Hot Paper in Medicine

March 2015
“Human infection with a novel avian-origin influenza virus A (H7N9),” by R.B. Gao, et al., New England Journal of Medicine, 368(20): 1888-97, 16 May 2013.

Abstract: “BACKGROUND Infection of poultry with influenza A subtype H7 viruses occurs worldwide, but the introduction of this subtype to humans in Asia has not been observed previously. In March 2013, three urban residents of Shanghai or Anhui, China, presented with rapidly progressing lower respiratory tract infections and were found to be infected with a novel reassortant avian-origin influenza A (H7N9) virus. METHODS We obtained and analyzed clinical, epidemiologic, and virologic data from these patients. Respiratory specimens were tested for influenza and other respiratory viruses by means of real-time reverse-transcriptase-polymerase-chain-reaction assays, viral culturing, and sequence analyses. RESULTS A novel reassortant avian-origin influenza A (H7N9) virus was isolated from respiratory specimens obtained from all three patients and was identified as H7N9. Sequencing analyses revealed that all the genes from these three viruses were of avian origin, with six internal genes from avian influenza A (H9N2) viruses. Substitution Q226L (H3 numbering) at the 210-loop in the hemagglutinin (HA) gene was found in the A/Anhui/1/2013 and A/Shanghai/2/2013 virus but not in the A/Shanghai/1/2013 virus. A T160A mutation was identified at the 150-loop in the HA gene of all three viruses. A deletion of five amino acids in the neuraminidase (NA) stalk region was found in all three viruses. All three patients presented with fever, cough, and dyspnea. Two of the patients had a history of recent exposure to poultry. Chest radiography revealed diffuse opacities and consolidation. Complications included acute respiratory distress syndrome and multiorgan failure. All three patients died. CONCLUSIONS Novel reassortant H7N9 viruses were associated with severe and fatal respiratory disease in three patients.”

This 2013 report from the New England Journal of Medicine was cited 50 times in current journal articles indexed by Thomson Reuters during November-December 2014. During that two-month period, only one Medicine paper published in the last two years, aside from reviews, collected a higher number of citations. Prior to the most recent bimonthly count, citations have accrued as follows, as tracked by Essential Science Indicators Hot Papers:

September-October 2014: 47 citations
July-August 2014: 47
May-June 2014: 48
March-April 2014: 59
January-February 2014: 69
November-December 2013: 54
September-October 2013: 48
July-August 2013: 40
May-June 2013: 34

Total citations to date: 496

SOURCE: Thomson Reuters Web of Science

The data and citation records included in this report are from Thomson Reuters Web of ScienceTM. Web of ScienceTM is a registered trademark of Thomson Reuters. All rights reserved.