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Heterogeneity of Early Host Response to Infection with Four Low-Pathogenic H7 Viruses with a Different Evolutionary History in the Field. Viruses 2021; 13:v13112323. [PMID: 34835129 PMCID: PMC8620788 DOI: 10.3390/v13112323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022] Open
Abstract
Once low-pathogenic avian influenza viruses (LPAIVs) of the H5 and H7 subtypes from wild birds enter into poultry species, there is the possibility of them mutating into highly pathogenic avian influenza viruses (HPAIVs), resulting in severe epizootics with up to 100% mortality. This mutation from a LPAIV to HPAIV strain is the main cause of an AIV’s major economic impact on poultry production. Although AIVs are inextricably linked to their hosts in their evolutionary history, the contribution of host-related factors in the emergence of HPAI viruses has only been marginally explored so far. In this study, transcriptomic sequencing of tracheal tissue from chickens infected with four distinct LP H7 viruses, characterized by a different history of pathogenicity evolution in the field, was implemented. Despite the inoculation of a normalized infectious dose of viruses belonging to the same subtype (H7) and pathotype (LPAI), the use of animals of the same age, sex and species as well as the identification of a comparable viral load in the target samples, the analyses revealed a heterogeneity in the gene expression profile in response to infection with each of the H7 viruses administered.
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2
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Abstract
In early 2013, human infections caused by a novel H7N9 avian influenza virus (AIV) were first reported in China; these infections caused severe disease and death. The virus was initially low pathogenic to poultry, enabling it to spread widely in different provinces, especially in live poultry markets. Importantly, the H7N9 low pathogenic AIVs (LPAIVs) evolved into highly pathogenic AIVs (HPAIVs) in the beginning of 2017, causing a greater threat to human health and devastating losses to the poultry industry. Fortunately, nationwide vaccination of chickens with an H5/H7 bivalent inactivated avian influenza vaccine since September 2017 has successfully controlled H7N9 avian influenza infections in poultry and, importantly, has also prevented human infections. In this review, we summarize the biological properties of the H7N9 viruses, specifically their genetic evolution, adaptation, pathogenesis, receptor binding, transmission, drug resistance, and antigenic variation, as well as the prevention and control measures. The information obtained from investigating and managing the H7N9 viruses could improve our ability to understand other novel AIVs and formulate effective measures to control their threat to humans and animals.
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Affiliation(s)
- Chengjun Li
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin 150069, China
| | - Hualan Chen
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin 150069, China
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3
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Goni MD, Hasan H, Wan-Arfah N, Naing NN, Deris ZZ, Arifin WN, Baaba AA, Aliyu A, Adam BM. Health Education Intervention as an Effective Means for Prevention of Respiratory Infections Among Hajj Pilgrims: A Review. Front Public Health 2020; 8:449. [PMID: 33014965 PMCID: PMC7494962 DOI: 10.3389/fpubh.2020.00449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/21/2020] [Indexed: 11/13/2022] Open
Abstract
The prevalence of respiratory illness has continued to surge among Hajj pilgrims from different countries despite having some practices of preventive measures. Respiratory illnesses during Hajj could be due to many reasons and many factors that promote disease spread. These factors include overcrowding, cigarette smoking, and direct contact with infectious agents particularly viruses promote the spread of respiratory infections. However, due to the longer duration of the pilgrimage, there are high chances of pilgrims contracting various respiratory illnesses due to exposure to respiratory pathogens. Hajj pilgrims' knowledge, attitudes, and practices toward respiratory tract infections are used as the determinant of the effectiveness of the health education interventions. Knowledge and application of basic hygiene principles, use of face masks, following cough etiquettes, engaging in social distancing, and engaging in other measures are highly important. In this paper, we reviewed the various effective intervention strategies implemented to help prevent respiratory tract infections during Hajj.
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Affiliation(s)
- Mohammed Dauda Goni
- Department of Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Habsah Hasan
- Department of Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Nadiah Wan-Arfah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Nyi Nyi Naing
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Zakuan Zainy Deris
- Department of Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Wan Nor Arifin
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Aisha Abubakar Baaba
- Centre for Language Studies and Generic Development, Universiti Malaysia Kelantan, Kota Bharu, Malaysia
| | - Abdulwahab Aliyu
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Gombe State University, Gombe, Nigeria
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4
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Shan X, Wang Y, Song R, Wei W, Liao H, Huang H, Xu C, Chen L, Li S. Spatial and temporal clusters of avian influenza a (H7N9) virus in humans across five epidemics in mainland China: an epidemiological study of laboratory-confirmed cases. BMC Infect Dis 2020; 20:630. [PMID: 32842978 PMCID: PMC7449057 DOI: 10.1186/s12879-020-05345-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/13/2020] [Indexed: 12/31/2022] Open
Abstract
Background Avian influenza A (H7N9) virus was first reported in mainland China in 2013, and alarming in 2016–17 due to the surge across a wide geographic area. Our study aimed to identify and explore the spatial and temporal variation across five epidemics to reinforce the epidemic prevention and control. Methods We collected spatial and temporal information about all laboratory-confirmed human cases of A (H7N9) virus infection reported in mainland China covering 2013–17 from the open source. The autocorrelation analysis and intensity of cases were used to analyse the spatial cluster while circular distribution method was used to analyse the temporal cluster. Results Across the five epidemics, a total of 1553 laboratory-confirmed human cases with A (H7N9) virus were reported in mainland China. The global Moran’s I index values of five epidemic were 0.610, 0.132, 0.308, 0.306, 0.336 respectively, among which the differences were statistically significant. The highest intensity was present in the Yangtze River Delta region and the Pearl River Delta region, and the range enlarged from the east of China to inner provinces and even the west of China across the five epidemics. The temporal clusters of the five epidemics were statistically significant, and the peak period was from the end of January to April with the first and the fifth epidemic later than the mean peak period. Conclusions Spatial and temporal clusters of avian influenza A (H7N9) virus in humans are obvious, moreover the regions existing clusters may enlarge across the five epidemics. Yangtze River Delta region and the Pearl River Delta region have the spatial cluster and the peak period is from January to April. The government should facilitate the tangible improvement for the epidemic preparedness according to the characteristics of spatial and temporal clusters of patients with avian influenza A (H7N9) virus.
