Volume 19, Number 7—July 2013
Avian Influenza A(H7N9) Virus Infections, Shanghai, China
|Exposure to poultry||None||Continuous||None||None|
|Sign or symptom at admission||Fever (40.6°C) for 7 d, cough for 1 d, difficulty breathing starting 7 d after illness onset||Fever (39.8°C) for 3 d, cough for 5 d, difficulty breathing and cyanosis starting 5 d after illness onset||Fever (39.7°C) and cough for 7 d starting 7 d after illness onset||Fever (39.0°C) for 5 d, cough for 2 d starting 5 d after illness onset|
|Physical examination results||HR 120 bpm, RR 40 breaths/min, BP 140/75 mm Hg, decreased breath sounds, no rales||RR 40 breaths/min, BP 240/160 mm Hg, diffuse moist rales||HR 100 bpm, RR 30 breaths/min, BP 110/78 mm Hg, moist rales mainly in left lung||HR 82 bpm, RR 21 breaths/min, BP 118/74 mm Hg, decreased breath sounds in lower left lung, no rales|
|Leukocyte count, ×109/L||3.29||2.9||2.89||3.74|
|Platelet count, ×109/L||155||71||172||82|
|Medications after hospitalization|
|Oseltamivir||Started d 13 after illness onset||None||Started d 11 after illness onset||Started d 10 after illness onset|
|Antimicrobial drugs||MOX started d 13 after illness onset||MOX started d 10 after illness onset||AZT started d 11 after illness onset, MOX started d 15 after illness onset||CEF started d 11–12 after illness onset, MOX started d 13 after illness onset|
|Corticosteroids||MEP, 80 mg/d started d 14 after illness onset||MEP, 80 mg/d started d 10 after illness onset||MEP, 80 mg/d started d 11 after illness onset, decreased to 40 mg/d, stopped after 1 wk||None|
|Immunoglobulin||Started d 13 after illness onset||None||Given d 11–15 after illness onset||None|
|Other conditions||Diabetes mellitus, surgery for thyroid cancer||Obesity||None||Hypertension|
|Outcome||Died 14 d after illness onset||Died 10 d after illness onset||Discharged 30 d after illness onset||Discharged 27 d after illness onset|
*HR, heart rate; RR, respiratory rate; BP, blood pressure, AST, aspartate aminotransferase; LDH, lactate dehydrogenase; CPK, creatine phosphokinase; CK-MB, creatine kinase isoenzyme MB; MOX, moxifloxacin; AZT, azithromycin; CEF, ceftriaxone; MEP, methylprednisolone.
†Data for patient 1 were reported by Yang et al. (3) and are included for comparison.
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- World Health Organization. Human infection with influenza A (H7N9) virus in China [cited 2013 Apr 22]. ww.who.int/csr/don/2013_04_19/en/index.html
- Yang F, Wang J, Jiang L, Jin JL, Shao LY, Zhang Y, A fatal case caused by novel H7N9 avian influenza A virus in China. Emerging Microbes and Infections. 2013;2:e19 .
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- World Health Organization. Avian influenza: assessing the pandemic threat, 2005, Table 3, Documented human infections with avian influenza viruses [cited 2013 Apr 22]. www.who.int/influenza/resources/documents/h5n1_assessing_pandemic_threat/en
- Van Kerkhove MD, Vandemaele KA, Shinde V, Jaramillo-Gutierrez G, Koukounari A, Donnelly CA, Risk factors for severe outcomes following 2009 influenza A (H1N1) infection: a global pooled analysis. PLoS Med. 2011;8:e1001053.
1These authors contributed equally to this article.