Extra-pulmonary viral shedding in H7N9 Avian Influenza patients

Zhaoqin Zhu; Yi Liu; Lei Xu; Wencai Guan; Xiaonan Zhang; Tangkai Qi; Bisheng Shi; Zhigang Song; Xinian Liu; Yanmin Wan; Di Tian; Jing He; Xiaoling Zhang; Min Wu; Hongzhou Lu; Shuihua Lu; Zhiyong Zhang; Zhenghong Yuan; Yunwen Hu

doi:10.1016/j.jcv.2015.05.013

Extra-pulmonary viral shedding in H7N9 Avian Influenza patients

Zhaoqin Zhu, Yi Liu, Lei Xu, Wencai Guan, Xiaonan Zhang, Tangkai Qi, Bisheng Shi, Zhigang Song, Xinian Liu, Yanmin Wan, Di Tian, Jing He, Xiaoling Zhang, Min Wu, Hongzhou Lu, Shuihua Lu, Zhiyong Zhang, Zhenghong Yuan, Yunwen Hu

Research output: Contribution to journal › Comment/debate

25 Citations (Scopus)

Abstract

BACKGROUND: The clinical features of avian-origin influenza virus A (H7N9) virus infection have been extensively characterized, but viral RNA detection in extra-pulmonary samples has seldom been studied.

OBJECTIVES: To study shedding of viral RNA in extra pulmonary samples in patients with avian influenza H7N9 infections.

STUDY DESIGN: A retrospective study of throat swabs, urine, fecal samples and sera collected sequentially from 18 hospitalized patients with H7N9 infections in Shanghai, China, between April and July in 2013 was conducted.

RESULTS: Viral RNA could be detected in urine samples from 17 patients, in fecal samples from 15 and in sera from 14 with a real-time reverse transcription polymerase chain reaction. The median duration of shedding of viral RNA was 19.7 days in throat swabs, 22 days in feces, 21.1 days in urines and 16.2 days in sera, indicating prolonged shedding of viral RNA in feces and urine compared with that in throat swabs. Prolonged duration of viral RNA detection in throat swabs and urine samples was observed in more severe patients. Moreover, in previously reported oseltamivir resistant patients, the NA gene with a 292K mutation could also be detected in their extra-pulmonary as well as in their respiratory samples.

CONCLUSION: Our data indicated a high frequency of viral RNA detection in feces, urine and sera in H7N9-infected patients and pointed out the potential risk of transmission.

Original language	English
Pages (from-to)	30-32
Number of pages	3
Journal	Clinical and Diagnostic Virology
Volume	69
DOIs	https://doi.org/10.1016/j.jcv.2015.05.013
Publication status	Published - Aug 2015
Externally published	Yes

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10.1016/j.jcv.2015.05.013

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@article{457ec8558e644da398bc2193eb735a61,

title = "Extra-pulmonary viral shedding in H7N9 Avian Influenza patients",

abstract = "BACKGROUND: The clinical features of avian-origin influenza virus A (H7N9) virus infection have been extensively characterized, but viral RNA detection in extra-pulmonary samples has seldom been studied.OBJECTIVES: To study shedding of viral RNA in extra pulmonary samples in patients with avian influenza H7N9 infections.STUDY DESIGN: A retrospective study of throat swabs, urine, fecal samples and sera collected sequentially from 18 hospitalized patients with H7N9 infections in Shanghai, China, between April and July in 2013 was conducted.RESULTS: Viral RNA could be detected in urine samples from 17 patients, in fecal samples from 15 and in sera from 14 with a real-time reverse transcription polymerase chain reaction. The median duration of shedding of viral RNA was 19.7 days in throat swabs, 22 days in feces, 21.1 days in urines and 16.2 days in sera, indicating prolonged shedding of viral RNA in feces and urine compared with that in throat swabs. Prolonged duration of viral RNA detection in throat swabs and urine samples was observed in more severe patients. Moreover, in previously reported oseltamivir resistant patients, the NA gene with a 292K mutation could also be detected in their extra-pulmonary as well as in their respiratory samples.CONCLUSION: Our data indicated a high frequency of viral RNA detection in feces, urine and sera in H7N9-infected patients and pointed out the potential risk of transmission.",

keywords = "Aged, Aged, 80 and over, Animals, China, Feces/virology, Female, Hospitalization, Humans, Influenza A Virus, H7N9 Subtype/genetics, Influenza in Birds, Influenza, Human/transmission, Male, Middle Aged, Mutation, Pharynx/virology, Poultry, RNA, Viral/blood, Real-Time Polymerase Chain Reaction, Retrospective Studies, Virus Shedding",

author = "Zhaoqin Zhu and Yi Liu and Lei Xu and Wencai Guan and Xiaonan Zhang and Tangkai Qi and Bisheng Shi and Zhigang Song and Xinian Liu and Yanmin Wan and Di Tian and Jing He and Xiaoling Zhang and Min Wu and Hongzhou Lu and Shuihua Lu and Zhiyong Zhang and Zhenghong Yuan and Yunwen Hu",

