Clinical preparedness for severe pneumonia with highly pathogenic avian influenza A (H5N1): Experiences with cases in Vietnam

Kudo, Kohsuke; Binh, Nguyen Gia; Manabe, Toshie; Co, Dao Xuan; Tuan, Nguyen Dang; Jin, Tao; Minh, Dang Hung; Thuy, Pham Thi Phuong; Van, Vu Thi Tuong; Hanh, Tran Thuy; Chau, Ngo Quy

doi:10.1016/j.resinv.2012.08.005

Cited by 21 publications

(23 citation statements)

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“…All subtypes of FluA comprise various combinations of the H and N glycoproteins. Sixteen H subtypes (H1-H16) and nine N subtypes (N1-N9) have been characterized in avian species, while the H17N10 subtype is found in bats [3,4]. Most subtypes of FluA virus such as H5 and H7 subtypes are not pathogenic in poultry, but outbreaks in poultry and wild birds are correlated with the highly virulent FluA virus, which can cause severe economic losses owing to massive numbers of deaths of domestic poultry [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Detection of a novel avian influenza A (H7N9) virus in humans by multiplex one-step real-time RT-PCR assay

et al. 2014

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BackgroundA novel avian influenza A (H7N9) virus emerged in eastern China in February 2013. 413 confirmed human cases, including 157 deaths, have been recorded as of July 31, 2014.MethodsClinical specimens, including throat swabs, sputum or tracheal aspirates, etc., were obtained from patients exhibiting influenza-like illness (ILIs), especially from those having pneumonia and a history of occupational exposure to poultry and wild birds. RNA was extracted from these samples and a multiplex one-step real-time RT-PCR assay was developed to specifically detect the influenza A virus (FluA). PCR primers targeted the conserved M and Rnase P (RP) genes, as well as the hemagglutinin and neuraminidase genes of the H7N9 virus.ResultsThe multiplex assay specifically detected the avian H7N9 virus, and no cross-reaction with other common respiratory pathogens was observed. The detection limit of the assay was approximately 0.05 50% tissue culture infective doses (TCID50), or 100 copies per reaction. Positive detection of the H7N9 virus in sputum/tracheal aspirates was higher than in throat swabs during the surveillance of patients with ILIs. Additionally, detection of the matrix (M) and Rnase P genes aided in the determination of the novel avian H7N9 virus and ensured the quality of the clinical samples.ConclusionsThese results demonstrate that the multiplex assay detected the novel avian H7N9 virus with high specificity and sensitivity, which is essential for the early diagnosis and treatment of infected patients.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-541) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Detection of a novel avian influenza A (H7N9) virus in humans by multiplex one-step real-time RT-PCR assay

et al. 2014

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“…Human infections with FluA viruses are commonly associated with the human H1, H2, and H3 subtypes that can cause outbreaks of FluA virus infection, such as the seasonal H3N2 virus and the pandemic (H1N1) 2009 virus (Cox and Subbarao 2000; Chen et al 2011; Bedford et al 2015; Davlin et al 2016; Yang et al 2015). However, sporadic cases or outbreaks of the avian FluA subtypes H5N1, H7N3, H10N8, and H9N2, and the reassortant avian H7N9 virus have resulted in the direct transmission from avians to humans and have caused many deaths in humans (Kudo et al 2012; Kim et al 2012; Koopmans et al 2004; Chen et al 2013, 2014; Cheng et al 2011; Ostrowsky et al 2012; Gao et al 2013). Most patients infected with these subtypes have mild symptoms during the early stages of the disease, such as acute respiratory infections associated with fever and/or sore throat, with or without fatigue symptoms; however, the patients with H5N1 virus and reassortant avian H7N9 virus have a high mortality rate (Cheng et al 2011, 2013, 2014; Ostrowsky et al 2012; Gao et al 2013; Chong et al 2016; Kang et al 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, pandemic (H1N1) 2009 emerged worldwide in 2009, and the human H3N2 outbreak in 2015 resulted in substantial human infections and deaths (Bedford et al 2015; Wu et al 2014; Davlin et al 2016; Yang et al 2015). Moreover, sporadic cases or outbreaks of the avian Flu A subtype, such as H5N1, H7N7, H10N8, and H9N2, have displayed direct transmission from domestic poultry and/or wild birds to humans, especially the reassortant avian H7N9 virus from live poultry or avian outbreaks in China in 2013 (Wu et al 2014; Kudo et al 2012; Kim et al 2012; Koopmans et al 2004; Chen et al 2013, 2014; Cheng et al 2011; Ostrowsky et al 2012; Gao et al 2013). Most patients infected with these subtypes present similar symptoms with influenza-like illness (ILIs) in the early stages of disease, such as fever, fatigue and/or sore throat, severe acquired pneumonia, and even death.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous detection of influenza A subtypes of H3N2 virus, pandemic (H1N1) 2009 virus and reassortant avian H7N9 virus in humans by multiplex one-step real-time RT-PCR assay

