Human infection with a novel, highly pathogenic avian influenza A (H5N6) virus: Virological and clinical findings

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• 作者：Ming Pan^a ; ^j ; Rongbao Gao^b ; ^j ; Qiang Lv^a ; ^j ; Shunhe Huang^c ; ^j ; Zhonghui Zhou^d ; ^j ; Lei Yang^b ; Xiaodan Li^b ; Xiang Zhao^b ; Xiaohui Zou^b ; Wenbin Tong^a ; Suling Mao^a ; Shumei Zou^b ; Hong Bo^b ; Xiaoping Zhu^a ; Lei Liu^a ; Heng Yuan^a ; Minghong Zhang^c ; Daqing Wang^d ; Zumao Li^d ; Wei Zhao^e ; Maoli Ma^f ; Yaqiang Li^g ; Tianshu Li^a ; Huiping Yang^a ; Jianan Xu^a ; Lijun Zhou^a ; Xingyu Zhou^a ; Wei Tang^c ; Ying Song^h ; Tao Chen^b ; Tian Bai^b ; Jianfang Zhou^b ; Dayan Wang^b ; Guizhen Wu^b ; Dexin Li^b ; Zijian Fengⁱ ; George F. Gaoⁱ ; Yu Wangⁱ ; Shusen He^a ; Yuelong Shu^b ; ^{yshu@cnic.org.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Highly pathogenic avian influenza virus ; H5N6 ; Reassortment ; Emerging infectious diseases
• 刊名：Journal of Infection
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：72
• 期：1
• 页码：52-59
• 全文大小：1238 K

文摘

Severe infection with avian influenza A (H5N6) virus in humans was identified first in 2014 in China. Before that, it was unknown or unclear if the disease or the pathogen affected people. This study illustrates the virological and clinical findings of a fatal H5N6 virus infection in a human patient.

Methods

We obtained and analyzed the clinical, epidemiological, and virological data from the patient. Reverse transcription polymerase chain reaction (RT-PCR), viral culture, and sequencing were conducted for determination of the causative pathogen.

Results

The patient, who presented with fever, severe pneumonia, leucopenia, and lymphopenia, developed septic shock and acute respiratory distress syndrome (ARDS), and died on day 10 after illness onset. A novel reassortant avian-origin influenza A (H5N6) virus was isolated from the throat swab or trachea aspirate of the patient. The virus was reassorted with the HA gene of clade 2.3.4.4 H5, the internal genes of clade 2.3.2.1 H5, and the NA gene of the H6N6 avian virus. The cleavage site of the HA gene contained multiple basic amino acids, indicating that the novel H5N6 virus was highly pathogenic in chicken.

Conclusions

A novel, highly pathogenic avian influenza H5N6 virus with a backbone of H5N1 virus acquired from the NA gene from the H6N6 virus has been identified. It caused human infection resulting in severe respiratory disease.