title: Nosocomial Co-Transmission of Avian Influenza A(H7N9) and A(H1N1)pdm09 Viruses between 2 Patients with Hematologic Disorders.
abstract: A nosocomial cluster induced by co-infections with avian influenza A(H7N9) and A(H1N1)pdm09 (pH1N1) viruses occurred in 2 patients at a hospital in Zhejiang Province, China, in January 2014. The index case-patient was a 57-year-old man with chronic lymphocytic leukemia who had been occupationally exposed to poultry. He had co-infection with H7N9 and pH1N1 viruses. A 71-year-old man with polycythemia vera who was in the same ward as the index case-patient for 6 days acquired infection with H7N9 and pH1N1 viruses. The incubation period for the second case-patient was estimated to be <4 days. Both case-patients died of multiple organ failure. Virus genetic sequences from the 2 case-patients were identical. Of 103 close contacts, none had acute respiratory symptoms; all were negative for H7N9 virus. Serum samples from both case-patients demonstrated strong proinflammatory cytokine secretion but incompetent protective immune responses. These findings strongly suggest limited nosocomial co-transmission of H7N9 and pH1N1 viruses from 1 immunocompromised patient to another.
authors.forename: Huazhong
authors.initials: H
authors.lastname: Chen
authors.forename: Shelan
authors.initials: S
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Chengliang
authors.initials: C
authors.lastname: Chai
authors.forename: Haiyan
authors.initials: H
authors.lastname: Mao
authors.forename: Zhao
authors.initials: Z
authors.lastname: Yu
authors.forename: Yuming
authors.initials: Y
authors.lastname: Tang
authors.forename: Geqin
authors.initials: G
authors.lastname: Zhu
authors.forename: Haixiao X
authors.initials: HX
authors.lastname: Chen
authors.forename: Chengchu
authors.initials: C
authors.lastname: Zhu
authors.forename: Hui
authors.initials: H
authors.lastname: Shao
authors.forename: Shuguang
authors.initials: S
authors.lastname: Tan
authors.forename: Qianli
authors.initials: Q
authors.lastname: Wang
authors.forename: Yuhai
authors.initials: Y
authors.lastname: Bi
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zou
authors.forename: Guang
authors.initials: G
authors.lastname: Liu
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.forename: Chengyu
authors.initials: C
authors.lastname: Jiang
authors.forename: George F
authors.initials: GF
authors.lastname: Gao
authors.forename: Malik
authors.initials: M
authors.lastname: Peiris
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
authors.forename: Enfu
authors.initials: E
authors.lastname: Chen
mesh_terms: D000368:Aged; D000818:Animals; D002681:China; D003428:Cross Infection / Q000175:diagnosis / Q000473:pathology / Q000635:transmission* / Q000821:virology; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D064766:Influenza A Virus, H7N9 Subtype / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D005585:Influenza in Birds / Q000635:transmission* / Q000821:virology; D007251:Influenza, Human / Q000150:complications / Q000276:immunology / Q000635:transmission* / Q000821:virology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011087:Polycythemia Vera / Q000150:complications / Q000276:immunology* / Q000821:virology; D011200:Poultry; D011201:Poultry Diseases / Q000635:transmission* / Q000821:virology
chemical_list: D016207:Cytokines
keywords: A(H1N1)pdm09; A(H1N1)pdm2009; H1N1; H7N9; chronic lymphocytic leukemia; cluster; co-infection; hematologic disorders; human-to-human transmission; immunocompromised; influenza; nosocomial transmission; pH1N1; pandemic; polycythemia vera; viruses; zoonoses