et al. 2016

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Background Influenza A virus is a leading causative pathogen of human acute respiratory infection. Recently, the co-circulation of pandemic (H1N1) 2009 and seasonal H3N2 viruses was reported, and sporadic cases with reassortant avian H7N9 virus are continually reported in China. We aimed to establish a multiplex one-step real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay to simultaneously detect and discriminate FluA subtypes, including human seasonal H3N2 virus, pandemic (H1N1) 2009 virus and reassortant avian H7N9 virus, in one reaction tube.MethodsClinical samples, including throat swabs and sputum, were collected from the patients with influenza-like illness (ILIs). Total viral RNA from each sample or viral culture was extracted, and the specific detection of FluA virus and its subtypes was performed using a multiplex rRT-PCR assay.ResultsThe limitation of detection (LOD) of the multiplex assay was 5.4 × 10−2 50% tissue culture infective dose (TCID50) per reaction or 4.8 × 101 copies per reaction for each virus of the three viruses. For simultaneously detecting the three viruses, the LOD was 1.8 × 10−2 TCID50 per reaction or 1.6 × 10 copies per reaction for testing the total FluA virus RNA and 5.6 × 10−2 TCID50 per reaction or 5.1 × 10 copies per reaction for the H3, H1, and H7 genes in one reaction tube. The multiplex assay specifically detected these viruses, and no cross-reaction with other pathogens was found. Moreover, the assay had reliable clinical sensitivity (100%) and valuable clinical specificity (>95%). The detection of FluA with the matrix (M) gene contributed to the further determination of these subtypes, and the Rnase P gene (RP) was considered an internal control to favourably evaluate the quality of the clinical samples.ConclusionsThese findings indicate that the multiplex assay can simultaneously detect and discriminate FluA subtypes with reliable sensitivity and specificity, which is required for the early clinical diagnosis and viral surveillance of patients with FluA infection.

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“…A recent study demonstrates that early initiation of antiviral treatment has a strong influence on the survival of patients with A (H5N1) infection. Kudo et al [6] have most recently reported that renal replacement therapy using Polymyxin B-immobilized polystyrene fibers (PMX) and Continuous Hemodiafiltration (CHDF) could provide a practical tool to effectively treat H5N1-infected patients with acute respiratory distress syndrome (ARDS). PMX (Toray industries Inc, Tokyo, Japan) binds endotoxin and inflammatory cytokines in both in vitro and in vivo studies [7].…”

Section: Editorialmentioning

confidence: 99%

“…Accordingly, the PaO 2 /FiO 2 ratio increased to 128 at 24 h and to 203 at 3 days after initiation of PMX hemoperfusion. Thus, renal replacement therapy using PMX and Continuous Hemodiafiltration (CHDF) provided a practical tool to effectively treat H5N1-infected patients with Acute Respiratory Distress Syndrome (ARDS) [6].…”

Section: Editorialmentioning

confidence: 99%

Clinical Preparedness for Cytokine Storm Induced By the Highly Pathogenic H5N1 Influenza Virus

Ishikawa¹

2012

J Pharmacogenom Pharmacoproteomics

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Clinical preparedness for severe pneumonia with highly pathogenic avian influenza A (H5N1): Experiences with cases in Vietnam

Cited by 21 publications

References 35 publications

Detection of a novel avian influenza A (H7N9) virus in humans by multiplex one-step real-time RT-PCR assay

Detection of a novel avian influenza A (H7N9) virus in humans by multiplex one-step real-time RT-PCR assay

Simultaneous detection of influenza A subtypes of H3N2 virus, pandemic (H1N1) 2009 virus and reassortant avian H7N9 virus in humans by multiplex one-step real-time RT-PCR assay

Clinical Preparedness for Cytokine Storm Induced By the Highly Pathogenic H5N1 Influenza Virus

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