Pandemic influenza A (2009 H1N1) in hospitalized patients in a Saudi Arabian hospital: Epidemiology and clinical comparison with H1N1-negative patients (original) (raw)
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BMC Research Notes, 2011
Background: The World Health Organization alert for the H1N1 influenza pandemic led to the implementation of certain measures regarding admission of patients with flu-like symptoms. All these instructions were adopted by the Greek National Health System. The aim of this study was to retrospectively examine the characteristics of all subjects admitted to the Unit of Infectious Diseases with symptoms indicating H1N1 infection, and to identify any differences between H1N1 positive or negative patients. Patients from the ED (emergency department) with flu-like symptoms (sore throat, cough, rhinorhea, or nasal congestion) and fever >37.5°C were admitted in the Unit of Infectious diseases and gave pharyngeal or nasopharyngeal swabs. Swabs were tested with real-time reversetranscriptase-polymerase-chain-reaction (RT-PCR). Findings: Patients were divided into two groups. Group A comprised 33 H1N1 positive patients and Group B (control group) comprised of 27 H1N1 negative patients. The two groups did not differ in terms of patient age, co-morbidities, length of hospitalization, temperature elevation, hypoxemia, as well as renal and liver function. There were also no significant differences in severity on admission. C-reactive protein (CRP) (mean 12.8 vs. 5.74) and white blood count (WBC) (mean 10.528 vs. 7.114) were significantly higher in group B than in group A upon admission. Obesity was noted in 8 patients of Group A (mean 31.67) and 14 patients of Group B (mean 37.78). Body mass index (BMI) was lower in H1N1 positive than in H1N1 negative patients (mean 31.67 vs. 37.78, respectively; p = 0.009). Conclusions: The majority of patients in both groups were young male adults. CRP, WBC and BMI were higher among H1N1 negative patients. Finally, clinical course of patients in both groups was mild and uneventful.
International Journal of General Medicine, 2012
The purpose of the present retrospective study was to examine the clinical differences between patients hospitalized with H1N1 virus and those hospitalized with nonvirus respiratory tract infection in 2009 and 2010. Methods: Adult patient data were collected from three tertiary hospital centers. Real-time reverse transcriptase polymerase chain reaction testing was used to confirm the diagnosis. We included 106 H1N1-positive patients (52 from 2009 and 54 from 2010). These data were compared with those from 108 patients with H1N1-negative respiratory tract infection (51 patients from 2009 and 57 from 2010). Results: In 2009, the mean age was 36.4 years for H1N1-positive patients versus 46.4 years for H1N1-negative patients, and mean body mass index (BMI) was 26.4 kg/m 2 patients and 28.1 kg/m 2 , respectively. In 2009, seven patients required intubation, six of whom were H1N1-positive. In 2010, the mean age was 43.8 years for H1N1-positive patients versus 60.2 years for H1N1-negative patients, and mean BMI was 32.3 kg/m 2 and 26.9 kg/m 2 , respectively. In 2010, six patients required intubation, three of whom were H1N1-positive. Abnormal chest x-ray findings were found significantly more frequently in H1N1-negative patients than in H1N1-positive patients. Conclusion: In comparison with 2009, H1N1-positive patients in 2010 were older, were more likely to be obese, and had more severe clinical and laboratory perturbations. However, this did not affect their outcomes. H1N1-negative patients were older in comparison with those who were H1N1-positive, and had more severe clinical and laboratory perturbations.
