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	<title>건강과 대안 &#187; 치명률</title>
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		<title>[식품] 55세 이하, 1일 커피 4잔 이상 마시면 사망위험 56% 증가</title>
		<link>http://www.chsc.or.kr/?post_type=reference&#038;p=5870</link>
		<comments>http://www.chsc.or.kr/?post_type=reference&#038;p=5870#comments</comments>
		<pubDate>Thu, 29 Aug 2013 02:26:34 +0000</pubDate>
		<dc:creator>건강과대안</dc:creator>
				<category><![CDATA[식품 · 의약품]]></category>
		<category><![CDATA[All-Cause Mortality]]></category>
		<category><![CDATA[Cardiovascular Disease Mortality]]></category>
		<category><![CDATA[Coffee Consumption]]></category>
		<category><![CDATA[confounding]]></category>
		<category><![CDATA[early death]]></category>
		<category><![CDATA[Heavy coffee drinking]]></category>
		<category><![CDATA[담배]]></category>
		<category><![CDATA[세대 효과(cohort effect)]]></category>
		<category><![CDATA[식품]]></category>
		<category><![CDATA[조기사망]]></category>
		<category><![CDATA[치명률]]></category>
		<category><![CDATA[커피]]></category>

		<guid isPermaLink="false">http://www.chsc.or.kr/?post_type=reference&#038;p=5870</guid>
		<description><![CDATA[사우스캐롤라이나 대학교 연구팀이 메이요 클리닉 회보에 발표한 논문(첨부파일)입니다. Association of Coffee Consumption With All-Cause and Cardiovascular Disease Mortality Junxiu Liu, MD; Xuemei Sui, MD, PhD; Carl J. Lavie, [...]]]></description>
				<content:encoded><![CDATA[<p>사우스캐롤라이나 대학교 연구팀이 메이요 클리닉 회보에 발표한 논문(첨부파일)입니다.</p>
<p>Association of Coffee Consumption With All-Cause and Cardiovascular Disease Mortality</p>
<p>Junxiu Liu, MD; Xuemei Sui, MD, PhD; Carl J. Lavie, MD; James R. Hebert, ScD;<br />
Conrad P. Earnest, PhD; Jiajia Zhang, PhD; and Steven N. Blair, PED</p>
<p>Mayo Clin Proc. 2013;nn(n):1-9</p>
<p>연구 논문은 1979~1998년 사이 20~87세, 4만여 명의 미국인 개인 병력 기록을 분석한 것인데&#8230; 이 기간 동안 사망한 2만5천여명을 추적 조사한 결과 커피를 많이 마시는 사람은 흡연하는<br />
경우가 많았고&#8230; 당연히 폐와 간 상태도 좋지 않았습니다.(이 논문에서는 사망위험의 증가와<br />
흡연과의 연관관계에 대해서 명확하게 분석하지는 않았습니다.)</p>
<p>55세 이하에서 매일 4잔 이상(1주일에 28잔) 이상 커피를 마시는 사람은 사망 위험이 56% 증가하는 것으로 나타났습니다.</p>
<p>남성의 경우 55세 이하에서 커피를 마시는 사람은 그렇지 사망 위험이 21% 증가하는 것으로 나타났습니다.</p>
<p>여성의 경우는 55세 이하에서 커피를 마시는 사람은 그렇지 사망 위험이 2배로 늘어나는 것으로 나타났습니다.</p>
<p>논문에 따르면, 과체중 또는 비만인 경우 커피를 마시는 사람이 많았지만, 이것이 사망위험의 증가에 큰 영향을 끼친 것으로 보이지는 않은 것으로 판단한 것 같습니다.</p>
<p>이 논문은 역학 조사를 한 결과이기 때문에 커피의 어떤 성분 때문에 55세 이하 연령층에서<br />
사망 위험이 높게 나타나고&#8230; 그 이상의 노령층에서는 역학적 연관관계가 없었는지에 대해서<br />
명확하게 규명하지 못했으며&#8230; 커피 속에 들어 있는 어떤 성분 때문에 사망 위험이 높아졌는<br />
지에 대해서도 명확하게 규명하지 못했습니다.</p>
<p>논문의 공동저자 중 한 명인 쉬메이 수이는 언론 인터뷰에서 &#8220;커피에는 카페인이 들어 있는데, 카페인은 부신 피질 호르몬 분비를 촉진하고 인슐린 활동을 방해하며 혈압을 상승시킨다&#8221;고 주장하며, &#8220;많은 양의 커피를 마시는 사람들은 밤 늦게 잠이 들고 식사를 빈약하게 하는 생활습관이 있는 편&#8221;이라고 했습니다.</p>
<p>논문의 저자들은 이 논문의 한계에 대해서도 밝혀놓았습니다. 첫째, 연구 기간 동안 커피의 소비량에 대해 반복적으로 측정하지 않은 점, 둘째, 커피를 내리는 방법에 따라 커피의 구성성분이 달라지고 이에 따라 사망률의 차이가 발생할 수 있으나 이 논문에서는 그러한 데이터를 제시하지 못한 점, 셋째, 본 연구에서는 결혼 여부와 전체 에너지 소비를 포함시키지 않은 점, 넷째, 종속변수에 영향을 줄 수 있는 독립변수 이외의 변수인 confounding이 존재할 가능성이 있는 점.(저자들은 자신들이 비록 보정을 했지만, 담배 같은 변수가 사망위험에 영향을 끼칠 confounding이 될 수 있다는 점을 고려했지만, 저자들은 현재 흡연자와 비흡연자 간의 커피 소비와 모든 원인의 치명률 사이의 어떠한 중요한 연관관계도 찾아내지 못했다고 밝힘)</p>
<p>(참고 : 옮긴이 주 &#8211; 통계적으로 커피를 많이 마시는 사람은 췌장암에 많이 걸리는 것으로 나오지만&#8230; 사실은 커피를 많이 마시는 사람은 담배도 함께 피우기 때문에 췌장암에 걸리는 것입니다. 따라서 커피와 췌장암의 연관성은 흡연에 의한 confounding때문에 나타난 것입니다.)</p>
<p>마지막으로 저자들은 자신의 논문의 한계로 세대효과(cohort effect)가 존재할 수 있다고 밝혔습니다.</p>
<p>(참고 : 옮긴이 주 &#8211; 세대 효과(cohort effect)의 예로 한국과 미국의 유방암 발생의 차이를 설명하기도 합니다. 미국은 폐경 후 유방암에 걸리는 여성들이 훨씬 많은데, 한국은 오히려 폐경 전 유방암에 걸리는 여성들이 훨씬 많습니다. 경제적-사회적-문화적인 변화에 의해 한국 여성들의 라이프 스타일의 변화가 유방암 발생의 차이를 불러왔다는 것입니다. 한국 여성들의 결혼이 늦어지면서 유방암 예방 효과가 있는 출산과 수유를 기피하는 현상이 생겼으며, 유방암을 일으킬 수 있는 술이나 담배에 노출된 여성들이 증가한 것이 한국 여성들의 폐경전 유방암 환자 비율을 증가시킨 세대 효과(cohort effect)라고 분석하고 있습니다. 물론 이러한 분석이 과학적으로 정당한 것인가는 증명이 된 것은 아닙니다.)</p>
<p><a title="Permanent Link:Study: Heavy coffee drinking in people under 55 linked to early death" href="http://thechart.blogs.cnn.com/2013/08/15/study-heavy-coffee-drinking-in-people-under-55-linked-to-early-death/" rel="bookmark"><span style="color: #004276; font-size: x-large;">Study: Heavy coffee drinking in people under 55 linked to early death</span></a></p>
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<div>August 15th, 2013</div>
<div>08:00 PM ET</div>
