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Study: Most H7N9 patients have coexisting medical issues

MOST people infected with the H7N9 virus have pre-existing medical problems and are at greater risk of getting acute respiratory distress syndrome, according to China's first comprehensive study of the new bird flu virus.

The analysis was led by scientists from Fudan University and was published in the latest issue of the New England Journal of Medicine.

Zhong Nanshan, an expert on respiratory diseases in China, said such research is essential for infectious disease prevention and control.

Scientists in Shanghai, Beijing and Zhejiang Province conducted a retrospective study on 111 patients in Shanghai, Zhejiang and Jiangsu as of May 10.

The patients represented 85 percent of all 131 H7N9 cases in China.

The average age of the patients was 61 years while 42 percent were 65 years of age or older. Male patients represented 68 percent of the total.

Patients hospitalized with H7N9 had an uneven age distribution while patients who were hospitalized with H5N1 or H1N1 in the past were mostly young people.

Doctors said a possible explanation for the predominance of elderly patients in this outbreak of H7N9 is that retired persons have more opportunities to shop in wet markets and are therefore more likely to be exposed to live poultry. Other possibilities are that elderly persons have an increased risk of coexisting illnesses and are more susceptible to severe forms of disease than younger people, even after the same exposure.

Studies found 61 percent of the patients had one or more coexisting medical conditions. Coronary heart disease, hypertension, diabetes, and chronic obstructive pulmonary disease were the most common conditions.

Experts said the risk of death from H7N9 increased among patients who were 65 years of age or older, those who had a coexisting medical condition, acute respiratory distress syndrome, shock at any point during the illness, or an acute kidney injury and among those in whom antiviral therapy was initiated more than 5 days after the onset of symptoms.

As of May 10, 30 patients had died, 49 had fully recovered and 30 remained hospitalized.

"With the elderly population rising, the study indicates that controlling chronic diseases is also important for controlling infectious diseases," said doctor Lu Hongzhou, a leading researcher in the study.


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