Volume 19, Number 7—July 2013
Dispatch
Clinical Findings for Early Human Cases of Influenza A(H7N9) Virus Infection, Shanghai, China
Table 1
Clinical characteristics and treatment outcomes for 4 patients with early cases of influenza A(H7N9) virus infection, Shanghai, China*
Characteristic/treatment | Case-patient no. |
|||
---|---|---|---|---|
1 | 2 | 3 | 4 | |
Age, y/sex | 73/M | 65/M | 67/M | 58/M |
Occupation | Farmer | Retiree | Retiree | Retiree |
Location (district) in Shanghai | Fengxian | Baoshan | Songjiang | Pudong |
Disease history | Coronary heart disease; chronic hepatic schistosomiasis | Hypertension; articular gout; benign prostatic hyperplasia | None | Hypertension |
History of poultry exposure | At home | At live poultry markets | At live poultry markets | At live poultry markets |
Date of last visit to live poultry market | NA | 2013 Mar 29 | 2013 Mar 28 | 2013 Mar 19 |
Date of symptom onset | 2013 Mar 31 | 2013 Apr 1 | 2013 March 30 | 2013 Mar 20 |
Date of infection confirmation | 2013 Apr 6 | 2013 Apr 6 | 2013 Apr 7 | 2013 Apr 7 |
Date admitted to SHPHCC | 2013 Apr 6 | 2013 Apr 6 | 2013 Apr 7 | 2013 Apr 7 |
Clinical symptoms present when admitted SHPHCC | 6 d of fever (maximum temperature 39.3°C) and shortness of breath | 6 d of fever (maximum temperature 39.3°C), and 2 d of cough | 8 d of fever (maximum temperature 39.7°C) and cough | 18 d of cough, 10 d of fever (maximum temperature 39.7°C), and 5 d with shortness of breath |
Chest radiograph or CT findings | Bilateral GGO | Bilateral GGO | GGO in left lingular lobe and left inferior lobe | Extensive infiltrates, with pleural effusion, in lung (bilateral) |
Antiviral drug treatment | Oseltamivir (150 mg/bid) on days 7–12 of illness | Oseltamivir (75 mg/bid) on days 4–17 of illness | Oseltamivir (75 mg/bid) on days 6–21 of illness | Oseltamivir (75 mg/bid) on days 16–23 of illness; oseltamivir (150 mg/bid) on days 17–32 of illness |
Antibacterial drug treatment | Moxifloxacin on days 7–12 of illness | Ceftriaxone on days 4–5 of illness; moxifloxacin on days 6–17 of illness | Azithromycin on days 5–9 of illness; cefaclor on days 1–5 of illness; moxifloxacin on days 14–21 of illness | Moxifloxacin on days 18–21 of illness; piperacillin and tazobactam on days 18–21 of illness; meropenem on days 21–34 of illness; linezolid on days 25–32 of illness |
Glucocorticoid treatment | Methylprednisolone (40 mg/d) on days 7–12 of illness | No | Methylprednisolone (40 mg/d) on days 5–12 of illness | Methylprednisolone (40 mg/bid) on days 16–37 of illness |
Immunoglobulin treatment | Yes, on days 7–12 of illness | Yes, on days 6–12 of illness | Yes, on days 5–8 of illness | Yes, on days 16–37 of illness |
ECMO treatment | No | No | No | On day 25 of illness |
Oxygen use | Noninvasive ventilation on days 6–12 of illness | Oxygen inhalation through nasal tube on days 4–17 of illness | Oxygen inhalation through nasal tube on days 7-20 of illness | Noninvasive ventilation on days 17–19 of illness |
Endotracheal intubation and mechanical ventilation | Yes, on day 12 of illness | No | No | Yes, on days 19–32 of illness |
Status as of 2013 Apr 21 | Died on day 12 of illness | Recovered, discharged on day 18 after illness onset | Recovered, discharged on day 21 after illness onset | Condition worsened, receiving invasive breath machine and ECMO treatment |
*NA, not applicable; SHPHCC, Shanghai Public Health Clinical Center; CT, computed tomography scan; GGO, ground-glass opacity; bid, 2 times a day; ECMO, extracorporeal membrane oxygenation.
1These authors contributed equally to this article.