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Affiliation(s)
- Xuzheng Shan
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China.,Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yongqin Wang
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China
| | - Ruihong Song
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China
| | - Wen Wei
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongxiu Liao
- Transaction Management and Information Department, Panzhihua City Center for Disease Control and Prevention, Panzhihua, Sichuan, China
| | - Huang Huang
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China
| | - Chunqiong Xu
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China
| | - Lvlin Chen
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China
| | - Shiyun Li
- Prevention and Health Section, Affiliated Hospital, Chengdu University, Chengdu, Sichuan, China.
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5
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Wang WH, Erazo EM, Ishcol MRC, Lin CY, Assavalapsakul W, Thitithanyanont A, Wang SF. Virus-induced pathogenesis, vaccine development, and diagnosis of novel H7N9 avian influenza A virus in humans: a systemic literature review. J Int Med Res 2019; 48:300060519845488. [PMID: 31068040 PMCID: PMC7140199 DOI: 10.1177/0300060519845488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
H7N9 avian influenza virus (AIV) caused human infections in 2013 in China.
Phylogenetic analyses indicate that H7N9 AIV is a novel reassortant strain with
pandemic potential. We conducted a systemic review regarding virus-induced
pathogenesis, vaccine development, and diagnosis of H7N9 AIV infection in
humans. We followed PRISMA guidelines and searched PubMed, Web of Science, and
Google Scholar to identify relevant articles published between January 2013 and
December 2018. Pathogenesis data indicated that H7N9 AIV belongs to low
pathogenic avian influenza, which is mostly asymptomatic in avian species;
however, H7N9 induces high mortality in humans. Sporadic human infections have
recently been reported, caused by highly pathogenic avian influenza viruses
detected in poultry. H7N9 AIVs resistant to adamantine and oseltamivir cause
severe human infection by rapidly inducing progressive acute community-acquired
pneumonia, multiorgan dysfunction, and cytokine dysregulation; however,
mechanisms via which the virus induces severe syndromes remain unclear. An H7N9
AIV vaccine is lacking; designs under evaluation include synthesized peptide,
baculovirus-insect system, and virus-like particle vaccines. Molecular diagnosis
of H7N9 AIVs is suggested over conventional assays, for biosafety reasons.
Several advanced or modified diagnostic assays are under investigation and
development. We summarized virus-induced pathogenesis, vaccine development, and
current diagnostic assays in H7N9 AIVs.
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Affiliation(s)
- Wen-Hung Wang
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.,Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung
| | - Esmeralda Merari Erazo
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung
| | - Max R Chang Ishcol
- Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Chih-Yen Lin
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung.,Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung
| | - Wanchai Assavalapsakul
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | | | - Sheng-Fan Wang
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung.,Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung
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6
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Chen E, Wang MH, He F, Sun R, Cheng W, Zee BCY, Lau SYF, Wang X, Chong KC. An increasing trend of rural infections of human influenza A (H7N9) from 2013 to 2017: A retrospective analysis of patient exposure histories in Zhejiang province, China. PLoS One 2018; 13:e0193052. [PMID: 29447278 PMCID: PMC5814046 DOI: 10.1371/journal.pone.0193052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/02/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although investigations have shown that closing live poultry markets (LPMs) is highly effective in controlling human influenza A (H7N9) infections, many of the urban LPMs were shut down, but rural LPMs remained open. This study aimed to compare the proportional changes between urban and rural infections in the Zhejiang province from 2013 to 2017 by analyzing the exposure histories of human cases. METHODS All laboratory-confirmed cases of H7N9 from 2013 (the first wave) to 2017 (the fifth wave) in the Zhejiang province of China were analyzed. Urban and rural infections were defined based on the locations of poultry exposure (direct and indirect) in urban areas (central towns) and rural areas (towns and villages on the outskirts of cities). A Chi-square trend test was used to compare the proportional trend between urban and rural infections over time and logistic regression was used to obtain the odds ratio by years. RESULTS From 2013 to 2017, a statistically significant trend in rural infections was observed (p <0.01). The incremental odds ratio by years of rural infections was 1.59 with 95% confidence intervals of 1.34 to 1.86. Each year, significant increases in the proportion of live poultry transactions in LPMS and poultry processing plants were detected in conjunction with an increased proportion of urban and rural infections. CONCLUSION The empirical evidence indicated a need for heightened infection control measures in rural areas, such as serving rural farms and backyards as active surveillance points for the H7N9 virus. Other potential interventions such as the vaccination of poultry and extending the closure of LPMs to the provincial level require further careful investigations.
