title: Post-mortem findings in a patient with avian influenza A (H5N6) virus infection.
abstract: Avian influenza A (H5N6) has been found to infect humans, and has resulted in ten cases with six deaths in China since 2014. Here, we describe the systematic post-mortem pathology of a patient fatally infected with H5N6 virus and evaluate the associated pathogenesis compared with H1N1 pdm09 fatal cases. The most prominent histopathological features were diffuse alveolar damage and pulmonary vasculitis in the lungs of the patient. The virus disseminated to extrapulmonary organs, including the brain. Compared with H1N1 pdm09 fatal infection, H5N6 infection induced a more exacerbated immune response involving overt pulmonary inflammation, which led to alveolar damage and respiratory failure.
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: R
authors.initials: R
authors.lastname: Gao
authors.affiliation: Sichuan Provincial Disease Control and Prevention, Chengdu, China.
authors.forename: M
authors.initials: M
authors.lastname: Pan
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Zou
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Sichuan Provincial Disease Control and Prevention, Chengdu, China.
authors.forename: T
authors.initials: T
authors.lastname: Li
authors.affiliation: Sichuan Provincial Disease Control and Prevention, Chengdu, China.
authors.forename: H
authors.initials: H
authors.lastname: Yang
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: S
authors.initials: S
authors.lastname: Zou
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Bo
authors.affiliation: Sichuan Provincial Disease Control and Prevention, Chengdu, China.
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: Sichuan Provincial Disease Control and Prevention, Chengdu, China.
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.affiliation: Nanchong City Disease Control and Prevention, Nanchong, China.
authors.forename: M
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Affiliated Hospital of Chuanbei Medical School, Nanchong, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.
authors.forename: D
authors.initials: D
authors.lastname: Wang
authors.affiliation: Infectious Diseases Pathology Branch, Division of High-consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Zaki
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China. Electronic address: yshu@cnic.org.cn.
authors.forename: Y
authors.initials: Y
authors.lastname: Shu
mesh_terms: D000818:Animals; D001344:Autopsy; D001921:Brain / Q000473:pathology; D002681:China; D019267:Hemagglutinin Glycoproteins, Influenza Virus / Q000032:analysis*; D006801:Humans; D009980:Influenza A virus / Q000145:classification / Q000302:isolation & purification*; D007251:Influenza, Human / Q000473:pathology* / Q000821:virology*; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009439:Neuraminidase / Q000032:analysis*
chemical_list: D019267:Hemagglutinin Glycoproteins, Influenza Virus; C109963:hemagglutinin, avian influenza A virus; D009439:Neuraminidase
keywords: H5N6; highly pathogenic avian influenza virus; histology; immunopathological lesion; severe pneumonia