Severe human infection with a novel avian-origin influenza A(H7N4) virus

Human infections with influenza H7 subtypes, such as H7N9, have raised concerns worldwide. Here, we report a human infection with a novel influenza A(H7N4) virus. A 68 years-old woman with cardiovascular and cholecystic comorbidities developed rapidly progressed pneumonia with influenza-like-illness as initial symptom, recovered after 23 days-hospitalization including 8 days in ICU. Laboratory indicators for liver and blood coagulation dysfunction were observed. Oseltamivir phosphate, glucocorticoids and antibiotics were jointly implemented, with nasal catheterization of oxygen inhalation for this patient.We obtained the medical records and collected serial respiratory and blood specimens from her. We collected throat, cloacal and/or feces samples of poultry and wild birds from the patient's backyard, neighborhood, local live poultry markets(LPMs) and the nearest lake. All close contacts of the patient were followed up and sampled with throat swabs and sera. Influenza viruses and other respiratory pathogens were tested by real-time RT-PCR, viral culturing and/or sequencing for human respiratory and bird samples. Micro-neutralizing assay was performed for sera. A novel reassortant wild bird-origin H7N4 virus is identified from the patient and her backyard poultry(chickens and ducks) by sequencing, which is distinct from previously-reported avian H7N4 and H7N9 viruses. At least four folds increase of neutralizing antibodies to H7N4 was detected in her convalescent sera. No samples from close contacts, wild birds or other poultry were tested positive for H7N4 by real-time RT-PCR.

Economic burden and its associated factors of hospitalized patients infected with A (H7N9) virus: a retrospective study in Eastern China, 2013–2014

Background:H7N9 continues to cause human infections and remains a pandemic concern.Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation,including infectious disease prevention and control investment.However,there are limited data on such impacts.Methods:Hospitalized laboratory-confirmed H7N9 patients or their families in Jiangsu Province of China were interviewed.Patients’direct medical costs of hospitalization were derived from their hospital bills.A generalized linear model was employed to estimate the mean direct medical costs of patients with different characteristics.Results:The mean direct cost of hospitalization for H7N9 was estimated to be¥71060(95%CI,48180–104820),i.e.,US$10996(95%CI,7455–16220),and was¥12060(US$1861),¥136120(US$21001)and¥218610(US$33728)for those who had mild or severe symptoms or who died,respectively.The principal components of the total fees differed among patients with different disease severity,although medication fees were always the largest contributors.Disease severity,proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient’s direct medical cost of hospitalization.Conclusions:The direct medical costs of hospitalized patients with H7N9 are significant,and far surpass the annual per capita income of Jiangsu Province,China.The influencing factors identified should be taken into account when developing related health insurance policies and making health resource allocation.Trial registration:Not applicable.This is a survey study with no health care intervention implemented on human participants.

Massive migration promotes the early spread of COVID-19 in China: a study based on a scale-free network

Background The coronavirus disease 2019(COVID-19)epidemic met coincidentally with massive migration before Lunar New Year in China in early 2020.This study is to investigate the relationship between the massive migration and the coronavirus disease 2019(COVID-19)epidemic in China.Methods The epidemic data between January 25th and February 15th and migration data between Jan 1st and Jan 24th were collected from the official websites.Using the R package WGCNA,we established a scale-free network of the selected cities.Correlation analysis was applied to describe the correlation between the Spring Migration and COVID-19 epidemic.Results The epidemic seriousness in Hubei(except the city of Wuhan)was closely correlated with the migration from Wuhan between January 10 and January 24,2020.The epidemic seriousness in the other provinces,municipalities and autonomous regions was largely affected by the immigration from Wuhan.By establishing a scale-free network of the regions,we divided the regions into two modules.The regions in the brown module consisted of three municipalities,nine provincial capitals and other 12 cities.The COVID-19 epidemics in these regions were more likely to be aggravated by migration.Conclusions The migration from Wuhan could partly explain the epidemic seriousness in Hubei Province and other regions.The scale-free network we have established can better evaluate the epidemic.Three municipalities(Beijing,Shanghai and Tianjin),eight provincial capitals(including Nanjing,Changsha et al.)and 12 other cities(including Qingdao,Zhongshan,Shenzhen et al.)were hub cities in the spread of COVID-19 in China.

Experimental infections of mosquitoes with severe fever with thrombocytopenia syndrome virus

Background:Severe fever with thrombocytopenia syndrome(SFTS)is a newly identified emerging infectious disease,which is caused by a novel bunyavirus(termed SFTSV)in Asia.Although mosquitoes have not been identified as the primary vectors,as revealed by epidemiological surveys,their role in transmitting this SFTSV as a suspicious vector has not been validated.Findings:In this study,we conducted experimental infections of mosquitoes with SFTSV to examine the role of mosquitoes in the transmission of the virus.We did not detect viral replication in Culex pipiens pallens,Aedes aegyptis and Anopheles sinensis as revealed by qRT-PCR assay.In addition,we failed to isolate SFTSV from the Vero cells cultured with suspensions of SFTSV-infected mosquitoes.Conclusion:The results of the present study demonstrate little possibility that mosquitoes act as vectors for the emerging pathogen SFTSV.