Emerging Infectious Diseases (Aug 2017)

Human Infection with Highly Pathogenic Avian Influenza A(H7N9) Virus, China

  • Changwen Ke,
  • Chris Ka Pun Mok,
  • Wenfei Zhu,
  • Haibo Zhou,
  • Jianfeng He,
  • Wenda Guan,
  • Jie Wu,
  • Wenjun Song,
  • Dayan Wang,
  • Jiexiong Liu,
  • Qinhan Lin,
  • Daniel Ka Wing Chu,
  • Lei Yang,
  • Nanshan Zhong,
  • Zifeng Yang,
  • Yuelong Shu,
  • Joseph Sriyal Malik Peiris

DOI
https://doi.org/10.3201/eid2308.170600
Journal volume & issue
Vol. 23, no. 8
pp. 1332 – 1340

Abstract

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The recent increase in zoonotic avian influenza A(H7N9) disease in China is a cause of public health concern. Most of the A(H7N9) viruses previously reported have been of low pathogenicity. We report the fatal case of a patient in China who was infected with an A(H7N9) virus having a polybasic amino acid sequence at its hemagglutinin cleavage site (PEVPKRKRTAR/GL), a sequence suggestive of high pathogenicity in birds. Its neuraminidase also had R292K, an amino acid change known to be associated with neuraminidase inhibitor resistance. Both of these molecular features might have contributed to the patient’s adverse clinical outcome. The patient had a history of exposure to sick and dying poultry, and his close contacts had no evidence of A(H7N9) disease, suggesting human-to-human transmission did not occur. Enhanced surveillance is needed to determine whether this highly pathogenic avian influenza A(H7N9) virus will continue to spread.

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