The "Road Not (Yet) Taken" On H7N9 Flu — And How Far We've Gotten

Last week’s New England Journal of Medicine included a thoughtful meditation on the possibility that the new bird flu out of China, H7N9, could become a globe-spanning pandemic — and on how much knowledge is needed before we’ll be able to predict whether it will or not. The authors, all from the US National Institutes of Health, know a fair amount about pandemics: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. David Morens, Fauci’s senior advisor and a medical historian; and Dr. Jeffery Taubenberger, a physician and microbiologist who brought back to the world the viral cause of the worst pandemic: the influenza of 1918, which killed 100 million people.

In various combinations over the past 10 or so years, the three have written a number of papers looking back at the record fro 1918, interrogating its impact, and particularly examining the causes of its extraordinary death toll. So they are probably the perfect authors to write about gaps in knowledge about H7N9.

But aside from its useful examination of the virology, what struck me as most interesting about their paper is how soon it is to be able to write something like this. After all, H7N9 only emerged to public knowledge in late February, and so far has caused 132 cases and 37 deaths, all in eastern China. That these authors could write this paper now is yet another marker, I think, of how different this outbreak is from SARS 10 years ago, as well as how rapidly international public health science can move, if everyone cooperates.

So, the paper first. They write:

The critical but currently unanswerable question is whether every avian influenza virus capable of infecting humans can acquire serial pandemic-generating mutations without being limited by structural or functional evolutionary constraints — or whether pandemic viruses are rare entities whose complex gene constellations cannot easily be configured except by rare and still-obscure mechanisms…

Like every human influenza pandemic and major outbreak in more than a century, H7N9 has left us surprised and puzzled. It is only slightly reassuring that since 1918, we have never seen an influenza pandemic emerge through direct viral mutations alone. But every pandemic emergence seems to be a law unto itself, and we cannot know whether or under what circumstances the highly unusual H7N9 virus might be able to become pandemic. Influenza viruses’ unpredictability renders H7N9 pandemic preparedness essential… H7N9’s journey has just begun. We can only hope that the road to a pandemic is the road not taken.

Those paragraphs lie close to the beginning and end of the piece. In between comes a review of the genetics of influenza A, the 1918 virus, and H7N9, with additional comments about the clinical picture of H7N9 and the role of poultry trade and exploding Asian mega-cities. It is short but dense, and could only have been written if there were a number of papers that had gone before it.

So I took a look at how many papers on H7N9 there have been since this outbreak. According to PubMed, there have been 68 since February (update: using this search string). That’s quite striking. Here they are.

Pandemic Influenza Viruses – Hoping for the Road Not Taken.
Morens DM, Taubenberger JK, Fauci AS.
N Engl J Med. 2013 Jun 5. [Epub ahead of print]
PMID: 23738514 [PubMed – as supplied by publisher]

Deaths Associated with Avian Influenza A(H7N9) Virus in China.
Ke Y, Wang Y, Zhang W, Huang L, Chen Z.
Ann Intern Med. 2013 Jun 4. doi: 10.7326/0003-4819-159-2-201307160-00669. [Epub ahead of print] No abstract available.
PMID: 23736226 [PubMed – as supplied by publisher]
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High Severity and Fatality of Human Infections with Avian Influenza A (H7N9) Infection in China.
Ke Y, Wang Y, Liu S, Guo J, Zhang W, Yuan X, Zhang N, Wang Z, Song H, Huang L, Chen Z.
Clin Infect Dis. 2013 Jun 3. [Epub ahead of print] No abstract available.
PMID: 23735331 [PubMed – as supplied by publisher]

Is avian influenza A (H7N9) virus staggering its way to humans?
Chen GW, Lai MM, Wu SC, Chang SC, Huang LM, Shih SR.
J Formos Med Assoc. 2013 Jun 3. doi:pii: S0929-6646(13)00165-4. 10.1016/j.jfma.2013.04.015. [Epub ahead of print]
PMID: 23742902 [PubMed – as supplied by publisher]

