SAN DIEGO — In this video, Timothy M. Uyeki, MD, medical epidemiologist in the CDC’s Influenza Division, discusses the growing avian influenza A(H7N9) epidemic in China.
According to Uyeki, there have been five epidemic waves of H7N9 in China so far. The largest epidemic, he says, occurred recently in 2016 and 2017. As of early October, there have been 1,562 cases of H7N9, 99% of whom required hospitalization. The case fatality rate is “alarmingly high” at approximately 40% among hospitalized patients, Uyeki says.
“That has been consistently true since the first human infections were reported back in 2013,” he says.
Antiviral treatment with neuraminidase inhibitors is currently recommended for H7N9. However, the proportion of patients with resistance to these drugs has increased over the course of the epidemic to about 10%, according to Uyeki.
“This is very worrisome. Still, almost 90% of the viruses remain susceptible to neuraminidase inhibitors, so we would still recommend oral oseltamivir treatment as first-line [therapy],” Uyeki says. “But certainly, the issue of evolving resistance in treated patients remains a high concern, and it highlights a need for other kinds of viral drugs with different mechanisms of action. These are in development, but we do need some clinical trials of these other drugs, including combination antiviral treatment, in H7N9 patients. That’s a great need.”
Disclosure: Uyeki reports no relevant financial disclosures.