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The update of the clinical practice guide on seasonal influenza issued by the American Society of Infectious Diseases (IDSA) is mainly based on the content of the seasonal influenza guide issued by IDSA before the H1N1 influenza pandemic in 2009, combined with the latest literature. This guide covers the diagnosis, treatment, drug prevention and other aspects of seasonal influenza and emergency response suggestions for outbreaks in public institutions. Based on the full study of the guide and the actual situation of our country, this article interprets and discusses the diagnosis and treatment of seasonal influenza.
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Objective: The differences in clinical outcomes in hospitalized patients with hematological disorders (HD) who developed either coronavirus disease 2019 (COVID-19) or seasonal influenza (SI) are not fully understood. To examine these differences, we retrospectively analyzed the baseline characteristics and clinical outcomes of hospitalized patients with HD admitted from 2016 to 2021.Patients and Methods: Patients with HD who developed COVID-19 (in the past 1 year) (n=21) or SI (in the past 5 years) (n=23) in the Department of Hematology/Oncology, Asahikawa Kosei General Hospital were evaluated.Results: The median ages of the patients with HD with either COVID-19 or SI were 80 and 68 years, respectively (P=0.03). The groups showed no significant differences in sex ratio, body mass index, or Eastern Cooperative Oncology Group performance status. In the COVID-19 and SI groups, the most common primary diseases were diffuse large B-cell lymphoma (43%) and multiple myeloma (39%), respectively. The median numbers of days of oxygen administration (8 vs. 0 days), quarantine (25 vs. 6 days), and hospitalization (72 vs. 21 days) were significantly higher in HD patients with COVID-19 than those in HD patients with SI (all P<0.001). The overall 90-day survival of patients with HD and COVID-19 was significantly shorter than that of patients with HD and SI (P=0.019). Moreover, patients with HD and COVID-19 had a higher risk of in-hospital mortality (43% vs. 9%; odds ratio, 7.50; 95% confidence interval, 1.26–82.4; P=0.01) compared to patients with HD and SI.Conclusion: Patients with HD and COVID-19 required longer periods of in-hospital medical and showed poorer survival than those with SI. During the COVID-19 pandemic, hematologists should closely monitor the condition of patients with COVID-19 to closely monitor their condition to prevent deaths.
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Objective@#To evaluate the effectiveness of live attenuated influenza vaccine (LAIV) in the prevention of seasonal influenza in children aged 2-17 years.@*Methods@#Literature retrieval of case-control studies on the effectiveness of LAIV against seasonal influenza in children published from January 2003 to November 2018 was conducted through Web of Science, PubMed, and ScienceDirect databases. The Stata 13.1 software was used for Meta-analysis.@*Results@#A total of 14 studies were included in this study, and all were test-negative design (TND) studies. Our Meta-analysis showed that the effectiveness of LAIV in children was 49% (95%CI: 40%-57%). Subgroup analysis found that the protection rate of LAIV was 35% against influenza A (H1N1) pdm09 (95%CI: 5%-56%), 35% against influenza A (H3N2) (95%CI: 21%-46%), and 71% against influenza B (95%CI: 55%-82%). The protection rates of trivalent LAIV and quadrivalent LAIV in children were 56% (95%CI: 48%-63%) and 44% (95%CI: 27%-57%), respectively. The protection rates of LAIV in Europe and North America were 65% (95%CI: 47%-77%) and 46% (95%CI: 36%-55%), respectively.@*Conclusion@#LAIV has a certain preventive effect on seasonal influenza in children aged 2-17 years.
