中国广东省首例人感染H7N9禽流感的流行病学及病毒基因组特征
Epidemiological and viral genome characteristics of the first human H7N9 influenza infection in Guangdong Province, China.
作者信息
Yang Zi-Feng, He Jian-Feng, Li Xiao-Bo, Guan Wen-Da, Ke Chang-Wen, Wu Shi-Guan, Pan Si-Hua, Li Run-Feng, Kang Min, Wu Jie, Lin Jin-Yan, Ding Guo-Yun, Huang Ji-Cheng, Pan Wei-Qi, Zhou Rong, Lin Yong-Ping, Chen Rong-Chang, Li Yi-Min, Chen Ling, Xiao Wen-Long, Zhang Yong-Hui, Zhong Nan-Shan
机构信息
1 State Key Laboratory of Respiratory Disease (Guangzhou Medical University), 2 National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 3 Guangdong Center for Disease Control and Prevention, Guangzhou 511430, China ; 4 Health quarantine (BSL-3) Lab, Guangdong Inspection and Quarantine Technology Center, Guangzhou 510623, China ; 5 Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Huizhou Center for Disease Control and Prevention, Huizhou 516001, China.
出版信息
J Thorac Dis. 2014 Dec;6(12):1785-93. doi: 10.3978/j.issn.2072-1439.2014.12.09.
BACKGROUND
The first H7N9 human case in south of China was confirmed in Guangdong Province on August 2013, outside of the typical influenza season. For investigating the H7N9 virus source and transmission in the local community, we analyze the epidemiology and genome features of the virus isolated from the first human infection detected in Guangdong Province.
METHODS
The data including medical records, exposure history and time line of events for the H7N9 patient and close contacts was collected. Variation and genetic signatures of H7N9 virus in Guangdong was analyzed using ClustalW algorithm and comparison with mutations associated with changes in biological characteristics of the virus.
RESULTS
The female patient had a history of poultry exposure, and she was transferred from a local primary hospital to an intensive care unit (ICU) upon deterioration. No additional cases were reported. Similar to previous infections with avian influenza A (H7N9) virus, the patient presented with both upper and lower respiratory tract symptoms. Respiratory failure progressed quickly, and the patient recovered 4 weeks after the onset of symptoms. Genome analysis of the virus indicated that the predicted antigen city and internal genes of the virus are similar to previously reported H7N9 viruses. The isolated virus is susceptible to neuraminidase (NA) inhibitors but resistant to adamantine. Although this virus contains some unique mutations that were only detected in avian or environment-origin avian influenza A (H7N9) viruses, it is still quite similar to other human H7N9 isolates.
CONCLUSIONS
The epidemiological features and genome of the first H7N9 virus in Guangdong Province are similar to other human H7N9 infections. This virus may have existed in the environment and live poultry locally; therefore, it is important to be alert of the risk of H7N9 re-emergence in China, including emergence outside the typical influenza season.
背景
2013年8月，中国南方首例H7N9人感染病例在广东省得到确诊，当时并非典型流感季节。为调查H7N9病毒在当地社区的来源及传播情况，我们分析了从广东省首例人感染病例中分离出的病毒的流行病学特征和基因组特征。
方法
收集了该H7N9患者及其密切接触者的病历、暴露史和事件时间线等数据。采用ClustalW算法分析广东省H7N9病毒的变异和基因特征，并与病毒生物学特性变化相关的突变进行比较。
结果
该女性患者有禽类接触史，病情恶化后从当地一家基层医院转入重症监护病房（ICU）。未报告其他病例。与之前的甲型H7N9禽流感病毒感染情况类似，该患者同时出现了上呼吸道和下呼吸道症状。呼吸衰竭进展迅速，患者在症状出现4周后康复。对该病毒的基因组分析表明，预测的病毒抗原性和内部基因与之前报告的H7N9病毒相似。分离出的病毒对神经氨酸酶（NA）抑制剂敏感，但对金刚烷耐药。虽然该病毒含有一些仅在禽类或环境来源的甲型H7N9禽流感病毒中检测到的独特突变，但它仍与其他人类H7N9分离株非常相似。
结论
广东省首例H7N9病毒的流行病学特征和基因组与其他人类H7N9感染相似。这种病毒可能已在当地环境和活禽中存在；因此，在中国警惕H7N9再次出现的风险很重要，包括在非典型流感季节出现。
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