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Abstract

Since first identified in 2013, the H7N9 virus has caused several waves of human infections in China, with a current wave including a number of patients with very severe disease. Jiangsu is one of the most impacted provinces, whereby as of 31 January 2017, the number of human infections (n = 109) in the ongoing fifth H7N9 wave has exceeded the sum of those in the four preceding ones. Ten of 13 cities in Jiangsu have been affected, and clustered infections as well as one co-infection with seasonal influenza have been observed. With a median age of 58 years and 74.3% (81/109) of patients being male, the characteristics of cases are similar to those in previous waves, however patients with H7N9 seem to have an accelerated disease progression. Preliminary case fatality remains above 30%. No significant viral mutations have been found in key functional loci. Environmental H7N9 detection rate and number of days with high risk ambient temperatures were both significantly elevated during the month of December 2016 when most human infections were reported. A number of municipal governments in Jiangsu have implemented live poultry market closures to impede viral transmission to humans. A detectable decline in human infections has been observed in these municipalities and the entire province since January 2017.

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/content/10.2807/1560-7917.ES.2017.22.13.30496
2017-03-30
2024-04-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.13.30496
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References

  1. Zhou J, Wang D, Gao R, Zhao B, Song J, Qi X, et al. Biological features of novel avian influenza A (H7N9) virus. Nature. 2013;499(7459):500-3.  https://doi.org/10.1038/nature12379  PMID: 23823727 
  2. World Health Organization (WHO). Influenza at the human-animal interface. Geneva: WHO; 2017. [Accessed 4 Feb 2017]. Available from: http://www.who.int/influenza/human_animal_interface/Influenza_Summary_IRA_HA_interface_01_16_2017_FINAL.pdf?ua=1
  3. Zhou L, Ren R, Yang L, Bao C, Wu J, Wang D, et al. Sudden increase in human infection with avian influenza A(H7N9) virus in China, September-December 2016. Western Pac Surveill Response J. 2017;8(1). [Accessed 4 Feb 2017]. Available from: http://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/521/733
  4. Xiang N, Li X, Ren R, Wang D, Zhou S, Greene CM, et al. Assessing Change in Avian Influenza A(H7N9) Virus Infections During the Fourth Epidemic - China, September 2015-August 2016. MMWR Morb Mortal Wkly Rep. 2016;65(49):1390-4.  https://doi.org/10.15585/mmwr.mm6549a2  PMID: 27977644 
  5. Wang L, Wang Y, Jin S, Wu Z, Chin DP, Koplan JP, et al. Emergence and control of infectious diseases in China. Lancet. 2008;372(9649):1598-605.  https://doi.org/10.1016/S0140-6736(08)61365-3  PMID: 18930534 
  6. Qi X, Cui L, Yu H, Ge Y, Tang F. Whole-Genome Sequence of a Reassortant H5N6 Avian Influenza Virus Isolated from a Live Poultry Market in China, 2013. Genome Announc. 2014;2(5):e00706-14.  https://doi.org/10.1128/genomeA.00706-14  PMID: 25212611 
  7. Chan PK, Mok HY, Lee TC, Chu IM, Lam WY, Sung JJ. Seasonal influenza activity in Hong Kong and its association with meteorological variations. J Med Virol. 2009;81(10):1797-806.  https://doi.org/10.1002/jmv.21551  PMID: 19697414 
  8. Larkin MA, Blackshields G, Brown NP, Chenna R, McGettigan PA, McWilliam H, et al. Clustal W and Clustal X version 2.0. Bioinformatics. 2007;23(21):2947-8.  https://doi.org/10.1093/bioinformatics/btm404  PMID: 17846036 
  9. Tamura K, Stecher G, Peterson D, Filipski A, Kumar S. MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol. 2013;30(12):2725-9.  https://doi.org/10.1093/molbev/mst197  PMID: 24132122 
  10. Cowling BJ, Jin L, Lau EH, Liao Q, Wu P, Jiang H, et al. Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases. Lancet. 2013;382(9887):129-37.  https://doi.org/10.1016/S0140-6736(13)61171-X  PMID: 23803488 
  11. Qi X, Qian YH, Bao CJ, Guo XL, Cui LB, Tang FY, et al. Probable person to person transmission of novel avian influenza A (H7N9) virus in Eastern China, 2013: epidemiological investigation. BMJ. 2013;347(aug06 2):f4752.  https://doi.org/10.1136/bmj.f4752  PMID: 23920350 
