TY - JOUR T1 - Severe influenza A H7N9 pneumonia with rapid virological response to intravenous zanamivir JF - European Respiratory Journal JO - Eur Respir J SP - 535 LP - 537 DO - 10.1183/09031936.00006414 VL - 44 IS - 2 AU - Pak-Leung Ho AU - Wai-Ching Sin AU - Jasper Fuk-Woo Chan AU - Vincent Chi-Chung Cheng AU - Kwok-Hung Chan Y1 - 2014/08/01 UR - http://erj.ersjournals.com/content/44/2/535.abstract N2 - To the Editor:In March 2013, a novel influenza A H7N9 virus of avian origin was reported to cause severe pneumonia in mainland China [1–3]. While the great majority of patients were treated with oral oseltamivir, impaired gastrointestinal absorption in critically ill patients, the lack of virological response among patients requiring extracorporeal membrane oxygenation (ECMO) and detection of an amino acid change (arginine to lysine at residue 292 in N2) in the viral neuraminidase associated with drug resistance in two H7N9 strains are major concerns [1, 4]. Here, we report a case of severe pneumonia due to avian influenza A H7N9 requiring ECMO support; there was rapid clinical and virological response following intravenous zanamivir therapy.On November 21, 2013, in Hong Kong, China, a 36-year-old Indonesian female began to have fever, malaise and cough. She had been previously healthy except for a history of vitiligo. She sought medical advice from two clinics … ER -