Peer-reviewed veterinary case report
Human infection with a reassortment avian influenza A H3N8 virus: an epidemiological investigation study.
- Journal:
- Nature communications
- Year:
- 2022
- Authors:
- Bao, Pengtao et al.
- Affiliation:
- The Eighth Medical Center of Chinese PLA General Hospital · China
Plain-English summary
In April 2022, a four-year-old boy became very sick with repeated fevers and severe pneumonia. Tests showed he was infected with a special type of avian influenza virus called H3N8, which had genes from both birds and other viruses. His condition worsened, leading to serious issues with his breathing, liver, and kidneys, and he required advanced medical support like a breathing machine. Interestingly, the same virus was found in a dog and a cat living in his home, but no one else in the family got sick. The findings suggest that this H3N8 virus can cause serious illness in humans, but it doesn't seem to spread easily between people.
Abstract
A four-year-old boy developed recurrent fever and severe pneumonia in April, 2022. High-throughput sequencing revealed a reassortant avian influenza A-H3N8 virus (A/Henan/ZMD-22-2/2022(H3N8) with avian-origin HA and NA genes. The six internal genes were acquired from Eurasian lineage H9N2 viruses. Molecular substitutions analysis revealed the haemagglutin retained avian-like receptor binding specificity but that PB2 genes possessed sequence changes (E627K) associated with increased virulence and transmissibility in mammalian animal models. The patient developed respiratory failure, liver, renal, coagulation dysfunction and sepsis. Endotracheal intubation and extracorporeal membrane oxygenation were administered. H3N8 RNA was detected from nasopharyngeal swab of a dog, anal swab of a cat, and environmental samples collected in the patient's house. The full-length HA sequences from the dog and cat were identical to the sequence from the patient. No influenza-like illness was developed and no H3N8 RNA was identified in family members. Serological testing revealed neutralizing antibody response against ZMD-22-2 virus in the patient and three family members. Our results suggest that a triple reassortant H3N8 caused severe human disease. There is some evidence of mammalian adaptation, possible via an intermediary mammalian species, but no evidence of person-to-person transmission. The potential threat from avian influenza viruses warrants continuous evaluation and mitigation.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/36357398/