CO MORBIDITIES AND ITS SEVERITY IN H1N1 POSITIVE PATIENTS
Swine Flu, 2017
Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs and result in nasal secretions, a barking-like cough, decreased appetite (Bouvier et al, 2008). A highly contagious form of influenza seen in swine, caused by a virus of the family Orthomyxoviridae (Kimura et al, 1997). The infection is communicable to humans and caused a worldwide epidemic in 1918.The H1N1 virus (swine flu) is a new flu virus strain that has caused a worldwide pandemic in humans from June 2009 to August 2010.The Centers for Disease Control and Prevention now call the virus 2009 H1N1, an acute and highly contagious respiratory disease of swine caused by the orthomyxo virus thought to be the same virus that caused the 1918 influenza pandemic an acute febrile highly contagious viral disease. A highly contagious form of human influenza caused by a filterable virus identical or related to a virus formerly isolated from infected swine. The new virus, 2009 H1N1, spreads quickly and easily (Matsuzaki et al, 2002). A few months after the first cases were reported, rates of confirmed H1N1-related illness were increasing in almost all parts of the world. As a result, the World Health Organization declared the infection a global pandemic. That official designation remained in place for more than a year. Swine influenza was first proposed to be a disease related to human flu during the 1918 flu pandemic, when pigs became sick at the same time as humans. The risk factors for severe H1N1 infection include Pregnant woman Older age group 65 years Individuals with chronic hepatic disease Individuals with Diabetes mellitus Hematological abnormalities Immunosuppressant Individuals with renal failure Individuals with congestive heart failure Individuals with chronic lung disease as well as diseases related to smoking etc. The symptoms ofH1N1 influenza are Fever A temperature of 100f r higher for 3 to 4 days, Coughing : A non productive cough is usually present with the swine flu. Chills ,Tiredness, Aches, Headache. In the present study we tried to find out co relation between H1N1 infected patients and co morbidities. II. Material And Methods: Study design: Hospital based Retrospective study. sampling technique : convenient sampling site of study: Department of Medicine Isolation ward in GMCH Aurangabad. SEX WISE DISTRIBUTION : out of 45 swab positive cases 26 were females and 19 were males the incidence was higher in females during this period table no:2 ,fig:2 Background: Since the 2009 pandemic of H1N1, there have been respiratory emergencies every year throughout India, but in the early part of this year that is between February to June 2017 an explosion of cases was seen in Marathwada region in Maharashtra. The study of co morbidities and their relation to severity of H1N1 infection helps in early suspicion, isolation, detection and treatment of patients. Thereby further spread of the disease and its complication can be controlled and the patients can be saved. Material and methods: This is a Hospital based study conducted in a tertiary care centre at the Government medical college and hospital, Aurangabad between February to June 2017 Study sample was the total number of confirmed cases of swine flu who were admitted in the isolation ward .The objectives were to describe the incidence and outcome of H1N1 positive cases associated with various co morbid conditions. Result :Out of 169 suspects admitted, 45 tested were tested positive for H1N1of NIV Pune. Out of 45 cases the 26positive cases were females, and 19 were males Out of the 45 total cases, 26 cases had co morbidities like, Hypertension, diabetes mellitus, bronchial asthma ,hypothyroidism and pregnancy. Immunosuppressant, cerebral palsy, GBS. Majority of the patients with co morbidities had prolonged duration of hospital stay(> 10 days) than the patients without any co morbidities, and the mortality rate was higher in the patients with co morbidities
2010 Influenza H1N1 Lancet (2)
Background: We aimed to identify and characterise children hospitalised with influenza, document the impact of influenza H1N1 A (2009), and compare incidence and outcomes of pandemic with seasonal influenza Methods: A novel inpatient surveillance system (Paediatric Active Enhanced Disease Surveillance: PAEDS) was used to identify influenza cases in all three children's hospitals in NSW (The Children's Hospital at Westmead (CHW), Sydney Children's Hospital, John Hunter Children's Hospital), June 1-September 30, 2009. Demographic and clinical characteristics, management, complications and outcome were collected for children <15 years hospitalised with laboratory-proven influenza. For CHW, these data were compared with active surveillance from 2007 and retrospectively collected 2003 data (previous peak years). Findings: 324 children were admitted to the three children's hospitals (1802 hospital beddays and 230 PICU bed-days) with CHW having the highest incidence (38.5 per 100,000) and earliest peak. Most 237/324 (73.1%) had H1N1 (2009). Although 262 children (80.9%) presented with cough, 26 (8.0%) had no respiratory symptoms. The median age was 2.5 years and 65% were <5 years. One H1N1 case died. Comparison between admissions at CHW in 2009, 2007 and 2003 (226, 122 and 257), including PICU (22, 13 and 22) and fatal outcomes ( 0, 0, 3) indicates 2009 was more comparable to 2003.Vomiting was more frequent at CHW in 2009 than 2007 (38.5% versus 13.1%; p=0.0001) as were neurological complications (11.4% versus 2.4%; p=0.0027). Amongst 62 patients in 2009 not vomiting at presentation, only one developed vomiting during oseltamivir treatment.