Taiwan faces challenges on the emerging avian influenza A (H7N9) virus in China.
Wu HS, Chuang JH, Chang FY.
J Formos Med Assoc. 2013 Jun 3. doi:pii: S0929-6646(13)00171-X. 10.1016/j.jfma.2013.05.004. [Epub ahead of print] No abstract available.
PMID: 23742900 [PubMed – as supplied by publisher]

Genesis of avian-origin H7N9 influenza A viruses.
Van Ranst M, Lemey P.
Lancet. 2013 Jun 1;381(9881):1883-5. doi: 10.1016/S0140-6736(13)60959-9. Epub 2013 May 2. No abstract available.
PMID: 23643449 [PubMed – in process]

Origin and diversity of novel avian influenza A H7N9 viruses causing human infection: phylogenetic, structural, and coalescent analyses.
Liu D, Shi W, Shi Y, Wang D, Xiao H, Li W, Bi Y, Wu Y, Li X, Yan J, Liu W, Zhao G, Yang W, Wang Y, Ma J, Shu Y, Lei F, Gao GF.
Lancet. 2013 Jun 1;381(9881):1926-32. doi: 10.1016/S0140-6736(13)60938-1. Epub 2013 May 1.
PMID: 23643111 [PubMed – in process]

Avian influenza A H7N9 in Zhejiang, China.
Koopmans M, de Jong MD.
Lancet. 2013 Jun 1;381(9881):1882-3. doi: 10.1016/S0140-6736(13)60936-8. Epub 2013 Apr 27. No abstract available.
PMID: 23628442 [PubMed – in process]

Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome.
Chen Y, Liang W, Yang S, Wu N, Gao H, Sheng J, Yao H, Wo J, Fang Q, Cui D, Li Y, Yao X, Zhang Y, Wu H, Zheng S, Diao H, Xia S, Zhang Y, Chan KH, Tsoi HW, Teng JL, Song W, Wang P, Lau SY, Zheng M, Chan JF, To KK, Chen H, Li L, Yuen KY.
Lancet. 2013 Jun 1;381(9881):1916-25. doi: 10.1016/S0140-6736(13)60903-4. Epub 2013 Apr 25.
PMID: 23623390 [PubMed – in process]

A proportionate response to H7N9.
The Lancet Infectious Diseases.
Lancet Infect Dis. 2013 Jun;13(6):465. doi: 10.1016/S1473-3099(13)70134-8. Epub 2013 May 14. No abstract available.
PMID: 23680315 [PubMed – in process]

Lessons learnt from the human infections of avian-origin influenza A H7N9 virus: Live free markets and human health.
Wu Y, Gao GF.
Sci China Life Sci. 2013 Jun;56(6):493-4. doi: 10.1007/s11427-013-4496-y. Epub 2013 Jun 5. No abstract available.
PMID: 23737001 [PubMed – in process]

Environmental connections of novel avian-origin H7N9 influenza virus infection and virus adaptation to the human.
Li J, Yu X, Pu X, Xie L, Sun Y, Xiao H, Wang F, Din H, Wu Y, Liu D, Zhao G, Liu J, Pan J.
Sci China Life Sci. 2013 Jun;56(6):485-92. doi: 10.1007/s11427-013-4491-3. Epub 2013 May 8.
PMID: 23657795 [PubMed – in process]

The Novel H7N9 Influenza A Virus: Its Present Impact and Indeterminate Future.
Kahn RE, Richt JA.
Vector Borne Zoonotic Dis. 2013 Jun;13(6):347-8. doi: 10.1089/vbz.2013.999.ceezad. Epub 2013 Apr 30. No abstract available.
PMID: 23631726 [PubMed – in process]

[Nursing experience for patients with severe H7N9 bird flu virus in critical care unit].
Jiang R, Chen X, Tang R, Zhang X, Liu HS, Wu Q, Chen HM, Zeng ZG, Nie C, Qian KJ.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013 Jun;25(6):379. doi: 10.3760/cma. j. issn.2095-4352. 2013. 06.016. Chinese. No abstract available.
PMID: 23739576 [PubMed – in process]

Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance.
Hu Y, Lu S, Song Z, Wang W, Hao P, Li J, Zhang X, Yen HL, Shi B, Li T, Guan W, Xu L, Liu Y, Wang S, Zhang X, Tian D, Zhu Z, He J, Huang K, Chen H, Zheng L, Li X, Ping J, Kang B, Xi X, Zha L, Li Y, Zhang Z, Peiris M, Yuan Z.
Lancet. 2013 May 29. doi:pii: S0140-6736(13)61125-3. 10.1016/S0140-6736(13)61125-3. [Epub ahead of print]
PMID: 23726392 [PubMed – as supplied by publisher]

Serologic Study for Influenza A (H7N9) among High-Risk Groups in China.
Bai T, Zhou J, Shu Y.
N Engl J Med. 2013 May 29. [Epub ahead of print]
PMID: 23718151 [PubMed – as supplied by publisher] Free Article

Reducing exposure to avian influenza H7N9.
Xu J, Lu S, Wang H, Chen C.
Lancet. 2013 May 25;381(9880):1815-6. doi: 10.1016/S0140-6736(13)60950-2. Epub 2013 May 10. No abstract available.
PMID: 23664060 [PubMed – indexed for MEDLINE]

Exposure to avian influenza H7N9 in farms and wet markets.
Lee SS, Wong NS, Leung CC.
Lancet. 2013 May 25;381(9880):1815. doi: 10.1016/S0140-6736(13)60949-6. Epub 2013 May 10. No abstract available.
PMID: 23664058 [PubMed – indexed for MEDLINE]

Adapting Global Influenza Management Strategies to Address Emerging Viruses.
Noah DL, Noah JW.
Am J Physiol Lung Cell Mol Physiol. 2013 May 24. [Epub ahead of print]
PMID: 23709619 [PubMed – as supplied by publisher]

Evolutionary Characteristics of A/Hangzhou/1/2013 and Source of Avian Influenza Virus H7N9 Subtype in China.
Xiong C, Zhang Z, Jiang Q, Chen Y.
Clin Infect Dis. 2013 May 23. [Epub ahead of print] No abstract available.
PMID: 23650290 [PubMed – as supplied by publisher]

A comparison of rapid point-of-care tests for the detection of avian influenza A(H7N9) virus, 2013.
Baas C, Barr I, Fouchier R, Kelso A, Hurt A.
Euro Surveill. 2013 May 23;18(21). doi:pii: 20487. No abstract available.
PMID: 23725980 [PubMed – in process] Free Article

Infectivity, Transmission, and Pathology of Human H7N9 Influenza in Ferrets and Pigs.
Zhu H, Wang D, Kelvin DJ, Li L, Zheng Z, Yoon SW, Wong SS, Farooqui A, Wang J, Banner D, Chen R, Zheng R, Zhou J, Zhang Y, Hong W, Dong W, Cai Q, Roehrl MH, Huang SS, Kelvin AA, Yao T, Zhou B, Chen X, Leung GM, Poon LL, Webster RG, Webby RJ, Peiris JS, Guan Y, Shu Y.
Science. 2013 May 23. [Epub ahead of print]
PMID: 23704376 [PubMed – as supplied by publisher]

Induction of cross-reactive antibodies to novel H7N9 influenza virus by recombinant Newcastle disease virus expressing a North American lineage H7 subtype hemagglutinin.
Goff PH, Krammer F, Hai R, Seibert CW, Margine I, García-Sastre A, Palese P.
J Virol. 2013 May 22. [Epub ahead of print]
PMID: 23698299 [PubMed – as supplied by publisher]

CDC: Use antivirals early, aggressively for H7N9 flu.
Kuehn BM.
JAMA. 2013 May 22;309(20):2086. doi: 10.1001/jama.2013.6086. No abstract available.
PMID: 23695459 [PubMed – indexed for MEDLINE]

Live-Animal Markets and Influenza A (H7N9) Virus Infection.
Bao CJ, Cui LB, Zhou MH, Hong L, Gao GF, Wang H.
N Engl J Med. 2013 May 22. [Epub ahead of print]
PMID: 23697471 [PubMed – as supplied by publisher] Free Article

