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首页> 外文期刊>The Lancet >Clinical and epidemiological characteristics of a fatal case of avian influenza A H10N8 virus infection: A descriptive study
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Clinical and epidemiological characteristics of a fatal case of avian influenza A H10N8 virus infection: A descriptive study

机译：致命的甲型H10N8禽流感病毒感染病例的临床和流行病学特征：一项描述性研究

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摘要

Background: Human infections with different avian influenza viruses - eg, H5N1, H9N2, and H7N9 - have raised concerns about pandemic potential worldwide. We report the first human infection with a novel reassortant avian influenza A H10N8 virus. Methods: We obtained and analysed clinical, epidemiological, and virological data from a patient from Nanchang City, China. Tracheal aspirate specimens were tested for influenza virus and other possible pathogens by RT-PCR, viral culture, and sequence analyses. A maximum likelihood phylogenetic tree was constructed. Findings: A woman aged 73 years presented with fever and was admitted to hospital on Nov 30, 2013. She developed multiple organ failure and died 9 days after illness onset. A novel reassortant avian influenza A H10N8 virus was isolated from the tracheal aspirate specimen obtained from the patient 7 days after onset of illness. Sequence analyses revealed that all the genes of the virus were of avian origin, with six internal genes from avian influenza A H9N2 viruses. The aminoacid motif GlnSerGly at residues 226-228 of the haemagglutinin protein indicated avian-like receptor binding preference. A mixture of glutamic acid and lysine at residue 627 in PB2 protein - which is associated with mammalian adaptation - was detected in the original tracheal aspirate samples. The virus was sensitive to neuraminidase inhibitors. Sputum and blood cultures and deep sequencing analysis indicated no co-infection with bacteria or fungi. Epidemiological investigation established that the patient had visited a live poultry market 4 days before illness onset. Interpretation: The novel reassortant H10N8 virus obtained is distinct from previously reported H10N8 viruses. The virus caused human infection and could have been associated with the death of a patient. Funding: Emergency Research Project on human infection with avian influenza H7N9 virus, the National Basic Research Program of China, and the National Mega-projects for Infectious Diseases.
机译：背景：人类感染不同的禽流感病毒（例如H5N1，H9N2和H7N9）引起了人们对全球大流行潜力的担忧。我们报告首次人类感染的新型重配禽流感A H10N8病毒。方法：我们获得并分析了来自南昌市的一名患者的临床，流行病学和病毒学数据。通过RT-PCR，病毒培养和序列分析测试气管抽吸物标本中的流感病毒和其他可能的病原体。构造了最大似然系统树。调查结果：一名73岁的女性发烧，于2013年11月30日入院。她发展为多器官功能衰竭，发病9天后死亡。从发病后7天从患者获得的气管吸出物样本中分离出新型重配禽流感A H10N8病毒。序列分析显示，该病毒的所有基因均来自禽类，其中六个内部基因来自禽流感A H9N2病毒。血凝素蛋白残基226-228处的氨基酸基序GlnSerGly表明禽样受体结合偏好。在原始气管抽吸物样品中检测到PB2蛋白中第627位残基的谷氨酸和赖氨酸的混合物，这与哺乳动物的适应性有关。该病毒对神经氨酸酶抑制剂敏感。痰液和血液培养物以及深层测序分析表明没有细菌或真菌的共同感染。流行病学调查确定该患者在疾病发作前4天曾去过活禽市场。解释：获得的新型重配H10N8病毒不同于先前报道的H10N8病毒。该病毒引起人类感染，可能与患者死亡有关。资金资助：人类感染H7N9禽流感的应急研究项目，中国国家基础研究计划和国家重大传染病项目。

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