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To evaluate the effectiveness of live attenuated influenza vaccine (LAIV) in the prevention of seasonal influenza in children aged 2-17 years. Literature retrieval of case-control studies on the effectiveness of LAIV against seasonal influenza in children published from January 2003 to November 2018 was conducted through Web of Science, PubMed, and ScienceDirect databases. The Stata 13.1 software was used for Meta-analysis. A total of 14 studies were included in this study, and all were test-negative design (TND) studies. Our Meta-analysis showed that the effectiveness of LAIV in children was 49 (95: 40-57). Subgroup analysis found that the protection rate of LAIV was 35 against influenza A (H1N1) pdm09 (95: 5-56), 35 against influenza A (H3N2) (95: 21-46), and 71 against influenza B (95: 55-82). The protection rates of trivalent LAIV and quadrivalent LAIV in children were 56 (95: 48-63) and 44 (95: 27-57), respectively. The protection rates of LAIV in Europe and North America were 65 (95: 47-77) and 46 (95: 36-55), respectively. LAIV has a certain preventive effect on seasonal influenza in children aged 2-17 years.
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Background: Seasonal influenza, though contagious, is preventable, provided the community and its people are aware of its mode of transmission and basic steps of prevention.Methods: This was a cross-sectional descriptive study conducted in the rural field practice area of a Medical College Baroda in the month of February 2019, when the seasonal influenza cases were at its peak. A house to house survey was carried out to enquire about the knowledge, attitude, behavior related to seasonal influenza and its source of information. The structured questionnaire was based on the information, education and communication material displayed by the Health Department for the General Public. Respondents between the age of 15-60 years were interviewed after informed consent. Data-entry and analysis was done in Epi-Data software.Results: Out of 633 respondents, two-thirds of the respondents (427, 67.5%) were aware about seasonal influenza (swine flu). They were aware about common symptoms of flu such as cough, running nose and fever (43.8%, 43% and 41.4% respectively). Majority of those who knew about the flu were aware of it being preventable (59%); 37% knew it could be prevented by using a handkerchief, while 30% were aware about avoiding crowded places. Source of information was television (33%), followed by health care provider (14%) and newspaper (12%).Conclusions: Two-thirds of the respondents in the rural area were aware about seasonal influenza as a disease; majority of them knew that it could be prevented. The source of information was mainly media and health care providers. Attempts to improve the dissemination of information and behavior change communication is the way forward
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In China,the control and prevention programs on any disease has always been based on comprehensive strategies.Take influenza as an example,related contents would include:strengthening the surveillance,recommendation and promotion of vaccination,rational use of antiviral drugs,conducting outbreak investigation and control,and publicizing individual protective measures,etc.In terms of the response to challenges,specific proposals would include:adjustment of case reports,optimization of surveillance systems,reinforcement of vaccination recommendation by health care workers,improvement of access to vaccination,development of rapid diagnostic reagents,and rational use of antiviral drugs,etc.
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In China,the control and prevention programs on any disease has always been based on comprehensive strategies.Take influenza as an example,related contents would include:strengthening the surveillance,recommendation and promotion of vaccination,rational use of antiviral drugs,conducting outbreak investigation and control,and publicizing individual protective measures,etc.In terms of the response to challenges,specific proposals would include:adjustment of case reports,optimization of surveillance systems,reinforcement of vaccination recommendation by health care workers,improvement of access to vaccination,development of rapid diagnostic reagents,and rational use of antiviral drugs,etc.
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Compared with the 2009 pandemic influenza A (H1N1), the seasonal influenza A (H3N2) in 2011–2012 was self-limited and mild. However, some cases proceeded to acute respiratory distress syndrome (ARDS) due to underlying medical history. Here we report two cases with influenza A (H3N2) progressing to fatal ARDS. One case with several underlying medical conditions eventually died from multi-organ failure despite the application of extracorporeal membrane oxygenation. When patients are suspected to have influenza, it is imperative to investigate their medical histories and risk factors. If they have many co-morbidities or risk factors, clinicians should initiate aggressive management immediately regardless of the type of influenza infection.