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<div><a href="http://thechart.blogs.cnn.com/2013/08/15/study-heavy-coffee-drinking-in-people-under-55-linked-to-early-death/">http://thechart.blogs.cnn.com/2013/08/15/study-heavy-coffee-drinking-in-people-under-55-linked-to-early-death/</a></div>
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<p>When you make coffee with breakfast, or grab a to-go cup at a cafe before work, or raid your office&#8217;s break room for a cup in the afternoon, you&#8217;re probably not thinking about how scientists are studying it.</p>
<p>So we&#8217;ll just tell you: <a href="http://www.cnn.com/2012/08/18/health/coffee-health-benefits" target="_blank"><strong><span style="color: #004276;">Many studies have looked at the health effects of coffee</span></strong></a>, even though measuring the potential harms and benefits is not as easy as chugging a shot of espresso. Since a whole range of lifestyle and genetic factors influence a person&#8217;s physical well-being, it&#8217;s hard to know exactly if, or how, or to what extent, coffee would be good or bad for anyone&#8217;s longterm health.</p>
<p>The latest study, published in <a href="http://www.mayoclinicproceedings.org/webfiles/images/journals/jmcp/jmcp_ft88_9_1.pdf"><strong><span style="color: #5c7996;">Mayo Clinic&#8217;s Proceedings [PDF]</span></strong></a>, found an association between drinking more than 28 cups of coffee a week and an increased risk of death from all causes, in people 55 years old and younger. One cup of coffee is 8 ounces.</p>
<p>That doesn&#8217;t prove that coffee causes death. It also seems to contradict a study in the <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1112010?query=featured_home&amp;" target="_blank"><strong><span style="color: #004276;">New England Journal of Medicine</span></strong></a> last year, <a href="http://eatocracy.cnn.com/2012/05/17/coffee-makes-you-live-longer/" target="_blank"><strong><span style="color: #004276;">which found</span></strong></a> that people who drink two or more cups of coffee a day have a reduced risk of dying from particular diseases than those who consume little or no coffee.</p>
<p>&nbsp;</p>
<p>And a <a href="http://www.cnn.com/2011/HEALTH/05/17/coffee.prostate.cancer/index.html"><strong><span style="color: #004276;">May 2011 study found</span></strong></a> that men who drink six or more cups a day had a decreased risk of fatal prostate cancer.</p>
<p>How are we supposed to decide how much coffee to drink, when the information about its health effects is more confusing than a cafe menu written in a foreign language?</p>
<p>Experts say that the optimal dose of coffee varies widely, depending on the person. Different people have different tolerances for coffee.</p>
<p>But in general, the authors of this new study emphasized a message of moderation.</p>
<p><strong>The new study </strong></p>
<p>Researchers followed more than 40,000 people ages 20-87 for about 16 years.</p>
<p>They observed risks for heavy coffee drinkers in both men and women under 55 who drank more than four cups of coffee a day on average. In men who fit this description, the risk of death was 56% higher compared to non-coffee drinkers. In women, the risk was even greater &#8211; it doubled, compared to non-coffee drinkers.</p>
<p>The same association was not observed in individuals 55 and older, or in people who drank coffee in moderation.</p>
<p>&#8220;It appears that low doses of coffee are safe,&#8221; said Carl J. Lavie, study co-author from the John Ochsner Heart and Vascular Institute in New Orleans. &#8221;We did not see anything bad happening up to about 28 cups per week.&#8221;</p>
<p>He added, &#8220;no increase in cardiovascular mortality at any dose in men or women at any age&#8221; was seen.</p>
<p><strong>Caveats</strong></p>
<p>But wait! Although study authors found a connection between heavy coffee consumption and death, they did not prove that frequent java indulgence causes death. There may be other underlying factors that explain this association.</p>
<p>&#8220;What if people are super hyper, driven, stressed out, drinking 10 cups of coffee a day?&#8221; Lavie said. &#8220;And it&#8217;s not the coffee that&#8217;s killing them, it&#8217;s the fact that they&#8217;re stressed out that&#8217;s killing them.&#8221;</p>
<p>Lavie still suggests that heavy coffee drinkers scale back on their consumption, however.</p>