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Affiliation(s)
- Enfu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
| | - Maggie H. Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Fan He
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
| | - Riyang Sun
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
| | - Benny C. Y. Zee
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Steven Y. F. Lau
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoxiao Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Binjiang District, Hangzhou, Zhejiang, China
- * E-mail: (KCC); (XW)
| | - Ka Chun Chong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
- * E-mail: (KCC); (XW)
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7
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Wu H, Wang X, Xue M, Xue M, Wu C, Lu Q, Ding Z, Xv X, Lin J. Spatial characteristics and the epidemiology of human infections with avian influenza A(H7N9) virus in five waves from 2013 to 2017 in Zhejiang Province, China. PLoS One 2017; 12:e0180763. [PMID: 28750032 PMCID: PMC5531501 DOI: 10.1371/journal.pone.0180763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/21/2017] [Indexed: 11/18/2022] Open
Abstract
Background The five-wave epidemic of H7N9 in China emerged in the second half of 2016. This study aimed to compare the epidemiological characteristics among the five waves, estimating the possible infected cases and inferring the extent of the possible epidemic in the areas that have not reported cases before. Methods The data for the H7N9 cases from Zhejiang Province between 2013 and 2017 was obtained from the China Information Network System of Disease Prevention and Control. The start date of each wave was 16 March 2013, 1 July 2013, 1 July 2014, 1 July 2015 and 1 July 2016. The F test or Pearson’s chi-square test were used to compare the characteristics of the five waves. Global and local autocorrelation analysis was carried out to identify spatial autocorrelations. Ordinary kriging interpolation was analyzed to estimate the number of human infections with H7N9 virus and to infer the extent of infections in the areas with no cases reported before. Result There were 45, 94, 45, 34 and 80 cases identified from the first wave to the fifth, respectively. The death rate was significantly different among the five waves of epidemics (χ2 = 10.784, P = 0.029). The age distribution (F = 0.903, P = 0.462), gender (χ2 = 2.674, P = 0.614) and occupation(χ2 = 19.764, P = 0.407) were similar in each period. Most of the cases were males and farmers. A significant trend (χ2 = 70.328, P<0.001) was identified that showed a growing proportion of rural cases. There were 31 high-high clusters and 3 high-low clusters at the county level among the five waves and 12, 8, 2, 9 and 3 clusters in each wave, respectively. The total cases infected with the H7N9 virus were far more than those that have been reported now, and the affected areas continue to expand. The epidemic in the north of Zhejiang Province persisted in all five waves. Since the second wave, the virus spread to the south areas and central areas. There was an obvious decline in the infected cases in the urban areas, and the epidemics mostly occurred in the rural areas after the fourth wave. The epidemic was relatively dispersed since the third wave had fewer than two cases in most of the areas and showed a reinforcing trend again in the fifth wave. Conclusions The study revealed that there were few differences in the epidemiologic characteristics among the five waves of the epidemic. However, the areas where the possible epidemic circulated was larger than reported. The epidemic cross-regional expansion continued and mostly occurred in rural areas. Continuous closure of the live poultry market (LPM) is strongly recommended in both rural and urban areas. Illegal and scattered live poultry trading, especially in rural areas, must be forbidden. It is suggested too that a more rigorous management be performed on live poultry trade and wholesale across the area. Health education, surveillance of cases and pathogenicity should also be strengthened.
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Affiliation(s)
- Haocheng Wu
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
- Key Laboratory for Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, Zhejiang Province, China
| | - XinYi Wang
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Ming Xue
- Hangzhou Centre for Disease Control and Prevention, Hangzhou, Zhejiang, Province, China
| | - Melanie Xue
- Kingston University UK, London, United Kingdom
| | - Chen Wu
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Qinbao Lu
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Zheyuan Ding
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Xiaoping Xv
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Junfen Lin
- Zhejiang Province Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
- Key Laboratory for Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, Zhejiang Province, China
- * E-mail:
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8
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Su S, Gu M, Liu D, Cui J, Gao GF, Zhou J, Liu X. Epidemiology, Evolution, and Pathogenesis of H7N9 Influenza Viruses in Five Epidemic Waves since 2013 in China. Trends Microbiol 2017; 25:713-728. [PMID: 28734617 DOI: 10.1016/j.tim.2017.06.008] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 01/30/2023]
Abstract
H7N9 influenza viruses were first isolated in 2013 and continue to cause human infections. H7N9 infections represent an ongoing public health threat that has resulted in 1344 cases with 511 deaths as of April 9, 2017. This highlights the continued threat posed by the current poultry trade and live poultry market system in China. Until now, there have been five H7N9 influenza epidemic waves in China; however, the steep increase in the number of humans infected with H7N9 viruses observed in the fifth wave, beginning in October 2016, the spread into western provinces, and the emergence of highly pathogenic (HP) H7N9 influenza outbreaks in chickens and infection in humans have caused domestic and international concern. In this review, we summarize and compare the different waves of H7N9 regarding their epidemiology, pathogenesis, evolution, and characteristic features, and speculate on factors behind the recent increase in the number of human cases and sudden outbreaks in chickens. The continuous evolution of the virus poses a long-term threat to public health and the poultry industry, and thus it is imperative to strengthen prevention and control strategies.
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Affiliation(s)
- Shuo Su
- Jiangsu Engineering Laboratory of Animal Immunology, Institute of Immunology and College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China
| | - Min Gu
- Animal Infectious Disease Laboratory, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, China
| | - Di Liu
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Jie Cui
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China
| | - George F Gao
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China; National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Jiyong Zhou
- Jiangsu Engineering Laboratory of Animal Immunology, Institute of Immunology and College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China; Key Laboratory of Animal Virology of Ministry of Agriculture, Zhejiang University, Hangzhou 310058, China; Collaborative Innovation Center and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China.
| | - Xiufan Liu
- Animal Infectious Disease Laboratory, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, China; Jiangsu Co-Innovation Center for the Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou, Jiangsu, 225009, China; Jiangsu Research Centre of Engineering and Technology for Prevention and Control of Poultry Disease, Yangzhou, Jiangsu, 225009, China.
