Last reviewed:October 2019
Last updated:June  2018

Summary

Definition

History and exam

Key diagnostic factors

  • cough
  • typical influenza symptoms
  • dyspnea
  • fever
  • decreased breath sounds
  • tachypnea

Other diagnostic factors

  • vomiting, diarrhea
  • altered mental status

Risk factors

  • environmental exposure to Asian lineage A(H7N9) virus
  • close contact with infected humans
  • laboratory work with A(H7N9) virus

Diagnostic investigations

1st investigations to order

  • CBC with differential
  • liver function tests (alkaline phosphatase, hepatic aminotransferases, bilirubin)
  • CXR
  • pulse oximetry
  • sputum Gram stain
  • sputum and blood bacterial culture
  • reverse transcription (RT)-PCR of respiratory specimens for Asian lineage A(H7N9) virus and influenza A and B viruses
Full details

Investigations to consider

  • viral culture of respiratory specimens
Full details

Emerging tests

  • serologic testing for A(H7N9)-specific antibody for retrospective diagnosis
Full details

Treatment algorithm

Contributors

Consultant in Infectious Diseases and General (Internal) Medicine

Respiratory Virus Unit

Virus Reference Department

National Infection Service

Public Health England

London

UK

Disclosures

JD declares that he has no competing interests.

Assistant Professor of Medicine and Global Health

Associate Director

International Respiratory and Severe Illness Center (INTERSECT)

Division of Pulmonary and Critical Care Medicine

University of Washington

Seattle

WA

Disclosures

JRO declares that he has no competing interests.

Chief Medical Officer

Influenza Division

National Center for Immunization and Respiratory Diseases

Centers for Disease Control and Prevention

Atlanta

GA

Disclosures

TMU declares that he has no competing interests.

Peer reviewersVIEW ALL

To be added

Disclosures

RF declares that he has no competing interests.

Professor

Division of Infectious Diseases

Faculty of Medicine and Dentistry

University of Alberta

Edmonton

Alberta

Canada

Disclosures

NL declares that he has no competing interests.

Professor

Division of Infectious Diseases

Division of Organ Transplantation

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

MI declares that he received research support, paid to Northwestern University, from Beckman Coulter, Chimerix, and Gilead; is a paid consultant for Celltrion, Chimerix, Farmark, Genentech/Roche, Toyama/MediVector, Seqirus, and Shionogi; and is a member of the DSMB for GlaxoSmithKelin and Shionogi.

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