<p>&#8220;I think that if I find that having four or more cups of coffee per day looks like it&#8217;s associated with higher mortality, even though I don&#8217;t know that it&#8217;s for sure due to the coffee, to me that&#8217;s enough reason to me to try and keep my coffee to below four a day.&#8221;</p>
<p>The authors did not separate decaf coffee from regular, but &#8221;most people report they drink regular,&#8221; added Dr. Xuemei Sui, study co-author from the Arnold School of Public Health at the University of South Carolina.</p>
<p>They also did not explore what people were adding to their coffees, so they didn&#8217;t separate out whether the addition of sweeteners or milk had any effect on death risk.</p>
<p><strong>But what about coffee benefits</strong></p>
<p>There is, on the other hand, evidence from studies on type II diabetes suggesting that coffee can be good.</p>
<p>According to a <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761298/" target="_blank"><strong><span style="color: #004276;">2009 meta-analysis</span></strong></a>, the risk of type II diabetes goes down with each cup of coffee consumed daily. Additionally, <a href="http://www.ncbi.nlm.nih.gov/pubmed/17484871" target="_blank"><strong><span style="color: #004276;">a 2007 meta-analysis</span></strong></a> found a correlation between increased coffee consumption and lower risk of liver cancer.</p>
<p>Such research is still not persuasive enough to tell anyone who doesn&#8217;t already drink coffee to start.</p>
<p><strong>How much coffee do you drink? </strong></p>
<p>&#8220;A 20 ounce cup, we would count that as two and a half cups,&#8221; Lavie added.</p>
<p>For perspective, here are some measurements of that cup o&#8217; Joe you like to enjoy:</p>
<p>A short Starbucks coffee is 8 ounces. A tall is 12 ounces. A grande is 16 ounces, or two cups of coffee. Make it a venti and you&#8217;ve consumed 20 ounces.</p>
<p>Meanwhile, at Dunkin&#8217; Donuts, a small cup of coffee is 10 ounces. A medium contains 14. Order a large and you&#8217;ll get ounces 20 ounces and XL, 24 ounces, or three cups of coffee.</p>
<p>Experts told CNN in 2012 that they would not make a public health recommendation concerning coffee because there just isn&#8217;t enough solid evidence to do so.</p>
<p>&#8220;If you consume coffee, enjoy it,&#8221; Dr. Donald Hensrud of the Mayo Clinic said. &#8220;But I wouldn&#8217;t necessarily recommend taking it up if you don&#8217;t like it.&#8221;</p>
<p>A lot of people already consider it a regular part of their lives. For nearly two-thirds of Americans, the daily coffee routine is just habit.</p>
<p>Get out of bed. Make coffee. Start your work day.</p>
<p>Have more coffee. Repeat.  Hope it won&#8217;t kill you.</p>
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<td valign="top"><strong><span style="color: #999999; font-size: small;">Post by:</span></strong> <a href="http://thechart.blogs.cnn.com/tag/elizabeth-landau-cnncom-health-writerproducer/" rel="tag"><strong><span style="color: #004276; font-size: small;">Elizabeth Landau &#8211; CNN.com Health Writer/Producer</span></strong></a>, <a href="http://thechart.blogs.cnn.com/tag/georgiann-caruso-cnn-medical-producer/" rel="tag"><strong><span style="color: #004276; font-size: small;">Georgiann Caruso &#8212; CNN Medical Producer</span></strong></a><br />
<span style="color: #999999; font-size: small;"><strong>Filed under: </strong></span><a title="View all posts in Death and Dying" href="http://thechart.blogs.cnn.com/category/death-and-dying/" rel="category tag"><span style="color: #004276; font-size: small;"><strong>Death and Dying</strong></span></a><span style="color: #999999; font-size: small;"><strong> • </strong></span><a title="View all posts in Diet and Fitness" href="http://thechart.blogs.cnn.com/category/000-sections/diet-and-fitness/" rel="category tag"><strong><span style="color: #004276; font-size: small;">Diet and Fitness</span></strong></a></td>
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		<title>[조류독감] 중국  H7N9 조류독감 바이러스 분석 논문(Lancet)</title>
		<link>http://www.chsc.or.kr/?post_type=reference&#038;p=4185</link>
		<comments>http://www.chsc.or.kr/?post_type=reference&#038;p=4185#comments</comments>
		<pubDate>Mon, 24 Jun 2013 18:33:01 +0000</pubDate>
		<dc:creator>건강과대안</dc:creator>