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9
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Harris KA, Freidl GS, Munoz OS, von Dobschuetz S, De Nardi M, Wieland B, Koopmans MPG, Stärk KDC, van Reeth K, Dauphin G, Meijer A, de Bruin E, Capua I, Hill AA, Kosmider R, Banks J, Stevens K, van der Werf S, Enouf V, van der Meulen K, Brown IH, Alexander DJ, Breed AC. Epidemiological Risk Factors for Animal Influenza A Viruses Overcoming Species Barriers. ECOHEALTH 2017; 14:342-360. [PMID: 28523412 DOI: 10.1007/s10393-017-1244-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/30/2017] [Accepted: 04/10/2017] [Indexed: 05/21/2023]
Abstract
Drivers and risk factors for Influenza A virus transmission across species barriers are poorly understood, despite the ever present threat to human and animal health potentially on a pandemic scale. Here we review the published evidence for epidemiological risk factors associated with influenza viruses transmitting between animal species and from animals to humans. A total of 39 papers were found with evidence of epidemiological risk factors for influenza virus transmission from animals to humans; 18 of which had some statistical measure associated with the transmission of a virus. Circumstantial or observational evidence of risk factors for transmission between animal species was found in 21 papers, including proximity to infected animals, ingestion of infected material and potential association with a species known to carry influenza virus. Only three publications were found which presented a statistical measure of an epidemiological risk factor for the transmission of influenza between animal species. This review has identified a significant gap in knowledge regarding epidemiological risk factors for the transmission of influenza viruses between animal species.
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Affiliation(s)
- Kate A Harris
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Gudrun S Freidl
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Olga S Munoz
- OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human-Animal Interface, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Padua, Italy
- One Health Center of Excellence, Emerging Pathogens Institute and Institute of Food and Agricultural Sciences-Department of Animal Sciences, University of Florida, 32611, Gainesville, FL, USA
| | - Sophie von Dobschuetz
- Royal Veterinary College (RVC), London, UK
- Food and Agricultural Organization of the United Nations (FAO), Rome, Italy
| | - Marco De Nardi
- OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human-Animal Interface, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Padua, Italy
- SAFOSO AG, Liebefeld, Switzerland
| | - Barbara Wieland
- International Livestock Research Institute ILRI, Box 5689, Addis Ababa, Ethiopia
| | - Marion P G Koopmans
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Kristien van Reeth
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Gwen Dauphin
- Food and Agricultural Organization of the United Nations (FAO), Rome, Italy
| | - Adam Meijer
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Erwin de Bruin
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ilaria Capua
- OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human-Animal Interface, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Padua, Italy
- One Health Center of Excellence, Emerging Pathogens Institute and Institute of Food and Agricultural Sciences-Department of Animal Sciences, University of Florida, 32611, Gainesville, FL, USA
| | - Andy A Hill
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
- Royal Veterinary College (RVC), London, UK
- BAE Systems, Farnborough, UK
| | - Rowena Kosmider
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Jill Banks
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | | | | | | | - Karen van der Meulen
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Ian H Brown
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Dennis J Alexander
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Andrew C Breed
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK.
- Epidemiology and One Health Section, Department of Water Resources, Canberra, Australia.
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10
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Yu Z, Sun W, Zhang X, Cheng K, Zhao C, Gao Y, Xia X. Multiple amino acid substitutions involved in the virulence enhancement of an H3N2 avian influenza A virus isolated from wild waterfowl in mice. Vet Microbiol 2017; 207:36-43. [PMID: 28757037 DOI: 10.1016/j.vetmic.2017.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/23/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
Abstract
Frequent emergence of low pathogenic avian influenza H3N2 viruses in the wild birds has caused concern for human health. Here, we generated mouse-adapted strains of a wild waterfowl-origin low pathogenic avian influenza H3N2 virus to identify adaptive mutations that confer enhanced virulence in mammals. The mouse lethal doses (MLD50) of the adapted strains were reduced >562-fold compared to the parental virus. Mouse-adapted strains displayed enhanced replication in vitro and in vivo, and acquired the ability to replicate in extrapulmonary tissues. These observations suggest that enhanced growth characteristics and modified cell tropism may increase the virulence of H3N2 AIVs in mice. Genomic analysis revealed mutations in the PB2 (E192K and D701N), PB1 (F269S, I475V, and L598P), HA (V242E), NA (G170R), and M1 (M192V) proteins. Our results suggest that these amino acid substitutions collaboratively enhance the ability of H3N2 avian influenza A virus to replicate and cause severe disease in mammals.
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Affiliation(s)
- Zhijun Yu
- Institute of Poultry Science, Shandong Academy of Agricultural Sciences, Jinan, 250023, China.
| | - Weiyang Sun
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Research Institute, Academy of Military Medical Sciences, Changchun, 130122, China
| | - Xinghai Zhang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Research Institute, Academy of Military Medical Sciences, Changchun, 130122, China
| | - Kaihui Cheng
- Dairy Cattle Research Center, Shandong Academy of Agricultural Sciences, Jinan, 250132, China
| | - Chuqi Zhao
- Department of Animal Science, Agricultural College, Yanbian University, Yanji, 133002, China
| | - Yuwei Gao
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Research Institute, Academy of Military Medical Sciences, Changchun, 130122, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China.
| | - Xianzhu Xia
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Research Institute, Academy of Military Medical Sciences, Changchun, 130122, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China.
