Prevalence, Prevention and Treatment of Human Infection with H7N9 Avian Influenza Virus: Evidence, Challenge and Thinking_Chinese Journal of Evidence-Based Medicine

Authors：

LI Xianglian ,  LI Youping

Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LI Youping, Email: yzmylab@hotmail.com

Keywords：

H7N9; Human infection with avian influenza virus; Prevalence; Prevention and treatment; Evidence

DOI：

10.7507/1672-2531.20130139

Video：

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H7N9, a novel avian influenza A virus that causes human infections emerged in February, 2013 in Anhui and Shanghai, China. The epidemic quickly spread to Zhejiang, Jiangsu and other neighbor provinces. As of May 30th, 2013, WHO had reported 132 cases, 37 (28%) of which died. Aiming at such serious outbreak of epidemic, we retrospectively analyzed its etiology, epidemiology, clinical characteristics, treatment, prevention and control based on data and evidence. Experience and evidence of the risk surveillance and management of such a novel anthropozoonosis lacks in China, or even lacks around the world. Quick and accurate identification of the rules and of the variation and transmission of avian influenza virus becomes a key to prevention, control and treatment. According to current best available evidence around the world, Chinese medicine and biomedicine should be put in to parallel use. Only realizing evidence-based decision making can we effectively prevent and control the epidemic, treat patients, and reduce the loss.

Citation： LI Xianglian,LI Youping. Prevalence, Prevention and Treatment of Human Infection with H7N9 Avian Influenza Virus: Evidence, Challenge and Thinking. Chinese Journal of Evidence-Based Medicine, 2013, 13(7): 780-784. doi: 10.7507/1672-2531.20130139 Copy

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2.	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 Apr 24. [Epub ahead of print]. DOI: 10.1056/ NEJMoa1304617.
3.	WHO. Number of confirmed human cases of avian influenza A (H7N9) reported to WHO. 2013.05.30. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/Data_Reports/en/index.html.
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.
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7.	Zhu H, Wang D, Kelvin DJ, et al. Infectivity, Transmission, and Pathology of Human H7N9 Influenza in Ferrets and Pigs. Science, 2013 Jun 21. [Epub ahead of print]. DOI:10.1126/science.1239844.
8.	Gao HN, Lu HZ, Cao B, et al. Clinical Findings in 111 Cases of Influenza A (H7N9) Virus Infection. N Engl J Med, 2013, 368(24): 2277-2285.
9.	Skowronski DN, Janjua N, Kwindt T, et al. Virus-host interactions and the unusual age and sex distribution of human cases of influenza A(H7N9) in China, April 2013. Euro Surveill, 2013, 18(17): 20465.
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12.	Parry J. H7N9 virus is more transmissible and harder to detect than H5N1, say experts. BMJ, 2013, 346: f2568.
13.	中国疾病预防控制中心. 人感染 H7N9 禽流感诊疗方案 (2013年第2版). 2013.04.11. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130411_79740.htm.
14.	Kuehn BM. CDC: Use antivirals early, aggressively for H7N9 flu. JAMA, 2013, 309(20): 2086.
15.	WHO. Clinical management of human infection with avian influenza A (H5N1) virus. 2007. 08.15. Available from: http://www.who.int/influenza/resources/documents/clinical_management_h5n1_15_08_2007/en/.
16.	中华中医药学会. 中医药防治人禽流感专家建议. 中华中医药学刊, 2007, 25(7): 1535-1536.
17.	中国卫生部. 人禽流感诊疗方案(2008版). 中国中医药现代远程教育, 2009, 7(2): 1-6.
18.	Hu YW, Lu SH, Song ZG, 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. The Lancet, 2013, 381(9885): 2273-2279.
19.	首个H5N1型禽流感人用疫苗问世. 亚太传统医学, 2007, 4:90.
20.	中国卫生计生委.《人感染 H7N9 禽流感疫情防控方案》. 2013.05.13. Available from: http://www.chinacdc.cn/mtdx/crbxx/201305/t20130513_80912.htm.
21.	中国卫生计生委.《人感染 H7N9 禽流感医院感染预防与控制技术指南》.2013.04.04. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130404_79474.htm.
22.	WHO. Interim WHO surveillance recommendations for human infection with avian influenza A (H7N9) virus. 2013.05.10. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/InterimSurveillanceRecH7N9_10May13.pdf.