Clinical Findings in 111 Cases of Influenza A (H7N9) Virus Infection.
Gao HN, Lu HZ, Cao B, Du B, Shang H, Gan JH, Lu SH, Yang YD, Fang Q, Shen YZ, Xi XM, Gu Q, Zhou XM, Qu HP, Yan Z, Li FM, Zhao W, Gao ZC, Wang GF, Ruan LX, Wang WH, Ye J, Cao HF, Li XW, Zhang WH, Fang XC, He J, Liang WF, Xie J, Zeng M, Wu XZ, Li J, Xia Q, Jin ZC, Chen Q, Tang C, Zhang ZY, Hou BM, Feng ZX, Sheng JF, Zhong NS, Li LJ.
N Engl J Med. 2013 May 22. [Epub ahead of print]
PMID: 23697469 [PubMed – as supplied by publisher] Free Article

Avian influenza A (H7N9) infections: Intensivists as virus hunters in the new century.
Xi X, Fang Q, Gu Q, Du B; for the China Critical Care Clinical Trial Group (CCCCTG).
J Crit Care. 2013 May 21. doi:pii: S0883-9441(13)00126-3. 10.1016/j.jcrc.2013.05.001. [Epub ahead of print] No abstract available.
PMID: 23706866 [PubMed – as supplied by publisher]

Birds of ill omen – is H7N9 the harbinger of the next pandemic?
Häfner S.
Microbes Infect. 2013 May 18. doi:pii: S1286-4579(13)00092-0. 10.1016/j.micinf.2013.04.011. [Epub ahead of print]
PMID: 23688529 [PubMed – as supplied by publisher]

Epidemiologic Characteristics of Cases for Influenza A(H7N9) Virus Infections in China.
Zhang W, Wang L, Hu W, Ding F, Sun H, Li S, Huang L, Li C.
Clin Infect Dis. 2013 May 17. [Epub ahead of print] No abstract available.
PMID: 23633108 [PubMed – as supplied by publisher]

Population-level antibody estimates to novel influenza A/H7N9.
Boni MF, Chau NV, Dong N, Todd S, Nhat NT, de Bruin E, van Beek J, Hien NT, Simmons CP, Farrar J, Koopmans M.
J Infect Dis. 2013 May 17. [Epub ahead of print]
PMID: 23687225 [PubMed – as supplied by publisher]

Outbreak with a novel avian influenza A(H7N9) virus in China – scenarios and triggers for assessing risks and planning responses in the European Union, May 2013.
Schenk C, Plachouras D, Danielsson N, Nicoll A, Robesyn E, Coulombier D.
Euro Surveill. 2013 May 16;18(20). doi:pii: 20482. No abstract available.
PMID: 23725867 [PubMed – in process] Free Article

Epidemiological link between exposure to poultry and all influenza A(H7N9) confirmed cases in Huzhou city, China, March to May 2013.
Han J, Jin M, Zhang P, Liu J, Wang L, Wen D, Wu X, Liu G, Zou Y, Lv X, Dong X, Shao B, Gu S, Zhou D, Leng Q, Zhang C, Lan K.
Euro Surveill. 2013 May 16;18(20). doi:pii: 20481. No abstract available.
PMID: 23725866 [PubMed – in process] Free Article

Surveillance of avian influenza A(H7N9) virus infection in humans and detection of the first imported human case in Taiwan, 3 April to 10 May 2013.
Lo Y, Chen W, Huang W, Lin Y, Liu M, Kuo H, Chuang J, Yang J, Liu M, Wu H, Yang C, Chou J, Chang F.
Euro Surveill. 2013 May 16;18(20). doi:pii: 20479. No abstract available.
PMID: 23725865 [PubMed – as supplied by publisher] Free Article

Global concerns regarding novel influenza A (H7N9) virus infections.
Uyeki TM, Cox NJ.
N Engl J Med. 2013 May 16;368(20):1862-4. doi: 10.1056/NEJMp1304661. Epub 2013 Apr 11. No abstract available.
PMID: 23577629 [PubMed – indexed for MEDLINE] Free Article

