1
|
Chen LL, Huo X, Qi X, Liu C, Huang H, Yu H, Dong Z, Deng F, Peng J, Hang H, Wang S, Fan H, Pang Y, Bao C. A fatal paediatric case infected with reassortant avian influenza A(H5N6) virus in Eastern China. Transbound Emerg Dis 2020; 67:2118-2125. [PMID: 32248624 DOI: 10.1111/tbed.13561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 12/18/2022]
Abstract
Avian influenza A(H5N6) keeps evolving, causing outbreaks in birds and sporadic infections in human. Here, we report a fatal paediatric infection caused by a novel reassortant H5N6 virus. The patient was an obese 9-year-old girl. She initiated with fever and cough, then developed pneumonia, acute respiratory distress syndrome (ARDS) and respiratory failure. Lower respiratory tract aspirates and anal swabs were serially taken till the patient's death. Viral isolation, genome sequencing and phylogenetic analysis were conducted. A novel reassortant H5N6 virus was isolated from the patient. Except the PA gene, all other 7 genes of the virus belonged to H5N6 genotype A (S4-like virus). The PA gene was probably obtained from Eurasian waterfowl influenza viruses. The H5N6 virus was consistently detected from the patient's respiratory samples till the 17th day after symptom onset, but not from anal swabs or urine sample by real-time reverse transcription polymerase chain reaction (RT-PCR). Significantly elevated (32-fold) serum antibodies to H5N6 virus were observed during the patient's course of disease. Aside from the identified novel reassortant H5N6 viral strain, obesity, delayed confirmation of aetiology and specific antiviral treatment, and prolonged virus shedding could have contributed to the poor clinical outcome.
Collapse
Affiliation(s)
- Li-Ling Chen
- Department of Acute Infectious Diseases, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Xiang Huo
- Section of Epidemiology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xian Qi
- Section of Virology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Cheng Liu
- Department of Acute Infectious Diseases, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Haodi Huang
- Section of Epidemiology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Huiyan Yu
- Section of Virology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zefeng Dong
- Department of Acute Infectious Diseases, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Fei Deng
- Section of Virology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jiefu Peng
- Section of Virology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Hang
- Department of Acute Infectious Diseases, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Shenjiao Wang
- Section of Virology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Huan Fan
- Section of Virology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuanyuan Pang
- Department of Acute Infectious Diseases, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Changjun Bao
- Section of Epidemiology, Department of Acute Infectious Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- National Health Commission Key laboratory of Enteric Pathogenic Microbiology, Nanjing, China
| |
Collapse
|