Objective
Since the first case of avian influenza A (H7N9) virus infection in humans identified in Suining, Sichuan province on January 25th, 2017, there were other five severely ill patients confirmed in the following 3 weeks. It is urgent to find out the common clinical characters of these patients, so that to make sure the optimal ways for early diagnosis and treatment for H7N9 virus infection in community hospitals or primary hospitals as soon as possible.
Methods
The early symptoms, the data of early laboratory findings, the early imaging study, the early process of diagnosis and treatment of these six patients were collected and analyzed.
Results
All six patients had high fever, dry cough, hypocalcemia, and hypophosphatemia, with advanced CT image lesions manifested as consolidation and ground-grass opacity in bilateral lower lung lobes. Some patients had typically leukopenia, lymphopenia, thrombocytopenia. And most of them had a history of direct exposure to live poultry before complaining of flu-like syndromes. However, the flu can not be effectively controlled by routine anti-infection.
Conclusion
The human infection with H7N9 virus can be early identified by combining the epidemiology of live poultry exposure, the symptoms of high fever, dry cough, dramatical leukopenia, lymphopenia, thrombocytopenia, the typical CT image, and the rapidly worsen clinical condition.
Citation：
XIA Hongtao, CAO Lin, HE Zhengguang, CHEN Liang, JING Yi, GONG Yu, HE Yang, LIU Tao, ZHAO Chuan, LI Yi, LIANG Zongan. Severely ill human infection with avian influenza A (H7N9) virus firstly identified in Sichuan province: six cases report and clinical analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(2): 103-108. doi: 10.7507/1671-6205.201702024
Copy
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Li Q, Zhou L, Zhou MH, et al. Preliminary report: epidemiology of the avian influenza A (H7N9) outbreak in China. N Engl J Med, 2013, 370(6): 1668-1677.
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中国卫生计生委医政医管局. 国家卫生计生委办公厅关于做好人感染H7N9禽流感医疗救治工作的通知. 中国卫生和计划生育委员会, 2017. http://www.nhfpc.gov.cn/yzygj/s3593g/201701/ 2dbdbc6e82dd4fdfa57508499f61cdfc.shtml.
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Gao R, Cao B, Hu Y, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med, 2013, 368(20): 1888-1897.
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Chen Y, Liang WF, Yang SG, et al. Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome. Lancet, 2013, 381(9881): 1916-1925.
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Dai J, Zhou X, Dong D, et al. Human infection with a novel avian-origin influenza A (H7N9) virus: serial chest radiographic and CT findings. Chin Med J (Engl), 2014, 127(12): 2206-2211.
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- 1. Li Q, Zhou L, Zhou MH, et al. Preliminary report: epidemiology of the avian influenza A (H7N9) outbreak in China. N Engl J Med, 2013, 370(6): 1668-1677.
- 2. 中国卫生计生委医政医管局. 国家卫生计生委办公厅关于做好人感染H7N9禽流感医疗救治工作的通知. 中国卫生和计划生育委员会, 2017. http://www.nhfpc.gov.cn/yzygj/s3593g/201701/ 2dbdbc6e82dd4fdfa57508499f61cdfc.shtml.
- 3. Gao R, Cao B, Hu Y, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med, 2013, 368(20): 1888-1897.
- 4. Chen Y, Liang WF, Yang SG, et al. Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome. Lancet, 2013, 381(9881): 1916-1925.
- 5. Dai J, Zhou X, Dong D, et al. Human infection with a novel avian-origin influenza A (H7N9) virus: serial chest radiographic and CT findings. Chin Med J (Engl), 2014, 127(12): 2206-2211.
