Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China

Zhu, Wenfei; Li, Xiyan; Dong, Jie; Bo, Hong; Liu, Jia; Yang, Jiaying; Zhang, Ye; Wei, Hejiang; Huang, Weijuan; Zhao, Xiang; Chen, Tao; Yang, Jing; Li, Zi; Zeng, Xiaoxu; Li, Chao; Tang, Jing; Li, Xin; Gao, Rongbao; Liu, Liqi; Tan, Min; Shu, Yuelong; Yang, Lei; Wang, Dayang

doi:10.3201/eid2807.212482

Cited by 33 publications

(38 citation statements)

References 41 publications

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“…HA genes of the H5N1 viruses are closely related to those of the H5N6 human cases (Fig. S1) recently reported in China ( 8 , 9 ), and they carried mutations that can increase their viral replication ability or virulence in mammals ( 13 ), suggesting a potential threat of the circulating H5N1 viruses to humans. Meanwhile, the H5 gene of two vaccine strains, A/whooper/swan/Shanxi4-1/2020 (H5N8) ( 14 ) and A/Astrakhan/3212/2020 (H5N8) ( 15 ), clustered with those of the detected H5N1 viruses, implicating their potential usage for zoonotic vaccination.…”

Section: Discussionmentioning

confidence: 57%

“…After emerging in the Netherlands in 2020, H5N1 viruses from the 2.3.4.4b clade continue to circulate and spread worldwide ( 5 – 7 ). Beside outbreaks among bird species, human infection by HPAI H5N6 viruses bearing the clade 2.3.4.4b HA gene were reported in 2020 and 2021 in China ( 8 , 9 ), raising serious concerns about the risk of HPAIVs to human health.…”

Section: Observationmentioning

confidence: 99%

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Highly Pathogenic Avian Influenza A (H5N1) Virus in Swans, Central China, 2021

Yao

Tang

et al. 2022

Microbiol Spectr

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Section: Discussionmentioning

confidence: 57%

Section: Observationmentioning

confidence: 99%

Highly Pathogenic Avian Influenza A (H5N1) Virus in Swans, Central China, 2021

Yao

Tang

et al. 2022

Microbiol Spectr

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“…During their circulation in nature, the H5N8 viruses reassorted with other influenza viruses and generated several other subtypes of H5 viruses that bear the clade 2.3.4.4b HA gene. H5N2 viruses were detected in wild birds in Serbia and domestic poultry in Taiwan, China and Bulgaria [ 54 , 59 ]; H5N3 viruses were detected in wild birds in Denmark, France, Germany, Ireland, and The Netherlands [ 54 ]; H5N4 viruses were detected in wild birds in Germany, The Netherlands, and Sweden [ 54 ]; H5N5 viruses were detected in wild birds and domestic poultry in Iran and many countries in Europe [ 54 ]; and H5N6 viruses were detected in ducks in China and have caused multiple cases of human infection [ 2 , 60 ]. The most important descendant of the H5N8 virus is the novel H5N1 virus that was first detected in The Netherlands [ 61 ].…”

Section: Emergence Evolution and Global Dissemination Of The Recent H...mentioning

confidence: 99%

Alarming situation of emerging H5 and H7 avian influenza and effective control strategies

Shi

Zeng

Cui

et al. 2022

Emerging Microbes & Infections

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Avian influenza viruses continue to present challenges to animal and human health. Viruses bearing the hemagglutinin (HA) gene of the H5 subtype and H7 subtype have caused 2634 human cases around the world, including more than 1000 deaths. These viruses have caused numerous disease outbreaks in wild birds and domestic poultry, and are responsible for the loss of at least 422 million domestic birds since 2005. The H5 influenza viruses are spread by migratory wild birds and have caused three waves of influenza outbreaks across multiple continents, and the third wave that started in 2020 is ongoing. Many countries in Europe and North America control highly pathogenic avian influenza by culling alone, whereas some countries, including China, have adopted a “cull plus vaccination” strategy. As the largest poultry-producing country in the world, China lost relatively few poultry during the three waves of global H5 avian influenza outbreaks, and nearly eliminated the pervasive H7N9 viruses that emerged in 2013. In this review, we briefly summarize the damages the H5 and H7 influenza viruses have caused to the global poultry industry and public health, analyze the origin, evolution, and spread of the H5 viruses that caused the waves, and discuss how and why the vaccination strategy in China has been a success. Given that the H5N1 viruses are widely circulating in wild birds and causing problems in domestic poultry around the world, we recommend that any unnecessary obstacles to vaccination strategies should be removed immediately and forever.

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“…The first human influenza H5N6 AIV case was reported in Hunan Province, China, in 2014, and in the same year, the first death was reported in Sichuan Province, China [ 10 , 11 ]. At present, 65 cases of human infection with H5N6 AIVs, have been reported, with a mortality rate as high as 55% [ 12 ]. Some of the patients had a history of contact with infected poultry, raising concerns about its pandemic potential [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Pathogenicity and Transmissibility of Clade 2.3.4.4h H5N6 Avian Influenza Viruses in Mammals

Zhang

Zhang²,

Zhao

et al. 2022

Animals

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Avian influenza viruses (AIVs) have the potential for cross-species transmission and pandemics. In recent years, clade 2.3.4.4 H5N6 AIVs are prevalent in domestic poultry, posing a threat to the domestic poultry industry and public health. In this study, two strains of H5N6 AIVs were isolated from chickens in Hebei, China, in 2019: A/chicken/Hebei/HB1907/2019(H5N6) and A/chicken/Hebei/HB1905/2019(H5N6). Phylogenetic analysis showed that both viral HA genes clustered in the 2.3.4.4h clade. Receptor binding analysis showed that the HB1905 strain preferentially binds to α-2,3-linked sialic acid (SA) receptors, while the HB1907 strain preferentially binds to α-2,3- and α-2,6-linked sialic acid (SA) receptors. During early infection, the HB1907 strain is highly replicable in MDCK cells, more so than the HB1905 strain. Pathogenicity assays in mice showed that both viruses could replicate in the lungs without prior adaptation, with HB1907 being more highly pathogenic in mice than the HB1905 strain. Significantly, both the HB1905 and HB1907 strains can be transmitted through direct contact among guinea pigs, but the transmission efficiency of the HB1907 strain through contact between guinea pigs is much greater than that of the HB1905 strain. These results strengthen the need for ongoing surveillance and early warning of H5N6 AIVs in poultry.

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Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China

Cited by 33 publications

References 41 publications

Highly Pathogenic Avian Influenza A (H5N1) Virus in Swans, Central China, 2021

Highly Pathogenic Avian Influenza A (H5N1) Virus in Swans, Central China, 2021

Alarming situation of emerging H5 and H7 avian influenza and effective control strategies

Pathogenicity and Transmissibility of Clade 2.3.4.4h H5N6 Avian Influenza Viruses in Mammals

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