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Emerging respiratory tract viral infections

Hui, David S.a; Zumla, Alimuddinb

Current Opinion in Pulmonary Medicine: May 2015 - Volume 21 - Issue 3 - p 284–292
doi: 10.1097/MCP.0000000000000153
INFECTIOUS DISEASES: Edited by Alimuddin Zumla and Michael S. Niederman

Purpose of review This article reviews the clinical and treatment aspects of avian influenza viruses and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).

Recent findings Avian influenza A(H5N1) and A(H7N9) viruses have continued to circulate widely in some poultry populations and infect humans sporadically. Sporadic human cases of avian A(H5N6), A(H10N8) and A(H6N1) have also emerged. Closure of live poultry markets in China has reduced the risk of A(H7N9) infection. Observational studies have shown that oseltamivir treatment for adults hospitalized with severe influenza is associated with lower mortality and better clinical outcomes, even as late as 4–5 days after symptom onset. Whether higher than standard doses of neuraminidase inhibitor would provide greater antiviral effects in such patients requires further investigation. High-dose systemic corticosteroids were associated with worse outcomes in patients with A(H1N1)pdm09 or A(H5N1). MERS-CoV has continued to spread since its first discovery in 2012. The mortality rates are high in those with comorbid diseases. There is no specific antiviral treatment or vaccine available. The exact mode of transmission from animals to humans remains unknown.

Summary There is an urgent need for developing more effective antiviral therapies to reduce morbidity and mortality of these emerging viral respiratory tract infections.

aDivision of Respiratory Medicine and Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin New Territories, Hong Kong

bDivision of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK

Correspondence to David S. Hui, Division of Respiratory Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin New Territories, Hong Kong. Tel: +852 2632 3128; fax: +852 2648 9957; e-mail:

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