ETIDIOH - NEW

  Summary Highly pathogenic avian influenza A(H5N1) viruses have been circulating among wild birds and are enzootic in poultry in some areas of the world with spillover to a wide range of terrestrial and marine mammals. Since 1997, sporadic animal to human , primarily poultry to human, transmission of highly pathogenic avian influenza A(H5N1) viruses has been reported in 25 countries . More recently there have been locally acquired infections in the Americas due to the 2.3.4.4b clade of the virus. Most of the recently detected human infections in the USA have been relatively mild but there have been cases of critical illness reported in several countries. In this Grand Round we present the first locally acquired highly pathogenic avian influenza A(H5N1) virus infection in Canada , which was in a 13-year-old female, who developed severe disease requiring prolonged critical care . She was infected with a clade 2.3.4.4b, genotype D1.1 virus and developed evidence of cytokine storm and...

  Highlights •  Nonspecific early signs hinder prompt diagnosis of H10N3 infection. •  H10N3 human infection remains rare but with high clinical severity. •  All patients had bird exposure and developed fever, cough, and dyspnoea. •  Diagnosis was confirmed by sequencing; imaging revealed viral pneumonia. Abstract Background Since the first human case of H10N3 Avian Influenza in Jiangsu, China (April 2021), three cases have been reported globally. However, clinical and treatment data remain limited. Therefore, we describe the fourth patient’s epidemiology, clinical manifestations, diagnostics, treatment. Case presentation A 23-year-old woman, previously well , presented on 12 Dec 2024 with fever, dry cough and breathlessness after pig and chicken contact . CT showed bilateral pneumonia . Despite high-flow oxygen and broad-spectrum antibiotics she deteriorated , requiring intubation, lung-protective ventilation and VV-ECMO . Bronchoalveolar lavage isolated H10N3 ...

  Context and significance The avian influenza A virus subtype H10N3 is a possible candidate for causing a fatal flu and may present a serious public health threat . Research increasingly shows that the avian influenza virus H10N3 can be transmitted from birds to humans , causing severe viral pneumonia and potentially leading to acute respiratory distress syndrome and respiratory failure . Researchers at the Fourth People’s Hospital of Nanning (China) provide evidence supporting the cross-species transmission of the avian influenza virus H10N3 to humans, which can give rise to severe pneumonia. The authors report that a female patient with avian influenza virus H10N3 infection, who was suffering from severe pneumonia , respiratory failure, pneumothorax , and numbness and dysesthesia in her feet , recovered after receiving appropriate therapy and was discharged from the hospital. Highlights •  A young woman contracted the avian influenza virus H10N3 •  Secondary infections...

  Highlights -- Higher Mortality in COVID-19 ECMO Patients : COVID-19 patients on ECMO had a significantly higher in-hospital mortality rate (52%) compared to H1N1 patients (6%) (p < 0.0001). -- Increased Complications in COVID-19 : COVID-19 patients had a higher incidence of complications, including: •  Secondary bloodstream infections (OR = 14.3; p = 0.003) •  Neurological complications •  Acute kidney injury requiring renal replacement therapy (RRT) -- Longer ECMO Duration in COVID-19 : COVID-19 patients required longer durations of ECMO support compared to H1N1 patients. -- Age and Comorbidities Impact Mortality : Even after adjusting for age, BMI, gender, and ECMO duration, COVID-19 conferred a 16-fold higher risk of mortality compared to H1N1 (adjusted OR = 16.8). Abstract Background Veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO) in management of refractory respiratory failure due to viral respiratory infections has increased with recent pandemic...

Summary Background Extracorporeal membrane oxygenation (ECMO) for COVID-19 was thoroughly assessed during the first pandemic wave , but data on subsequent waves are limited. We aimed to investigate in-hospital and 6-month survival of patients with COVID-19 supported with ECMO from the second pandemic wave (Sept 15, 2020) until the end of the pandemic (March 21, 2023, announced by WHO). Methods EuroECMO-COVID is a prospective, observational study including adults (aged ≥16 years) requiring ECMO respiratory support for COVID-19 from 98 centres in 21 countries. We compared patient characteristics and outcomes between in-hospital survivors and non-survivors. Mixed-effects multivariable logistic regressions were used to investigate factors linked to in-hospital mortality. 6-month survival and overall patient status were determined via patient contact or chart review. This study is registered with ClinicalTrials.gov, NCT04366921, and is complete. Findings We included 3860 patients (2687 [69·...

To the Editor : Highly pathogenic avian influenza A(H5N1) viruses are circulating among wild birds and poultry in British Columbia, Canada .1 These viruses are also recognized to cause illness in humans . Here, we report a case of critical illness caused by influenza A(H5N1) virus infection in British Columbia. On November 4, 2024, a 13-year-old girl with a history of mild asthma and an elevated body-mass index (the weight in kilograms divided by the square of the height in meters) of greater than 35 presented to an emergency department in British Columbia with a 2-day history of conjunctivitis in both eyes and a 1-day history of fever . She was discharged home without treatment, but cough, vomiting, and diarrhea then developed, and she returned to the emergency department on November 7 in respiratory distress with hemodynamic instability. On November 8, she was transferred, while receiving bilevel positive airway pressure, to the pediatric intensive care unit at British Columbia Child...