, gastric ulcer

See table: Table 2. Date of disease onset, admission, confirmed infection, and discharge of 6 H7N9 cases
Date of illness onset: 5-Mar-13
Date of admission: 9-Mar-13
ICU: No
Confirmed infection: 14-Apr-13
Method of confirmation: Viral isolation
LOS: 3
Family aggregation: No
Recent exposure to poultry: No
Date of death or discharge: no date (appears to be 12-Apr-13)

also see
http://www.nejm.org/doi/suppl/10.105...7_appendix.pdf
12-Apr-13* convalescent serum antibody titers were more than four times, Virus specific antibodies (1:40) or (HAI titer <10 and 80, respectively) paired serum samples on day 7 and 46

-----

Shi et al.2013 case 2*
Table 1. Demographic characteristics of 6 H7N9 Cases.
Case 2 (12-Apr-13* convalescent serum antibody titers were more than four times, Virus specific antibodies (1:40) or (HAI titer <10 and 80, respectively) paired serum samples on day 7 and 46)
-
Age: 69 (Shanghai (26th))
Sex: Male
Nationality: Han
Occupation: Retired
Place of Residence: Minhang District of Shanghai
Smoking index (packyears): No
History of alcohol intake: No
Underlying conditions: hypertension

See table: Table 2. Date of disease onset, admission, confirmed infection, and discharge of 6 H7N9 cases
Date of illness onset: 19-Feb-13
Date of admission: 26-Feb-13
ICU: No
Confirmed infection: 12-Apr-13
Method of confirmation: Virus specific antibodies (1:40)
LOS: 15
Family aggregation: yes (b)
Recent exposure to poultry: Suspect (a)
Date of discharge: 13-Mar-13


(a) Case 2 had no history of direct contact with birds, but had gone to the market several times 1 week before disease onset and passed by stalls selling poultry.

(b) Case 2 was the son of case 1, whose other son (age, 55 years) developed severe pneumonia
on February 11 and died on February 28. However, the H7N9 virus was not detected in respiratory specimens from the
deceased son by RT-PCR or viral isolation.

--
Table 4. Laboratory findings in the early stage of H7N9 infection in 6 cases.
see: article:
Table 5. Treatment, complications, and outcome of H7N9 infection in 6 cases.
Antibiotic: yes
Antiviral:
Oseltamivir: 75 mg bid d7–12a (a Days from disease onset [edt. started 26-Feb-13)
Amantadine: No
Anti-inflammatory: Methylprednisolone
Globulin: yes
Thymic peptide: yes
Albumin: no
Oxygen therapy: Mechanical ventilation

Complications
ARDS: no
Secondary Infection: yes
Pleural effusion: no
Encephalopathy:no
Left heart failure: no
Rhabdomyolysis: no

Outcome: survived

----
Shi et al.2013 case 5
Table 1. Demographic characteristics of 6 H7N9 Cases.
Case 5 [Shanghai (29th)- 13-Apr-13 convalescent serum antibody titers were more than four times; Virus specific antibodies (1:40)]
Age: 41
Sex: Male
Nationality: Han
Occupation: Worker
Place of Residence: Minhang District of Shanghai
Smoking index (packyears): 4
History of alcohol intake: No
Underlying conditions: No

See table: Table 2. Date of disease onset, admission, confirmed infection, and discharge of 6 H7N9 cases
Date of illness onset: 3-Mar-13
Date of admission: 6-Mar-13
ICU: No
Confirmed infection: 13-Apr-13
Method of confirmation: Virus specific antibodies (1:40)
LOS: 12
Family aggregation : No
Recent exposure to poultry: Yes
Date of discharged: 18-Mar-13

-----

Shanghai (30th) is the 2 year old

Shanghai (31st) is #79 - Man, 89, ex-Jiangsu (?). onset date: April 12. Hospitalized on April 16. Date of confirmation April 17. Shanghai Death


My spreadsheet is slightly different in numbers but this is the background... where you want to use it, is up to FluTrackers!

