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Pregnancy a risk factor for severe H7N9 disease
Infection with influenza A(H7N9) may cause severe complications among pregnant women, according to a case report by officials from the Jiangsu Provincial Center for Disease Control and Prevention in Nanjing, China.
“According to epidemiologic and clinical data for infections with avian influenza A(H7N9) virus, most patients with severe illness, including severe pneumonia and acute respiratory distress syndrome, were elderly men with underlying medical conditions,” they wrote in a letter published in Emerging Infectious Diseases. “Our findings suggest that pregnancy might be a risk factor for clinically severe influenza in young women infected with H7N9 subtype virus.”
A 25-year-old pregnant woman presented with cough, fever of 38°C, mild myalgia and mild sore throat on March 30. She was estimated at 17 weeks gestation and had no underlying medical conditions. On April 5, she was admitted to the respiratory department with a fever of 39.9°C, a leukocyte count of 7.9 x 109 cells/L and a lymphocyte count of 0.7 x 109 cells/L.
On April 6, she was transferred to the ICU because of shortness of breath, respiratory failure and loss of consciousness, where she received mechanical ventilation, broad-spectrum antibiotics, oseltamivir (Tamiflu, Genentech), gamma-globulin, antifibrotic therapy and nutritional support. She regained consciousness April 21 and was extubated and transferred to the common ward April 23.
She was discharged May 14 in good health with no fetal abnormalities. The fetal heart rate and activity were normal during hospitalization. The fetus grew appropriately and was delivered at 35 weeks gestation on July 17.
The women lived with her husband and his parents and no live poultry were present in the district, but the parents worked as pork butchers in a live animal market where several types of live poultry were sold. Two weeks before the onset of illness, the patient had no contact with people known to be febrile, but she visited the live animal market once. Eighteen close contacts were identified and none developed respiratory symptoms.
Disclosure: The researchers report no relevant financial disclosures.