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Emerg Infect Dis. 2016 Apr;22(4):598-607. doi: 10.3201/eid2204.151561.

Nosocomial Co-Transmission of Avian Influenza A(H7N9) and A(H1N1)pdm09 Viruses between 2 Patients with Hematologic Disorders.

Abstract

A nosocomial cluster induced by co-infections with avian influenza A(H7N9) and A(H1N1)pdm09 (pH1N1) viruses occurred in 2 patients at a hospital in Zhejiang Province, China, in January 2014. The index case-patient was a 57-year-old man with chronic lymphocytic leukemia who had been occupationally exposed to poultry. He had co-infection with H7N9 and pH1N1 viruses. A 71-year-old man with polycythemia vera who was in the same ward as the index case-patient for 6 days acquired infection with H7N9 and pH1N1 viruses. The incubation period for the second case-patient was estimated to be <4 days. Both case-patients died of multiple organ failure. Virus genetic sequences from the 2 case-patients were identical. Of 103 close contacts, none had acute respiratory symptoms; all were negative for H7N9 virus. Serum samples from both case-patients demonstrated strong proinflammatory cytokine secretion but incompetent protective immune responses. These findings strongly suggest limited nosocomial co-transmission of H7N9 and pH1N1 viruses from 1 immunocompromised patient to another.

KEYWORDS:

A(H1N1)pdm09; A(H1N1)pdm2009; H1N1; H7N9; chronic lymphocytic leukemia; cluster; co-infection; hematologic disorders; human-to-human transmission; immunocompromised; influenza; nosocomial transmission; pH1N1; pandemic; polycythemia vera; viruses; zoonoses

PMID:
26982379
PMCID:
PMC4806937
DOI:
10.3201/eid2204.151561
[Indexed for MEDLINE]
Free PMC Article

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