2015
Background: Pandemic H1N1 influenza virus is a cause of a wide spread out break of febrile respiratory infection in Turkey and worldwide. We describe the characteristics of patients who were hospitalized with H1N1/A influenza in Dicle University, Diyarbakir, Turkey from October 2009 to mid-November 2009. Methods: We collected data of 36 patients who were hospitalized for at least 3 days for influenza-like illness and who were positive for the H1N1/A virus using by real-time reverse-transcriptase-polymerase-chain-reaction assay. Results: Of the 36 patients we studied, 17% were admitted to an intensive care unit and 8% died. Seventeen percent of the patients were children under the age of 18 years, but never were 45 years of age or older. Eighty percent of the patients had at least one underlying medical condition; these conditions included asthma, chronic obstructive pulmonary disease; diabetes; lung, heart, and neurologic diseases; and pregnancy. All of the patients who underwent chest radiography on admission, 28 (78%) had findings consistent with pneumonia. Three (8%) of the patient were died. The median age of patients who died (29.6 years) was not significantly higher than that of the non-fatal cases (26.5 years, p > 0.05). Of the 36 patients for whom data were available regarding the use of antiviral drugs, such therapy was initiated in 26 patients (72%) at a median of 3 days after the onset of illness. Conclusions: During of the 45 daily period, H1N1/A influenza caused severe illness requiring hospitalization, including pneumonia and death. Nearly three quarters of the patients had one or more underlying medical conditions. One severe illnesses were reported among person with pregnancy. Patients seemed to benefit from antiviral therapy. Data suggest that the use of antiviral drugs was beneficial in hospitalized patients, especially when such therapy was initiated early.
Hospitalized pandemic influenza A (H1N1) patients in a university hospital
Central European Journal of Medicine, 2011
The purpose of this study was to describe the demographic and clinical features of hospitalized patients with the pandemic H1N1 influenza A virus infection in a tertiary care hospital in Central Anatolia, Turkey. The patients, all over 16 years of age and hospitalized for influenza-like symptoms between 1 November 2009 and 31 December 2009, were retrospectively identified from the records of the Infectious Diseases Department. Eighty patients whose diagnoses were confirmed by real-time PCR were included in this study. The median age of the patients was 27 years; 41 of them were male. Thirty-seven of the patients had a radiologically proven pneumonia. Eighteen of 37 (48.6%) patients with pneumonia had an underlying co-morbid medical condition, and 14 required intensive care unit admission. Patients with pneumonia had higher levels of C-reactive protein. All patients but one received oseltamivir treatment. Six patients with pneumonia received only antiviral therapy, while 31 of the pa...
Mortality from Pandemic Influenza A (H1N1) in Iran
Iranian Red Crescent …, 2011
BackgroundDue to worldwide spread of influenza A (H1N1) virus, the World Health Organization declared the first pandemic of influenza in four decades. This study aims to report the mortality from pandemic influenza A (H1N1) in Iran population and its epidemiologic and clinical characteristics up to December 21, 2009.MethodsThe data were obtained from all provinces and reported to center for disease control of Ministry of Health and Medical Education (MOHME) of Iran through nationwide surveillance system for influenza A (H1N1) was implemented by MOHME since April 2009.ResultsOf 3672 confirmed cases of influenza A (H1N1) in Iran between 22 May and 21 December 2009, 140 (3.8%) deaths were reported, mostly in 15-65 year old (yo) age group (67%). The highest admission mortality rate was in > 65 yo group (107 deaths/1000 hospitalized cases). Of decedent patients, 54% had no long term condition or risk factor, 34% had one, 11% had two, and 1% had three. Diabetes mellitus, pregnancy, chronic respiratory diseases and hypertension were the most common underlying conditions. The most common clinical pictures of death were acute respiratory distress syndrome and viral pneumonia. Although 66% of decedent patients received oseltamivir, enough information was not available about time of onset of antiviral therapy.ConclusionAs death due to influenza A (H1N1) occurs in all age groups and in those with and without any predisposing factors, we recommend health policy makers to provide influenza vaccination for people with underlying conditions and respiratory hygiene for all people.