title: Clinical, epidemiological and virological characteristics of the first detected human case of avian influenza A(H5N6) virus.
abstract: A human infection with novel avian influenza A H5N6 virus emerged in Changsha city, China in February, 2014. This is the first detected human case among all human cases identified from 2014 to early 2016. We obtained and summarized clinical, epidemiological, and virological data from this patient. Complete genome of the virus was determined and compared to other avian influenza viruses via the construction of phylogenetic trees using the neighbor-joining approach. A girl aged five and half years developed fever and mild respiratory symptoms on Feb. 16, 2014 and visited hospital on Feb. 17. Throat swab specimens were obtained from the patient and a novel reassortant avian influenza A H5N6 virus was detected. All eight viral gene segments were of avian origin. The hemagglutinin (HA) and neuraminidase (NA) gene segments were closely related to A/duck/Sichuan/NCXN11/2014(H5N1) and A/chicken/Jiangxi/12782/2014(H10N6) viruses, respectively. The six internal genes were homologous to avian influenza A (H5N2) viruses isolated in duck from Jiangxi in China. This H5N6 virus has not gained genetic mutations necessary for human infection and was suggested to be sensitive to neuraminidase inhibitors, but resistant to adamantanes. Epidemiological investigation of the exposure history of the patient found that a live poultry market could be the source place of infection and the incubation period was 2-5days. This novel reassortant Avian influenza A(H5N6) virus could be low pathogenic in humans. The prevalence and genetic evolution of this virus should be closely monitored.
authors.affiliation: Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, Hunan, People's Republic of China; Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Rusheng
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China. Electronic address: 13698665@qq.com.
authors.forename: Tianmu
authors.initials: T
authors.lastname: Chen
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Ou
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Ruchun
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Ye
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Jingfang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yao
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Biancheng
authors.initials: B
authors.lastname: Sun
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Xixing
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Yuhua Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China.
authors.forename: Jianxiang
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Changsha Central Hospital, Changsha, Hunan, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, People's Republic of China. Electronic address: 351985738@qq.com.
authors.forename: Faming
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, Hunan, People's Republic of China. Electronic address: spwang@126.com.
authors.forename: Shi-Ping
authors.initials: SP
authors.lastname: Wang
mesh_terms: D019943:Amino Acid Substitution; D000818:Animals; D001717:Birds; D002645:Chickens; D002681:China / Q000453:epidemiology; D019143:Evolution, Molecular; D005814:Genes, Viral; D016679:Genome, Viral; D006801:Humans; D009980:Influenza A virus / Q000145:classification* / Q000235:genetics*; D005585:Influenza in Birds / Q000453:epidemiology* / Q000821:virology*; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D010802:Phylogeny; D012367:RNA, Viral; D016865:Reassortant Viruses
chemical_list: D012367:RNA, Viral
keywords: Avian influenza; H5N6; Reassortant; Sequence; The first detected human case