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| 題 名 | 中國H7N9禽流感疫情之回顧=Review of the 2013 Avian Flu H7N9 in China |
|---|---|
| 作 者 | 陳怡任; | 書刊名 | 感染控制雜誌 |
| 卷 期 | 24:2 2014.04[民103.04] |
| 頁 次 | 頁76-84 |
| 分類號 | 415.239 |
| 關鍵詞 | 禽流感; 流行病學; H7N9; Avian influenza; Reassortant; Epidemiology; |
| 語 文 | 中文(Chinese) |
| 英文摘要 | In March 2013, 3 urban residents in China were found to be infected with a novel avian-origin influenza A (H7N9) virus. More than 100 infected cases have since been reported in China. The median age of patients was 61 years, and nearly 70% were men. Further, 60% of the patients had a history of poultry contact. The estimated incubation period was 10 days. The most common symptoms were fever and cough. Neutropenia and thrombocytopenia were most often noted in hemograms. The most common complications were pneumonia, acute respiratory distress syndrome, shock, acute renal failure, and rhabdomyolysis. Pneumonia was found in 97% of patients by chest radiography, and consolidation and ground-glass patterns were noted in 89% and 56% of the patients, respectively. About 70% of patients were admitted to the intensive care unit. Further, 60% of patients required mechanical ventilation, and nearly 20% needed extracorporeal membrane oxygenation. The median time from the onset of illness to death or recovery was 11-14 days and 18 days, respectively. The mortality rate was 32%. Sequence analyses revealed that the H7N9 virus was a reassortant of H7, N9, and H9N2 avian influenza viruses from Eurasian wild birds, domestic ducks, bramblings, and chickens. This virus also has some mutations associated with mammalian receptor binding that increase replication and even transmission, such as Q226L substitution in the HA gene and 5 amino acid deletions in the NA stalk. These raise concerns of a pandemic. Anti-viral medication (e.g., neuraminidase inhibitors) and supportive treatment are the main therapeutic strategy for H7N9 infection patients. Treatment with corticosteroids is not recommended, and no vaccine is available thus far. Personal hygiene and avoidance of poultry contact are the most efficient preventions at present. Continuous monitoring of the epidemic and viral evolution as well as further studies of disease pathogenesis and transmission mechanisms will improve the clinical outcomes and contribute to outbreak control and measures against potential pandemics. |
本系統中英文摘要資訊取自各篇刊載內容。