				<category><![CDATA[식품 · 의약품]]></category>
		<category><![CDATA[AI]]></category>
		<category><![CDATA[H5N1 비교]]></category>
		<category><![CDATA[H7N9형]]></category>
		<category><![CDATA[도시]]></category>
		<category><![CDATA[성별 차이]]></category>
		<category><![CDATA[조류독감]]></category>
		<category><![CDATA[조류인플루엔자]]></category>
		<category><![CDATA[지방]]></category>
		<category><![CDATA[치명률]]></category>

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		<description><![CDATA[랜싯(The Lancet)지에 중국에서 발생한 H7N9 조류독감 바이러스에 대한 분석 논문이게재되었습니다.2013년 5월 28일까지 실험실 진단을 통해&#160; H7N9 조류독감 바이러스에 감염된 확진환자에 대한 정보를 분석했는데요, 5월 28일까지 확정진단을 받은 123명의 [...]]]></description>
				<content:encoded><![CDATA[<p>랜싯(The Lancet)지에 중국에서 발생한 H7N9 조류독감 바이러스에 대한 분석 논문이<BR>게재되었습니다.<BR><BR>2013년 5월 28일까지 실험실 진단을 통해&nbsp; H7N9 조류독감 바이러스에 감염된 확진<BR>환자에 대한 정보를 분석했는데요, 5월 28일까지 확정진단을 받은 123명의 환자 중에서<BR>37명(30%)가 사망했습니다. 연구진은 여전히 병원에 입원 중인 17명의 환자에 대한<BR>불충분한 자료까지 포함하여 전 연령 층의 입원 환자 중 36%가 사망했다고 밝혔습니다.<BR><BR>연구진은&nbsp; H7N9 조류독감의 위험도가&nbsp;예전에 보고된 자료보다는 낮다고 평가했습니다. <BR>그리고 가벼운 증상을 앓는 환자들이 상당히 발생하여 이미 치유가 되었을 가능성이 <BR>높다고 추정했습니다. <BR><BR>같은 날짜로 랜싯(The Lancet)지에 게재된 또 다른 논문에서는&nbsp; H7N9&nbsp;조류독감에 감염되어<BR>확정진단을 받은 130명 환자의 평균 연령이 62세였으며, 지금까지 H5N1 조류독감에 감염되어<BR>확정진단을 받은 43명 환자의 평균 연령은 26세였다고 비교하였습니다. 도시지역에서 H7N9과<BR>H5N1 조류독감에 감염된 사람 중 남성이 74%였으나, 시골지역에서는 H7N9 조류독감에 감염<BR>된 남성이 &nbsp;62%, H5N1 조류독감에 감염된 남성이 33%로 성별에 따른 차이가 있었음을<BR>밝혔습니다.<BR><BR>그리고 H7N9 조류독감에 감염된 사람의 75%와 H5N1 조류독감에 감염된 사람의 71%가<BR>감염되기 직전 가금류와 접촉한 사실이 있다고 밝혔습니다.(70% 이상의 사례에서 가금류를&nbsp;<BR>매개로 한 인체전염이 밝혀진 셈입니다)<BR><BR>잠복기는 H7N9이&nbsp;3.1일, H5N1이 3.3일이었으므로 거의 비슷하게 나왔고, 치명률은<BR>&nbsp;H7N9이 36%, H5N1이 70%로 계산되었습니다.(치명률은 H5N1이 훨씬 더 병독력이 높은<BR>것으로 나타났습니다)<BR><BR><br />
<DIV class=ja50-ce-simple-para>&nbsp;</DIV><br />
<DIV id=article_cite>The Lancet, Early Online Publication, 24 June 2013</DIV><br />
<DIV id=article_DOI>doi:10.1016/S0140-6736(13)61207-<BR><BR><A href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract</A><BR><BR><br />
<H1 class=ja50-ce-title>Human infection with avian influenza A H7N9 virus: an assessment of clinical severity</H1><br />
<DIV class=ja50-ce-author-group><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Hongjie+Yu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Hongjie Yu'); return false;">Hongjie Yu</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#fn1" name=back-fn1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>†</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Benjamin J+Cowling" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Benjamin J Cowling'); return false;">Benjamin J Cowling</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#fn1" name=back-fn1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>†</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Luzhao+Feng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Luzhao Feng'); return false;">Luzhao Feng</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#fn1" name=back-fn1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>†</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Eric HY+Lau" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Eric HY Lau'); return false;">Eric HY Lau</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#fn1" name=back-fn1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>†</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Qiaohong+Liao" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Qiaohong Liao'); return false;">Qiaohong Liao</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Tim K+Tsang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Tim K Tsang'); return false;">Tim K Tsang</A> MPhil <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zhibin+Peng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zhibin Peng'); return false;">Zhibin Peng</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Peng+Wu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Peng Wu'); return false;">Peng Wu</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Fengfeng+Liu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Fengfeng Liu'); return false;">Fengfeng Liu</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Vicky J+Fang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Vicky J Fang'); return false;">Vicky J Fang</A> MPhil <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Honglong+Zhang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Honglong Zhang'); return false;">Honglong Zhang</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Ming+Li" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Ming Li'); return false;">Ming Li</A> ME <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Lingjia+Zeng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Lingjia Zeng'); return false;">Lingjia Zeng</A> MSc <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zhen+Xu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zhen Xu'); return false;">Zhen Xu</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zhongjie+Li" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zhongjie Li'); return false;">Zhongjie Li</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Huiming+Luo" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Huiming Luo'); return false;">Huiming Luo</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff2" name=back-aff2 cmImpressionSent="1"><SPAN class=ja50-ce-sup>b</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Qun+Li" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Qun Li'); return false;">Qun Li</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zijian+Feng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zijian Feng'); return false;">Zijian Feng</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Bin+Cao" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Bin Cao'); return false;">Bin Cao</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff6" name=back-aff6 cmImpressionSent="1"><SPAN class=ja50-ce-sup>f</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Weizhong+Yang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Weizhong Yang'); return false;">Weizhong Yang</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff4" name=back-aff4 cmImpressionSent="1"><SPAN class=ja50-ce-sup>d</SPAN></A>, </SPAN><SPAN class=ja50-ce-author>Dr <A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Joseph T+Wu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Joseph T Wu'); return false;">Joseph T Wu</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#cor1" name=back-cor1 cmImpressionSent="1"><IMG alt="Corresponding Author" src="http://www.thelancet.com/images/article_notepad.gif" border=0></IMG></A><A class=ja50-ce-e-address href="mailto:joewu@hku.hk" cmImpressionSent="1"><IMG alt="Email Address" src="http://www.thelancet.com/images/article_email.gif" border=0></IMG></A>, </SPAN><SPAN class=ja50-ce-author>Dr <A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Yu+Wang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Yu Wang'); return false;">Yu Wang</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff4" name=back-aff4 cmImpressionSent="1"><SPAN class=ja50-ce-sup>d</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#cor2" name=back-cor2 cmImpressionSent="1"><IMG alt="Corresponding Author" src="http://www.thelancet.com/images/article_notepad.gif" border=0></IMG></A><A class=ja50-ce-e-address href="mailto:wangyu@chinacdc.cn" cmImpressionSent="1"><IMG alt="Email Address" src="http://www.thelancet.com/images/article_email.gif" border=0></IMG></A>, </SPAN><SPAN class=ja50-ce-author>Prof <A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Gabriel M+Leung" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Gabriel M Leung'); return false;">Gabriel M Leung</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61207-6/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A></SPAN></DIV><br />
<DIV class=ja50-ce-abstract><br />
<H2 class=ja50-ce-section-title>Summary</H2><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Background</H3><br />
<DIV class=ja50-ce-simple-para>Characterisation of the severity profile of human infections with influenza viruses of animal origin is a part of pandemic risk assessment, and an important part of the assessment of disease epidemiology. Our objective was to assess the clinical severity of human infections with avian influenza A H7N9 virus, which emerged in China in early 2013.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Methods</H3><br />
