Poster Presentation Lorne Infection and Immunity 2014

New Emerging Avian Influenza (H7N9) Virus Extra-pulmonary Distribution in Shanghai, China (#230)

Zhaoqin Zhu 1 , Yi Liu 1 , Lei Xu 1 , Wencai Guan 1 , Xiaonan Zhang 2 , Tangkai Qi 3 , Bisheng Shi 4 , Zhigang Song 1 , Yanmin Wan , Di Tian 1 , Jing He 1 , Xialing Zhang 1 , Min Wu 2 , Hongzhou Lv , Shuihua Lv 3 , Zhenghong Yuan 5 , Yunwen Hu 1 5
  1. Pathogen Diagnosis and Biosafety department, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
  2. Scientific Research department, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
  3. Department of Infectious Diseases，Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
  4. Scientific Research department, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
  5. Key laboratory of Medical Molecular Virology of the Ministries of Education, School of Basic Medical Science, Fudan University, Shanghai, China

Objective
As a new emerging avian-origin influenza virus A (H7N9) just broke the species barrier and infected human, there is an urgent need to qualify charactristic of H7N9 cases for its pathogenic mechanism studies.
Methods
Throat swab, serum, feces and urine samples were collected sequentially and clinical record data was obtained from 18 patients with A/H7N9 disease admitted to the Shanghai Public Health Clinical Centre (SPHCC), China, between April 4 and July 10, 2013, who were symptoms developed and were tested for the presence of the H7N9 virus testing by means of real-time RT-PCR and given antiviral treatment (Oseltamivir or Peramivir) before admission.

Results
The detection positive rate in ECMO group (73.33% in swab samples; 70% in feces samples; 53.33% in urine samples) was higher than that in MV group (71.72% in swab samples; 55.81% in feces samples; 49.15% in urine samples) which was higher than that in PG group (34.21% in swab samples; 33.33% in feces samples; 30.56% in urine samples) in the same time. The median persistent time of virus was 2 days in serum samples (0 d.p.i-23d.p.i), The viral RNA appearing in feces samples was earlier than that in urine samples, particularly in the patients from ECMO and MV groups (feces vs urine 10.5:11 in ECMO group; 9:11 in MV group). The peak of viral load was significant difference between ECMO and PG groups (p=0.0325). We found swab positive detection time was earlier than in feces (p=0.0459 in MV group; p=0.0406 in PG group) and urine (p=0.0740 in MV group; p=0.0221 in PG group) samples in all three case groups. The feces detected positive time was earlier than urine samples in ECMO and MV groups, but was later in PG group.

 Conclusions
we showed the characteristics of H7N9 virus extra-pulmonary distribution, and compared the first detected positive and the virus clearance time among three groups patients.The virus clearance in extra-pulmonary has relation with the prognosis of disease.