scholarly journals Clinical impact of influenza – lessons learnt from the pandemic influenza A (H1N1) 2009

2011 ◽  
Vol 32 (1) ◽  
pp. 29
Author(s):  
Alex Dierig ◽  
Gulam Khandaker ◽  
Robert Booy
Keyword(s):  
Clinical Features ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Influenza Pandemic ◽  
Gastrointestinal Symptoms ◽  
H1n1 Influenza ◽  
World Health ◽  
Pandemic H1n1 ◽  
Pandemic H1n1 Influenza ◽  
Influenza A H1n1

Influenza is generally an acute, self-limiting, febrile illness without further complications in the majority of people. However, it can be associated with severe morbidity and mortality and the burden of the disease on society is likely to be underestimated. In 2009 an outbreak of H1N1 influenza A virus infection was detected in Mexico with further cases soon observed worldwide. Subsequently, in June 2009, the first influenza pandemic of the 21st century due to influenza A (H1N1) was declared by the World Health Organization (WHO). There were many uncertainties regarding the virulence, clinical symptoms and epidemiological features of this newly evolved influenza A strain. Over time, many similarities, but also some differences between the pandemic H1N1 influenza A and seasonal influenza were identified. We recently performed a systematic review of the literature, looking at articles published between 1 April 2009 and 31 January 2010, to identify the epidemiological and clinical features of the pandemic H1N1 influenza. In this current article we compare our findings with others from the international literature. There was more severe impact on young and healthy adults, children, pregnant women and the obese. Clinical features in general were similar between seasonal and pandemic influenza; however, there were more gastrointestinal symptoms associated with pandemic H1N1 influenza. Shortness of breath was characteristic of more severe pH1N1 2009 infection with a higher possibility of being admitted to an intensive care unit (ICU).

scholarly journals Approach to Pandemic 2009 influenza: first report from a main referral hospital for Pandemic H1N1 influenza care in Iran

2010 ◽  
Vol 4 (10) ◽  
pp. 629-635 ◽  
Author(s):  
Simin Dashti-Khavidaki ◽  
Hossein Khalili ◽  
Farid Gholamalipour ◽  
Abdolreza Soudbakhsh ◽  
Azita Hajhossein Talasaz ◽  
...  
Keyword(s):  
Influenza A ◽  
Adverse Reactions ◽  
Gastrointestinal Symptoms ◽  
H1n1 Influenza ◽  
Cross Sectional Study ◽  
World Health ◽  
Pandemic H1n1 ◽  
Cross Sectional ◽  
Pandemic H1n1 Influenza ◽  
Influenza A H1n1

Introduction: Pandemic H1N1 influenza A (pdmH1N1) was a major health threat worldwide. Methodology:  A prospective cross-sectional study was conducted at Imam Khomeini Hospital in Iran. Cases of suspicious pdmH1N1 patients referred to the emergency ward of the hospital were enrolled in the study, regardless of whether the final location of treatment was the community, the hospital ward, or the intensive care unit.   Oseltamivir was administered within three hours of the patient's admission.  The median length of stay for hospitalized patients was 3 days. Results:  Gastrointestinal symptoms (nausea [164/434; 37.8%] and vomiting [98/434; 22.6%]) were the most common adverse reactions to oseltamivir in the study population, followed by dizziness (74/434; 17.1%). Out of 434 patients, 209 (48.2%) were treated in the community, 201 (46.3%) were admitted to the general ward in the hospital, and 24 (5.5%) were admitted to an ICU. Conclusions: This study provided insight on the effectiveness of oseltamivir in treating pandemic influenza A, as well as possible adverse reactions to the drug.  The study further drew attention to a variety of pdmH1N1 complications, in particular secondary bacterial pneumonia. We also determined that 2009 influenza A (H1N1) infection-related critical illness and mortality affected fewer elderly than younger patients. Additionally, it was shown that our approach to patients with suspected Influenza A/H1N1 virus in our hospital was compatible with World Health Organization pandemic flu guidelines in our country.

scholarly journals Pandemic H1N1 influenza: predicting the course of a pandemic and assessing the efficacy of the planned vaccination programme in the United States

2009 ◽  
Vol 14 (41) ◽  
Author(s):  
S Towers ◽  
Z Feng
Keyword(s):  
United States ◽  
Influenza A ◽  
Influenza Pandemic ◽  
Vaccination Campaign ◽  
H1n1 Influenza ◽  
The United States ◽  
Pandemic H1n1 ◽  
Pandemic H1n1 Influenza ◽  
Influenza A H1n1 ◽  
Control And Prevention

