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Nosocomial transmission of avian influenza virus A (H7N9)

BMJ 2015; 351 doi: (Published 19 November 2015) Cite this as: BMJ 2015;351:h5980
  1. Marianne A B van der Sande, head of centre for epidemiology and surveillance of infectious diseases12,
  2. Wim van der Hoek, head of department for respiratory infections1
  1. 1Centre for Infectious Disease Control, RIVM, Bilthoven, Netherlands
  2. 2Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
  1. marianne.van.der.sande{at}

We should not accept nosocomial transmission, of any pathogen, in any setting

Since the first notification in March 2013 through to 15 October 2015, a total of 679 laboratory confirmed cases of human infection with avian influenza A (H7N9) viruses, including 275 (40%) deaths, have been reported to the World Health Organization.1 These individuals have presumably contracted their infection in China directly from infected birds or their environment, particularly when visiting live poultry markets. Limited human to human transmission has been suspected in a few clusters of cases of family members.2 In a linked article, Fang and colleagues report on a presumed case of nosocomial, human to human, transmission of influenza A (H7N9) between unrelated individuals.3 Both patients, showing symptoms, spent time in the same hospital room, were infected with comparable strains, and—because no other common exposure was identified—the authors concluded that nosocomial infection was the most likely route of transmission.

Although Fang and colleagues’ report does not prove nosocomial transmission beyond any doubt, …

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