<DIV class=ja50-ce-simple-para>We obtained information about laboratory-confirmed cases of avian influenza A H7N9 virus infection reported as of May 28, 2013, from an integrated database built by the Chinese Center for Disease Control and Prevention. We estimated the risk of fatality, mechanical ventilation, and admission to the intensive care unit for patients who required hospital admission for medical reasons. We also used information about laboratory-confirmed cases detected through sentinel influenza-like illness surveillance to estimate the symptomatic case fatality risk.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Findings</H3><br />
<DIV class=ja50-ce-simple-para>Of 123 patients with laboratory-confirmed avian influenza A H7N9 virus infection who were admitted to hospital, 37 (30%) had died and 69 (56%) had recovered by May 28, 2013. After we accounted for incomplete data for 17 patients who were still in hospital, we estimated the fatality risk for all ages to be 36% (95% CI 26—45) on admission to hospital. Risks of mechanical ventilation or fatality (69%, 95% CI 60—77) and of admission to an intensive care unit, mechanical ventilation, or fatality (83%, 76—90) were high. With assumptions about coverage of the sentinel surveillance network and health-care-seeking behaviour for patients with influenza-like illness associated with influenza A H7N9 virus infection, and pro-rata extrapolation, we estimated that the symptomatic case fatality risk could be between 160 (63—460) and 2800 (1000—9400) per 100&nbsp;000 symptomatic cases.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Interpretation</H3><br />
<DIV class=ja50-ce-simple-para>Human infections with avian influenza A H7N9 virus seem to be less serious than has been previously reported. Many mild cases might already have occurred. Continued vigilance and sustained intensive control efforts are needed to minimise the risk of human infection.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Funding</H3><br />
<DIV class=ja50-ce-simple-para>Chinese Ministry of Science and Technology; Research Fund for the Control of Infectious Disease; Hong Kong University Grants Committee; China—US Collaborative Program on Emerging and Re-emerging Infectious Diseases; Harvard Center for Communicable Disease Dynamics; US National Institute of Allergy and Infectious Disease; and the US National Institutes of Health.<BR><BR>==============<BR></DIV></DIV></DIV></DIV><br />
<DIV id=article_cite>The Lancet, Early Online Publication, 24 June 2013</DIV><br />
<DIV id=article_DOI>doi:10.1016/S0140-6736(13)61171-X<BR><BR><A href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract</A><BR><BR><br />
<H1 class=ja50-ce-title>Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases</H1><br />
<DIV class=ja50-ce-author-group><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Benjamin J+Cowling" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Benjamin J Cowling'); return false;">Benjamin J Cowling</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#fn1" name=back-fn1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>†</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Lianmei+Jin" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Lianmei Jin'); return false;">Lianmei Jin</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff2" name=back-aff2 cmImpressionSent="1"><SPAN class=ja50-ce-sup>b</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#fn1" name=back-fn1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>†</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Eric HY+Lau" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Eric HY Lau'); return false;">Eric HY Lau</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Qiaohong+Liao" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Qiaohong Liao'); return false;">Qiaohong Liao</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Peng+Wu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Peng Wu'); return false;">Peng Wu</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Hui+Jiang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Hui Jiang'); return false;">Hui Jiang</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Tim K+Tsang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Tim K Tsang'); return false;">Tim K Tsang</A> MPhil <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Jiandong+Zheng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Jiandong Zheng'); return false;">Jiandong Zheng</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Vicky