Giuseppe
Emeritus
[Source: The Lancet Respiratory Medicine, full page: (LINK). Abstract, edited.]
The Lancet Respiratory Medicine, Available online 14 November 2013 - In Press, Corrected Proof.
Articles
Human infection with avian influenza A H6N1 virus: an epidemiological analysis
Sung-Hsi Wei, MD<SUP>a</SUP><SUP>, </SUP><SUP>b</SUP><SUP>, </SUP><SUP>?</SUP>, Ji-Rong Yang, MS<SUP>a</SUP><SUP>, </SUP><SUP>?</SUP>, Ho-Sheng Wu, PhD<SUP>a</SUP><SUP>, </SUP><SUP>c</SUP><SUP>, </SUP><SUP>?</SUP>, Prof Ming-Chuan Chang, MD<SUP>d</SUP><SUP>, </SUP><SUP>?</SUP>, Jen-Shiou Lin, MS<SUP>e</SUP>, Chi-Yung Lin, MS<SUP>e</SUP>, Yu-Lun Liu, MD<SUP>a</SUP>, Yi-Chun Lo, MD<SUP>a</SUP>, Chin-Hui Yang, MD<SUP>a</SUP>, Jen-Hsiang Chuang, MD<SUP>a</SUP><SUP>, </SUP><SUP>b</SUP>, Min-Cheng Lin, MS<SUP>a</SUP>, Wen-Chen Chung, MD<SUP>f</SUP>, Chia-Hung Liao, MD<SUP>f</SUP>, Min-Shiuh Lee, PhD<SUP>g</SUP>, Wan-Ting Huang, MD<SUP>a</SUP>, Pei-Jung Chen, MS<SUP>a</SUP>, Prof Ming-Tsan Liu PhD<SUP>a</SUP>, Prof Feng-Yee Chang, MD<SUP>a</SUP><SUP>, </SUP><SUP>h</SUP>
<SUP></SUP>
<SUP>a</SUP> Centres for Disease Control, Taipei, Taiwan; <SUP>b</SUP> School of Medicine, National Yang-Ming University, Taipei, Taiwan; <SUP>c</SUP> School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan; <SUP>d</SUP> Nantou Christian Hospital, Changhua, Taiwan; <SUP>e</SUP> Changhua Christian Hospital, Changhua, Taiwan; <SUP>f</SUP> Nantou Hospital, Nantou City, Taiwan; <SUP>g</SUP> Animal Health Research Institute, Council of Agriculture, New Taipei City, Taiwan; <SUP>h</SUP> Department of Internal Medicine, National Defence Medical Centre, Taipei, Taiwan
Available online 14 November 2013
S2213260013702339
Summary
Background
Avian influenza A H6N1 virus is one of the most common viruses isolated from wild and domestic avian species, but human infection with this virus has not been previously reported. We report the clinical presentation, contact, and environmental investigations of a patient infected with this virus, and assess the origin and genetic characteristics of the isolated virus.
Methods
A 20-year-old woman with an influenza-like illness presented to a hospital with shortness of breath in May, 2013. An unsubtyped influenza A virus was isolated from her throat-swab specimen and was transferred to the Taiwan Centres for Disease Control (CDC) for identification. The medical records were reviewed to assess the clinical presentation. We did a contact and environmental investigation and collected clinical specimens from the case and symptomatic contacts to test for influenza virus. The genomic sequences of the isolated virus were determined and characterised.
Findings
The unsubtyped influenza A virus was identified as the H6N1 subtype, based on sequences of the genes encoding haemagglutinin and neuraminidase. The source of infection was not established. Sequence analyses showed that this human isolate was highly homologous to chicken H6N1 viruses in Taiwan and had been generated through interclade reassortment. Notably, the virus had a G228S substitution in the haemagglutinin protein that might increase its affinity for the human α2-6 linked sialic acid receptor.
Interpretation
This is the first report of human infection with a wild avian influenza A H6N1 virus. A unique clade of H6N1 viruses with a G228S substitution of haemagglutinin have circulated persistently in poultry in Taiwan. These viruses continue to evolve and accumulate changes, increasing the potential risk of human-to-human transmission. Our report highlights the continuous need for preparedness for a pandemic of unpredictable and complex avian influenza.
Funding
? Contributed equally
Copyright ? 2013 Elsevier Ltd. All rights reserved.
Note to users: Corrected proofs are Articles in Press that contain the authors' corrections. Final citation details, e.g., volume/issue number, publication year and page numbers, still need to be added and the text might change before final publication.
Although corrected proofs do not have all bibliographic details available yet, they can already be cited using the year of online publication and the DOI , as follows: author(s), article title, journal (year), DOI. Please consult the journal's reference style for the exact appearance of these elements, abbreviation of journal names and use of punctuation.
When the final article is assigned to an issue of the journal, the Article in Press version will be removed and the final version will appear in the associated published issue of the journal. The date the article was first made available online will be carried over.
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The Lancet Respiratory Medicine, Available online 14 November 2013 - In Press, Corrected Proof.
