title: [Study on a fatal pregnant woman died from by avian influenza (H5N1)].
abstract: OBJECTIVE
  To ascertain the causation of a pregnant woman with undefined pneumonia reported from the People's Hospital of Tongling city in Anhui province on November 2005.
  
  
  METHODS
  Epidemiological and clinical information of the case was collected from the keypersons close to the case and referring to the medical record. A medical observation was carried out on the close contacts of the case and sick or dead poultry. Tracheal aspirates being collected were tested by both RT-PCR and real-time PCR to detect viral nucleic acids of A/H5N1, and were inoculated into special pathogen free (SPF) embryonated hens' eggs.
  
  
  RESULTS
  The pregnant woman was found to have been contacted with the sick/dead poultry directly on the 4th day before onset of illness. All the 122 close contacts were healthy after a 10-day medical observation. The major clinical features of the case were viral pneumonia with rapidly developed leukopenia and lymphopenia. The progress to acute respiratory distress syndrome and multiple organ dysfunction syndromes was found at clinical presentation. HA and NA gene of A/H5N1 virus were positive. The 8 gene fragments of A/Anhui/1/2005 (H5N1) isolated from the tracheal aspirates had not carried genes from a human virus through reassortment, and the receptor-binding site of the hemagglutinin was polybasic cleavage site.
  
  
  CONCLUSIONS
  This was the first documented case of H5N1 infection in pregnant woman. The immunotolerant state of pregnancy might have predisposed to the fatal outcome of the patient.
authors.affiliation: Anhui Provincial Center for Disease Control and Prevention, Hefei 230061, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Li
authors.forename: Yu
authors.initials: Y
authors.lastname: Lan
authors.forename: Cui-ling
authors.initials: CL
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Tong-sheng
authors.initials: TS
authors.lastname: Wu
authors.forename: Le-ying
authors.initials: LY
authors.lastname: Wen
authors.forename: Ni-juan
authors.initials: NJ
authors.lastname: Xiang
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jia-bing
authors.initials: JB
authors.lastname: Wu
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
authors.forename: Chuan-long
authors.initials: CL
authors.lastname: Xiong
authors.forename: Xiao-ling
authors.initials: XL
authors.lastname: Xu
authors.forename: Wan-fu
authors.initials: WF
authors.lastname: Hu
authors.forename: Zhong-jie
authors.initials: ZJ
authors.lastname: Li
authors.forename: Dai-lin
authors.initials: DL
authors.lastname: Hu
authors.forename: Lei
authors.initials: L
authors.lastname: Zhou
authors.forename: Ming-ying
authors.initials: MY
authors.lastname: Ma
authors.forename: Zhi-tao
authors.initials: ZT
authors.lastname: Liu
authors.forename: Xu-xiang
authors.initials: XX
authors.lastname: Liu
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Shou-kui
authors.initials: SK
authors.lastname: Hu
authors.forename: Jun
authors.initials: J
authors.lastname: He
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Xian-xiang
authors.initials: XX
authors.lastname: Li
authors.forename: Fu-qing
authors.initials: FQ
authors.lastname: Wu
authors.forename: Yue-long
authors.initials: YL
authors.lastname: Shu
authors.forename: Mao-wu
authors.initials: MW
authors.lastname: Wang
authors.forename: Zi-jun
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Wei-zhong
authors.initials: WZ
authors.lastname: Yang
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Hong-jie
authors.initials: HJ
authors.lastname: Yu
mesh_terms: D000328:Adult; D002681:China; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications / Q000473:pathology*; D009102:Multiple Organ Failure; D011014:Pneumonia / Q000821:virology*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D012128:Respiratory Distress Syndrome; D014132:Trachea / Q000821:virology