Human co-infection with novel avian influenza A H7N9 and influenza A H3N2 viruses in Jiangsu province, China

摘要: In February, 2013, a novel avian infl uenza A H7N9 virus emerged in east China and quickly spread to other areas. By May 27, 130 human infections had been confi rmed, with 37 deaths. Transmission can occur through direct or close contact poultry exposure environments that are contaminated poultry. No human-to-human trans mission has reported. Coinfection of viruses beings, birds, animals provides the possibility for emergence new reassortant virus. Here, we report co-infection seasonal H3N2 viruses. On April 25, previously healthy 15-year-old male student began have uenza-like symptoms fever, mild cough, headache, sore throat. The patient did not history sick persons animals. Retrospective investigation showed none his contacts developed symptoms. went local hospital on 26 when he felt were getting worse. physical examination, temperature was 39·0°C. white blood cell count 5·63 cells × 109/L 65% neutrophils 21% lymphocytes. admitted received oseltamivir 75 mg twice daily alleviate He recovered 2. Two throat swabs collected fi rst visit 26. One specimen used detection B by rapid, point-ofcare colloid gold assay (ABON, Alere Inc, Hangzhou, China), which positive A. sent Nanjing Municipal Center Disease Control Prevention (NJCDC), where subtypespecifi c primers provided CDC detect (H1 H3), pdm2009 H1N1, subtypes (H5N1, H9N2, H7N9) an ABI 7500 real-time PCR system. Ct values general A, H7, H3 18, 30, 18 respectively. remainder sample following this analysis then Jiangsu Provincial rmation these ndings. We isolated from using Madin-Darby canine kidney cells. Further sequence RNA extracted culture supernatants MiSeq platform (Illumina inc., San Diego, CA, USA) 3130 automatic DNA analyzer (Life Technologies, Applied Biosystems, Foster City, H3, N2, N9 genes coexisted sample. Nucleoid acid comparison H7 (A/Nanjing/M2/2013, GISAID accession number EPI450526 EPI450527) em erging (A/Zhejiang/DTID-ZJU01/2013[H7N9]) simi larity 99·9% 99·8%, similarity N2 (A/Nanjing/M1/2013, EPI450524 EPI450525) currently circulating (A/Texas/ JMM_21/ 2012[H3N2]) 99·5% Since mid-April, 2013 (fi gure, appendix), H1N1 replaced become dominant strain Province, China. So far no However, dual infec tions potential source reassort ment between viral strain. nding shows beings could act as mixing vessels reassortment, might facilitate transmission. public health scientifi com mun ities should enhance surveillance evolution.