The genesis and source of the H7N9 influenza viruses causing human infections in China.

Tommy Tsan-Yuk Lam1 Jia Wang Yongyi Shen Boping Zhou Lian Duan Chung-Lam Cheung Chi Ma Samantha J Lycett Connie Yin-Hung Leung Xinchun Chen Lifeng Li Wenshan Hong Yujuan Chai Linlin Zhou Huyi Liang Zhihua Ou Yongmei Liu Amber Farooqui David J Kelvin Leo L M Poon David K Smith Oliver G Pybus Gabriel M Leung Yuelong Shu Robert G Webster Richard J Webby Joseph S M Peiris Andrew Rambaut Huachen Zhu Yi Guan
Affiliations 1 institutions
  1. Joint Influenza Research Centre (SUMC/HKU), Shantou University Medical College, Shantou 515041, China.

Abstract

A novel H7N9 influenza A virus first detected in March 2013 has since caused more than 130 human infections in China, resulting in 40 deaths. Preliminary analyses suggest that the virus is a reassortant of H7, N9 and H9N2 avian influenza viruses, and carries some amino acids associated with mammalian receptor binding, raising concerns of a new pandemic. However, neither the source populations of the H7N9 outbreak lineage nor the conditions for its genesis are fully known. Using a combination of active surveillance, screening of virus archives, and evolutionary analyses, here we show that H7 viruses probably transferred from domestic duck to chicken populations in China on at least two independent occasions. We show that the H7 viruses subsequently reassorted with enzootic H9N2 viruses to generate the H7N9 outbreak lineage, and a related previously unrecognized H7N7 lineage. The H7N9 outbreak lineage has spread over a large geographic region and is prevalent in chickens at live poultry markets, which are thought to be the immediate source of human infections. Whether the H7N9 outbreak lineage has, or will, become enzootic in China and neighbouring regions requires further investigation. The discovery here of a related H7N7 influenza virus in chickens that has the ability to infect mammals experimentally, suggests that H7 viruses may pose threats beyond the current outbreak. The continuing prevalence of H7 viruses in poultry could lead to the generation of highly pathogenic variants and further sporadic human infections, with a continued risk of the virus acquiring human-to-human transmissibility.

Supporting text Virus Host Location
Phylogeny 805 Animals 1948 Chickens 146 China 229 Ducks 81 Genes, Viral 37 Humans 1440 Influenza A virus 186 Influenza A Virus, H7N7 Subtype 9 Influenza A Virus, H9N2 Subtype 71 Influenza in Birds 341 Influenza, Human 286 Molecular Sequence Data 160 Reassortant Viruses 103

Evidence records

6 total
Transmission Evidence
1 records · 1 evidence types
Evidence type
1 records
OVE1557
Key finding

A novel H7N9 influenza A virus outbreak detected in March 2013 in China caused more than 130 human infections and 40 deaths, with live poultry markets identified as the immediate source of human infections.

Virus
Host
Location
Supporting text

A novel H7N9 influenza A virus first detected in March 2013 has since caused more than 130 human infections in China, resulting in 40 deaths. The H7N9 outbreak lineage has spread over a large geographic region and is prevalent in chickens at live poultry markets, which are thought to be the immediate source of human infections.

Method
active surveillance | screening of virus archives | evolutionary analyses
Transmission direction
animal-to-human
Geographic raw
China
Country inferred
CHN
Outbreak setting
live poultry markets
Outbreak time
March 2013
Outbreak scale
more than 130 human infections and 40 deaths
Experimental Infection
1 records · 1 evidence types
Evidence type
1 records
OVE1555
Key finding

A related H7N7 influenza virus originally found in chickens was able to infect mammals under experimental conditions, showing cross-species pathogenic potential.

Virus
Host
Location
Not specified
Supporting text

The discovery here of a related H7N7 influenza virus in chickens that has the ability to infect mammals experimentally, suggests that H7 viruses may pose threats beyond the current outbreak.

Method
experimental infection assay
Experimental system
controlled experimental infection
Genomic Evolution
4 records · 2 evidence types
Evidence type
2 records
OVE1551
Key finding

H7 viruses reassorted with enzootic H9N2 viruses to generate the H7N9 outbreak lineage in China.

Virus
Host
Not specified
Location
Not specified
Supporting text

We show that the H7 viruses subsequently reassorted with enzootic H9N2 viruses to generate the H7N9 outbreak lineage, and a related previously unrecognized H7N7 lineage.

Event type
reassortment
OVE1552
Key finding

H7 viruses reassorted with enzootic H9N2 viruses to generate a related previously unrecognized H7N7 lineage in China.

Virus
Host
Not specified
Location
Not specified
Supporting text

We show that the H7 viruses subsequently reassorted with enzootic H9N2 viruses to generate the H7N9 outbreak lineage, and a related previously unrecognized H7N7 lineage.

Event type
reassortment
Evidence type
2 records
OVE1553
Key finding

H7 influenza viruses were transmitted from domestic ducks to chicken populations in China on at least two independent occasions.

Virus
Host
Location
Supporting text

Here we show that H7 viruses probably transferred from domestic duck to chicken populations in China on at least two independent occasions.

Analysis methods
surveillance | screening of virus archives | evolutionary analysis
OVE1554
Key finding

H7N9 outbreak lineage viruses circulating in chickens at live poultry markets were identified as the immediate source of human infections during the outbreak in China.

Virus
Host
Location
Supporting text

The H7N9 outbreak lineage has spread over a large geographic region and is prevalent in chickens at live poultry markets, which are thought to be the immediate source of human infections.

Analysis methods
active surveillance | screening of virus archives | evolutionary analyses