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Update: Increase in Human Infections with Novel Asian Lineage Avian Influenza A(H7N9) Viruses During the Fifth Epidemic - China, October 1, 2016-August 7, 2017.

Abstract Among all influenza viruses assessed using CDC's Influenza Risk Assessment Tool (IRAT), the Asian lineage avian influenza A(H7N9) virus (Asian H7N9), first reported in China in March 2013,* is ranked as the influenza virus with the highest potential pandemic risk (1). During October 1, 2016-August 7, 2017, the National Health and Family Planning Commission of China; CDC, Taiwan; the Hong Kong Centre for Health Protection; and the Macao CDC reported 759 human infections with Asian H7N9 viruses, including 281 deaths, to the World Health Organization (WHO), making this the largest of the five epidemics of Asian H7N9 infections that have occurred since 2013 (Figure 1). This report summarizes new viral and epidemiologic features identified during the fifth epidemic of Asian H7N9 in China and summarizes ongoing measures to enhance pandemic preparedness. Infections in humans and poultry were reported from most areas of China, including provinces bordering other countries, indicating extensive, ongoing geographic spread. The risk to the general public is very low and most human infections were, and continue to be, associated with poultry exposure, especially at live bird markets in mainland China. Throughout the first four epidemics of Asian H7N9 infections, only low pathogenic avian influenza (LPAI) viruses were detected among human, poultry, and environmental specimens and samples. During the fifth epidemic, mutations were detected among some Asian H7N9 viruses, identifying the emergence of high pathogenic avian influenza (HPAI) viruses as well as viruses with reduced susceptibility to influenza antiviral medications recommended for treatment. Furthermore, the fifth-epidemic viruses diverged genetically into two separate lineages (Pearl River Delta lineage and Yangtze River Delta lineage), with Yangtze River Delta lineage viruses emerging as antigenically different compared with those from earlier epidemics. Because of its pandemic potential, candidate vaccine viruses (CVV) were produced in 2013 that have been used to make vaccines against Asian H7N9 viruses circulating at that time. CDC is working with partners to enhance surveillance for Asian H7N9 viruses in humans and poultry, to improve laboratory capability to detect and characterize H7N9 viruses, and to develop, test and distribute new CVV that could be used for vaccine production if a vaccine is needed.
PMID
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Authors

Mayor MeshTerms

Population Surveillance

Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 28880856
OWN - NLM
STAT- MEDLINE
DA  - 20170907
DCOM- 20170911
LR  - 20170911
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 66
IP  - 35
DP  - 2017 Sep 08
TI  - Update: Increase in Human Infections with Novel Asian Lineage Avian Influenza
      A(H7N9) Viruses During the Fifth Epidemic - China, October 1, 2016-August 7,
      2017.
PG  - 928-932
LID - 10.15585/mmwr.mm6635a2 [doi]
AB  - Among all influenza viruses assessed using CDC's Influenza Risk Assessment Tool
      (IRAT), the Asian lineage avian influenza A(H7N9) virus (Asian H7N9), first
      reported in China in March 2013,* is ranked as the influenza virus with the
      highest potential pandemic risk (1). During October 1, 2016-August 7, 2017, the
      National Health and Family Planning Commission of China; CDC, Taiwan; the Hong
      Kong Centre for Health Protection; and the Macao CDC reported 759 human
      infections with Asian H7N9 viruses, including 281 deaths, to the World Health
      Organization (WHO), making this the largest of the five epidemics of Asian H7N9
      infections that have occurred since 2013 (Figure 1). This report summarizes new
      viral and epidemiologic features identified during the fifth epidemic of Asian
      H7N9 in China and summarizes ongoing measures to enhance pandemic preparedness.
      Infections in humans and poultry were reported from most areas of China,
      including provinces bordering other countries, indicating extensive, ongoing
      geographic spread. The risk to the general public is very low and most human
      infections were, and continue to be, associated with poultry exposure, especially
      at live bird markets in mainland China. Throughout the first four epidemics of
      Asian H7N9 infections, only low pathogenic avian influenza (LPAI) viruses were
      detected among human, poultry, and environmental specimens and samples. During
      the fifth epidemic, mutations were detected among some Asian H7N9 viruses,
      identifying the emergence of high pathogenic avian influenza (HPAI) viruses as
      well as viruses with reduced susceptibility to influenza antiviral medications
      recommended for treatment. Furthermore, the fifth-epidemic viruses diverged
      genetically into two separate lineages (Pearl River Delta lineage and Yangtze
      River Delta lineage), with Yangtze River Delta lineage viruses emerging as
      antigenically different compared with those from earlier epidemics. Because of
      its pandemic potential, candidate vaccine viruses (CVV) were produced in 2013
      that have been used to make vaccines against Asian H7N9 viruses circulating at
      that time. CDC is working with partners to enhance surveillance for Asian H7N9
      viruses in humans and poultry, to improve laboratory capability to detect and
      characterize H7N9 viruses, and to develop, test and distribute new CVV that could
      be used for vaccine production if a vaccine is needed.
FAU - Kile, James C
AU  - Kile JC
FAU - Ren, Ruiqi
AU  - Ren R
FAU - Liu, Liqi
AU  - Liu L
FAU - Greene, Carolyn M
AU  - Greene CM
FAU - Roguski, Katherine
AU  - Roguski K
FAU - Iuliano, A Danielle
AU  - Iuliano AD
FAU - Jang, Yunho
AU  - Jang Y
FAU - Jones, Joyce
AU  - Jones J
FAU - Thor, Sharmi
AU  - Thor S
FAU - Song, Ying
AU  - Song Y
FAU - Zhou, Suizan
AU  - Zhou S
FAU - Trock, Susan C
AU  - Trock SC
FAU - Dugan, Vivien
AU  - Dugan V
FAU - Wentworth, David E
AU  - Wentworth DE
FAU - Levine, Min Z
AU  - Levine MZ
FAU - Uyeki, Timothy M
AU  - Uyeki TM
FAU - Katz, Jacqueline M
AU  - Katz JM
FAU - Jernigan, Daniel B
AU  - Jernigan DB
FAU - Olsen, Sonja J
AU  - Olsen SJ
FAU - Fry, Alicia M
AU  - Fry AM
FAU - Azziz-Baumgartner, Eduardo
AU  - Azziz-Baumgartner E
FAU - Davis, C Todd
AU  - Davis CT
LA  - eng
PT  - Journal Article
DEP - 20170908
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
SB  - IM
MH  - Animals
MH  - China/epidemiology
MH  - Epidemics/*statistics & numerical data
MH  - Humans
MH  - Influenza A Virus, H7N9 Subtype/*isolation & purification
MH  - Influenza in Birds/transmission/virology
MH  - Influenza, Human/*epidemiology/*virology
MH  - Pandemics/prevention & control
MH  - *Population Surveillance
MH  - Poultry
EDAT- 2017/09/08 06:00
MHDA- 2017/09/12 06:00
CRDT- 2017/09/08 06:00
AID - 10.15585/mmwr.mm6635a2 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2017 Sep 8;66(35):928-932. doi:
      10.15585/mmwr.mm6635a2.