Human Infection with Highly Pathogenic A(H7N7) Avian Influenza Virus, Italy, 2013

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Abstract

During an influenza A(H7N7) virus outbreak among poultry in Italy during August–September 2013, infection with a highly pathogenic A(H7N7) avian influenza virus was diagnosed for 3 poultry workers with conjunctivitis. Genetic analyses revealed that the viruses from the humans were closely related to those from chickens on affected farms.

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Most cited references 12

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Molecular basis for high virulence of Hong Kong H5N1 influenza A viruses.

M Hatta (2001)

In 1997, an H5N1 influenza A virus was transmitted from birds to humans in Hong Kong, killing 6 of the 18 people infected. When mice were infected with the human isolates, two virulence groups became apparent. Using reverse genetics, we showed that a mutation at position 627 in the PB2 protein influenced the outcome of infection in mice. Moreover, high cleavability of the hemagglutinin glycoprotein was an essential requirement for lethal infection.

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Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands.

Marion Koopmans, Berry Wilbrink, Marina Conyn … (2004)

An outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans. All workers in poultry farms, poultry farmers, and their families were asked to report signs of conjunctivitis or influenza-like illness. People with complaints were tested for influenza virus type A subtype H7 (A/H7) infection and completed a health questionnaire about type of symptoms, duration of illness, and possible exposures to infected poultry. 453 people had health complaints--349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26.4%) people with conjunctivitis only, in five (9.4%) with influenza-like illness and conjunctivitis, in two (5.4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme. We noted an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, and we noted evidence for person-to-person transmission. Our data emphasise the importance of adequate surveillance, outbreak preparedness, and pandemic planning.

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The molecular basis of the specific anti-influenza action of amantadine.

A Hay, A Wolstenholme, J Skehel … (1985)

Amantadine (1-aminoadamantane hydrochloride) is effective in the prophylaxis and treatment of influenza A infections. In tissue culture this selective, strain-specific antiviral activity occurs at relatively low concentrations (5 microM or less), which inhibit either the initiation of infection or virus assembly. The data reported here demonstrate that the basis of these actions is similar and resides in the virus-coded M2 membrane protein, the product of a spliced transcript of RNA segment 7. Mutations which confer resistance to amantadine are restricted to four amino acids within a hydrophobic sequence, indicating that the drug is targetted against the putative membrane-associated portion of the molecule. The influence of the virus haemagglutinin on the amantadine sensitivity of virus strains implies that the drug may interfere with interactions between these two virus proteins.

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Author and article information

Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (iso-abbrev): Emerging Infect. Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): October 2014

Volume: 20

Issue: 10

Pages: 1745-1749

Affiliations

[1]Istituto Superiore di Sanità, Rome, Italy (S. Puzelli, M. Facchini, G. Vaccari, L. Di Trani, A. Di Martino, G. Rezza, M.R. Castrucci, I. Donatelli);

[2]St. Orsola University Hospital, Bologna, Italy (G. Rossini, P. Gaibani, C. Vocale, M.P. Landini);

[3] Istituto Zooprofilattico delle Venezie, Padua, Italy (G. Cattoli);

[4]Medical Research Council National Institute for Medical Research, London, UK (M. Bennett, J.W. McCauley);

[5]Emilia-Romagna Region, Bologna (M.L. Moro, R. Rangoni, A.C. Finarelli)

Author notes

Address for correspondence: Simona Puzelli, National Influenza Centre, Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161 Roma, Italy; email: simona.puzelli@ 123456iss.it

Article

Publisher ID: 14-0512

DOI: 10.3201/eid2010.140512

PMC ID: 4193179

PubMed ID: 25271444

SO-VID: 543324e5-47af-4d29-b7cb-90652660e9e3

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