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Humans , Extracorporeal Membrane Oxygenation , Influenza, Human , Orthomyxoviridae , Pandemics , Respiratory Distress Syndrome , Risk Factors , SeasonsABSTRACT
Objective To investigate and dispose an outbreak of seasonal influenza in hospital,so as to provide reference for the prevention and control of influenza outbreak in hospital.Methods Eight cases of influenza-like in-fection occurred in the department of neurosurgery at a hospital between July 29 and August 7,2014,epidemiologi-cal investigation was conducted,throat swabs of infected persons were collected for laboratory detection.Results Of 8 infected persons,6 were health care workers (HCWs)in department of neurosurgery,1 was a family member of HCW,and 1 was a patient,the major symptoms of the infected persons were low-grade fever,sore throat,and ma-laise,there were 67 patients and HCWs in this department,the attack rate of influenza was 11.94%,there was no similar infection in other departments of the hospital during the same period.The throat swabs from 6 infected HCWs were positive in influenza virus nucleic acid detection.Office for healthcare-associated infection (HAI)man-agement participated the investigation,after active isolation and antiviral treatment,the outbreak was effectively controlled.Conclusion This HAI outbreak is a seasonal influenza H3 outbreak,ventilation and environmental dis-infection in wards should be strengthened when central air conditioning is running,anti-influenza vaccination among HCWs should be performed during the epidemic season of influenza,and surveillance should be strengthened to pre-vent influenza outbreak in hospital.
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<p><b>INTRODUCTION</b>The pandemic caused by the H1N1 influenza virus in 2009 resulted in extensive morbidity and mortality worldwide. As the virus was a novel virus, there was limited data available on the clinical effects of the virus on children in Malaysia. Herein, we describe the clinical characteristics of children hospitalised with H1N1 influenza in a tertiary care centre; we also attempted to identify the risk factors associated with disease severity.</p><p><b>METHODS</b>In this retrospective study, we compared the characteristics of the children who were admitted into the University of Malaya Medical Centre, Malaysia, for H1N1 influenza during the pandemic with those who were admitted for seasonal influenza in 2002-2007.</p><p><b>RESULTS</b>Among the 77 children (aged ≤ 12 years) admitted to the centre due to H1N1 influenza from 1 July 2009-30 June 2010, nearly 60% were aged < 6 years and 40.3% had an underlying medical condition. The top three underlying medical conditions were bronchial asthma (14.3%), cardiac disease (10.4%) and neurological disorder (11.7%). The risk factors for severe disease were age < 2 years, underlying bronchial asthma and chronic lung disease. The three patients who died had a comorbid medical condition. The underlying cause of the deaths was acute respiratory distress syndrome or shock.</p><p><b>CONCLUSION</b>The clinical presentation of the children infected with the pandemic (H1N1) 2009 influenza virus did not differ significantly from that of children infected with seasonal influenza. However, there were more complaints of fever, cough and vomiting in the former group.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Child, Hospitalized , Disease Outbreaks , Follow-Up Studies , Influenza A Virus, H1N1 Subtype , Influenza, Human , Epidemiology , Therapeutics , Malaysia , Epidemiology , Retrospective Studies , Risk Factors , Seasons , Tertiary Care CentersABSTRACT
To observe the efficacy of Bairui granules combined with ribavirin aerosol in the treatment of children with seasonal influenza. Methods:Totally 60 cases of children with seasonal influenza were randomly divided into the observation group and the control group with 30 ones in each. The children in the control group were given ribavirin aerosol, and the children in the observa-tion group were given ribavirin aerosol combined with Bairui granules. The disappearance time of symptoms and curative effect of the two groups were observed after the treatment. Results:The total effective rate of the observation group was 96. 67%,that of the control group was 86. 67%,and the difference was not statistically significant (P>0. 05). The time of fever relieving, the disappearance time of headache, whole body pain and red and swollen thoroat and cough in the observation group were all significantly shorter than those in the control group (P<0. 05 or P<0. 01). Conclusion: Bairui granules combined with ribavirin aerosol is an effective method in the treatment of children with seasonal influenza.