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11
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Comparison of Influenza Epidemiological and Virological Characteristics between Outpatients and Inpatients in Zhejiang Province, China, March 2011-June 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020217. [PMID: 28241447 PMCID: PMC5334771 DOI: 10.3390/ijerph14020217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/17/2017] [Accepted: 02/19/2017] [Indexed: 11/18/2022]
Abstract
Given the rapid rate of global spread and consequently healthcare costs related to influenza, surveillance plays an important role in monitoring the emerging pandemics in China. However, the characteristics of influenza in Southeast of China haven’t been fully studied. Our study use the surveillance data collected from 16 sentinel hospitals across Zhejiang Province during March 2011 through June 2015, including the demographic information and respiratory specimens from influenza-like illness (ILI) patients and severe acute respiratory illness (SARI) patients. As analysis results, most SARI and ILI patients were in the age group of 0–4 years old (62.38% of ILI and 71.54% of SARI). The respiratory specimens have statistically significantly higher positive rate for influenza among ILI patients than that among SARI patients (p < 0.001). The comparison between ILI patients and SARI patients shows no statistically significantly difference in detecting influenza virus type and influenza A virus subtype. The SARI and ILI patients were found to be positively correlated for overall positive rate (r = 0.63, p < 0.001), the weekly percentage of A(H1N1)pdm09 (r = 0.51, p < 0.001), influenza B virus (r = 0.17, p = 0.013), and A/H3N2 (r = 0.43, p < 0.001) among all the positive numbers. Our study demonstrated that the activities of influenza virus, including its subtypes, had a similar temporal pattern between ILI and SARI cases.
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Ge E, Zhang R, Li D, Wei X, Wang X, Lai PC. Estimating Risks of Inapparent Avian Exposure for Human Infection: Avian Influenza Virus A (H7N9) in Zhejiang Province, China. Sci Rep 2017; 7:40016. [PMID: 28054599 PMCID: PMC5214706 DOI: 10.1038/srep40016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 11/09/2016] [Indexed: 11/09/2022] Open
Abstract
Inapparent avian exposure was suspected for the sporadic infection of avian influenza A(H7N9) occurring in China. This type of exposure is usually unnoticed and difficult to model and measure. Infected poultry with avian influenza H7N9 virus typically remains asymptomatic, which may facilitate infection through inapparent poultry/bird exposure, especially in a country with widespread practice of backyard poultry. The present study proposed a novel approach that integrated ecological and case-control methods to quantify the risk of inapparent avian exposure on human H7N9 infection. Significant associations of the infection with chicken and goose densities, but not with duck density, were identified after adjusting for spatial clustering effects of the H7N9 cases across multiple geographic scales of neighborhood, community, district and city levels. These exposure risks varied geographically in association with proximity to rivers and lakes that were also proxies for inapparent exposure to avian-related environment. Males, elderly people, and farmers were high-risk subgroups for the virus infection. These findings enable health officials to target educational programs and awareness training in specific locations to reduce the risks of inapparent exposure.
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Affiliation(s)
- Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Renjie Zhang
- Zhejiang Provincial Center for Disease Prevention &Control, Hangzhou, P.R. China
| | - Dengkui Li
- School of Mathematics &Statistics, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Xiaolin Wei
- Division of Clinical Public Health and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Xiaomeng Wang
- Zhejiang Provincial Center for Disease Prevention &Control, Hangzhou, P.R. China
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13
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Huo X, Chen LL, Hong L, Xiang LH, Tang FY, Chen SH, Gao Q, Chen C, Dai QG, Sun CW, Xu K, Dai WJ, Qi X, Li CC, Yu HY, Zhou Y, Huang HD, Pan XY, Xu CS, Zhou MH, Bao CJ. Economic burden and its associated factors of hospitalized patients infected with A (H7N9) virus: a retrospective study in Eastern China, 2013-2014. Infect Dis Poverty 2016; 5:79. [PMID: 27580946 PMCID: PMC5007809 DOI: 10.1186/s40249-016-0170-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND H7N9 continues to cause human infections and remains a pandemic concern. Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation, including infectious disease prevention and control investment. However, there are limited data on such impacts. METHODS Hospitalized laboratory-confirmed H7N9 patients or their families in Jiangsu Province of China were interviewed. Patients' direct medical costs of hospitalization were derived from their hospital bills. A generalized linear model was employed to estimate the mean direct medical costs of patients with different characteristics. RESULTS The mean direct cost of hospitalization for H7N9 was estimated to be ¥ 71 060 (95 % CI, 48 180-104 820), i.e., US$ 10 996 (95 % CI, 7 455-16 220), and was ¥12 060 (US$ 1 861), ¥136 120 (US$ 21 001) and ¥218 610 (US$ 33 728) for those who had mild or severe symptoms or who died, respectively. The principal components of the total fees differed among patients with different disease severity, although medication fees were always the largest contributors. Disease severity, proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient's direct medical cost of hospitalization. CONCLUSIONS The direct medical costs of hospitalized patients with H7N9 are significant, and far surpass the annual per capita income of Jiangsu Province, China. The influencing factors identified should be taken into account when developing related health insurance policies and making health resource allocation. TRIAL REGISTRATION Not applicable. This is a survey study with no health care intervention implemented on human participants.
