Document Detail

H5N1 infection of the respiratory tract and beyond: a molecular pathology study.
MedLine Citation:
PMID:  17905166     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Human infection with avian influenza H5N1 is an emerging infectious disease characterised by respiratory symptoms and a high fatality rate. Previous studies have shown that the human infection with avian influenza H5N1 could also target organs apart from the lungs. METHODS: We studied post-mortem tissues of two adults (one man and one pregnant woman) infected with H5N1 influenza virus, and a fetus carried by the woman. In-situ hybridisation (with sense and antisense probes to haemagglutinin and nucleoprotein) and immunohistochemistry (with monoclonal antibodies to haemagglutinin and nucleoprotein) were done on selected tissues. Reverse-transcriptase (RT) PCR, real-time RT-PCR, strand-specific RT-PCR, and nucleic acid sequence-based amplification (NASBA) detection assays were also undertaken to detect viral RNA in organ tissue samples. FINDINGS: We detected viral genomic sequences and antigens in type II epithelial cells of the lungs, ciliated and non-ciliated epithelial cells of the trachea, T cells of the lymph node, neurons of the brain, and Hofbauer cells and cytotrophoblasts of the placenta. Viral genomic sequences (but no viral antigens) were detected in the intestinal mucosa. In the fetus, we found viral sequences and antigens in the lungs, circulating mononuclear cells, and macrophages of the liver. The presence of viral sequences in the organs and the fetus was also confirmed by RT-PCR, strand-specific RT-PCR, real-time RT-PCR, and NASBA. INTERPRETATION: In addition to the lungs, H5N1 influenza virus infects the trachea and disseminates to other organs including the brain. The virus could also be transmitted from mother to fetus across the placenta.
Jiang Gu; Zhigang Xie; Zhancheng Gao; Jinhua Liu; Christine Korteweg; Juxiang Ye; Lok Ting Lau; Jie Lu; Zifen Gao; Bo Zhang; Michael A McNutt; Min Lu; Virginia M Anderson; Encong Gong; Albert Cheung Hoi Yu; W Ian Lipkin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  370     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-01     Completed Date:  2007-10-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  1137-45     Citation Subset:  AIM; IM    
Infectious Disease Centre, Peking University, Beijing, China.
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MeSH Terms
Fetus / pathology*
Genome, Viral
In Situ Hybridization / methods
Infectious Disease Transmission, Vertical
Influenza A Virus, H5N1 Subtype / genetics,  isolation & purification,  pathogenicity*
Influenza, Human / pathology*,  transmission,  virology
Respiratory System / pathology*
Reverse Transcriptase Polymerase Chain Reaction
Self-Sustained Sequence Replication / methods
Comment In:
Lancet. 2007 Sep 29;370(9593):1106-8   [PMID:  17905148 ]

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