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Objective To estimate the rates due to influenza-associated-excess-hospitalization in children aged 0-14 years in Wuxi city,Jiangsu province in 2005-2010. Methods We collected data on hospitalization due to influenza,pneumonia and other respiratory diseases from fourteen 2nd level or above hospitals in Wuxi,as well as data on influenza virological surveillance in southern China to fit the negative binomial regression models,to estimate the rate on influenza-associated-excess hospitalization. Results During 2005-2010,an average annual hospitalization rate appeared as 91.6‰(79.2‰-99.3‰). Among the total hospitalization eases,respiratory diseases accounted for 54.2%,while both influenza and pneumonia accounted for 38.1%. The average annual influenza-associated-excess-hospitalization rates due to influenza and pneumonia appeared as 1.28‰(95%CI:0.29‰-4.84‰),while 2.18‰(95%CI:0.61‰-6.79‰) due to respiratory diseases. In 2009,A(H1N1)pdm induced influenza pandemic caused 993 excess hospitalizations due to influenza/pneumonia and 1 042 excess hospitalizations due to respiratory diseases,with rates as 1.14‰ and 1.20‰ respectively. Conclusion Both seasonal and pandemic A(H1N1)pdm influenza caused considerable burden on hospitalization in children aged 0-14 years in Wuxi.
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Objective To estimate the rates due to influenza-associated-excess-hospitalization in children aged 0-14 years in Wuxi city,Jiangsu province in 2005-2010. Methods We collected data on hospitalization due to influenza,pneumonia and other respiratory diseases from fourteen 2nd level or above hospitals in Wuxi,as well as data on influenza virological surveillance in southern China to fit the negative binomial regression models,to estimate the rate on influenza-associated-excess hospitalization. Results During 2005-2010,an average annual hospitalization rate appeared as 91.6‰(79.2‰-99.3‰). Among the total hospitalization eases,respiratory diseases accounted for 54.2%,while both influenza and pneumonia accounted for 38.1%. The average annual influenza-associated-excess-hospitalization rates due to influenza and pneumonia appeared as 1.28‰(95%CI:0.29‰-4.84‰),while 2.18‰(95%CI:0.61‰-6.79‰) due to respiratory diseases. In 2009,A(H1N1)pdm induced influenza pandemic caused 993 excess hospitalizations due to influenza/pneumonia and 1 042 excess hospitalizations due to respiratory diseases,with rates as 1.14‰ and 1.20‰ respectively. Conclusion Both seasonal and pandemic A(H1N1)pdm influenza caused considerable burden on hospitalization in children aged 0-14 years in Wuxi.
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PURPOSE: The aim for this study was to investigate clinical manifestation of seasonal influenza A and B during the 2012 winter season in Wonju, South Korea. Their clinical and laboratorial characteristics and effect of oseltamivir were compared and analyzed. METHODS: Children under the age of 18 years who visited the Wonju Severance Christian Hospital with fever or acute respiratory symptoms and who were diagnosed with influenza A or B by rapid antigen test from nasopharyngeal swab were selected for the study. The medical records of patients were retrospectively reviewed. RESULTS: Influenza A was detected in 374 patients (83.7%), and influenza B in 72 (16.6%). The incidence of influenza A was highest in February (n=186), while that of influenza B was highest in March (n=36). The most common symptoms were fever (n=434, 97.1%) and cough (n=362, 81.0%). No significant differences were observed between influenza A and B in symptoms and laboratory data. Patients who had used oseltamivir within 2 days showed statistically lower admission rate, shorter admission duration, and lower incidence of pneumonia. CONCLUSION: This study found no statistical difference between influenza A and B, in symptoms, progression, and laboratory test, but those who were treated with oseltamivir given within 2 days of the onset of fever experienced more positive outcomes.
