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Volume 28, Number 7—July 2022
Research

Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China

Wenfei Zhu1, Xiyan Li1, Jie Dong1, Hong Bo, Jia Liu, Jiaying Yang, Ye Zhang, Hejiang Wei, Weijuan Huang, Xiang Zhao, Tao Chen, Jing Yang, Zi Li, Xiaoxu Zeng, Chao Li, Jing Tang, Li Xin, Rongbao Gao, Liqi Liu, Min Tan, Yuelong Shu, Lei YangComments to Author , and Dayan WangComments to Author 
Author affiliations: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (W. Zhu, X. Li, J. Dong, H. Bo, J. Liu, Jiaying Yang, Y. Zhang, H. Wei, W. Huang, X. Zhao, T. Chen, Jing Yang, Z. Li, X. Zeng, C. Li. J. Tang, L. Xin, R. Gao, L. Liu, M. Tan, Y. Shu, L. Yang, D. Wang); Chinese Center for Disease Control and Prevention, Beijing (C. Li); World Health Organization Collaborating Centre for Reference and Research on Influenza, Beijing (W. Zhu, X. Li, J. Dong, H. Bo, J. Liu, Jiaying Yang, Y. Zhang, H. Wei, W. Huang, X. Zhao, T. Chen, Jing Yang, Z. Li, X. Zeng, J. Tang, L. Xin, R. Gao, L. Liu, M. Tan, Y. Shu, L. Yang, D. Wang); Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing (W. Zhu, X. Li, J. Dong, H. Bo, J. Liu, Jiaying Yang, Y. Zhang, H. Wei, W. Huang, X. Zhao, T. Chen, Jing Yang, Z. Li, X. Zeng, J. Tang, L. Xin, R. Gao, L. Liu, M. Tan, Y. Shu, L. Yang, D. Wang); Sun Yat-sen University, Guangzhou, China (Jiaying Yang, Y. Shu)

Main Article

Table 4

Mammalian adaptation–related molecular markers of the human and nonhuman A(H5N6) viruses, China

Protein Biologic effect Mutations Amino acids Human viruses Nonhuman viruses
HA*
 Altered receptor specificity T192I T 22 1,238
A 2 24
I 18 36
K 0 2
Altered receptor specificity Q226L Q 39 1,302
L 2 0
Q\R 1 0
Altered receptor specificity S2227N/R S 6 136
G 3 31
H 1 2
H/R 2 0
Q 0 92
R 30 1,036
C 0 4
Altered receptor specificity
 G228S
 G
 42
 1,302
NA†
 Reduced susceptibility to neuraminidase inhibitors
 E119V/A/D
 E 41 1,253
D 1 34
G
 0
 1
M2
 Reduced susceptibility to amantadine V27A V 41 1,154
A 1 20
G 0 9
I 0 15
Reduced susceptibility to amantadine A30V/T/S A 41 1,197
A/T 1 0
S 0 1
Reduced susceptibility to amantadine
 S31N/G
 S 33 994
N
 9
 204
PA
 Reduced susceptibility to endonuclease inhibitors
 I38M/T/S/L
 I 39 1,181
L 0 1
M 0 1
V
 1
 1
PB2
 Increased virulence in mammalian models Q591K Q 40 1,194
K 1 0
Increased virulence in mammalian models E627K E 28 1,180
K 12 3
E/V 1 1
V 0 9
Increased virulence in mammalian models
 D701N
 D 36 1,193
D/N 1 0
N
 4
 0
NS1
 Altered virulence in mice D92E D 18 185
E 24 1,011
G 0 1
Altered virulence in mice L103F L 8 165
F 26 1,020
S 0 11
V 7 1
Y 1 0
Altered virulence in mice
 I106M
 I 8 166
K 0 4
M
 34
 1,027
M1 Altered virulence in mice N30D D 42 1,200
Impacts growth and transmission in the guinea pig P41A A 42 1,199
S 0 1
Altered virulence in mice T139A T 40 1,113
A 2 58
P 0 29
Altered virulence in mice T215A A 42 1,200

*H3 numbering system was used. †N2 numbering system was used.

Main Article

1These authors contributed equally to this article.

Page created: April 16, 2022
Page updated: June 18, 2022
Page reviewed: June 18, 2022
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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