Clinical characteristics of 26 human cases of highly pathogenic avian influenza A (H5N1) virus infection in China.

Bibliographic Details
Title: Clinical characteristics of 26 human cases of highly pathogenic avian influenza A (H5N1) virus infection in China.
Authors: Hongjie Yu, Zhancheng Gao, Zijian Feng, Yuelong Shu, Nijuan Xiang, Lei Zhou, Yang Huai, Luzhao Feng, Zhibin Peng, Zhongjie Li, Cuiling Xu, Junhua Li, Chengping Hu, Qun Li, Xiaoling Xu, Xuecheng Liu, Zigui Liu, Longshan Xu, Yusheng Chen, Huiming Luo, Liping Wei, Xianfeng Zhang, Jianbao Xin, Junqiao Guo, Qiuyue Wang, Zhengan Yuan, Longnv Zhou, Kunzhao Zhang, Wei Zhang, Jinye Yang, Xiaoning Zhong, Shichang Xia, Lanjuan Li, Jinquan Cheng, Erdang Ma, Pingping He, Shui Shan Lee, Yu Wang, Timothy M Uyeki, Weizhong Yang
Source: PLoS ONE, Vol 3, Iss 8, p e2985 (2008)
Publisher Information: Public Library of Science (PLoS), 2008.
Publication Year: 2008
Collection: LCC:Medicine
LCC:Science
Subject Terms: Medicine, Science
More Details: BACKGROUND: While human cases of highly pathogenic avian influenza A (H5N1) virus infection continue to increase globally, available clinical data on H5N1 cases are limited. We conducted a retrospective study of 26 confirmed human H5N1 cases identified through surveillance in China from October 2005 through April 2008. METHODOLOGY/PRINCIPAL FINDINGS: Data were collected from hospital medical records of H5N1 cases and analyzed. The median age was 29 years (range 6-62) and 58% were female. Many H5N1 cases reported fever (92%) and cough (58%) at illness onset, and had lower respiratory findings of tachypnea and dyspnea at admission. All cases progressed rapidly to bilateral pneumonia. Clinical complications included acute respiratory distress syndrome (ARDS, 81%), cardiac failure (50%), elevated aminotransaminases (43%), and renal dysfunction (17%). Fatal cases had a lower median nadir platelet count (64.5 x 10(9) cells/L vs 93.0 x 10(9) cells/L, p = 0.02), higher median peak lactic dehydrogenase (LDH) level (1982.5 U/L vs 1230.0 U/L, p = 0.001), higher percentage of ARDS (94% [n = 16] vs 56% [n = 5], p = 0.034) and more frequent cardiac failure (71% [n = 12] vs 11% [n = 1], p = 0.011) than nonfatal cases. A higher proportion of patients who received antiviral drugs survived compared to untreated (67% [8/12] vs 7% [1/14], p = 0.003). CONCLUSIONS/SIGNIFICANCE: The clinical course of Chinese H5N1 cases is characterized by fever and cough initially, with rapid progression to lower respiratory disease. Decreased platelet count, elevated LDH level, ARDS and cardiac failure were associated with fatal outcomes. Clinical management of H5N1 cases should be standardized in China to include early antiviral treatment for suspected H5N1 cases.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1932-6203
Relation: http://europepmc.org/articles/PMC2515635?pdf=render; https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0002985
Access URL: https://doaj.org/article/a1ba834ad599468c87684bcbae838fd8
Accession Number: edsdoj.1ba834ad599468c87684bcbae838fd8
Database: Directory of Open Access Journals
More Details
ISSN:19326203
DOI:10.1371/journal.pone.0002985
Published in:PLoS ONE
Language:English