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Affiliation(s)
- Xiang Huo
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Li-Ling Chen
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Lei Hong
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Lun-Hui Xiang
- Baoshan District Center for Disease Control and Prevention, Shanghai, China
| | - Fen-Yang Tang
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Shan-Hui Chen
- Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Qiang Gao
- Huaian Center for Disease Control and Prevention, Huaian, China
| | - Cong Chen
- Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Qi-Gang Dai
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Chuan-Wu Sun
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Ke Xu
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Wen-Jun Dai
- Taizhou Center for Disease Control and Prevention, Taizhou, China
| | - Xian Qi
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Chang-Cheng Li
- Yancheng Center for Disease Control and Prevention, Yancheng, China
| | - Hui-Yan Yu
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Yin Zhou
- Zhenjiang Center for Disease Prevention and Control, Zhenjiang, China
| | - Hao-Di Huang
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Xing-Yang Pan
- Yangzhou Center for Disease Control and Prevention, Yangzhou, China
| | - Chang-Sha Xu
- Suqian Municipal Center for Disease Control and Prevention, Suqian, China
| | - Ming-Hao Zhou
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China
| | - Chang-Jun Bao
- Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
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14
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Liu S, Sha J, Yu Z, Hu Y, Chan TC, Wang X, Pan H, Cheng W, Mao S, Zhang RJ, Chen E. Avian influenza virus in pregnancy. Rev Med Virol 2016; 26:268-84. [PMID: 27187752 DOI: 10.1002/rmv.1884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/19/2016] [Accepted: 03/29/2016] [Indexed: 12/19/2022]
Abstract
The unprecedented epizootic of avian influenza viruses, such as H5N1, H5N6, H7N1 and H10N8, has continued to cause disease in humans in recent years. In 2013, another novel influenza A (H7N9) virus emerged in China, and 30% of those patients died. Pregnant women are particularly susceptible to avian influenza and are more likely to develop severe complications and to die, especially when infection occurs in the middle and late trimesters. Viremia is believed to occur infrequently, and thus vertical transmission induced by avian influenza appears to be rare. However, avian influenza increases the risk of adverse pregnancy outcomes, including spontaneous abortion, preterm birth and fatal distress. This review summarises 39 cases of pregnant women and their fetuses from different countries dating back to 1997, including 11, 15 and 13 infections with H7N9, H5N1 and the 2009 pandemic influenza (H1N1), respectively. We analysed the epidemic features, following the geographical, population and pregnancy trimester distributions; underlying diseases; exposure history; medical timelines; human-to-human transmission; pathogenicity and vertical transmission; antivirus treatments; maternal severity and mortality and pregnancy outcome. The common experiences reported in different countries and areas suggest that early identification and treatment are imperative. In the future, vigilant virologic and epidemiologic surveillance systems should be developed to monitor avian influenza viruses during pregnancy. Furthermore, extensive study on the immune mechanisms should be conducted, as this will guide safe, rational immunomodulatory treatment among this high-risk population. Most importantly, we should develop a universal avian influenza virus vaccine to prevent outbreaks of the different subtypes. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Jianping Sha
- Department of Endocrinology, The 421 Hospital of Chinese People's Liberation Army, Guangzhou, China
| | - Zhao Yu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Yan Hu
- Department of Endocrinology, The 421 Hospital of Chinese People's Liberation Army, Guangzhou, China
| | - Ta-Chien Chan
- Centre for Geographic Information Science, Research Centre for Humanities and Social Science, Academia Sinica, Taipei, Taiwan
| | - Xiaoxiao Wang
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Hao Pan
- Department of Infectious Diseases, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Wei Cheng
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Shenghua Mao
- Department of Infectious Diseases, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Run Ju Zhang
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Enfu Chen
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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15
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Mammalian Pathogenesis and Transmission of H7N9 Influenza Viruses from Three Waves, 2013-2015. J Virol 2016; 90:4647-4657. [PMID: 26912620 DOI: 10.1128/jvi.00134-16] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 02/18/2016] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Three waves of human infection with H7N9 influenza viruses have concluded to date, but only viruses within the first wave (isolated between March and September 2013) have been extensively studied in mammalian models. While second- and third-wave viruses remain closely linked phylogenetically and antigenically, even subtle molecular changes can impart critical shifts in mammalian virulence. To determine if H7N9 viruses isolated from humans during 2013 to 2015 have maintained the phenotype first identified among 2013 isolates, we assessed the ability of first-, second-, and third-wave H7N9 viruses isolated from humans to cause disease in mice and ferrets and to transmit among ferrets. Similar to first-wave viruses, H7N9 viruses from 2013 to 2015 were highly infectious in mice, with lethality comparable to that of the well-studied A/Anhui/1/2013 virus. Second- and third-wave viruses caused moderate disease in ferrets, transmitted efficiently to cohoused, naive contact animals, and demonstrated limited transmissibility by respiratory droplets. All H7N9 viruses replicated efficiently in human bronchial epithelial cells, with subtle changes in pH fusion threshold identified between H7N9 viruses examined. Our results indicate that despite increased genetic diversity and geographical distribution since their initial detection in 2013, H7N9 viruses have maintained a pathogenic phenotype in mammals and continue to represent an immediate threat to public health. IMPORTANCE H7N9 influenza viruses, first isolated in 2013, continue to cause human infection and represent an ongoing public health threat. Now entering the fourth wave of human infection, H7N9 viruses continue to exhibit genetic diversity in avian hosts, necessitating continuous efforts to monitor their pandemic potential. However, viruses isolated post-2013 have not been extensively studied, limiting our understanding of potential changes in virus-host adaptation. In order to ensure that current research with first-wave H7N9 viruses still pertains to more recently isolated strains, we compared the relative virulence and transmissibility of H7N9 viruses isolated during the second and third waves, through 2015, in the mouse and ferret models. Our finding that second- and third-wave viruses generally exhibit disease in mammals comparable to that of first-wave viruses strengthens our ability to extrapolate research from the 2013 viruses to current public health efforts. These data further contribute to our understanding of molecular determinants of pathogenicity, transmissibility, and tropism.
