Infection of immunocompromised patients by avian H9N2 influenza A virus

Cheng, Vincent C.C.; Chan, Jasper F.W.; Wen, X.; Wu, W.L.; Que, T.L.; Chen, H.; Chan, K.H.; Yuen, K.Y.

doi:10.1016/j.jinf.2011.02.007

« Previous Next »Journal of Infection
Volume 62, Issue 5 , Pages 394-399, May 2011

Infection of immunocompromised patients by avian H9N2 influenza A virus

Vincent C.C. Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Jasper F.W. Chan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
X. Wen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China
W.L. Wu
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China
T.L. Que
- Department of Pathology, Tuen Mun Hospital, Hong Kong Special Administrative Region, China
H. Chen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Research Center of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China
K.H. Chan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
K.Y. Yuen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- State Key Laboratory for Emerging Infectious Diseases, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Research Center of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Corresponding author. Department of Microbiology, Queen Mary Hospital, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China. Tel.: +852 22553206; fax: +852 28724555.

Accepted 19 February 2011. published online 17 March 2011.

Summary

Avian influenza A (H9N2) virus is transmitted sporadically from avian species to human causing mild diseases in immunocompetent person. We report two cases of human infection in immunocompromised patients in Hong Kong between 2008 and 2009. One patient had uneventful recovery with viral shedding at day 10 after symptom onset despite her underlying acute lymphoblastic leukaemia. The other patient with post-bone marrow transplant chronic graft-versus-host disease and bronhioltis obliterans went into respiratory failure. Genetic analysis revealed that these cases were caused by different genetic variants which are circulating in poultry in this region. Review of literature identified another 9 human cases reported in Southern China since 1988. It is possible that human infection with H9N2 is more common than what has been recognized. Continuous surveillance of H9N2 influenza virus infection in human is warranted.

Keywords: Avian influenza A H9N2, Bone marrow transplantation, Immunocompromised host