Since throat swab specimens obtained from three adult Chinese patients were confirmed as an avian-origin influenza A (H7N9) virus by local Centers for Disease Control and Prevention (CDC) in 2013,^[1] many confirmed cases have been reported in Mainland of China. Although family and hospital clusters with confirmed or suspected avian H7N9 virus infection were previously reported and person-to-person transmission was put forward, human infection of H7N9 appears to be associated with exposure to infected live poultry or contaminated environments ^[2] and no clear evidence has proved that it could transmit from person to person. Here, we report a case confirmed with H7N9 after intimately contact with his H7N9 ward mate, it may be the first case infected between ward mates in a ward, so we report it here.

The index case, a 66-year-old male with hypertension and type II diabetes for more than 10 years, was admitted to the respiratory department for cough and expectoration with 3 days, aggravation with bloody sputum with 1 day on December 17, 2016. He was transferred to the nephrology department for elevated serum creatinine and hypourocrinia the next day (December 18). The symptom of cough and expectoration was exacerbated, developed with dyspnea, dizzy, pink foam sputum, and descend transcutaneous oxygen saturation in the 3^rd day (December 19), and was transferred to intensive care unit soon. Laboratory investigation of the throat swabs showed that he was positive for H7N9 by real-time polymerase chain reaction (RT-PCR). X-rays showed bilateral pneumonia and high-density patchiness in the left lung [December 19, He was died of persistent hyperpyrexia, respiratory failure, and acute respiratory distress syndrome at last although treated with mechanical ventilation, broad-spectrum antibiotics, oseltamivir, and immunological therapy. The index patient had visited a live-poultry market (LPM) to buy food every day within 10 days before his illness onset and had no direct contact with live poultry in the market.