First H10N8 Fatality in Humans due to reassortment?

Nobody panic! There have been only two cases and it’s not yet documented as being readily transmissible person-to-person (yes we understand that’s a lot of caveats). Unsurprisingly, live poultry is thought to be the source of the infection. It remains unclear why or how the virus has jumped to humans. Chinese health authorities are, as always, very closely monitoring the situation. Can we have a moment of silent appreciation for Chinese epidemiologists and biosurveillance professionals? Just as H7N9 starts to pick up again (301st case this week),  a brand new, potentially-pandemic strain never before seen in humans pops up. Same for the Saudi epidemiologists trying to work out MERS and the health authorities in any country in which Ebola is endemic (good grief).

From the Lancet: “Human infections with different avian influenza viruses—eg, H5N1, H9N2, and H7N9—have raised concerns about pandemic potential worldwide. We report the first human infection with a novel reassortant avian influenza A H10N8 virus. A woman aged 73 years presented with fever and was admitted to hospital on Nov 30, 2013. She developed multiple organ failure and died 9 days after illness onset. A novel reassortant avian influenza A H10N8 virus was isolated from the tracheal aspirate specimen obtained from the patient 7 days after onset of illness. Sequence analyses revealed that all the genes of the virus were of avian origin, with six internal genes from avian influenza A H9N2 viruses. The aminoacid motif GlnSerGly at residues 226—228 of the haemagglutinin protein indicated avian-like receptor binding preference. A mixture of glutamic acid and lysine at residue 627 in PB2 protein—which is associated with mammalian adaptation—was detected in the original tracheal aspirate samples. The virus was sensitive to neuraminidase inhibitors. Sputum and blood cultures and deep sequencing analysis indicated no co-infection with bacteria or fungi. Epidemiological investigation established that the patient had visited a live poultry market 4 days before illness onset. The novel reassortant H10N8 virus obtained is distinct from previously reported H10N8 viruses. The virus caused human infection and could have been associated with the death of a patient.”

The full article is available behind their paywall, or summarized on the BBC.

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