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J Infect. 2016 Jan;72(1):52-9. doi: 10.1016/j.jinf.2015.06.009. Epub 2015 Jul 2.

Human infection with a novel, highly pathogenic avian influenza A (H5N6) virus: Virological and clinical findings.

Author information

1
Sichuan Provincial Disease Control and Prevention, Chengdu 610041, China.
2
National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing 102206, China.
3
Nanchong City Disease Control and Prevention, Nanchong 637000, China.
4
Affiliated Hospital of Chuanbei Medical School, Nanchong 637000, China.
5
Nanbu County Disease Control and Prevention, Nanchong 637300, China.
6
Nanbu County Hospital, Nanchong 637300, China.
7
Dongba Center Hospital of Nanbu County, Nanchong 637300, China.
8
Department of Pathology, Beijing Renhe Hospital, Beijing 102600, China.
9
Chinese Center for Disease Control and Prevention, Beijing 102206, China.
10
National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing 102206, China. Electronic address: yshu@cnic.org.cn.

Abstract

BACKGROUND AND OBJECTIVES:

Severe infection with avian influenza A (H5N6) virus in humans was identified first in 2014 in China. Before that, it was unknown or unclear if the disease or the pathogen affected people. This study illustrates the virological and clinical findings of a fatal H5N6 virus infection in a human patient.

METHODS:

We obtained and analyzed the clinical, epidemiological, and virological data from the patient. Reverse transcription polymerase chain reaction (RT-PCR), viral culture, and sequencing were conducted for determination of the causative pathogen.

RESULTS:

The patient, who presented with fever, severe pneumonia, leucopenia, and lymphopenia, developed septic shock and acute respiratory distress syndrome (ARDS), and died on day 10 after illness onset. A novel reassortant avian-origin influenza A (H5N6) virus was isolated from the throat swab or trachea aspirate of the patient. The virus was reassorted with the HA gene of clade 2.3.4.4 H5, the internal genes of clade 2.3.2.1 H5, and the NA gene of the H6N6 avian virus. The cleavage site of the HA gene contained multiple basic amino acids, indicating that the novel H5N6 virus was highly pathogenic in chicken.

CONCLUSIONS:

A novel, highly pathogenic avian influenza H5N6 virus with a backbone of H5N1 virus acquired from the NA gene from the H6N6 virus has been identified. It caused human infection resulting in severe respiratory disease.

KEYWORDS:

Emerging infectious diseases; H5N6; Highly pathogenic avian influenza virus; Reassortment

PMID:
26143617
DOI:
10.1016/j.jinf.2015.06.009
[Indexed for MEDLINE]

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