Influenza A (H7N9) and the importance of digital epidemiology.
Influenza A (H7N9) and the importance of digital epidemiology.
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DOI：
10.1056/nejmp1307752
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发表时间：
2013-08-01
期刊：
影响因子：
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通讯作者：
Brownstein JS
中科院分区：
文献类型：
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作者：
Salathé M;Freifeld CC;Mekaru SR;Tomasulo AF;Brownstein JS
2013年3月31日，中国卫生官员向世界卫生组织通报了三例人感染新型甲型流感病毒（H7N9）病例。自那时以来，已有132人感染，其中37人死亡（见图A）。到目前为止，没有证据表明正在进行人际传播。然而，该病毒的一些特征值得高度关注：首先，近年来人类没有大规模接触过血凝素7（H7）和神经氨酸酶9（N9）抗原，因此很可能缺乏对该毒株的免疫力。其次，对病毒基因组序列的初步分析表明，病毒适应哺乳动物的迹象，如附着在呼吸组织上的能力和在哺乳动物体温下复制的能力1，这可能有助于人传人。第三，由于该病毒在鸟类中的致病性较低，仅通过症状监测难以在鸟群中发现其存在。对中国2万多名流感样疾病患者的检测显示，只有6例H7N9感染病例，这表明H7N9的轻度病例并不普遍。2
On March 31, 2013, Chinese health officials notified the World Health Organization of three cases of human infection with novel inf luenza A (H7N9). Since then, 132 people have been infected, 37 of them fatally (see figure, Panel A). To date, there is no evidence of ongoing human-to-human transmission. However, a number of characteristics of this virus are cause for heightened attention.First, the human population has not been exposed on a large scale to hemagglutinin 7 (H7) and neuraminidase 9 (N9) antigens in recent times and therefore most likely lacks immunity against this strain. Second, initial analyses of viral genome sequences suggest signs of adaptation to mammals—such as the ability to attach to respiratory tissue and to replicate at mammalian body temperatures1—which could facilitate human-to-human transmission. Third, because the virus has low pathogenicity in birds, its presence is difficult to detect in bird f locks by symptomatic surveillance alone. Testing of more than 20,000 people with inf luenza-like illness in China revealed only six cases of H7N9 infection, suggesting that there are not widespread mild cases of H7N9. 2