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Volume 19, Number 7—July 2013

Dispatch

Clinical Findings for Early Human Cases of Influenza A(H7N9) Virus Infection, Shanghai, China

Shuihua Lu1Comments to Author , Yufang Zheng1, Tao Li1, Yunwen Hu1, Xinian Liu, Xiuhong Xi, Qingguo Chen, Qingle Wang, Ye Cao, Yanbing Wang, Lijun Zhou, Douglas Lowrie, and Jing Bao
Author affiliations: Shanghai Public Health Clinical Center, Shanghai, China (S. Lu, Y. Zheng, T. Li, Y. Hu, X. Liu, X. Xi, Q. Chen, Q. Wang, Y. Cao, Y. Wang, L. Zhou, D. Lowrie); Henry M Jackson Foundation–Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA (J. Bao)

Main Article

Table 1

Clinical characteristics and treatment outcomes for 4 patients with early cases of influenza A(H7N9) virus infection, Shanghai, China*

Characteristic/treatment Case-patient no.
1 2 3 4
Age, y/sex 73/M 65/M 67/M 58/M
Occupation Farmer Retiree Retiree Retiree
Location (district) in Shanghai Fengxian Baoshan Songjiang Pudong
Disease history Coronary heart disease; chronic hepatic schistosomiasis Hypertension; articular gout; benign prostatic hyperplasia None Hypertension
History of poultry exposure At home At live poultry markets At live poultry markets At live poultry markets
Date of last visit to live poultry market NA 2013 Mar 29 2013 Mar 28 2013 Mar 19
Date of symptom onset 2013 Mar 31 2013 Apr 1 2013 March 30 2013 Mar 20
Date of infection confirmation 2013 Apr 6 2013 Apr 6 2013 Apr 7 2013 Apr 7
Date admitted to SHPHCC 2013 Apr 6 2013 Apr 6 2013 Apr 7 2013 Apr 7
Clinical symptoms present when admitted SHPHCC 6 d of fever (maximum temperature 39.3°C) and shortness of breath 6 d of fever (maximum temperature 39.3°C), and 2 d of cough 8 d of fever (maximum temperature 39.7°C) and cough 18 d of cough, 10 d of fever (maximum temperature 39.7°C), and 5 d with shortness of breath
Chest radiograph or CT findings Bilateral GGO Bilateral GGO GGO in left lingular lobe and left inferior lobe Extensive infiltrates, with pleural effusion, in lung (bilateral)
Antiviral drug treatment Oseltamivir (150 mg/bid) on days 7–12 of illness Oseltamivir (75 mg/bid) on days 4–17 of illness Oseltamivir (75 mg/bid) on days 6–21 of illness Oseltamivir (75 mg/bid) on days 16–23 of illness; oseltamivir (150 mg/bid) on days 17–32 of illness
Antibacterial drug treatment Moxifloxacin on days 7–12 of illness Ceftriaxone on days 4–5 of illness; moxifloxacin on days 6–17 of illness Azithromycin on days 5–9 of illness; cefaclor on days 1–5 of illness; moxifloxacin on days 14–21 of illness Moxifloxacin on days 18–21 of illness; piperacillin and tazobactam on days 18–21 of illness; meropenem on days 21–34 of illness; linezolid on days 25–32 of illness
Glucocorticoid treatment Methylprednisolone (40 mg/d) on days 7–12 of illness No Methylprednisolone (40 mg/d) on days 5–12 of illness Methylprednisolone (40 mg/bid) on days 16–37 of illness
Immunoglobulin treatment Yes, on days 7–12 of illness Yes, on days 6–12 of illness Yes, on days 5–8 of illness Yes, on days 16–37 of illness
ECMO treatment No No No On day 25 of illness
Oxygen use Noninvasive ventilation on days 6–12 of illness Oxygen inhalation through nasal tube on days 4–17 of illness Oxygen inhalation through nasal tube on days 7-20 of illness Noninvasive ventilation on days 17–19 of illness
Endotracheal intubation and mechanical ventilation Yes, on day 12 of illness No No Yes, on days 19–32 of illness
Status as of 2013 Apr 21 Died on day 12 of illness Recovered, discharged on day 18 after illness onset Recovered, discharged on day 21 after illness onset Condition worsened, receiving invasive breath machine and ECMO treatment

*NA, not applicable; SHPHCC, Shanghai Public Health Clinical Center; CT, computed tomography scan; GGO, ground-glass opacity; bid, 2 times a day; ECMO, extracorporeal membrane oxygenation.

Main Article

1These authors contributed equally to this article.

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