We use data on confirmed cases of pandemic influenza A(H1N1), disseminated by the United States Centers for Disease Control and Prevention(US CDC), to fit the parameters of a seasonally forced Susceptible, Infective, Recovered (SIR) model. We use the resulting model to predict the course of the H1N1 influenza pandemic in autumn 2009, and we assess the efficacy of the planned CDC H1N1 vaccination campaign. The model predicts that there will be a significant wave in autumn, with 63% of the population being infected, and that this wave will peak so early that the planned CDC vaccination campaign will likely not have a large effect on the total number of people ultimately infected by the pandemic H1N1 influenza virus.

scholarly journals Pulmonary Pathologic Findings of Fatal 2009 Pandemic Influenza A/H1N1 Viral Infections

2010 ◽  
Vol 134 (2) ◽  
pp. 235-243 ◽  
Author(s):  
James R. Gill ◽  
Zong-Mei Sheng ◽  
Susan F. Ely ◽  
Donald G. Guinee ◽  
Mary B. Beasley ◽  
...  
Keyword(s):  
Pandemic Influenza ◽  
Influenza A ◽  
Bacterial Infections ◽  
Diffuse Alveolar Damage ◽  
Influenza Pandemic ◽  
Alveolar Epithelial Cells ◽  
World Health ◽  
Medical Examiner ◽  
Influenza A H1n1 ◽  
Pathologic Findings

Abstract Context In March 2009, a novel swine-origin influenza A/H1N1 virus was identified. After global spread, the World Health Organization in June declared the first influenza pandemic in 41 years. Objective To describe the clinicopathologic characteristics of 34 people who died following confirmed A/H1N1 infection with emphasis on the pulmonary pathology findings. Design We reviewed medical records, autopsy reports, microbiologic studies, and microscopic slides of 34 people who died between May 15 and July 9, 2009, and were investigated either by the New York City Office of Chief Medical Examiner (32 deaths) or through the consultation service of a coauthor (2 deaths). Results Most of the 34 decedents (62%) were between 25 and 49 years old (median, 41.5 years). Tracheitis, bronchiolitis, and diffuse alveolar damage were noted in most cases. Influenza viral antigen was observed most commonly in the epithelium of the tracheobronchial tree but also in alveolar epithelial cells and macrophages. Most cases were reverse transcription–polymerase chain reaction positive for influenza. Histologic and microbiologic autopsy evidence of bacterial pneumonia was detected in 55% of cases. Underlying medical conditions including cardiorespiratory diseases and immunosuppression were present in 91% of cases. Obesity (body mass index, >30) was noted in 72% of adult and adolescent cases. Conclusions The pulmonary pathologic findings in fatal disease caused by the novel pandemic influenza virus are similar to findings identified in past pandemics. Superimposed bacterial infections of the respiratory tract were common. Preexisting obesity, cardiorespiratory diseases, and other comorbidities also were prominent findings among the decedents.

scholarly journals Hospitalizations associated with 2009 influenza A (H1N1) and seasonal influenza in Saurashtra region, India

2010 ◽  
Vol 4 (12) ◽  
pp. 834-841 ◽  
Author(s):  
Rajesh K Chudasama ◽  
Umed V Patel ◽  
Pramod B Verma
Keyword(s):  
Influenza Virus ◽  
Median Time ◽  
Influenza A ◽  
Seasonal Influenza ◽  
H1n1 Influenza ◽  
Pandemic H1n1 ◽  
H1n1 Influenza Virus ◽  
Pandemic H1n1 Influenza ◽  
Influenza A H1n1 ◽  
Epidemiological Characteristics

