Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study

Newly emerging or “re-emerging” influenza viruses have been regarded as a huge global threat to human public health. However, there are few reports of human deaths caused by newly emerging influenza viruses derived from pigs and poultry. Here, we described the clinical and virological features of a...

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Main Authors: Wenlei Wang, Xuhua Mao, Ming Li, Kaituo Liu, Bo Peng, Qin Su, Zehua Wang, Zhihui Zheng, Zihan Chen, Weiqing Shi, Muhammad Ali, Yin Wang, Min Gu, Junjie Lu, Xiaoquan Wang, Xiufan Liu, Pinghu Zhang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Emerging Microbes and Infections
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Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2025.2528536
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author Wenlei Wang
Xuhua Mao
Ming Li
Kaituo Liu
Bo Peng
Qin Su
Zehua Wang
Zhihui Zheng
Zihan Chen
Weiqing Shi
Muhammad Ali
Yin Wang
Min Gu
Junjie Lu
Xiaoquan Wang
Xiufan Liu
Pinghu Zhang
author_facet Wenlei Wang
Xuhua Mao
Ming Li
Kaituo Liu
Bo Peng
Qin Su
Zehua Wang
Zhihui Zheng
Zihan Chen
Weiqing Shi
Muhammad Ali
Yin Wang
Min Gu
Junjie Lu
Xiaoquan Wang
Xiufan Liu
Pinghu Zhang
author_sort Wenlei Wang
collection DOAJ
description Newly emerging or “re-emerging” influenza viruses have been regarded as a huge global threat to human public health. However, there are few reports of human deaths caused by newly emerging influenza viruses derived from pigs and poultry. Here, we described the clinical and virological features of a fatal encephalitis caused by a novel H3N2 reassortant virus generated from swine H3N2 and human H7N9 viruses. A 7-year-old boy was diagnosed with acute encephalitis in Yixing, China, in August 2022. Chest computed tomography (CT) showed mild pneumonia. Brain CT indicated acute encephalitis companied brain parenchyma swelling. Haematological examinations revealed a markedly elevation of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine kinase and cytokines. Pathogenic analysis confirmed that a novel H3N2 virus (A/Yixing/805/2022, YX805) was responsible for this case. Phylogenetic analysis showed that the surface protein-coding genes were originated from swine-origin H3N2 viruses, whereas the internal protein-coding genes were derived from human-origin H7N9 viruses. This virus triggers stronger cytokines storm than these genetically related H7N9 viruses and has a natural resistance to neuraminidase inhibitors. The YX805 virus is highly pathogenic to mice. Our study highlights the urgent need to enhance epidemiological surveys for reassortment events between swine and avian influenza virus by full genome sequencing.
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spelling doaj-art-529b4fbedf8a47659986a218e1dc07572025-08-20T02:39:41ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512025-12-0114110.1080/22221751.2025.2528536Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive studyWenlei Wang0Xuhua Mao1Ming Li2Kaituo Liu3Bo Peng4Qin Su5Zehua Wang6Zhihui Zheng7Zihan Chen8Weiqing Shi9Muhammad Ali10Yin Wang11Min Gu12Junjie Lu13Xiaoquan Wang14Xiufan Liu15Pinghu Zhang16The Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaJoint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, People’s Republic of ChinaMicrobiology Laboratory, Shenzhen Center for Disease Control and Prevention, Shenzhen, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaJiangsu Provincial Center for Disease Control and Prevention, Nanjing, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaYangzhou Center for Disease Control and Prevention & the Affiliated CDC of Yangzhou University, Yangzhou, People’s Republic of ChinaCollege of Veterinary Medicine & Jiangsu Key Laboratory of Human Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Affiliated Yixing Clinical School of Medical School of Yangzhou University, Yangzhou University, Yixing, People’s Republic of ChinaCollege of Veterinary Medicine & Jiangsu Key Laboratory of Human Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, People’s Republic of ChinaCollege of Veterinary Medicine & Jiangsu Key Laboratory of Human Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, People’s Republic of ChinaThe Key Laboratory of the Jiangsu Higher Education Institutions for Integrated Traditional Chinese and Western Medicine in Senile Diseases Control, Institute of Translational Medicine, School of Medicine, Yangzhou University, Yangzhou, People’s Republic of ChinaNewly emerging or “re-emerging” influenza viruses have been regarded as a huge global threat to human public health. However, there are few reports of human deaths caused by newly emerging influenza viruses derived from pigs and poultry. Here, we described the clinical and virological features of a fatal encephalitis caused by a novel H3N2 reassortant virus generated from swine H3N2 and human H7N9 viruses. A 7-year-old boy was diagnosed with acute encephalitis in Yixing, China, in August 2022. Chest computed tomography (CT) showed mild pneumonia. Brain CT indicated acute encephalitis companied brain parenchyma swelling. Haematological examinations revealed a markedly elevation of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine kinase and cytokines. Pathogenic analysis confirmed that a novel H3N2 virus (A/Yixing/805/2022, YX805) was responsible for this case. Phylogenetic analysis showed that the surface protein-coding genes were originated from swine-origin H3N2 viruses, whereas the internal protein-coding genes were derived from human-origin H7N9 viruses. This virus triggers stronger cytokines storm than these genetically related H7N9 viruses and has a natural resistance to neuraminidase inhibitors. The YX805 virus is highly pathogenic to mice. Our study highlights the urgent need to enhance epidemiological surveys for reassortment events between swine and avian influenza virus by full genome sequencing.https://www.tandfonline.com/doi/10.1080/22221751.2025.2528536Influenza-associated encephalitisInfluenza A virusH3N2H7N9Reassortment
spellingShingle Wenlei Wang
Xuhua Mao
Ming Li
Kaituo Liu
Bo Peng
Qin Su
Zehua Wang
Zhihui Zheng
Zihan Chen
Weiqing Shi
Muhammad Ali
Yin Wang
Min Gu
Junjie Lu
Xiaoquan Wang
Xiufan Liu
Pinghu Zhang
Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study
Emerging Microbes and Infections
Influenza-associated encephalitis
Influenza A virus
H3N2
H7N9
Reassortment
title Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study
title_full Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study
title_fullStr Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study
title_full_unstemmed Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study
title_short Clinical features of a fatal case of acute encephalitis associated with a novel influenza H3N2 recombinant virus possessing human-origin H7N9 internal genes: a descriptive study
title_sort clinical features of a fatal case of acute encephalitis associated with a novel influenza h3n2 recombinant virus possessing human origin h7n9 internal genes a descriptive study
topic Influenza-associated encephalitis
Influenza A virus
H3N2
H7N9
Reassortment
url https://www.tandfonline.com/doi/10.1080/22221751.2025.2528536
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