1. Gao RB, Cao B, Hu YW, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med, 2013, 368 (20): 1888-1897.
2. 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 Apr 24. [Epub ahead of print]. DOI: 10.1056/ NEJMoa1304617.
3. WHO. Number of confirmed human cases of avian influenza A (H7N9) reported to WHO. 2013.05.30. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/Data_Reports/en/index.html.
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. Xiong CL, Zhang ZJ, Jiang QW, et al. Evolutionary Characteristics of A/Hangzhou/1/2013 and Source of Avian Influenza Virus H7N9 Subtype in China. Clin Infect Dis, 2013 May 23.[Epub ahead of print]. DOI: 10.1093/cid/cit29 4.
6. Liu D, Shi WF, Shi Y, et al. Origin and diversity of novel avian influenza A H7N9 viruses causing human infection: phylogenetic, structural, and coalescent analyses. Lancet, 2013, 381(9881): 1926-1932.
7. Zhu H, Wang D, Kelvin DJ, et al. Infectivity, Transmission, and Pathology of Human H7N9 Influenza in Ferrets and Pigs. Science, 2013 Jun 21. [Epub ahead of print]. DOI:10.1126/science.1239844.
8. Gao HN, Lu HZ, Cao B, et al. Clinical Findings in 111 Cases of Influenza A (H7N9) Virus Infection. N Engl J Med, 2013, 368(24): 2277-2285.
9. Skowronski DN, Janjua N, Kwindt T, et al. Virus-host interactions and the unusual age and sex distribution of human cases of influenza A(H7N9) in China, April 2013. Euro Surveill, 2013, 18(17): 20465.
10. WHO. Cumulative number of confirmed human cases of avian influenza A (H5N1) reported to WHO. 2013.04.26. Avaliable from: http://www.who.int/influenza/human_animal_interface/H5N1_cumulative_table_archives/en/index.html.
11. 陈观升, 王桂林, 许世禄. 人禽流感研究现状. 河南预防医学杂志, 2009, 20(3): 229-232.
12. Parry J. H7N9 virus is more transmissible and harder to detect than H5N1, say experts. BMJ, 2013, 346: f2568.
13. 中国疾病预防控制中心. 人感染 H7N9 禽流感诊疗方案 (2013年第2版). 2013.04.11. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130411_79740.htm.
14. Kuehn BM. CDC: Use antivirals early, aggressively for H7N9 flu. JAMA, 2013, 309(20): 2086.
15. WHO. Clinical management of human infection with avian influenza A (H5N1) virus. 2007. 08.15. Available from: http://www.who.int/influenza/resources/documents/clinical_management_h5n1_15_08_2007/en/.
16. 中华中医药学会. 中医药防治人禽流感专家建议. 中华中医药学刊, 2007, 25(7): 1535-1536.
17. 中国卫生部. 人禽流感诊疗方案(2008版). 中国中医药现代远程教育, 2009, 7(2): 1-6.
18. Hu YW, Lu SH, Song ZG, 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. The Lancet, 2013, 381(9885): 2273-2279.
19. 首个H5N1型禽流感人用疫苗问世. 亚太传统医学, 2007, 4:90.
20. 中国卫生计生委.《人感染 H7N9 禽流感疫情防控方案》. 2013.05.13. Available from: http://www.chinacdc.cn/mtdx/crbxx/201305/t20130513_80912.htm.
21. 中国卫生计生委.《人感染 H7N9 禽流感医院感染预防与控制技术指南》.2013.04.04. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130404_79474.htm.
22. WHO. Interim WHO surveillance recommendations for human infection with avian influenza A (H7N9) virus. 2013.05.10. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/InterimSurveillanceRecH7N9_10May13.pdf.

Chinese Journal of Evidence-Based Medicine

Prevalence, Prevention and Treatment of Human Infection with H7N9 Avian Influenza Virus: Evidence, Challenge and Thinking

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