A human case died by avian influenza A (H5N6) infection in Jiangxi province, China: an epidemiological and clinical survey

Background: After the first case was laboratory-confirmed, a total of 9 human avian influenza A (H5N6) infection index cases were reported and treated in China as of January 28, 2016. The aim of this study was to analyze the epidemiological and clinical characteristics of the first fatal H5N6 case in Jiangxi province and provide scientific recommendations for control and prevention of this epidemic. Methods: Thereal-time reverse-transcription polymerase chain reaction (RT-PCR) method was conducted to test for the presence of nucleic acid from the influenza A virus and its subtypes. RNA from throat swab specimens was extracted and reverse-transcribed to double-strand DNA. Embryonated chicken eggs were used to isolate the virus. Epidemiological and clinical information of this case were collected by the use of a standard questionnaire, which was recommended by the China Provincial Center for Disease Control and Prevention. Results: The onset of illness for this case began on December 12, 2014, where the patient then died from respiratory failure on December 21, 2014. On January 6, 2016, it was confirmed to be a case of human infection with the H5N6 virus. There were no secondary cases confirmed among the individual’s close contacts. There was a clear history of avian exposure for this case and the avian influenza A (H5) nucleic acid was found in the patient’s residence. Conclusion: The initial presentation of this case was similar to other avian influenza or influenza viruses, presenting as fever, cough, and other influenza-like illness symptoms. Similar to other human H5N6 infection cases reported previously, this case suffered from multiple organ failure and died from respiratory failure. A delay in initiating antiviral therapy was the main cause of death for this case. The epidemiological survey conducted in this case did not uncover any evidence to suggest human-to-human transmission of the infection.