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Human Infection with Highly Pathogenic A(H7N7) Avian Influenza Virus, Italy, 2013 - Volume 20, Number 10—October 2014 - Emerging Infectious Disease journal - CDC

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Human Infection with Highly Pathogenic A(H7N7) Avian Influenza Virus, Italy, 2013 - Volume 20, Number 10—October 2014 - Emerging Infectious Disease journal - CDC

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Volume 20, Number 10—October 2014


Human Infection with Highly Pathogenic A(H7N7) Avian Influenza Virus, Italy, 2013

Simona PuzelliComments to Author , Giada Rossini, Marzia Facchini, Gabriele Vaccari, Livia Di Trani, Angela Di Martino, Paolo Gaibani, Caterina Vocale, Giovanni Cattoli, Michael Bennett, John W. McCauley, Giovanni Rezza, Maria Luisa Moro, Roberto Rangoni, Alba Carola Finarelli, Maria Paola Landini, Maria Rita Castrucci, Isabella Donatelli, and the Influenza Task Force
Author affiliations: Istituto Superiore di Sanità, Rome, Italy (S. Puzelli, M. Facchini, G. Vaccari, L. Di Trani, A. Di Martino, G. Rezza, M.R. Castrucci, I. Donatelli)St. Orsola University Hospital, Bologna, Italy (G. Rossini, P. Gaibani, C. Vocale, M.P. Landini)Istituto Zooprofilattico delle Venezie, Padua, Italy (G. Cattoli)Medical Research Council National Institute for Medical Research, London, UK (M. Bennett, J.W. McCauley)Emilia-Romagna Region, Bologna (M.L. Moro, R. Rangoni, A.C. Finarelli)


During an influenza A(H7N7) virus outbreak among poultry in Italy during August–September 2013, infection with a highly pathogenic A(H7N7) avian influenza virus was diagnosed for 3 poultry workers with conjunctivitis. Genetic analyses revealed that the viruses from the humans were closely related to those from chickens on affected farms.
In Europe, avian influenza viruses of subtype H7 have been responsible for several disease outbreaks among poultry, which resulted in human infections (1,2). Notably, since 2000, outbreaks of avian influenza caused by high and low pathogenicity influenza A(H7N1) viruses and low pathogenicity A(H7N3) viruses occurred on poultry farms located mainly in northeastern Italy (3). On August 14, 2013, infection caused by a highly pathogenic avian influenza A(H7N7) virus was initially detected on a layer farm in Ostellato, Ferrara Province, Italy, representing the start of an epizootic that affected another 5 poultry farms in Ferrara and Bologna Provinces (Emilia-Romagna Region) during the next 3 weeks. Nearly 1 million chickens on the 6 farms were culled (4). All workers (≈200) who participated in depopulating infected premises applied strict infection prevention procedures and were monitored for symptoms. Among the workers, infection with highly pathogenic A(H7N7) avian influenza virus was confirmed for 3 who had conjunctivitis but no respiratory symptoms. We describe the clinical and virologic findings of the investigation conducted with regard to these 3 human cases of influenza A(H7N7) virus infection.

Dr Puzelli is a researcher in the Department of Infectious, Parasitic and Immune-mediated Diseases at the National Institute of Health, Rome. Her primary research interests include molecular mechanisms of genetic variability of influenza viruses and antiviral susceptibility.


We are grateful to Ruth Manvell, Ian Brown, and Bob Newman for supplying antiserum for hemagglutination inhibition testing and to Tiziana Grisetti for editing the manuscript.
This work was funded by the Italian Ministry of Health project “Virological surveillance of epidemic and pandemic influenza” (grant no. 4M13) and by the Emilia-Romagna Region. Work at the Medical Research Council National Institute for Medical Research was funded by Medical Research Council program no. U117512723.


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Suggested citation for this article: Puzelli S, Rossini G, Facchini M, Vaccari G, Di Trani L, Di Martino A, et al. Human infection with highly pathogenic A(H7N7) avian influenza virus, Italy, 2013. Emerg Infect Dis [Internet]. 2014 Oct [date cited]. http://dx.doi.org/10.3201/eid2010.140512
DOI: 10.3201/eid2010.140512
1Influenza Task Force members: Laura Calzoletti, Concetta Fabiani, Monica Meola, Annapina Palmieri, Arianna Boni, Guendalina Zaccaria (Istituto Superiore di Sanità, Rome); Marisa Cova, Valerio Parmeggiani, Claudio Po, Roberto Cagarelli, Gabriele Squintani, Emanuela Bedeschi (Emilia-Romagna Region, Bologna); and Maria Grazia Pompa (Ministry of Health, Rome).

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