Human infection with a novel avian-origin influenza A (H7N9) virus.
Gao R, Cao B, Hu Y, Feng Z, Wang D, Hu W, Chen J, Jie Z, Qiu H, Xu K, Xu X, Lu H, Zhu W, Gao Z, Xiang N, Shen Y, He Z, Gu Y, Zhang Z, Yang Y, Zhao X, Zhou L, Li X, Zou S, Zhang Y, Li X, Yang L, Guo J, Dong J, Li Q, Dong L, Zhu Y, Bai T, Wang S, Hao P, Yang W, Zhang Y, Han J, Yu H, Li D, Gao GF, Wu G, Wang Y, Yuan Z, Shu Y.
N Engl J Med. 2013 May 16;368(20):1888-97. doi: 10.1056/NEJMoa1304459. Epub 2013 Apr 11.
PMID: 23577628 [PubMed – indexed for MEDLINE] Free Article

Influenza A(H7N9): From Anxiety to Preparedness.
Pavia AT.
Ann Intern Med. 2013 May 14. doi: 10.7326/0003-4819-159-3-201308060-00653. [Epub ahead of print] No abstract available.
PMID: 23697995 [PubMed – as supplied by publisher]

The first case of H7N9 influenza in Taiwan.
Chang SY, Lin PH, Tsai JC, Hung CC, Chang SC.
Lancet. 2013 May 11;381(9878):1621. doi: 10.1016/S0140-6736(13)60943-5. Epub 2013 Apr 29. No abstract available.
PMID: 23639487 [PubMed – indexed for MEDLINE]

Molecular Detection of Human H7N9 Influenza A Virus Causing Outbreaks in China.
Wong CK, Zhu H, Li OT, Leung YH, Chan MC, Guan Y, Peiris JS, Poon LL.
Clin Chem. 2013 May 10. [Epub ahead of print]
PMID: 23665848 [PubMed – as supplied by publisher]

Emergence of Avian Influenza A(H7N9) Virus Causing Severe Human Illness – China, February-April 2013.
Centers for Disease Control and Prevention (CDC).
MMWR Morb Mortal Wkly Rep. 2013 May 10;62(18):366-71.
PMID: 23657113 [PubMed – in process] Free Article

Preliminary inferences on the age-specific seriousness of human disease caused by avian influenza A(H7N9) infections in China, March to April 2013.
Cowling B, Freeman G, Wong J, Wu P, Liao Q, Lau E, Wu J, Fielding R, Leung G.
Euro Surveill. 2013 May 9;18(19). doi:pii: 20475. No abstract available.
PMID: 23725807 [PubMed – in process] Free Article

Major Challenges in Providing an Effective and Timely Pandemic Vaccine for Influenza A(H7N9).
Osterholm MT, Ballering KS, Kelley NS.
JAMA. 2013 May 9:1-2. doi: 10.1001/jama.2013.6589. [Epub ahead of print] No abstract available.
PMID: 23700117 [PubMed – as supplied by publisher]

Viruses from ducks and chickens dominate the family tree of H7N9.
[No authors listed]
BMJ. 2013 May 8;346:f2895. doi: 10.1136/bmj.f2895. No abstract available.
PMID: 23657185 [PubMed – in process]

Visual detection of human infection with influenza A (H7N9) virus by subtype-specific reverse transcription loop-mediated isothermal amplification with hydroxynaphthol blue dye.
Nie K, Zhao X, Ding X, Li XD, Zou SM, Guo JF, Wang DY, Gao RB, Li XY, Huang WJ, Shu YL, Ma XJ.
Clin Microbiol Infect. 2013 May 7. doi: 10.1111/1469-0691.12263. [Epub ahead of print]
PMID: 23718218 [PubMed – as supplied by publisher]

Emerging risk of H7N9 influenza in China.
Wu S, Wu F, He J.
Lancet. 2013 May 4;381(9877):1539-40. doi: 10.1016/S0140-6736(13)60767-9. Epub 2013 Apr 19. No abstract available.
PMID: 23602315 [PubMed – indexed for MEDLINE]