year = "2015",

month = aug,

doi = "10.1016/j.jcv.2015.05.013",

language = "English",

volume = "69",

pages = "30--32",

journal = "Clinical and Diagnostic Virology",

issn = "1386-6532",

publisher = "Elsevier",

}

TY - JOUR

T1 - Extra-pulmonary viral shedding in H7N9 Avian Influenza patients

AU - Zhu, Zhaoqin

AU - Liu, Yi

AU - Xu, Lei

AU - Guan, Wencai

AU - Zhang, Xiaonan

AU - Qi, Tangkai

AU - Shi, Bisheng

AU - Song, Zhigang

AU - Liu, Xinian

AU - Wan, Yanmin

AU - Tian, Di

AU - He, Jing

AU - Zhang, Xiaoling

AU - Wu, Min

AU - Lu, Hongzhou

AU - Lu, Shuihua

AU - Zhang, Zhiyong

AU - Yuan, Zhenghong

AU - Hu, Yunwen

PY - 2015/8

Y1 - 2015/8

N2 - BACKGROUND: The clinical features of avian-origin influenza virus A (H7N9) virus infection have been extensively characterized, but viral RNA detection in extra-pulmonary samples has seldom been studied.OBJECTIVES: To study shedding of viral RNA in extra pulmonary samples in patients with avian influenza H7N9 infections.STUDY DESIGN: A retrospective study of throat swabs, urine, fecal samples and sera collected sequentially from 18 hospitalized patients with H7N9 infections in Shanghai, China, between April and July in 2013 was conducted.RESULTS: Viral RNA could be detected in urine samples from 17 patients, in fecal samples from 15 and in sera from 14 with a real-time reverse transcription polymerase chain reaction. The median duration of shedding of viral RNA was 19.7 days in throat swabs, 22 days in feces, 21.1 days in urines and 16.2 days in sera, indicating prolonged shedding of viral RNA in feces and urine compared with that in throat swabs. Prolonged duration of viral RNA detection in throat swabs and urine samples was observed in more severe patients. Moreover, in previously reported oseltamivir resistant patients, the NA gene with a 292K mutation could also be detected in their extra-pulmonary as well as in their respiratory samples.CONCLUSION: Our data indicated a high frequency of viral RNA detection in feces, urine and sera in H7N9-infected patients and pointed out the potential risk of transmission.

AB - BACKGROUND: The clinical features of avian-origin influenza virus A (H7N9) virus infection have been extensively characterized, but viral RNA detection in extra-pulmonary samples has seldom been studied.OBJECTIVES: To study shedding of viral RNA in extra pulmonary samples in patients with avian influenza H7N9 infections.STUDY DESIGN: A retrospective study of throat swabs, urine, fecal samples and sera collected sequentially from 18 hospitalized patients with H7N9 infections in Shanghai, China, between April and July in 2013 was conducted.RESULTS: Viral RNA could be detected in urine samples from 17 patients, in fecal samples from 15 and in sera from 14 with a real-time reverse transcription polymerase chain reaction. The median duration of shedding of viral RNA was 19.7 days in throat swabs, 22 days in feces, 21.1 days in urines and 16.2 days in sera, indicating prolonged shedding of viral RNA in feces and urine compared with that in throat swabs. Prolonged duration of viral RNA detection in throat swabs and urine samples was observed in more severe patients. Moreover, in previously reported oseltamivir resistant patients, the NA gene with a 292K mutation could also be detected in their extra-pulmonary as well as in their respiratory samples.CONCLUSION: Our data indicated a high frequency of viral RNA detection in feces, urine and sera in H7N9-infected patients and pointed out the potential risk of transmission.

KW - Aged

KW - Aged, 80 and over

KW - Animals

KW - China

KW - Feces/virology

KW - Female

KW - Hospitalization

KW - Humans

KW - Influenza A Virus, H7N9 Subtype/genetics

KW - Influenza in Birds

KW - Influenza, Human/transmission

KW - Male

KW - Middle Aged

KW - Mutation

KW - Pharynx/virology

KW - Poultry

KW - RNA, Viral/blood

KW - Real-Time Polymerase Chain Reaction

KW - Retrospective Studies

KW - Virus Shedding

UR - http://www.scopus.com/inward/record.url?scp=84937918674&partnerID=8YFLogxK

U2 - 10.1016/j.jcv.2015.05.013

DO - 10.1016/j.jcv.2015.05.013

M3 - Comment/debate

C2 - 26209373

SN - 1386-6532

VL - 69

SP - 30

EP - 32

JO - Clinical and Diagnostic Virology

JF - Clinical and Diagnostic Virology

ER -

Extra-pulmonary viral shedding in H7N9 Avian Influenza patients

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