Introduction: This study investigated the clinico-epidemiological characteristics of patients who were hospitalized with 2009 pandemic H1N1 influenza virus infection and seasonal influenza in the Saurashtra region of India. Methodology: From September 2009 to February 2010, a total of 773 patients with influenza virus attending different hospitals in Rajkot city were studied. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features of the disease were closely monitored. Results: Of the 733 patients, 35.4% (274/773) were cases of 2009 pandemic H1N1 influenza and 64.6% (499/773) were cases of seasonal influenza. Of the 274 patients with 2009 pandemic H1N1 influenza, the median age was 29.5 years, and 51.5% were males. Only 1.1% positive patients had recent travel history to an infected region. A median time of five days was observed from onset of illness to influenza A (H1N1) diagnosis, and a median time of six days was reported for hospital stay. All admitted influenza A (H1N1) patients received Oseltamivir drug, but only 16.1% received it within two days of onset of illness. One fourth of the admitted positive patients died. The most common symptoms were cough, fever, sore throat, and shortness of breath. The coexisting conditions were diabetes mellitus, hypertension, chronic pulmonary diseases, and pregnancy (p = 0.001). Chest radiography revealed 93% of the positive patients had pneumonia. Conclusion: The clinical course and outcomes of the 2009 pandemic (H1N1) influenza virus are comparable to those of the currently circulating seasonal influenza, with high mortality in influenza A (H1N1) patients.

scholarly journals Prolonged shedding of influenza A(H1N1)v virus: two case reports from France 2009

2009 ◽  
Vol 14 (49) ◽  
Author(s):  
H Fleury ◽  
S Burrel ◽  
C Balick Weber ◽  
R Hadrien ◽  
P Blanco ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Influenza A ◽  
Case Reports ◽  
Resistance Mutation ◽  
Neuraminidase Inhibitor ◽  
H1n1 Influenza ◽  
Pandemic H1n1 ◽  
Pandemic H1n1 Influenza ◽  
Influenza A H1n1 ◽  
Emergence Of Resistance

We observed a prolonged shedding of virus 14 and 28 days after symptom onset in two patients with pandemic H1N1 influenza, who did not have immunodepression and were treated with neuraminidase inhibitor. This prolonged shedding was not associated with the emergence of resistance mutation H275Y in the viral neuraminidase gene.

scholarly journals The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific

2009 ◽  
Vol 14 (42) ◽  
Author(s):  
G La Ruche ◽  
A Tarantola ◽  
P Barboza ◽  
L Vaillant ◽  
J Gueguen ◽  
...  
Keyword(s):  
Influenza A ◽  
Influenza Infection ◽  
Severe Disease ◽  
H1n1 Influenza ◽  
Indigenous Populations ◽  
Chronic Obstructive ◽  
Pandemic H1n1 ◽  
Pandemic H1n1 Influenza ◽  
The Pacific ◽  
Influenza A H1n1

There are few structured data available to assess the risks associated with pandemic influenza A(H1N1)v infection according to ethnic groups. In countries of the Americas and the Pacific where these data are available, the attack rates are higher in indigenous populations, who also appear to be at approximately three to six-fold higher risk of developing severe disease and of dying. These observations may be associated with documented risk factors for severe disease and death associated with pandemic H1N1 influenza infection (especially the generally higher prevalence of diabetes, obesity, asthma, chronic obstructive pulmonary disease and pregnancy in indigenous populations). More speculative factors include those associated with the risk of infection (e.g. family size, crowding and poverty), differences in access to health services and, perhaps, genetic factors. Whatever the causes, this increased vulnerability of indigenous populations justify specific immediate actions in the control of the current pandemic including primary prevention (intensified hygiene promotion, chemoprophylaxis and vaccination) and secondary prevention (improved access to services and early treatment following symptoms onset) of severe pandemic H1N1 influenza infection.

scholarly journals A Functional Variation in CD55 Increases the Severity of 2009 Pandemic H1N1 Influenza A Virus Infection

2012 ◽  
Vol 206 (4) ◽  
pp. 495-503 ◽  
Author(s):  
Jie Zhou ◽  
Kelvin Kai-Wang To ◽  
Hui Dong ◽  
Zhong-Shan Cheng ◽  
Candy Choi-Yi Lau ◽  
...  
Keyword(s):  
Virus Infection ◽  
Influenza A Virus ◽  
Influenza A ◽  
H1n1 Influenza ◽  
Pandemic H1n1 ◽  
Functional Variation ◽  
Pandemic H1n1 Influenza ◽  
Influenza A Virus Infection

scholarly journals Changes in epidemiology, clinical features and severity of influenza A (H1N1) 2009 pneumonia in the first post-pandemic influenza season

2012 ◽  
Vol 18 (3) ◽  
pp. E55-E62 ◽  
Author(s):  
D. Viasus ◽  
E. Cordero ◽  
J. Rodríguez-Baño ◽  
J.A. Oteo ◽  
A. Fernández-Navarro ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Influenza Season ◽  
Influenza A H1n1
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