How to interpret the transmissibility of novel influenza A(H7N9): an analysis of initial epidemiological data of human cases from China.
Nishiura H, Mizumoto K, Ejima K.
Theor Biol Med Model. 2013 May 4;10:30. doi: 10.1186/1742-4682-10-30.
PMID: 23642092 [PubMed – in process] Free PMC Article

Understanding H7N9 avian flu.
Dai C, Jiang M.
BMJ. 2013 May 3;346:f2755. doi: 10.1136/bmj.f2755. No abstract available.
PMID: 23645899 [PubMed – in process]

Risk assessment on the epidemics of human infection with a novel avian influenza A (H7N9) virus in Jiangsu Province, China.
Liu W, Zhu Y, Qi X, Xu K, Ge A, Ji H, Ai J, Bao C, Tang F, Zhou M.
J Biomed Res. 2013 May;27(3):163-6. doi: 10.7555/JBR.27.20130071. Epub 2013 May 16.
PMID: 23720670 [PubMed – in process] Free PMC Article

An overview of the recent outbreaks of the avian-origin influenza A (H7N9) virus in the human.
Tang RB, Chen HL.
J Chin Med Assoc. 2013 May;76(5):245-8. doi: 10.1016/j.jcma.2013.04.003. Epub 2013 May 4.
PMID: 23651506 [PubMed – in process]

Pathogenesis, transmissibility, and ocular tropism of a highly pathogenic avian influenza A (H7N3) virus associated with human conjunctivitis.
Belser JA, Davis CT, Balish A, Edwards LE, Zeng H, Maines TR, Gustin KM, Martínez IL, Fasce R, Cox NJ, Katz JM, Tumpey TM.
J Virol. 2013 May;87(10):5746-54. doi: 10.1128/JVI.00154-13. Epub 2013 Mar 13.
PMID: 23487452 [PubMed – in process]

Emerging epidemiology of H7N9 avian flu.
[No authors listed]
BMJ. 2013 Apr 30;346:f2717. doi: 10.1136/bmj.f2717. No abstract available.
PMID: 23637153 [PubMed – in process]

Genomic signature and protein sequence analysis of a novel influenza A (H7N9) virus that causes an outbreak in humans in China.
Liu Q, Lu L, Sun Z, Chen GW, Wen Y, Jiang S.
Microbes Infect. 2013 Apr 27. doi:pii: S1286-4579(13)00085-3. 10.1016/j.micinf.2013.04.004. [Epub ahead of print]
PMID: 23628410 [PubMed – as supplied by publisher]

Influenza. Despite large research effort, H7N9 continues to baffle.
Hvistendahl M, Normile D, Cohen J.
Science. 2013 Apr 26;340(6131):414-5. doi: 10.1126/science.340.6131.414. No abstract available.
PMID: 23620023 [PubMed – indexed for MEDLINE]

Joint ECDC CNRL and WHO/Europe briefing note on diagnostic preparedness in Europe for detection of avian influenza A(H7N9) viruses.
Eurosurveillance editorial team.
Euro Surveill. 2013 Apr 25;18(17). doi:pii: 20466. No abstract available.
PMID: 23647629 [PubMed – in process] Free Article

Virus-host interactions and the unusual age and sex distribution of human cases of influenza A(H7N9) in China, April 2013.
Skowronski D, Janjua N, Kwindt T, De Serres G.
Euro Surveill. 2013 Apr 25;18(17). doi:pii: 20465. No abstract available.
PMID: 23647627 [PubMed – in process] Free Article

H7N9 is a virus worth worrying about.
Horby P.
Nature. 2013 Apr 25;496(7446):399. doi: 10.1038/496399a. No abstract available.
PMID: 23619655 [PubMed – indexed for MEDLINE]

Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China.
Li Q, Zhou L, Zhou M, Chen Z, Li F, Wu H, Xiang N, Chen E, Tang F, Wang D, Meng L, Hong Z, Tu W, Cao Y, Li L, Ding F, Liu B, Wang M, Xie R, Gao R, Li X, Bai T, Zou S, He J, Hu J, Xu Y, Chai C, Wang S, Gao Y, Jin L, Zhang Y, Luo H, Yu H, Gao L, Pang X, Liu G, Shu Y, Yang W, Uyeki TM, Wang Y, Wu F, Feng Z.
N Engl J Med. 2013 Apr 24. [Epub ahead of print]
PMID: 23614499 [PubMed – as supplied by publisher] Free Article

