PT  - JOURNAL ARTICLE
AU  - Jindong Shi
AU  - Juan Xie
AU  - Zebao He
AU  - Fangming Li
AU  - Yanchao He
AU  - Qihui Huang
AU  - Yong Gu
AU  - Zhijun Jie
TI  - The analysis of a local outbreak of avian-origin influenza A (H7N9) in Shanghai
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P4393
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P4393.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P4393.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Background: Our hospital received the first patient infected with avian influenza H7N9 in the world. Shortly thereafter, several other cases emerged in the local area. To achieve early detection of H7N9 for timely diagnosis and treatment, the epidemiological and clinical information of all 6 cases were analyzed.Methods and Results: 2 cases were family members. 3 cases had a history of contacting with poultry. All of the 6 patients lived around two markets where H7N9 virus were found in chickens and pigeons. The main symptoms were fever, cough, and hemoptysis. At onset, a decreased lymphocyte counts and elevated creatine kinase (CK), LDH, and CRP levels were observed. As the disease progressed, most patients had dyspnea and hypoxemia. Imaging showed lung consolidation and multiple ground-glass opacities at the early stage, rapidly extending bilaterally. All patients were treated with oseltamivir tablets. The complication rates were as follows: ARDS(83.3%), secondary bacterial infection (66.7%), pleural effusion (50%), left ventricular failure (33.3%), neuropsychiatric symptoms (33.3%), and rhabdomyolysis (16.7%). 4 of 6 cases died of ARDS, only 2 cases were recovered.Conclusions: An outbreak of H7N9 infection was taken place in the Minhang District of Shanghai, which easily progressed to ARDS. Two cases showed family aggregation, which provided the key to discover H7N9 virus and indicated human transmission might exist.