OVERVIEW
OVERVIEW
H7N9 avian influenza is a new type of avian influenza, an acute respiratory infection caused by the H7N9 subtype avian influenza virus. Patients usually present with flu-like symptoms, such as fever, cough, and little sputum, which may be accompanied by headache, muscle aches, and general malaise. Severe cases are often complicated by acute respiratory distress syndrome (ARDS), septic shock, and multiple organ dysfunction syndrome (MODS), which are life-threatening.
Whether medical insurance
Yes, it is
Department
Infection
Alias
Human H7N9 Avian Influenza
Clinical Symptoms
Patients usually present with flu-like symptoms, such as fever, cough, little sputum, which may be accompanied by headache, muscle pain and general malaise. In severe cases, the disease progresses rapidly and manifests as severe pneumonia, with body temperature persistently above 39℃, respiratory distress, and bloody sputum.
Hazards
In severe cases, the disease progresses rapidly, which may lead to multi-organ dysfunction and even death.
Complications
Acute respiratory distress syndrome, mediastinal emphysema, sepsis, shock, impaired consciousness, acute kidney injury and so on.
Examination
1. blood routine. 2. blood biochemical examination.
3. Pathogenetic testing.
(1)Nucleic acid test.
(2)Virus isolation.
4. Chest X-ray, CT and other imaging tests.
Diagnosis
Diagnosis is based on a history of contact with birds, their secretions and excretions, and influenza-like clinical manifestations combined with pathogenetic testing and chest imaging.
Treatment principle
Isolate the patient, apply anti-influenza virus drugs as early as possible, active symptomatic treatment and supportive therapy.
Curability
Early detection, early reporting, early diagnosis and early treatment are the keys to increase the cure rate and reduce the morbidity and mortality rate. Patients with 2 negative viral nucleic acid tests 24 hours apart after treatment are considered cured and can be released from isolation.
Dietary advice
Provide total gastrointestinal parenteral nutritional support to those with severe disease; give high-calorie, high-protein and high-fat nutrients to those with mild disease who can eat on their own.
Important reminders
Pay attention to colds and seek prompt medical attention for symptoms such as fever, headache, and diarrhea.
Causes
Epidemiology
Those who are engaged in poultry farming, sales, slaughtering, processing industry, and those who have been in contact with poultry within 1 week before the onset of the disease are at high risk of infection. Winter and spring are the seasons of high incidence of H7N9 avian influenza viruses.
Etiology
H7N9 subtype avian influenza virus infection. H7N9 avian influenza virus infection can induce a cytokine storm, leading to systemic inflammatory response.
Route of transmission
Transmission through the respiratory tract or infection through close contact with secretions or excretions of infected birds; or infection through contact with virus-contaminated environment.
Symptoms and Diagnosis
Typical symptoms
Pneumonia is the main clinical manifestation, often with fever, cough, sputum, accompanied by headache, muscle pain, diarrhea or vomiting and other symptoms. In severe cases, the disease develops rapidly and manifests as severe pneumonia, with body temperature persisting above 39℃, respiratory distress, which may be accompanied by coughing up bloody sputum; acute respiratory distress syndrome, mediastinal emphysema, sepsis, shock, impaired consciousness, and acute renal injury, etc., which may progress rapidly.
Other symptoms
A small number of patients can be mild, only manifested as fever with upper respiratory tract infection symptoms.
Diagnostic basis
1. Epidemiologic history
History of contact with birds or their secretions and excretions within 1 week before the onset of the disease.
2.Diagnostic criteria
(1) Suspected cases: meet the above clinical symptoms and blood routine, biochemistry and chest imaging characteristics, influenza A virus universal primer positive and ruled out seasonal influenza, can have a history of epidemiological contact.
(2) Confirmed cases: meeting the diagnostic criteria for suspected cases and isolation of H7N9 avian influenza virus in respiratory secretion specimens or positive nucleic acid test for H7N9 avian influenza virus.
(3) Serious cases: Pneumonia combined with respiratory failure or other organ failure are considered serious cases.
Treatment
Treatment guidelines
Isolate patients, give anti-influenza virus drugs to suspected or confirmed H7N9 cases as early as possible, closely observe changes in condition, and actively give symptomatic and supportive treatment.
Drug treatment
1. Antiviral drug treatment, commonly used neuraminidase inhibitors, such as oseltamivir, paramivir, zanamivir, etc.
2. Those with high fever can be physically cooled down, or apply antipyretic drugs; those with severe cough and phlegm can be given cough expectorant drugs; those with concurrent bacterial infection can be given antibiotic treatment.
3. Traditional Chinese medicine.
Other treatments
Oxygen therapy, mechanical ventilation and other respiratory support should be given to severe cases.
Prognosis
The prognosis of patients with severe human H7N9 avian influenza is poor. Factors affecting the prognosis may include patient’s age, underlying diseases, comorbidities, and so on.
Nursing care
Daily care
1. Isolate patients for treatment.
2. Minimize unnecessary contact with poultry, especially with sick or dead birds. Wash hands frequently and keep away from poultry secretions. After contact with birds or bird droppings, take care to clean hands thoroughly with disinfectant and water.
3. You should try to buy quarantined poultry products from regular sales outlets. Both poultry meat and eggs should be cooked well and thoroughly before consumption.
4. Adopt good personal hygiene habits, strengthen indoor air circulation, open the windows for half an hour once or twice a day. Strengthen physical exercise, ensure adequate sleep and rest to enhance resistance.
Diet
Take care of nutrition and consume more foods rich in vitamin C and other immunity-enhancing foods.
Other Attention
During the epidemic period, you should pay attention to protection and do not go to public places where crowds gather and air flow is poor to avoid infection.