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Child , Humans , Cough , Fever , Incidence , Influenza, Human , Korea , Medical Records , Oseltamivir , Pneumonia , Retrospective Studies , SeasonsABSTRACT
Background & objectives: Pandemic H1N1 caused deluge of cases from 74 countries and prompted World Health Organization to raise warning to phase 6. The present study was conducted on throat and nasal swab samples received and tested at National Centre for Disease Control, Delhi, India during 2009-2010 to collect epidemiological and clinical information on positive cases. Methods: Throat and nasopharyngeal swabs from category C influenza A H1N1 patients during May 2009-September 2010 along with their clinico-epidemiological details were collected from identified hospitals from Delhi and other States. Samples were tested by Real time reverse transcriptase PCR using primers and probes developed at CDC, Atlanta for four influenza target genes. Results: A total of 33,751 samples, both throat and nasal swab samples from each patient were tested for H1N1 influenza virus, of which, 7943 (23.5%) were positive for pandemic influenza A H1N1 and 3759 (11.1%) were positive for influenza A (seasonal flu). Maximum number of positive cases (N=2792, 35.1%) were from 20-39 yr age group, comprising 1790 (22.5%) males and 1182 (14.8%) females. Only 2620 (33%) positive cases were close contact of influenza A H1N1 positive patient. Majority cases presented (N=2792, 35.1%) with fever 7005 (88.1%), followed by 6133 cases (77.2%) exhibiting fever and cough, 377 (4.7%) complained of fever, cough, nasal catarrh and 362 (4.5%) cases had fever with shortness of breath. Interpretation & conclusions: The study showed a peak of cases of pandemic influenza A H1N1 in December 2009 and indicated predominance of H1N1 positive cases among 20-39 yr age group and among males compared to females.
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Humans , India/epidemiology , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Influenza A Virus, H1N1 Subtype/isolation & purification , Pandemics , Reverse Transcriptase Polymerase Chain Reaction/methodsABSTRACT
PURPOSE: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. METHODS: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. RESULTS: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. CONCLUSION: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.
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Child , Humans , Bronchitis , Cross Infection , Encephalitis , Influenza, Human , Medical Records , Meningitis , Pandemics , Pericarditis , Pneumonia , Respiratory Tract Infections , Retrospective Studies , Risk Factors , Seasons , Ventilators, MechanicalABSTRACT
INTRODUCTION: The case definition of influenza-like illness (ILI) is a powerful epidemiological tool during influenza epidemics. METHODS: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature ≤ 38ºC) in period 1, and the definition of severe acute respiratory infection (ARS) (coughing + temperature ≤ 38ºC and dyspnoea) in period 2. RESULTS: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50%) than in children (21.6%) ( p < 0.0001) and influenza infection was more prevalent in the ILI definition (53%) than ARS (24.4%) (p < 0.0001). Adults reported more chills and myalgia than children (p = 0.0001). Oseltamivir was administered in 58% and 46% of adults and children with influenza A H1N1, respectively. The influenza A H1N1 case fatality rate was 7% in adults and 8.3% in children. The mean time from onset of illness until antiviral administration was 4 days. CONCLUSIONS: The modification of ILI to ARS definition resulted in less accuracy in influenza diagnosis and did not improve the appropriate time and use of antiviral medication.
INTRODUÇÃO: A definição de síndrome gripal é uma ferramenta epidemiológica importante durante epidemias de influenza. MÉTODOS: Foi conduzido estudo de coorte prospectivo para avaliar o impacto das definições de síndrome gripal (SG) e doença respiratória aguda grave (DRAG) como ferramenta de vigilância epidemiológica, em adultos e crianças, durante a epidemia de influenza A H1N1. Os pacientes foram incluídos se tivessem coleta de secreção respiratória alta testada por PCR real time para o vírus da influenza. Os dados clínicos e epidemiológicos foram estudados comparando-se dois períodos: período 1: SG (tosse + temperatura ≤ 38ºC), e período 2: DRAG (tosse + temperatura ≤ 38 e dispnéia). RESULTADOS: Foram incluídos 366 adultos e 147 crianças, em um total de 243 casos de SG e 270 DRAG. A confirmação laboratorial de influenza em adultos (50%) foi significativamente maior do que em crianças (21,6%) (p < 0,0001) e a definição de SG foi mais confirmatória de infecção por influenza (53%) do que DRAG (24,4%) (p < 0,0001). Adultos referiam mais calafrios e mialgias do que as crianças (p = 0,0001). Oseltamivir foi prescrito, respectivamente, em 58% e 46% dos adultos e crianças com influenza A H1N1. A letalidade por influenza A H1N1 foi de 7% em adultos e 8,3% em crianças. CONCLUSÕES: A mudança de definição do critério de vigilância epidemiologia de SG para DRAG resultou em redução significativa da acurácia do diagnóstico de influenza e não contribuiu para melhor indicação do antiviral como também para a sua prescrição no tempo apropriado.
