14.09.2012

CDC: Morbidity and Mortality Weekly Report. Sep 14, 2012

During June–August 2012, Mexico's National Service for Health, Safety, and Food Quality reported outbreaks of highly pathogenic avian influenza (HPAI) A/H7N3 virus in poultry on farms throughout the state of Jalisco. Two cases of conjunctivitis without fever or respiratory symptoms caused by HPAI A/H7N3 virus infection in humans associated with exposure to infected poultry were reported.
Patient 1. On July 7, a poultry worker aged 32 years complaining of pruritus in her left eye was examined at a clinic in Jalisco. Physical findings included redness, swelling, and tearing. Conjunctivitis was diagnosed; the patient was treated symptomatically and recovered fully. Because the patient had collected eggs in a farm where HPAI A (H7N3) virus was detected, the Institute for Epidemiological Diagnosis and Reference, Mexico, tested ocular swabs from both of her eyes for influenza A (H7) by real-time reverse transcription–polymerase chain reaction (rRT-PCR), and embryonated chicken eggs were inoculated for viral isolation. The swab material was positive for influenza A (H7) virus by rRT-PCR and virus was isolated from each eye. These findings were reported to the World Health Organization on July 19, and full genome sequences (CY125725–32) were uploaded to GenBank. The virus was closely related by nucleotide sequence to previously reported HPAI A (H7N3) viruses collected during poultry outbreaks in Jalisco.
Patient 2. A man aged 52 years, who was a relative of patient 1 and worked on the same farm, developed symptoms consistent with conjunctivitis on July 10 and sought care at a local clinic on July 13. He was treated symptomatically and recovered without sequelae. When public health authorities became aware of this patient, they obtained eye swabs, which were tested by rRT-PCR, revealing influenza A (H7).
The conjunctivitis cases in Jalisco most likely represent HPAI A (H7N3) virus transmission from infected poultry to humans through direct contact.