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NTU Hospital Successfully Treats First Imported Case of H7N9

The first confirmed human cases of avian influenza A (H7N9) occurred in the region of Shanghai and Jiangsu Province in China in February and March 2013. As of May 23, China had reported 130 cases of human H7N9, and 36 subsequent deaths. The mortality rate for the virus stood at 27.7%.

People travel regularly between Taiwan and China for business and tourism. At present, Taiwan is the only country to confirm a case of H7N9 imported from China. The government confirmed on April 24 that a Mr. Lee, who had travelled to China for business, had been infected by the virus. Thanks to aggressive treatment by a team of doctors at NTU Hospital, the patient recovered from his critical illness and was released on May 24.

Mr. Lee had arrived in the city of Suzhou in Jiangsu Province on March 28 and returned to Taiwan on April 9. On April 12, he began to suffer fever, night sweats and fatigue, yet did not experience either respiratory or intestinal difficulties. On April 16, Mr. Lee sought medical treatment due to a high fever. He was admitted to a hospital and began treatment with the antiviral drug Tamiflu the same day.

Unfortunately, the patient started to suffer rapid breathing on the night of April 19. The following day, a chest X-ray revealed that both lungs were filling with fluid, and his doctors had him transferred to NTU Hospital, where he was admitted to the intensive care unit. Due to Mr. Lee’s lung failure, doctors inserted a breathing tube and placed him in a negative pressure isolation room.

The patient’s breathing continued to deteriorate and, on April 22, his doctors decided to use extracorporeal membrane oxygenation (ECMO) to keep him alive. Mr. Lee was also transferred to the surgical intensive care unit. During this period, two tests proved negative for H7N9. However, on April 23, a sputum sample was delivered to the Center for Disease Control for reverse transcription polymerase chain reaction testing. The test results were positive, finally confirming that Mr. Lee was infected by the H7N9 virus.

The same day, doctors commenced intravenoustreatment with the antiviral drug Peramivir. Also, since the patient’s kidney function continued to deteriorate, the doctors started dialysis on April 25. During this time, the hospital formed a team of physicians and surgeons to provide joint treatment. Mr. Lee’s condition stabilized gradually and he was removed from ECMO on May 2. Chest X-rays and pulmonary function improved daily, and the patient’s breathing tube was extracted on May 7. He was transferred to a regular hospital ward on May 9. Mr. Lee’s breathing continued to improve and he gradually recovered kidney function and no longer required dialysis. As a result of the persistent efforts of the NTU Hospital team, Mr. Lee was released from the hospital in healthy condition on May 24.

Chinese version