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| H5N1亚型高致病性禽流感在中国人群之间的传播可能较为有限 |
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| Probable limited person-to-person transmission of highly pathogenic avian influenza A (H5N1) virus in China |
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| Wang H., Feng Z., Shu Y., Yu H., Zhou L., Zu R., Huai Y., Dong J., Bao C., Wen L., Wang H., Yang P., Zhao W., Dong L., Zhou M., Liao Q., Yang H., Wang M., Lu X., Shi Z., Wang W., Gu L., Zhu F., Li Q., Yin W., Yang W., Li D., Uyeki T.M., Wang Y. 2009/5/29 18:39:20 |
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The Lancet, 2008, Volume 371, Issue 9622
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| Background: In December, 2007, a family cluster of two individuals infected with highly pathogenic avian influenza A (H5N1) virus was identified in Jiangsu Province, China. Field and laboratory investigations were implemented immediately by public-health authorities. Methods: Epidemiological, clinical, and virological data were collected and analysed. Respiratory specimens from the patients were tested by reverse transcriptase (RT) PCR and by viral culture for the presence of H5N1 virus. Contacts of cases were monitored for symptoms of illness for 10 days. Any contacts who became ill had respiratory specimens collected for H5N1 testing by RT PCR. Sera were obtained from contacts for H5N1 serological testing by microneutralisation and horse red-blood-cell haemagglutinin inhibition assays. Findings: The 24-year-old index case died, and the second case, his 52-year-old father, survived after receiving early antiviral treatment and post-vaccination plasma from a participant in an H5N1 vaccine trial. The index case's only plausible exposure to H5N1 virus was a poultry market visit 6 days before the onset of illness. The second case had substantial unprotected close exposure to his ill son. 91 contacts with close exposure to one or both cases without adequate protective equipment provided consent for serological investigation. Of these individuals, 78 (86%) received oseltamivir chemoprophylaxis and two had mild illness. Both ill contacts tested negative for H5N1 by RT PCR. All 91 close contacts tested negative for H5N1 antibodies. H5N1 viruses isolated from the two cases were genetically identical except for one non-synonymous nucleotide substitution. Interpretation: Limited, non-sustained person-to-person transmission of H5N1 virus probably occurred in this family cluster. Funding: Chinese Ministry of Science and Technology; US National Institute of Allergy and Infectious Diseases, National Institutes of Health; China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases. © 2008 Elsevier Ltd. All rights reserved. |
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| Correspondence Address: Wang, Y.; Office for Disease Control and Emergency Response, Chinese Centre for Disease Control and Prevention (China CDC), Beijing, China; email: wangyu@chinacdc.cn |
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 疾病资源中心
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
医学数据库
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