NBC News 
April 13, 2013
A new report on three of the first patients in China to contract a novel strain of bird flu has U.S. officials worried about a grim scenario that includes severe illness with pneumonia, septic shock, brain damage and multi-organ failure.
All three of the patients died, according to a Thursday report  by a group of Chinese scientists in the New England Journal of Medicine.
“It is possible that these severely ill patients represent the tip of the iceberg,” wrote Dr. Timothy Uyeki and Dr. Nancy Cox, both of the influenza division at the Centers for Disease Control and Prevention, in a perspective piece accompanying  the article.
The reports chronicle the early days of an outbreak of a new influenza A virus, H7N9, which has never before been seen in humans. As of Friday, Chinese officials said it had infected at least 43 people in four Chinese provinces and killed 11 in the past two months.