Epidemiological and clinical characteristics of humans with avian influenza A (H7N9) infection in Guangdong, China, 2013–2017

Yang, Yue; Zhong, Huan; Song, Tie; He, Jianfeng; Guo, Lan; Tan, Xiaohua; Huang, Guofeng; Kang, Min

doi:10.1016/j.ijid.2017.07.021

Cited by 15 publications

(23 citation statements)

References 41 publications

(61 reference statements)

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“…All H7N9 human patients in Chongqing were infected with the virus after being exposed to live chickens, the patients were from both urban and rural areas, and no close contact was confirmed to be infected. These findings are similar with previous studies (Bao et al, 2013;Han et al, 2013;Chen et al, 2013;Yang et al, 2017).…”

Section: Discussionsupporting

confidence: 94%

Influenza A(H7N9) virus emerged and resulted in human infections in Chongqing, southwestern China since 2017

Qin²,

Xie

et al. 2019

International Journal of Infectious Diseases

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Section: Discussionsupporting

confidence: 94%

Influenza A(H7N9) virus emerged and resulted in human infections in Chongqing, southwestern China since 2017

Qin²,

Xie

et al. 2019

International Journal of Infectious Diseases

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“…1A and B and Table 1). The H7N9 virus from the Yangtze River Delta region was introduced into Guangdong Province and caused the first human infection in Huizhou City at the end of wave 1 (early August 2013 [12]) (Fig. 1B).…”

Section: Resultsmentioning

confidence: 99%

Two Outbreak Sources of Influenza A (H7N9) Viruses Have Been Established in China

Wang

Yang

Zhu

et al. 2016

J Virol

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Due to enzootic infections in poultry and persistent human infections in China, influenza A (H7N9) virus has remained a public health threat. The Yangtze River Delta region, which is located in eastern China, is well recognized as the original source for H7N9 outbreaks. Based on the evolutionary analysis of H7N9 viruses from all three outbreak waves since 2013, we identified the Pearl River Delta region as an additional H7N9 outbreak source. H7N9 viruses are repeatedly introduced from these two sources to the other areas, and the persistent circulation of H7N9 viruses occurs in poultry, causing continuous outbreak waves. Poultry movements may contribute to the geographic expansion of the virus. In addition, the AnH1 genotype, which was predominant during wave 1, was replaced by JS537, JS18828, and AnH1887 genotypes during waves 2 and 3. The establishment of a new source and the continuous evolution of the virus hamper the elimination of H7N9 viruses, thus posing a long-term threat of H7N9 infection in humans. Therefore, both surveillance of H7N9 viruses in humans and poultry and supervision of poultry movements should be strengthened. IMPORTANCESince its occurrence in humans in eastern China in spring 2013, the avian H7N9 viruses have been demonstrating the continuing pandemic threat posed by the current influenza ecosystem in China. As the viruses are silently circulated in poultry, with potentially severe outcomes in humans, H7N9 virus activity in humans in China is very important to understand. In this study, we identified a newly emerged H7N9 outbreak source in the Pearl River Delta region. Both sources in the Yangtze River Delta region and the Pearl River Delta region have been established and found to be responsible for the H7N9 outbreaks in mainland China.

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“…This led to the exclusion of 131 articles so that a total of 15 studies (2.21% of all titles and abstracts) were included in the final series of meta-analyses via formal searches. 4 – 7 , 11 – 21 …”

Section: Resultsmentioning

confidence: 99%

Impacts of age and gender at the risk of underlying medical conditions and death in patients with avian influenza A (H7N9): a meta-analysis study

Cheng

Zhao

Xie

et al. 2018

TCRM

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ObjectiveThe objective of our study was to conduct a series of analyses that examined the impacts of age and gender at the risk of underlying medical conditions (UMCs) and death in patients with influenza A (H7N9).MethodsWe began by searching for potentially relevant articles in English or Chinese before February 28, 2018. Additionally, we reviewed our own files and reference lists of articles identified by this search.ResultsThe association between death and UMCs was significant in H7N9 patients, with an OR of 1.49 (95% CI: 1.24–1.78). Subgroup analyses showed that having two or more UMCs of any type (OR: 2.24; P=0.044), chronic respiratory diseases (OR: 1.81; P=0.032), and chronic cardiovascular disease (OR: 1.63; P=0.013) had an association with increased fatality in H7N9 patients. Age (60 years or older) [adjusted OR (AOR): 1.86; P=0.032] and gender (male: AOR: 1.68, P=0.006; female: AOR: 1.88, P=0.044) were significantly associated with death in H7N9 patients with UMCs compared to H7N9 patients without any UMC. Stratification analyses found statistically significant increased death in H7N9 patients with UMCs who were 60 years of age and older (AOR: 2.72; P<0.001) and gender (male; AOR=1.64; P=0.033), compared to H7N9 patients without these respective conditions.ConclusionImpacts of age are substantial and significant at the risk of UMCs and death in H7N9 patients. This analysis did not find a significant difference in gender comparisons. Efforts should particularly focus on reducing fatality rates in patients with combined risks from UMCs and other significant impact factor such as age (60 years or older).

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Epidemiological and clinical characteristics of humans with avian influenza A (H7N9) infection in Guangdong, China, 2013–2017

Abstract: Preventive measures should focus on high-risk populations, such as the elderly and the groups with high frequency exposure to live poultry. Earlier oseltamivir and zanamivir treatment were recommended.

Cited by 15 publications

References 41 publications

Influenza A(H7N9) virus emerged and resulted in human infections in Chongqing, southwestern China since 2017

Influenza A(H7N9) virus emerged and resulted in human infections in Chongqing, southwestern China since 2017

Two Outbreak Sources of Influenza A (H7N9) Viruses Have Been Established in China

Impacts of age and gender at the risk of underlying medical conditions and death in patients with avian influenza A (H7N9): a meta-analysis study

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