Hope this helps!

It's open access, it can be attached or maybe not! I'll leave that up to you at Flu trackers!

Please see
FluTrackers - View Single Post - FluTrackers 2013 Human Case List of Confirmed and Highly Suspected/Probable Influenza A(H7N9) Cases
http://www.flutrackers.com/forum/showpost.php?p=489904&postcount=1
 
Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 16 2013):14 cases / 2 deaths (Total 78 / 16)

Re: H7N9, China: Cumulative number of today confirmed and suspected cases (April 16 2013):14 cases / 2 deaths (Total 78 / 16)

Thanks Biological. WHO has never identified the mystery Shanghai cases.

The 74 year old we have as case #17.

The 63 year old is not have listed as a specific case. Could be one of the mystery Shanghai cases.

The 69 year old we have as case #74.

The 41 is not listed on our list as a specific case. Could be one of the mystery Shanghai cases.
 
Re: Retrospective clarification for cases from Minhang District, Shanghai Cluster

Shanghai (7th) is the 17 case described in S, Zheng Y, Li T, Hu Y, Liu X, Xi S, et al. Clinical findings for early human cases of influenza A(H7N9) virus infection, Shanghai, China. Emerg Infect Dis. 2013 Vol. 19 No. 7 - July 2013 DOI: 10.3201/eid1907.130612

Case-patient 1 was receiving noninvasive ventilator-assisted breathing when he arrived at SHPHCC. His oxygen saturation remained at ≈95%, and he was given continuous intravenous dopamine infusion. He had acute respiratory failure, coronary heart disease (stage 2 heart failure), and renal function insufficiency at admission. On April 11, 11 days after the onset of the symptoms and 2 hours after endotracheal intubation and mechanical ventilation began, he died from respiratory failure. (Fatal- 11-Apr-13)

http://wwwnc.cdc.gov/eid/article/19/...gestedcitation

I believe this is a different case the dates are different!

69 is already described earlier! I just happened to put it in for mete data assistance!
 
Re: Retrospective clarification for cases from Minhang District, Shanghai Cluster

Ok.

Can you fix the link above please. Thanks!
 
Re: Retrospective clarification for cases from Minhang District, Shanghai Cluster

Shi J, Xie J, He Z, Hu Y, He Y, et al. (2013) A Detailed Epidemiological and Clinical Description of 6 Human Cases of Avian-Origin Influenza A
(H7N9) Virus Infection in Shanghai. PLoS ONE 8(10): e77651. doi:10.1371/journal.pone.0077651
http://www.plosone.org/article/fetc....1371/journal.pone.0077651&representation=PDF

Clinical Findings for Early Human Cases of Influenza A(H7N9) Virus Infection, Shanghai, China - Volume 19, Number 7—July 2013 - Emerging Infectious Disease journal - CDC
http://wwwnc.cdc.gov/eid/article/19/7/13-0612_article.htm#suggestedcitation
 
Re: Retrospective clarification for cases from Minhang District, Shanghai Cluster

Thanks! I will make a note on our case list as to the possible identities of the Shanghai mystery cases. It is problematic because the WHO/Chinese CDC has never publicly provided any details - but it is good work to have a notation on our list.
 
Re: Retrospective clarification for cases from Minhang District, Shanghai Cluster

I agree 100% .... WHO has never released this information... that's the problem... attach the article... it's open access!
 
Re: Retrospective clarification for cases from Minhang District, Shanghai Cluster

The most likely correlation of H7N9 cases 1-6 reported in the PLoS article cited above is:

case 1 = FluTracker's (FT) case number 1 (died)
case 2 = FT case number 74
case 3 = FT case number 75 (died)
case 4 = FT case number 2 (died)
case 5 = FT case number 78 (died?)
case 6 = FT case number 77

The only discrepancy is whether there were three or four deaths among these six cases.
 
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