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16
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Zhu H, Lam TTY, Smith DK, Guan Y. Emergence and development of H7N9 influenza viruses in China. Curr Opin Virol 2016; 16:106-113. [PMID: 26922715 DOI: 10.1016/j.coviro.2016.01.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/27/2016] [Indexed: 02/05/2023]
Abstract
The occurrence of human infections with avian H7N9 viruses since 2013 demonstrates the continuing pandemic threat posed by the current influenza ecosystem in China. Influenza surveillance and phylogenetic analyses showed that these viruses were generated by multiple interspecies transmissions and reassortments among the viruses resident in domestic ducks and the H9N2 viruses enzootic in chickens. A large population of domestic ducks hosting diverse influenza viruses provided the precondition for these events to occur, while acquiring internal genes from enzootic H9N2 influenza viruses in chickens promoted the spread of these viruses. Human infections effectively act as sentinels, reflecting the intensity of the activity of these viruses in poultry.
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Affiliation(s)
- Huachen Zhu
- Joint Influenza Research Centre (SUMC/HKU), Shantou University Medical College, Shantou 515041, China; State Key Laboratory of Emerging Infectious Diseases (HKU-Shenzhen Branch), Shenzhen Third People's Hospital, Shenzhen 518112, China; Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Tommy Tsan-Yuk Lam
- Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - David Keith Smith
- Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yi Guan
- Joint Influenza Research Centre (SUMC/HKU), Shantou University Medical College, Shantou 515041, China; State Key Laboratory of Emerging Infectious Diseases (HKU-Shenzhen Branch), Shenzhen Third People's Hospital, Shenzhen 518112, China; Centre of Influenza Research, School of Public Health, The University of Hong Kong, Hong Kong, China
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17
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Interpreting the transmissibility of the avian influenza A(H7N9) infection from 2013 to 2015 in Zhejiang Province, China. Epidemiol Infect 2015; 144:1584-91. [PMID: 26645357 PMCID: PMC4855998 DOI: 10.1017/s0950268815002812] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Three epidemic waves of human influenza A(H7N9) were documented in several different provinces in China between 2013 and 2015. With limited understanding of the potential for human-to-human transmission, it was difficult to implement control measures efficiently or to inform the public adequately about the application of interventions. In this study, the human-to-human transmission rate for the epidemics that occurred between 2013 and 2015 in Zhejiang Province, China, was analysed. The reproduction number (R), a key indicator of transmission intensity, was estimated by fitting the number of infections from poultry to humans and from humans to humans into a mathematical model. The posterior mean R for human-to-human transmission was estimated to be 0·27, with a 95% credible interval of 0·14–0·44 for the first wave, whereas the posterior mean Rs decreased to 0·15 in the second and third waves. Overall, these estimates indicate that a human H7N9 pandemic is unlikely to occur in Zhejiang. The reductions in the viral transmissibility and the number of poultry-transmitted infections after the first epidemic may be attributable to the various intervention measures taken, including changes in the extent of closures of live poultry markets.
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18
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Liu B, Wang Z, Qi X, Zhang X, Chen H. Assessing cyber-user awareness of an emerging infectious disease: evidence from human infections with avian influenza A H7N9 in Zhejiang, China. Int J Infect Dis 2015; 40:34-6. [PMID: 26432409 DOI: 10.1016/j.ijid.2015.09.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/19/2015] [Accepted: 09/22/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess cyber-user awareness of human infections with avian influenza A H7N9 in Zhejiang, China. METHODS Daily Baidu index values were compared for different keywords, different periods (epidemic and non-epidemic), different levels of epidemic publicity (whether new cases were publicized), and different cities (divided into high, medium, low, and zero groups according to the number of cases). Furthermore, the correlation between the daily Baidu index values and the daily number of new cases was analyzed. RESULTS Three epidemic periods (periods A/C/E) and three non-epidemic periods (periods B/D/F) were identified from April 2013 to May 2015 according to the curves of daily new cases. Each epidemic period was followed by a non-epidemic period. Baidu index values using 'H7N9' as a keyword were higher than the values using the keyword '' (avian influenza in Chinese) in earlier periods, but the situation reversed in later periods. Index values for 'H7N9' in the epidemic periods were higher than in the non-epidemic periods. In the first epidemic period (period A), the Baidu index values for 'H7N9' showed no difference between the different levels of epidemic publicity and had no correlation with the daily number of new cases. The index values in cities without reported cases showed no difference from the values recorded in the medium and low groups. However, a difference and a correlation were found in a later epidemic period. CONCLUSIONS The Baidu index would be a useful tool for assessing cyber-user awareness of an emerging infectious disease.
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Affiliation(s)
- Biyao Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
| | - Zhen Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaohua Qi
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xingqin Zhang
- West Lake Scenic Area Center for Disease Control and Prevention, Hangzhou, China
| | - Huiping Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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19
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He F, Chen EF, Li FD, Wang XY, Wang XX, Lin JF. Human infection and environmental contamination with Avian Influenza A (H7N9) Virus in Zhejiang Province, China: risk trend across the three waves of infection. BMC Public Health 2015; 15:931. [PMID: 26392274 PMCID: PMC4576372 DOI: 10.1186/s12889-015-2278-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 09/14/2015] [Indexed: 11/24/2022] Open
Abstract
Background The third wave of H7N9 cases in China emerged in the second half of 2014. This study was conducted to identify the risk trends of H7N9 virus in human infections and environment contamination. Methods A surveillance program for H7N9 virus has been conducted in all 90 counties in Zhejiang since March 2013. All H7N9 cases were reported by hospitals through the China Information System for Disease Control and Prevention. Sampling sites for environment specimens were randomly selected by a multi-stage sampling strategy. Poultry-related workers for serological surveillance were randomly selected from the sampling sites for environmental specimens in the first quarter of each year. rRT-PCR and viral isolation were performed to identify H7N9 virus. A hemagglutination inhibition assay was conducted to detect possible H7N9 infection among poultry-related workers. Results A total of 170 H7N9 cases were identified in Zhejiang from 20 March 2013 to 28 February 2015. The proportion of rural cases increased from 42.2 % (19/45) to 67.7 % (21/31) with progression of the three epidemics (P < 0.05). In 32 % (161/503) of towns and 16.0 % (238/1488) of surveyed premises, H7N9 virus was detected in the environment. The positive rate of environmental specimens was 6.1 % (868/14207). In addition, 912 poultry-related workers were recruited and 3.7 % (34) of them tested positive for H7N9 antibodies. Positive detection of H7N9 virus during environmental surveillance increased from the first to third wave (P < 0.05). Almost all positive rates of environmental surveillance were higher in urban than rural in the second wave (P < 0.05), however they were higher in rural area in the third wave (P < 0.05). Conclusions Our study highlights that the severity of poultry-related environmental contamination by H7N9 virus is intensifying. We strongly recommend that the local government stop illegal trading immediately and close live poultry markets in the territory. Poultry operations in slaughtering plants must be supervised rigorously. Prior to the closure of live poultry markets, daily cleaning and disinfecting of areas potentially contaminated by H7N9 virus, centralized collection and disposal of trash, designating certain days as market rest days, banning overnight poultry storage and other measures should be strictly carried out in both urban and rural areas.