H7N9 virus is more transmissible and harder to detect than H5N1, say experts.
Parry J.
BMJ. 2013 Apr 22;346:f2568. doi: 10.1136/bmj.f2568. No abstract available.
PMID: 23610381 [PubMed – in process]

As H7N9 spreads in China, experts watch and wait.
Alcorn T.
Lancet. 2013 Apr 20;381(9875):1347. No abstract available.
PMID: 23610775 [PubMed – indexed for MEDLINE]

From SARS to H7N9: will history repeat itself?
[No authors listed]
Lancet. 2013 Apr 20;381(9875):1333. doi: 10.1016/S0140-6736(13)60865-X. No abstract available.
PMID: 23601933 [PubMed – indexed for MEDLINE]

Specific detection by real-time reverse-transcription PCR assays of a novel avian influenza A(H7N9) strain associated with human spillover infections in China.
Corman VM, Eickmann M, Landt O, Bleicker T, Brünink S, Eschbach-Bludau M, Matrosovich M, Becker S, Drosten C.
Euro Surveill. 2013 Apr 18;18(16):20461.
PMID: 23611031 [PubMed – in process] Free Article

Guiding outbreak management by the use of influenza A(H7Nx) virus sequence analysis.
Jonges M, Meijer A, Fouchier RA, Koch G, Li J, Pan JC, Chen H, Shu YL, Koopmans MP.
Euro Surveill. 2013 Apr 18;18(16):20460.
PMID: 23611030 [PubMed – in process] Free Article

H7N9 Incident, immune status, the elderly and a warning of an influenza pandemic.
Guan Y, Farooqui A, Zhu H, Dong W, Wang J, Kelvin DJ.
J Infect Dev Ctries. 2013 Apr 17;7(4):302-7. doi: 10.3855/jidc.3675.
PMID: 23592638 [PubMed – in process] Free Article

Genetic analysis of novel avian A(H7N9) influenza viruses isolated from patients in China, February to April 2013.
Kageyama T, Fujisaki S, Takashita E, Xu H, Yamada S, Uchida Y, Neumann G, Saito T, Kawaoka Y, Tashiro M.
Euro Surveill. 2013 Apr 11;18(15):20453.
PMID: 23594575 [PubMed – in process] Free Article

A novel reassortant avian influenza A(H7N9) virus in China – what are the implications for Europe.
Nicoll A, Danielsson N.
Euro Surveill. 2013 Apr 11;18(15):20452. No abstract available.
PMID: 23594574 [PubMed – in process] Free Article

H7N9 avian flu kills seven and infects 23 in China.
Parry J.
BMJ. 2013 Apr 9;346:f2222. doi: 10.1136/bmj.f2222. No abstract available.
PMID: 23571744 [PubMed – indexed for MEDLINE]

H7N9 avian flu infects humans for the first time.
Parry J.
BMJ. 2013 Apr 4;346:f2151. doi: 10.1136/bmj.f2151. No abstract available.
PMID: 23558347 [PubMed – indexed for MEDLINE]

Analysis of the clinical characteristics and treatment of two patients with avian influenza virus (H7N9).
Lu S, Xi X, Zheng Y, Cao Y, Liu X, Lu H.
Biosci Trends. 2013 Apr;7(2):109-12.
PMID: 23612081 [PubMed – in process] Free Article

Changes in and shortcomings of control strategies, drug stockpiles, and vaccine development during outbreaks of avian influenza A H5N1, H1N1, and H7N9 among humans.
Mei L, Song P, Tang Q, Shan K, Tobe RG, Selotlegeng L, Ali AH, Cheng Y, Xu L.
Biosci Trends. 2013 Apr;7(2):64-76.
PMID: 23612075 [PubMed – in process] Free Article



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