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Volume 22, Number 4—April 2016
Synopsis

Nosocomial Co-Transmission of Avian Influenza A(H7N9) and A(H1N1)pdm09 Viruses between 2 Patients with Hematologic Disorders

Huazhong Chen1, Shelan Liu1, Jun Liu1, Chengliang Chai, Haiyan Mao, Zhao Yu, Yuming Tang, Geqin Zhu, Haixiao X. Chen, Chengchu Zhu, Hui Shao, Shuguang Tan, Qianli Wang, Yuhai Bi, Zhen Zou, Guang Liu, Tao Jin, Chengyu Jiang, George F. Gao, Myoung-don Oh2, Sheng Wei2Comments to Author , and Enfu Chen2Comments to Author 
Author affiliations: Taizhou Hospital, Wenzhou Medical College, Taizhou, China (H. Chen, H.X. Chen, C. Zhu, H. Shao); Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China (S. Liu, C. Chai, H. Mao, Z. Yu, E. Chen); National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (J. Liu, G.F. Gao); Linhai District Center for Disease Control and Prevention, Taizhou (Y. Tang); Jiaojiang District Center for Disease Control and Prevention, Taizhou (G. Zhu); Institute of Microbiology, Chinese Academy of Sciences, Beijing (S. Tan, Q. Wang, Y. Bi, G.F. Gao); Chinese Academy of Medical Sciences, Beijing (Z. Zou, C. Jiang); University of Chinese Academy of Sciences, Beijing (G. Liu); BGI-Shenzhen, Shenzhen, China (G. Liu, T. Jin); University of Hong Kong, Hong Kong, China (M. Peiris); Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing (H. Yu)

Main Article

Table 1

Selected characteristics of 5 patients who shared the same hematology ward at Taizhou Hospital, Zhejiang Province, China, January 2014*

Characteristic Index case-patient Case-patient 2 Patient 3 Patient 4 Patient 5
Demographics and medical history
Age, y 57 71 78 50 61
Sex M M M M M
Type of residence Rural Urban Urban Rural Rural
Occupation Farmer Retiree Retiree Farmer Farmer
History of smoking No Yes No No No
History of alcohol use No No No No No
Obesity No No No No No
Underlying conditions Chronic lymphocytic leukemia; hernia operation Polycythemia vera; cerebral infarction; diabetes B cell lymphocytic leukemia; hypertension Acute myeloid leukemia (M2a) Macroglobulinemia; gout; kidney stone
Chronic drug use No Yes Yes Yes Yes
No. family members
 5
 3
 6
 4
 5
Exposure history
Birds, other animals at home Yes No No Yes No
Visited an LPM Yes No No Yes No
Exposure to a febrile person No Yes Yes Yes Yes
Duration of exposure, d (source) — 5 (index patient) 5 (index patient); 11 (patient 2) 4 (patient 2) 3 (patient 2)
Specimen collection date (type) Jan 19 (throat swab
and serum) Jan 21 (throat swab and serum) Jan 26
(Serum) Jan 20
(throat swab); Jan 26 (serum) Jan 20 (throat swab); Jan 26 (serum)
Diagnostic method Virus isolation;
rRT-PCR; HI Virus isolation;
rRT-PCR;HI HI rRT-PCR;HI rRT-PCR;HI
Date of confirmation Jan 19 Jan 21 NA (negative) NA (negative) NA (negative)
Laboratory results
 H7N9 and
pH1N1 positive
 H7N9 and
pH1N1 positive
 Negative
 Negative
 Negative
Clinical features
Exposure to onset, d 1 4 NA NA NA
Onset to admission, d 2 6 NA NA NA
Onset to ICU, d 7 5 NA NA NA
Onset to antiviral drugs, d 10 6 NA NA NA
Onset to death, d 15 10 NA NA NA
Days in hospital 13 16 23 9 5
Date of outcome Jan 23 Jan 24 Jan 17 Jan 23 Jan 22
Outcome Died Died Survived Survived Survived

*H7N9, avian influenza A(H7N9) virus; HI, hemagglutination inhibition; ICU, intensive care unit; LPM, live poultry market; NA, not available; pH1N1, influenza A(H1N1)pdm09 virus; rRT-PCR, real-time reverse transcription PCR.

Main Article

1These authors contributed equally to this article.

2These authors contributed equally to this article.

Page created: March 15, 2016
Page updated: March 15, 2016
Page reviewed: March 15, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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