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Epidemics , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Population Surveillance/methods , Acute Disease , Antiviral Agents/therapeutic use , Brazil/epidemiology , Cohort Studies , Hospitals, University , Influenza A Virus, H1N1 Subtype/genetics , Influenza, Human/diagnosis , Influenza, Human/drug therapy , Oseltamivir/therapeutic use , Prospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SeasonsABSTRACT
INTRODUCCIÓN: en abril de 2009 las autoridades de salud de México reportan a la Organización Panamericana de la Salud un incremento de las hospitalizaciones por neumonía con tasas elevadas de mortalidad. El Sistema Nacional de Vigilancia Epidemiológica, notó que este incremento se presentaba fundamentalmente en las edades de 20 a 40 años. Se identificó un nuevo virus influenza A de origen porcino subtipo (H1N1) como agente causal de la primera pandemia del siglo XXI. El 26 de abril de 2009 el plan nacional de enfrentamiento a la pandemia por influenza (H1N1) es activado por las autoridades nacionales de salud de la República de Cuba y el 7 de mayo se diagnosticó el caso índice de influenza pandémica (H1N1) en Cuba. Se estableció un sistema de vigilancia integrada con confirmación de laboratorio. OBJETIVOS: detectar e identificar el virus de la influenza pandémica durante la ola pandémica. MÉTODOS: durante las semanas epidemiológicas de la 37 a la 41 se observó un alza en el número de atenciones médicas. En este período se seleccionaron para este análisis solo las muestras colectadas de pacientes con diagnóstico clínico de infección respiratoria aguda grave divididas en tres grupos fundamentales, 370 niños y adultos graves, 55 gestantes graves y 30 fallecidos. El diagnóstico fue realizado por reacción en cadena de la polimerasa en tiempo real para los virus de influenza pandémica y reacción en cadena de la polimerasa convencional para otros virus respiratorios. RESULTADOS: el virus de la influenza pandémica se detectó en 65, 20 y 9 casos, respectivamente. El virus de la influenza estacional A (H3N2) en 81 casos de infección respiratoria aguda grave, donde se incluyeron pacientes de todas las edades; 10 gestantes graves y en 5 fallecidos, los cuales fueron detectados por reacción en cadena de la polimerasa en tiempo real. Otros virus respiratorios también fueron monitoreados por reacción en cadena de la polimerasa a punto final. CONCLUSIONES: el análisis integral de estos resultados constituye un aporte a la vigilancia nacional y regional de los virus respiratorios para el perfeccionamiento de los programas de prevención y control de las infecciones respiratorias agudas.
INTRODUCTION: on April 2009, the Mexican health authorities reported increased hospitalization indexes caused by pneumonia with high mortality rates to the Pan-American Health Organization (PAHO). The National Epidemiological Surveillance System of Mexico noticed that this increase mainly occurred in the 20-40 year old population. A new type of swine influenza A (H1N1) virus was identified by laboratory studies as the etiological agent of the first pandemic of the 21st century. On April 26 2009, the National Anti-pandemic Plan was activated by the Cuban Ministry of Public Health, and on May 7th, the lab-confirmed index case appeared. An integrated surveillance system with laboratory confirmation was set up. OBJECTIVES: to detect pandemic influenza virus during the pandemic wave. METHODS: the epidemiological weeks 37 to 41 witnessed a rise of the number of sick people seen by the medical services. In this period, the samples taken from patients clinically diagnosed with severe acute respiratory infection were selected for this analysis; they were divided into three groups, that is, 370 children and adults in critical condition, 55 pregnant women in severe condition and 30 fatal cases. The diagnosis of the pandemic virus was performed by Real Time Polymerase Chain Reaction Test (PCR). Other respiratory viruses were tested by conventional PCR. RESULTS: the pandemic influenza virus was detected in 65 children and adults, 20 pregnant women and 9 fatal cases. The seasonal influenza A (H3N2) virus was identified in 81 cases of severe acute respiratory infection covering all age groups, 10 pregnant women and 5 deceased on the basis of real time polymerase chain reaction test. Other respiratory viruses were also monitored by the end-point polymerase chain reaction. CONCLUSIONS: the comprehensive analysis of these results contributes to the national and regional surveillance of respiratory viruses for the improvement of the prevention and control programs of the acute respiratory infections.
