The findings provide the strongest evidence yet of H7N9 transmission between humans, but researchers stress that its ability to transmit itself is "limited and non-sustainable."
Avian influenza A (H7N9) virus was recently identified in Eastern China. As of June 30, 133 cases have been reported, resulting in 43 deaths, according to a report published on bmj.Com.
Most cases appear to have visited live poultry markets or had close contact with live poultry 7-10 days before illness onset. Currently, no definite evidence indicates sustained human-to-human transmission of the H7N9 virus.
The first (index) patient - a 60 year old man - regularly visited a live poultry market and became ill five to six days after his last exposure to poultry. He was admitted to hospital on March 11.
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When his symptoms became worse, he was transferred to the hospital's intensive care unit (ICU). He was transferred to another ICU on March 18 and died of multi-organ failure.
The second patient, his healthy 32-year-old daughter, had no known exposure to live poultry before becoming sick. However, she provided direct and unprotected bedside care for her father in the hospital before his admission to intensive care.
Two almost genetically identical virus strains were isolated from each patient, suggesting transmission from father to daughter.
Forty-three close contacts of both cases were interviewed by public health officials and tested for influenza virus. Of these, one had mild illness, but all contacts tested negative for H7N9 infection.
Environmental samples from poultry cages, water at two local poultry markets, and swans from the residential area, were also tested. One strain was isolated but was genetically different to the two strains isolated from the patients.
But they stress that "the virus has not gained the ability to transmit itself sustained from person to person efficiently."
"To our best knowledge, this is the first report of probable transmissibility of the novel virus person to person with detailed epidemiological, clinical, and virological data. Our findings reinforce that the novel virus possesses the potential for pandemic spread," researchers said.