  12. Zhu Y, Qi X, Cui L, Zhou M, Wang H. Human co-infection with novel avian influenza A H7N9 and influenza A H3N2 viruses in Jiangsu province, China. Lancet. 2013;381(9883):2134.  https://doi.org/10.1016/S0140-6736(13)61135-6  PMID: 23769236 
  13. Hu Y, Lu S, Song Z, Wang W, Hao P, Li J, et al. Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance. Lancet. 2013;381(9885):2273-9.  https://doi.org/10.1016/S0140-6736(13)61125-3  PMID: 23726392 
  14. Labadie K, Dos Santos Afonso E, Rameix-Welti MA, van der Werf S, Naffakh N. Host-range determinants on the PB2 protein of influenza A viruses control the interaction between the viral polymerase and nucleoprotein in human cells. Virology. 2007;362(2):271-82.  https://doi.org/10.1016/j.virol.2006.12.027  PMID: 17270230 
  15. Liu B, Havers F, Chen E, Yuan Z, Yuan H, Ou J, et al. Risk factors for influenza A(H7N9) disease--China, 2013. Clin Infect Dis. 2014;59(6):787-94.  https://doi.org/10.1093/cid/ciu423  PMID: 24928293 
  16. Zhou J, Wu J, Zeng X, Huang G, Zou L, Song Y, et al. Isolation of H5N6, H7N9 and H9N2 avian influenza A viruses from air sampled at live poultry markets in China, 2014 and 2015. Euro Surveill. 2016;21(35):30331.  https://doi.org/10.2807/1560-7917.ES.2016.21.35.30331  PMID: 27608369 
  17. He Y, Liu P, Tang S, Chen Y, Pei E, Zhao B, et al. Live poultry market closure and control of avian influenza A(H7N9), Shanghai, China. Emerg Infect Dis. 2014;20(9):1565-6.  https://doi.org/10.3201/eid2009.131243  PMID: 25148432 
  18. Yuan J, Lau EH, Li K, Leung YH, Yang Z, Xie C, et al. Effect of Live Poultry Market Closure on Avian Influenza A(H7N9) Virus Activity in Guangzhou, China, 2014. Emerg Infect Dis. 2015;21(10):1784-93.  https://doi.org/10.3201/eid2110.150623  PMID: 26402310 
  19. Lowen AC, Mubareka S, Steel J, Palese P. Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog. 2007;3(10):1470-6.  https://doi.org/10.1371/journal.ppat.0030151  PMID: 17953482 
  20. Soebiyanto RP, Clara W, Jara J, Castillo L, Sorto OR, Marinero S, et al. The role of temperature and humidity on seasonal influenza in tropical areas: Guatemala, El Salvador and Panama, 2008-2013. PLoS One. 2014;9(6):e100659.  https://doi.org/10.1371/journal.pone.0100659  PMID: 24956184 
  21. Charland KM, Buckeridge DL, Sturtevant JL, Melton F, Reis BY, Mandl KD, et al. Effect of environmental factors on the spatio-temporal patterns of influenza spread. Epidemiol Infect. 2009;137(10):1377-87.  https://doi.org/10.1017/S0950268809002283  PMID: 19296868 
  22. Zhang Y, Feng C, Ma C, Yang P, Tang S, Lau A, et al. The impact of temperature and humidity measures on influenza A (H7N9) outbreaks-evidence from China. Int J Infect Dis. 2015;30:122-4.  https://doi.org/10.1016/j.ijid.2014.11.010  PMID: 25462179 
  23. Bi Y, Xiao H, Chen Q, Wu Y, Fu L, Quan C, et al. Changes in the Length of the Neuraminidase Stalk Region Impact H7N9 Virulence in Mice. J Virol. 2015;90(4):2142-9.  https://doi.org/10.1128/JVI.02553-15  PMID: 26656694 
  24. Zhu W, Zou X, Zhou J, Tang J, Shu Y. Residues 41V and/or 210D in the NP protein enhance polymerase activities and potential replication of novel influenza (H7N9) viruses at low temperature. Virol J. 2015;12(1):71.  https://doi.org/10.1186/s12985-015-0304-6  PMID: 25940512 
  25. World Health Organization (WHO). Human infection with avian influenza A(H7N9) virus – China. Geneva: WHO; 2017. [Accessed on 6 Mar 2017]. Available from: http://www.who.int/csr/don/27-february-2017-ah7n9-china/en/
  26. Claes F, Morzaria SP, Donis RO. Emergence and dissemination of clade 2.3.4.4 H5Nx influenza viruses-how is the Asian HPAI H5 lineage maintained. Curr Opin Virol. 2016;16:158-63.  https://doi.org/10.1016/j.coviro.2016.02.005  PMID: 26991931 
  27. Yu Z, Gao X, Wang T, Li Y, Li Y, Xu Y, et al. Fatal H5N6 Avian Influenza Virus Infection in a Domestic Cat and Wild Birds in China. Sci Rep. 2015;5:10704.  https://doi.org/10.1038/srep10704  PMID: 26034886 
  28. Sun H, Pu J, Hu J, Liu L, Xu G, Gao GF, et al. Characterization of clade 2.3.4.4 highly pathogenic H5 avian influenza viruses in ducks and chickens. Vet Microbiol. 2016;182:116-22.  https://doi.org/10.1016/j.vetmic.2015.11.001  PMID: 26711037 
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