Epidemiological and clinical characteristics of humans with avian influenza A (H7N9) infection in Guangdong, China, 2013-2017

Int J Infect Dis. 2017 Dec:65:148-155. doi: 10.1016/j.ijid.2017.07.021. Epub 2017 Nov 8.

Abstract

Objective: To describe the demographics and clinical characteristics of patients with A (H7N9) infection, to test the differences in the distribution of demographics and clinical characteristics by clinical severity, and to explore potential factors associated with clinical severity.

Methods: This retrospective study was conducted to collect epidemiological and clinical information regarding the confirmed cases in Guangdong through field investigation and review of medical records.

Results: Of the 256 cases, 100 (39.0%) patients died, and 168 (65.6%) patients were admitted to ICUs. The male-to-female ratio was approximately 2.0:1, and the median age was 56 years (range, 1 to 88). Among the 215 patients accepting oseltamivir treatment, the median time from the onset of illness to oseltamivir treatment was 5days (range, 0 to 16); 35 patients received zanamivir treatment after a median of 8days (range, 0 to 23). The univariable logistic regression models demonstrated that time from the onset of illness to oseltamivir treatment (OR=1.10, 95% CI=1.01-1.10) and zanamivir treatment (OR=1.05, 95% CI=1.02-1.07) were associated with the death of patients.

Conclusions: Preventive measures should focus on high-risk populations, such as the elderly and the groups with high frequency exposure to live poultry. Earlier oseltamivir and zanamivir treatment were recommended.

Keywords: Avian influenza; Clinical characteristics; Epidemiological characteristics; H7N9 subtype.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • China / epidemiology
  • Demography
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Influenza A Virus, H7N9 Subtype*
  • Influenza, Human / drug therapy
  • Influenza, Human / epidemiology*
  • Influenza, Human / physiopathology
  • Influenza, Human / virology
  • Intensive Care Units
  • Male
  • Middle Aged
  • Oseltamivir / therapeutic use
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Antiviral Agents
  • Oseltamivir