Fatal Avian Influenza A (H5N1) in a Child Presenting with Diarrhea Followed by Coma

Jong, De; Vc, Bach; Tq, Phan; Mh, Vo; Tran, Thi-Nguyen-Ny; Bh, Nguyen; Beld, Marcel; Tp, Le; Hk, Truong; Vv, Nguyen; Th, Tran; Qh, Do; Farrar, Jeremy

doi:10.1056/nejmoa044307

Cited by 465 publications

(386 citation statements)

References 21 publications

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“…One case with fever, diarrhea, seizure and coma has been reported from Vietnam leading to a clinical diagnosis of encephalitis. H5N1 was detected from CSF, serum, throat and fecal samples [12]. Conjunctivitis is also described occasionally [13,14].…”

Section: Clinical Featuresmentioning

confidence: 95%

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

2009

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The last decade has seen the emergence of two new infl uenza A subtypes and they have become a cause of concern for the global community. These are the highly pathogenic H5N1 infl uenza A virus (H5N1) and the Pandemic 2009 infl uenza H1N1 virus. Since 2003 the H5N1 virus has caused widespread disease and death in poultry, mainly in south East Asia and Africa. In humans the number of cases infected with this virus is few but the mortality has been about 60%. Most patients have presented with severe pneumonia and acute respiratory distress syndrome. The second infl uenza virus, the pandemic H1N1 2009, emerged in Mexico in March this year. This virus acquired the ability for sustained human to human spread and within a few months spread throughout the world and infected over 4 lakh individuals. The symptoms of infection with this virus are similar to seasonal infl uenza but it currently affecting younger individuals more often. Fortunately the mortality has been low. Both these new infl uenza viruses are currently circulating and have different clinical and epidemiological characteristics.

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Section: Clinical Featuresmentioning

confidence: 95%

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

2009

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“…We feel that this is a useful distinction due to the impact that productive replication may have on disease progression. Despite presumably being an infrequent occurrence, extrapulmonary detection of H5N1 IAV in infected humans has been reported in the literature [18,19]. Productive virus replication in macrophages may be the mechanism by which systemic infection occurs in these rare cases, as has already been demonstrated for other viruses [20].…”

Section: Introductionmentioning

confidence: 99%

Influenza virus replication in macrophages: balancing protection and pathogenesis

Cline

Beck

Bianchini

2017

Journal of General Virology

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Macrophages are essential for protection against influenza A virus infection, but are also implicated in the morbidity and mortality associated with severe influenza disease, particularly during infection with highly pathogenic avian influenza (HPAI) H5N1 virus. While influenza virus infection of macrophages was once thought to be abortive, it is now clear that certain virus strains can replicate productively in macrophages. This may have important consequences for the antiviral functions of macrophages, the course of disease and the outcome of infection for the host. In this article, we review findings related to influenza virus replication in macrophages and the impact of productive replication on macrophage antiviral functions. A clear understanding of the interactions between influenza viruses and macrophages may lead to new antiviral therapies to relieve the burden of severe disease associated with influenza viruses.

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“…No se señaló ningún síntoma respiratorio en el hospital. Al principio se pensó que la paciente tenía una sepsis gastrointestinal o una encefalitis aguda, pero posteriormente murió de encefalitis 86 . Dos semanas más tarde su hermano de 4 años desarrolló fiebre, cefalea, vómitos y diarrea.…”

Section: Manifestaciones Clínicasunclassified

“…Cinco días después falleció de encefalitis. Durante su estancia en el hospital el H5N1 fue aislado en las heces, garganta, suero y líquido cerebroespinal 86 .…”

Section: Manifestaciones Clínicasunclassified

Gripe aviar: lo que un intensivista debe conocer

Casillas¹,

Fernandez²,

Varon³

2008

Medicina Intensiva

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En el siglo pasado, la humanidad ha hecho frente a tres de las mayores pandemias de infecciones por el virus de la gripe. La primera fue en 1918, y causó una cantidad significativa de muertes. Éste ha sido también capaz de cruzar la barrera de la especie y afectar a los mamíferos y, lo más preocupante, a los seres humanos. Desde entonces se han publicado varios brotes en el sudeste de Asia. Una gran cantidad de pacientes presenta un curso severo que desarrolla neumonía y disfunción, que implica al hígado, los riñones, el cerebro y los pulmones.Puesto que el virus carece de control regulador de la división genética, experimenta mutaciones constantes que conducen a nuevos subtipos y a nuevas cepas. Los únicos fármacos que han mostrado cierta protección son oseltamivir y zanamivir. Es crucial desarrollar vacunas eficaces y no costosas para prevenir la extensión del virus y la infección, no solamente en seres humanos sino también en aves. PALABRAS CLAVE: gripe aviar, fallo respiratorio agudo, virus H5N1, neuraminidasa, oseltamivir. BIRD FLU: WHAT THE INTENSIVIST MUST KNOWIn the last century, humankind has faced 3 major pandemics of influenza virus infections. The first one occurred in 1918 and caused a significant amount of deaths. It was also capable of crossing over species barrier and affecting mammals, and most worrisome, humans. Since then several outbreaks have been reported in the Southeast of Asia. Many patients with the flu-like illness have a severe course and the patient develops pneumonia and in some cases multiorgan failure involving liver, kidneys, brain and lungs.Since the virus lacks regulatory control of genetic division it undergoes constant mutations leading to new subtypes and, sometimes, new strains. The only drugs that have shown some protection are oseltamivir and zanamivir. It is crucial to develop effective and non-expensive vaccines to prevent the virus spread and infection not only in humans but in birds too.

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Fatal Avian Influenza A (H5N1) in a Child Presenting with Diarrhea Followed by Coma

Cited by 465 publications

References 21 publications

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

Influenza virus replication in macrophages: balancing protection and pathogenesis

Gripe aviar: lo que un intensivista debe conocer

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