J+Fang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Vicky J Fang'); return false;">Vicky J Fang</A> MPhil <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zhaorui+Chang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zhaorui Chang'); return false;">Zhaorui Chang</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Michael Y+Ni" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Michael Y Ni'); return false;">Michael Y Ni</A> MPH <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Qian+Zhang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Qian Zhang'); return false;">Qian Zhang</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Dennis KM+Ip" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Dennis KM Ip'); return false;">Dennis KM Ip</A> MPhil <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Jianxing+Yu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Jianxing Yu'); return false;">Jianxing Yu</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Yu+Li" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Yu Li'); return false;">Yu Li</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Liping+Wang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Liping Wang'); return false;">Liping Wang</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Wenxiao+Tu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Wenxiao Tu'); return false;">Wenxiao Tu</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff2" name=back-aff2 cmImpressionSent="1"><SPAN class=ja50-ce-sup>b</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Ling+Meng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Ling Meng'); return false;">Ling Meng</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff2" name=back-aff2 cmImpressionSent="1"><SPAN class=ja50-ce-sup>b</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Joseph T+Wu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Joseph T Wu'); return false;">Joseph T Wu</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Huiming+Luo" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Huiming Luo'); return false;">Huiming Luo</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff4" name=back-aff4 cmImpressionSent="1"><SPAN class=ja50-ce-sup>d</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Qun+Li" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Qun Li'); return false;">Qun Li</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff2" name=back-aff2 cmImpressionSent="1"><SPAN class=ja50-ce-sup>b</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Yuelong+Shu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Yuelong Shu'); return false;">Yuelong Shu</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff5" name=back-aff5 cmImpressionSent="1"><SPAN class=ja50-ce-sup>e</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zhongjie+Li" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zhongjie Li'); return false;">Zhongjie Li</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Zijian+Feng" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Zijian Feng'); return false;">Zijian Feng</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff2" name=back-aff2 cmImpressionSent="1"><SPAN class=ja50-ce-sup>b</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Weizhong+Yang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Weizhong Yang'); return false;">Weizhong Yang</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff6" name=back-aff6 cmImpressionSent="1"><SPAN class=ja50-ce-sup>f</SPAN></A>, </SPAN><SPAN class=ja50-ce-author><A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Yu+Wang" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Yu Wang'); return false;">Yu Wang</A> PhD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff6" name=back-aff6 cmImpressionSent="1"><SPAN class=ja50-ce-sup>f</SPAN></A>, </SPAN><SPAN class=ja50-ce-author>Prof <A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Gabriel M+Leung" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Gabriel M Leung'); return false;">Gabriel M Leung</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff1" name=back-aff1 cmImpressionSent="1"><SPAN class=ja50-ce-sup>a</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#cor1" name=back-cor1 cmImpressionSent="1"><IMG alt="Corresponding