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

Ke, Changwen; Mok, Chris Ka Pun; Zhu, Wenfei; Zhou, Haibo; He, Jianfeng; Guan, Weijun; Wu, Jie; Song, Wenjun; Wang, Dayang; Liu, Jiexiong; Lin, Qinhan; Chu, Daniel K.W.; Yang, Lei; Zhong, Nanshan; Yang, Zifeng; Shu, Yuelong; Peiris, Malik

doi:10.3201/eid2308.170600

Cited by 143 publications

(130 citation statements)

References 20 publications

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“…Though the case fatality rate and severity in humans were similar between highly pathogenic and low pathogenic H7N9 strains [2, 23], highly pathogenic H7N9 exhibited a R292K mutation, where an amino acid change had occurred that was known to be associated with neuraminidase inhibitor resistance. This lead to severe and complicated clinical sequelae [5, 24, 25]. The rapid geographical expansion and genetic evolution of the HPAI H7N9 viruses pose a great challenge, not only for poultry production but also for public health [26].…”

Section: Discussionmentioning

confidence: 99%

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The Protective Effects of the A/ZJU01/ PR8/2013 Split H7N9 Avian Influenza Vaccine Against Highly Pathogenic H7N9 in BALB/c Mice

Deng

et al. 2018

Cell Physiol Biochem

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Background/Aims: Since the first case of novel H7N9 infection was reported, China has experienced five epidemics of H7N9. During the fifth wave, a highly pathogenic H7N9 strain emerged. In order to assess whether the H7N9 vaccine based on A/Zhejiang/DTID-ZJU01/2013(H7N9) was effective in protecting against highly pathogenic H7N9, we conducted this study. Methods: Groups of mice were immunized twice by intraperitoneal injection with 500 µl of either split vaccine alone or MF59-adjuvanted vaccine. Serum was collected 2 weeks after the second vaccine booster. The hemagglutinin inhibition test was conducted on vaccine seed and highly pathogenic H7N9 to evaluate the neutralization of highly pathogenic H7N9. We also immunized mice and challenged them with highly pathogenic H7N9. Mice were observed for illness, weight loss, and death at 1 week and 2 weeks post-infection. Then, the mice were sacrificed and lungs were removed. Antibody responses were assessed and pathological changes in the lung tissue were evaluated. Results: The ability of serum to neutralize highly pathogenic H7N9 was reduced. In mice, highly pathogenic H7N9 was more virulent than A/Zhejiang/DTID-ZJU01/2013(H7N9). After challenge with highly pathogenic H7N9, all mice died while mice challenged with A/Zhejiang/DTID-ZJU01/2013(H7N9) all recovered. The A/ZJU01/PR8/2013 split H7N9 avian influenza vaccine was able to protect against infection with highly pathogenic H7N9 in mice, with or without MF59. Moreover, H7N9 vaccine adjuvanted with MF59 produced high antibody levels, which lead to better protection. Conclusions: The A/ZJU01/PR8/2013 split H7N9 avian influenza vaccine based on A/Zhejiang/DTID-ZJU01/2013(H7N9) is effective in protecting against highly pathogenic H7N9. H7N9 vaccine adjuvanted with MF59 offers better protection against infection with highly pathogenic H7N9. In order to make the H7N9 vaccine applicable to humans, further clinical trials are required to evaluate MF59 adjuvanted vaccine. Meanwhile, the vaccine strain should be updated based on the highly pathogenic H7N9 gene sequence.

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Section: Discussionmentioning

confidence: 99%

“…The 2017 isolate also possessed an R292K substitution in the neuraminidase protein, which confers oseltamivir resistance [5]. Animal experiments showed that these novel HPAI H7N9 variants were both highly pathogenic in chickens and lethal to mice.…”

Section: Introductionmentioning

confidence: 99%

The Protective Effects of the A/ZJU01/ PR8/2013 Split H7N9 Avian Influenza Vaccine Against Highly Pathogenic H7N9 in BALB/c Mice

Deng

et al. 2018

Cell Physiol Biochem

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“…Compared to urban residents, rural residents usually have higher likelihood of exposure to sick or dead poultry, which were attributed to the popular country lifestyle of raising backyard poultry in China 5, 20, 21, 22. The human cases of infection with highly pathogenic avian influenza (HPAI) A(H7N9) virus have been found in Guangxi, Guangdong, and Hunan Provinces during the fifth wave 23, 24, 25. So far, there were no human cases of infection with HPAI A(H7N9) virus confirmed in Zhejiang province.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the three waves of avian influenza A(H7N9) virus circulation since live poultry markets were permanently closed in the main urban areas in Zhejiang Province, July 2014‐June 2017

Cheng

Wang

Shen

et al. 2018

Influenza Resp Viruses

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BackgroundThe sudden increase in the number of human cases infected with avian influenza A(H7N9) virus after September 2016 raised global concern.ObjectivesTo assess the changes in epidemiological characteristics of H7N9 cases since the massive closure of live poultry markets (LPMs) in the main urban areas in Zhejiang province.MethodsWe used descriptive statistics to compare epidemiological characteristics of the three distinct waves of H7N9 cases in Zhejiang province. The rural or urban cases were defined according to the location where the patients had exposure within 2 weeks before illness onset.ResultsBetween July 2014 and June 2017, 166 H7N9 cases were reported in Zhejiang province, with 45, 34, and 87 cases reported in the third, fourth, and fifth wave, respectively. Across the three waves, most reported cases were from rural areas. A similar percentage of cases in all three waves reported exposure to LPMs, raising poultry at home or around the house, as well as occupational exposure. Compared to the third (80.00%) and fourth wave (70.59%), a significantly larger proportion of cases from the non‐LPMs closure areas were observed in the fifth wave (89.66%) (P = .034).ConclusionEpidemiological characteristics of human cases infected with avian influenza A(H7N9) virus had generally remained unchanged since the massive closure of LPMs in the main urban area of Zhejiang province. The sudden increase in the number of H7N9 cases in the fifth wave was mainly attributed to the excessive cases reported from areas where LPMs were not permanently closed.

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“…Although maintaining dual receptor-binding preference, their HA antigenicity was distinct from LPAI A (H7N9). Furthermore, NA R292K conferred a multidrug resistance phenotype (13).…”

Section: Human Infections Due To a Novel Avian Influenza A (H7n9)mentioning

confidence: 99%

Avian influenza A (H7N9) virus infections in humans across five epidemics in mainland China, 2013–2017

2017

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

Cited by 143 publications

References 20 publications

The Protective Effects of the A/ZJU01/ PR8/2013 Split H7N9 Avian Influenza Vaccine Against Highly Pathogenic H7N9 in BALB/c Mice

The Protective Effects of the A/ZJU01/ PR8/2013 Split H7N9 Avian Influenza Vaccine Against Highly Pathogenic H7N9 in BALB/c Mice

Comparison of the three waves of avian influenza A(H7N9) virus circulation since live poultry markets were permanently closed in the main urban areas in Zhejiang Province, July 2014‐June 2017

Avian influenza A (H7N9) virus infections in humans across five epidemics in mainland China, 2013–2017

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