Articles
Human infection with avian influenza A H6N1 virus: an epidemiological analysis
Sung-Hsi Wei, MD<SUP>a</SUP><SUP>, </SUP><SUP>b</SUP><SUP>, </SUP><SUP>?</SUP>, Ji-Rong Yang, MS<SUP>a</SUP><SUP>, </SUP><SUP>?</SUP>, Ho-Sheng Wu, PhD<SUP>a</SUP><SUP>, </SUP><SUP>c</SUP><SUP>, </SUP><SUP>?</SUP>, Prof Ming-Chuan Chang, MD<SUP>d</SUP><SUP>, </SUP><SUP>?</SUP>, Jen-Shiou Lin, MS<SUP>e</SUP>, Chi-Yung Lin, MS<SUP>e</SUP>, Yu-Lun Liu, MD<SUP>a</SUP>, Yi-Chun Lo, MD<SUP>a</SUP>, Chin-Hui Yang, MD<SUP>a</SUP>, Jen-Hsiang Chuang, MD<SUP>a</SUP><SUP>, </SUP><SUP>b</SUP>, Min-Cheng Lin, MS<SUP>a</SUP>, Wen-Chen Chung, MD<SUP>f</SUP>, Chia-Hung Liao, MD<SUP>f</SUP>, Min-Shiuh Lee, PhD<SUP>g</SUP>, Wan-Ting Huang, MD<SUP>a</SUP>, Pei-Jung Chen, MS<SUP>a</SUP>, Prof Ming-Tsan Liu PhD<SUP>a</SUP>, Prof Feng-Yee Chang, MD<SUP>a</SUP><SUP>, </SUP><SUP>h</SUP>
<SUP></SUP>
<SUP>a</SUP> Centres for Disease Control, Taipei, Taiwan; <SUP>b</SUP> School of Medicine, National Yang-Ming University, Taipei, Taiwan; <SUP>c</SUP> School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan; <SUP>d</SUP> Nantou Christian Hospital, Changhua, Taiwan; <SUP>e</SUP> Changhua Christian Hospital, Changhua, Taiwan; <SUP>f</SUP> Nantou Hospital, Nantou City, Taiwan; <SUP>g</SUP> Animal Health Research Institute, Council of Agriculture, New Taipei City, Taiwan; <SUP>h</SUP> Department of Internal Medicine, National Defence Medical Centre, Taipei, Taiwan
Available online 14 November 2013
S2213260013702339
Summary
Background
Avian influenza A H6N1 virus is one of the most common viruses isolated from wild and domestic avian species, but human infection with this virus has not been previously reported. We report the clinical presentation, contact, and environmental investigations of a patient infected with this virus, and assess the origin and genetic characteristics of the isolated virus.
Methods
A 20-year-old woman with an influenza-like illness presented to a hospital with shortness of breath in May, 2013. An unsubtyped influenza A virus was isolated from her throat-swab specimen and was transferred to the Taiwan Centres for Disease Control (CDC) for identification. The medical records were reviewed to assess the clinical presentation. We did a contact and environmental investigation and collected clinical specimens from the case and symptomatic contacts to test for influenza virus. The genomic sequences of the isolated virus were determined and characterised.
Findings
The unsubtyped influenza A virus was identified as the H6N1 subtype, based on sequences of the genes encoding haemagglutinin and neuraminidase. The source of infection was not established. Sequence analyses showed that this human isolate was highly homologous to chicken H6N1 viruses in Taiwan and had been generated through interclade reassortment. Notably, the virus had a G228S substitution in the haemagglutinin protein that might increase its affinity for the human α2-6 linked sialic acid receptor.
Interpretation
This is the first report of human infection with a wild avian influenza A H6N1 virus. A unique clade of H6N1 viruses with a G228S substitution of haemagglutinin have circulated persistently in poultry in Taiwan. These viruses continue to evolve and accumulate changes, increasing the potential risk of human-to-human transmission. Our report highlights the continuous need for preparedness for a pandemic of unpredictable and complex avian influenza.
Funding
Taiwan Centres for Disease Control.
Correspondence to: Prof Feng-Yee Chang, Centres for Disease Control, Taiwan, No 6, Linsen S Rd, Taipei, 10050, Taiwan; Prof Ming-Tsan Liu, Centres for Disease Control, Taiwan, No 161, Kunyang St, Taipei, 11561, Taiwan
? Contributed equally
Copyright ? 2013 Elsevier Ltd. All rights reserved.
Note to users: Corrected proofs are Articles in Press that contain the authors' corrections. Final citation details, e.g., volume/issue number, publication year and page numbers, still need to be added and the text might change before final publication.
Although corrected proofs do not have all bibliographic details available yet, they can already be cited using the year of online publication and the DOI , as follows: author(s), article title, journal (year), DOI. Please consult the journal's reference style for the exact appearance of these elements, abbreviation of journal names and use of punctuation.
When the final article is assigned to an issue of the journal, the Article in Press version will be removed and the final version will appear in the associated published issue of the journal. The date the article was first made available online will be carried over.
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