Author" src="http://www.thelancet.com/images/article_notepad.gif" border=0></IMG></A><A class=ja50-ce-e-address href="mailto:gmleung@hku.hk" cmImpressionSent="1"><IMG alt="Email Address" src="http://www.thelancet.com/images/article_email.gif" border=0></IMG></A>, </SPAN><SPAN class=ja50-ce-author>Dr <A class=ja50-ce-author href="http://www.thelancet.com/search/results?fieldName=Authors&#038;searchTerm=Hongjie+Yu" cmImpressionSent="1" _onclick="javascript:getListOfAuthorArticles('The Lancet','Hongjie Yu'); return false;">Hongjie Yu</A> MD <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#aff3" name=back-aff3 cmImpressionSent="1"><SPAN class=ja50-ce-sup>c</SPAN></A> <A class=ja50-ce-cross-ref title="" href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61171-X/abstract#cor2" name=back-cor2 cmImpressionSent="1"><IMG alt="Corresponding Author" src="http://www.thelancet.com/images/article_notepad.gif" border=0></IMG></A><A class=ja50-ce-e-address href="mailto:yuhj@chinacdc.cn" cmImpressionSent="1"><IMG alt="Email Address" src="http://www.thelancet.com/images/article_email.gif" border=0></IMG></A></SPAN></DIV><br />
<DIV class=ja50-ce-abstract><br />
<H2 class=ja50-ce-section-title>Summary</H2><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Background</H3><br />
<DIV class=ja50-ce-simple-para>The novel influenza A H7N9 virus emerged recently in mainland China, whereas the influenza A H5N1 virus has infected people in China since 2003. Both infections are thought to be mainly zoonotic. We aimed to compare the epidemiological characteristics of the complete series of laboratory-confirmed cases of both viruses in mainland China so far.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Methods</H3><br />
<DIV class=ja50-ce-simple-para>An integrated database was constructed with information about demographic, epidemiological, and clinical variables of laboratory-confirmed cases of H7N9 (130 patients) and H5N1 (43 patients) that were reported to the Chinese Centre for Disease Control and Prevention until May 24, 2013. We described disease occurrence by age, sex, and geography, and estimated key epidemiological variables. We used survival analysis techniques to estimate the following distributions: infection to onset, onset to admission, onset to laboratory confirmation, admission to death, and admission to discharge.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Findings</H3><br />
<DIV class=ja50-ce-simple-para>The median age of the 130 individuals with confirmed infection with H7N9 was 62 years and of the 43 with H5N1 was 26 years. In urban areas, 74% of cases of both viruses were in men, whereas in rural areas the proportions of the viruses in men were 62% for H7N9 and 33% for H5N1. 75% of patients infected with H7N9 and 71% of those with H5N1 reported recent exposure to poultry. The mean incubation period of H7N9 was 3·1 days and of H5N1 was 3·3 days. On average, 21 contacts were traced for each case of H7N9 in urban areas and 18 in rural areas, compared with 90 and 63 for H5N1. The fatality risk on admission to hospital was 36% (95% CI 26—45) for H7N9 and 70% (56—83%) for H5N1.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Interpretation</H3><br />
<DIV class=ja50-ce-simple-para>The sex ratios in urban compared with rural cases are consistent with exposure to poultry driving the risk of infection—a higher risk in men was only recorded in urban areas but not in rural areas, and the increased risk for men was of a similar magnitude for H7N9 and H5N1. However, the difference in susceptibility to serious illness with the two different viruses remains unexplained, since most cases of H7N9 were in older adults whereas most cases of H5N1 were in younger people. A limitation of our study is that we compared laboratory-confirmed cases of H7N9 and H5N1 infection, and some infections might not have been ascertained.</DIV></DIV><br />
<DIV class=ja50-ce-abstract-section><br />
<H3 class=ja50-ce-section-title>Funding</H3><br />
<DIV class=ja50-ce-simple-para>Ministry of Science and Technology, China; Research Fund for the Control of Infectious Disease and University Grants Committee, Hong Kong Special Administrative Region, China; and the US National Institutes of Health.<BR><BR>======================<BR><BR></DIV></DIV></DIV></DIV></p>
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