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Adult , Child , Humans , Influenza A Virus, H1N1 Subtype , Influenza, Human/complications , Influenza, Human/epidemiology , Pandemics , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Acute Disease , Cuba/epidemiology , Severity of Illness IndexABSTRACT
PURPOSE: This study was performed to compare the clinical features of pediatric patients who were diagnosed with influenza A (H1N1) or seasonal influenza A and B during 2009 and 2010 at a single institution. METHODS: Among children who visited the Dong-A University Hospital with fever (>37.8degrees C) and acute respiratory symptoms from September 2009 to February 2010, 1,004 children who were diagnosed with influenza A (H1N1) or seasonal influenza A and B by reverse transcription-polymerase chain reaction (RT-PCR) were enrolled. Monthly incidence, fever duration before diagnosis, symptoms (fever, cough, rhinorrhea, sore throat, headache, vomiting, abdominal pain, diarrhea, seizure, and dyspnea) and signs (rales, wheezing) were reviewed retrospectively in each group based on medical records. RESULTS: Influenza A (H1N1) was detected in 944 patients (94.0%), followed by seasonal influenza A in 42 (4.2%) and seasonal influenza B in 8 (1.8%). The positive rate of influenza infection was highest in November 2009 (n=557, 55.5%). Mean duration of fever before RT-PCR was 1.6 days (range, 1.5 to 1.8 days). Except fever, cough was the most common symptom (n=792, 78.9%), followed by rhinorrhea in 407 patients (40.5%). Rales and wheezing were detected in 16 patients (1.6%) and 19 (1.9%), respectively. Significant differences were observed for the number of patients who had cough, headache, vomiting, and wheezing among the three groups (P<0.05). CONCLUSION: Although the incidence of cough, headache, vomiting, and wheezing differed significantly among the three groups, the number of patients in each group was too different to compare the results.
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Child , Humans , Abdominal Pain , Cough , Diarrhea , Fever , Headache , Incidence , Influenza, Human , Pharyngitis , Respiratory Sounds , Retrospective Studies , Seasons , Seizures , VomitingABSTRACT
<b>Background:</b> Rapid and accurate diagnosis is essential for containing the novel influenza A/H1N1 pandemic. Polymerase chain reaction (PCR) testing is an accurate diagnostic method, but it is not routinely available worldwide. We herein evaluated the usefulness of pharyngeal “influenza follicles” in diagnosing seasonal influenza and influenza A/2009 (H1N1) pdm.<br><b>Methods:</b> Between August 3 and October 29, 2009, we evaluated 87 patients with influenza-like symptoms. Twenty-three had influenza follicles (22 on initial evaluation; 1 on follow-up) while 64 did not. Considering these two groups, we then compared the positive cases using rapid diagnostic testing (confirmed by PCR). In addition, 419 cases of seasonal influenza diagnosed between 2003 and 2009 were examined for the presence of influenza follicles based on Miyamoto's 2007 definition<sup>9</sup>, and new exclusion criteria were developed.<br><b>Results:</b> Among the 23 patients with influenza follicles, 21 were diagnosed with novel influenza. Of these, follicles were present on initial evaluation in 20 and on follow-up in 1. None of the 64 patients without influenza follicles were diagnosed with influenza (sensitivity 100%, specificity 97%). Among the 419 patients diagnosed with seasonal influenza between 2003 and 2009, influenza follicles occurred in all type A/H3N2, A/H1N1, and B cases (sensitivity 95.46%, specificity 98.42%). Thus, follicles were considered a specific sign of influenza.<br><b>Conclusion:</b> Influenza follicles occur in both seasonal and novel influenza. This identification method has higher diagnostic sensitivity and specificity than rapid diagnostic testing and is a promising clinical tool for diagnosing influenza when PCR is unavailable, or in pandemic situations.