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Affiliation(s)
- Fan He
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, People's Republic of China.
| | - En-Fu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, People's Republic of China.
| | - Fu-Dong Li
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, People's Republic of China.
| | - Xin-Yi Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, People's Republic of China.
| | - Xiao-Xiao Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, People's Republic of China.
| | - Jun-Fen Lin
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, People's Republic of China.
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20
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Surveillance of Avian H7N9 Virus in Various Environments of Zhejiang Province, China before and after Live Poultry Markets Were Closed in 2013-2014. PLoS One 2015; 10:e0135718. [PMID: 26308215 PMCID: PMC4550274 DOI: 10.1371/journal.pone.0135718] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 07/24/2015] [Indexed: 11/19/2022] Open
Abstract
Background To date, there have been a total of 637 laboratory-confirmed cases of human infection with avian influenza A (H7N9) virus across mainland China, with 28% (179/637) of these reported in Zhejiang Province. Surveillance of avian H7N9 virus was conducted to investigate environmental contamination during H7N9 outbreaks. We sought to evaluate the prevalence of H7N9 in the environment, and the effects of poultry market closures on the incidence of human H7N9 cases. Methods We collected 6740 environmental samples from 751 sampling sites across 11 cities of Zhejiang Province (China) between January 2013 and March 2014. The presence of H7N9 was determined by reverse transcription polymerase chain reaction, with prevalence compared between sites and over time. The relationship between environmental contamination and human cases of H7N9 infection were analyzed using Spearman’s ranked correlation coefficient. Results Of the 6740 samples, 10.09% (680/6740) were H7N9-positive. The virus was found to circulate seasonally, and peaked during the spring and winter of 2013–2014. The prevalence of the virus decreased from the north to the southeast of the province, coinciding with the geographical distribution of human H7N9 cases. Compared with other sampling sites, live poultry markets (LPMs) had the highest prevalence of H7N9 virus at 13.94% (667/4784). Of the various sample types analyzed, virus prevalence was highest for chopping board swabs at 15.49% (110/710). The prevalence of the virus in the environment positively correlated with the incidence of human H7N9 cases (r2 = 0.498; P < 0.01). Cities with a higher incidence of human H7N9 cases also had a higher prevalence of H7N9 among samples and at sampling sites. Following the closure of LPMs at the end of January 2014, the prevalence of H7N9 decreased from 19.18% (487/2539) to 6.92% (79/1141). This corresponded with a decrease in the number of human H7N9 cases reported. Conclusions The prevalence of H7N9 virus in environmental samples oscillated seasonally, regardless of whether LPMs were open. The presence of H7N9 in environmental samples positively correlated with the number of human H7N9 cases, indicating that eradication of the virus from the environment is essential in reducing the numbers of H7N9 cases and halting the spread of the virus.
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Hoffmann J, Otte A, Thiele S, Lotter H, Shu Y, Gabriel G. Sex differences in H7N9 influenza A virus pathogenesis. Vaccine 2015; 33:6949-54. [PMID: 26319064 DOI: 10.1016/j.vaccine.2015.08.044] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Abstract
Sex, gender and age have an impact on incidence and severity of several infectious diseases. Here, we analyzed reported human cases of avian H7N9 influenza A virus infections for potential sex-dependent incidence and mortality. We report that females in their reproductive years display an increased tendency to die of H7N9 influenza than males (female-to-male ratio=1.2). Next, we challenged this potential sex-dependent difference in influenza disease outcome using a mouse infection model. In general, female mice underwent more severe disease than male mice upon infection with various influenza A virus subtypes, such as H7N9, 2009 pH1N1 and H3N2. However, morbidity and mortality were most significantly affected in H7N9 influenza virus infected female mice associated with an increased inflammatory host response. Thus, our mouse infection model described here might assist future investigations on the underlying mechanisms of sex-dependent disease outcome upon zoonotic H7N9 influenza virus infection. Moreover, our findings might help to guide patient management strategies and current vaccine recommendations.
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Affiliation(s)
- Julia Hoffmann
- Viral Zoonosis and Adaptation, Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Anna Otte
- Viral Zoonosis and Adaptation, Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Swantje Thiele
- Viral Zoonosis and Adaptation, Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Hannelore Lotter
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Yuelong Shu
- Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Gülsah Gabriel
- Viral Zoonosis and Adaptation, Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany; Center for Structural and Cell Biology in Medicine, University of Lübeck, Lübeck, Germany.
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