Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus.
Background Human infection with an avian influenza A virus (subtype H5N1) was reported recently in Hong Kong.
We describe the clinical presentation of the first 12 patients and options for rapid viral diagnosis.
Methods Case notes of 12 patients with virus-culture-confirmed influenza A H5N1 infection were analysed.
The clinical presentation and risk factors associated with severe disease were defined and the results of methods for rapid virus diagnosis were compared.
Findings Patients ranged from 1 to 60 years of age.
Clinical presentation was that of an influenza-like illness with evidence of pneumonia in seven patients.
All seven patients older than 13 years had severe disease (four deaths), whereas children 5 years or younger had mild symptoms with the exception of one who died with Reye's syndrome associated with intake of aspirin.
Gastrointestinal manifestations, raised liver enzymes, renal failure unrelated to rhabdomyolysis, and pancytopenia were unusually prominent.
Factors associated with severe disease included older age, delay in hospitalisation, lower-respiratory-tract involvement, and a low total peripheral white blood cell count or lymphopenia at admission.
An H5-specific reverse-transcription PCR assay (RT-PCR) was useful for rapid detection of virus directly in respiratory specimens.
A commercially available enzyme immunoassay was more sensitive than direct immunofluorescence for rapid viral diagnosis. (...)
Mots-clés Pascal : Influenzavirus aviaire, Influenzavirus A, Orthomyxoviridae, Virus, Symptomatologie, Diagnostic, Exploration virologique, Facteur risque, Hong Kong, Chine, Asie, Homme, Virose, Infection, Influenza A subtype H5N1
Mots-clés Pascal anglais : Avian influenzavirus, Influenzavirus A, Orthomyxoviridae, Virus, Symptomatology, Diagnosis, Virological exploration, Risk factor, Hong Kong, China, Asia, Human, Viral disease, Infection
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0123491
Code Inist : 002B05C02J. Création : 22/06/1998.