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首页> 外文期刊>BMC Infectious Diseases >A family cluster of three confirmed cases infected with avian influenza A (H7N9) virus in Zhejiang Province of China
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A family cluster of three confirmed cases infected with avian influenza A (H7N9) virus in Zhejiang Province of China

机译：中国浙江省3例确诊病例感染甲型H7N9禽流感的家庭聚类

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Background A total of 453 laboratory-confirmed cases infected with avian influenza A (H7N9) virus (including 175 deaths) have been reported till October 2,2014, of which 30.68% (139/453) of the cases were identified from Zhejiang Province. We describe the largest reported cluster of virologically confirmed H7N9 cases, comprised by a fatal Index case and two mild secondary cases. Methods A retrospective investigation was conducted in January of 2014. Three confirmed cases, their close contacts, and relevant environments samples were tested by real-time reverse transcriptase-polymerase chain reaction (RT-PCR), viral culture, and sequencing. Serum samples were tested by haemagglutination inhibition (HI) assay. Results The Index case, a 49-year-old farmer with type II diabetes, who lived with his daughter (Case 2, aged 24) and wife (Case 3, aged 43) and his son-in-law (H7N9 negative). The Index case and Case 3 worked daily in a live bird market. Onset of illness in Index case occurred in January 13, 2014 and subsequently, he died of multi-organ failure on January 20. Case 2 presented with mild symptoms on January 20 following frequent unprotected bed-side care of the Index case between January 14 to 19, and exposed to live bird market on January 17. Case 3 became unwell on January 23 after providing bedside care to the Index case on January 17 to 18, and following the contact with Case 2 during January 21 to 22 at the funeral of the Index case. The two secondary cases were discharged on February 2 and 5 separately after early treatment with antiviral medication. Four virus strains were isolated and genome analyses showed 99.6 ~100% genetic homology, with two amino mutations (V192I in NS and V280A in NP). 42% (11/26) of environmental samples collected in January were H7N9 positive. Twenty-five close contacts remained well and were negative for H7N9 infection by RT-PCR and HI assay. Conclusions In the present study, the Index case was infected from a live bird market while the two secondary cases were infected by the Index case during unprotected exposure. This family cluster is, therefore, compatible with non-sustained person-to-person transmission of avian influenza A/H7N9.
机译：背景截至2014年10月2日，共报告了453例经实验室确认的A型禽流感（H7N9）感染病例（包括175例死亡），其中30.68％（139/453）病例来自浙江省。我们描述了最大的病毒学证实的H7N9病例报告群，其中包括一个致命的Index病例和两个轻度的继发病例。方法于2014年1月进行回顾性调查。通过实时逆转录聚合酶链反应（RT-PCR），病毒培养和测序对3例确诊病例，其密切接触者和相关环境样品进行了检测。通过血凝抑制（HI）测定法测试血清样品。结果Index病例是一名49岁，患有II型糖尿病的农民，与他的女儿（案例2，年龄24岁）和妻子（案例3，年龄43岁）以及其女son（H7N9阴性）一起生活。索引案例和案例3每天在活禽市场上工作。 Index病例的疾病发作于2014年1月13日发生，随后他于1月20日死于多器官功能衰竭。病例2在1月14日至1月14日至1月14日至1月20日之间频繁进行无保护的床旁护理后于1月20日出现轻度症状19，并在1月17日暴露于活禽市场。案例3在1月17日至18日为Index案例提供床边护理，并于1月21日至22日在案例2的葬礼上与案例2联系之后，于1月23日变得不适。索引大小写。两例继发病例在早期接受抗病毒药物治疗后分别于2月2日和5日出院。分离出四个病毒株，基因组分析显示99.6〜100％的遗传同源性，带有两个氨基酸突变（NS中的V192I和NP中的V280A）。一月份收集的42％（11/26）环境样品为H7N9阳性。通过RT-PCR和HI分析，有25个紧密接触保持良好，并且对H7N9感染呈阴性。结论在本研究中，Index病例是从活禽市场感染的，而两个继发病例是在无保护的接触下被Index病例感染的。因此，该家族群与禽流感A / H7N9的非持续人际传播兼容。

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