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Abstract Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.
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Introdução: A Lei nº 13.021, de 8 de agosto de 2014, renovou o conceito de farmácia, impulsionando ações da Agência Nacional de Vigilância Sanitária (Anvisa) para a atualização da RDC n° 44, de 17 de agosto de 2009, como a realização de uma consulta dirigida ao Sistema Nacional de Vigilância Sanitária sobre a resolução. Objetivo: Identificar ações de vigilância sanitária relacionadas aos serviços de saúde em farmácias comunitárias. Método: Trata-se de um estudo transversal descritivo realizado com dados secundários da consulta dirigida às Vigilâncias Sanitárias (Visa) municipais promovida em 2019 pela Anvisa. As respostas das 349 respondentes foram organizadas nos blocos "Considerações Gerais", "Estrutura", "Processo e Monitoramento" e categorizados conforme o formato de pergunta (aberta ou fechada) e o conteúdo, utilizando-se parâmetros de avaliação em saúde. Resultados: O compartilhamento do local da dispensação com outras atividades de saúde reï¬etiu um risco sanitário quanto a estrutura. O gerenciamento dos resíduos foi o processo mais citado, superando aqueles relacionados à assistência farmacêutica. Quanto ao monitoramento, a Declaração de Serviços Farmacêuticos mostrou-se um bom instrumento para o registro das atividades realizadas, enquanto notificações de eventos adversos e queixas técnicas não apareceram como rotineiros. A descentralização nas ações de Visa está bem estabelecida, mas evoluiu de forma desigual para produtos regulados e atividades de saúde, de forma que a RDC n° 44 de 2009 mostrou-se útil, mas desatualizada nos aspectos impactantes aos serviços de saúde. Conclusões: A delimitação de atividades de saúde em farmácias é um desafio para a vigilância sanitária, seja pelo ajuste do regulamento sanitário, seja pelas tecnologias de produtos e serviços que são atualizadas mais rapidamente do que a análise dos riscos envolvidos na sua exposição à população.
Introduction: Law No. 13.021, August 8, 2014, renewed the concept of pharmacy, driving actions of the Brazilian Health Regulatory Agency (Anvisa) to update RDC No. 44, August 17, 2009, such as conducting a consultation directed to the National Health Surveillance System on the resolution. Objective: To identify health surveillance actions related to health services in community pharmacies. Methods: This is a descriptive cross-sectional study carried out with secondary data from the consultation addressed to municipal Health Surveys (Visa) promoted in 2019 by Anvisa. The responses of the 349 respondents were organized in the blocks 'General Considerations', 'Structure', 'Process and Monitoring' and categorized according to the question format (open or closed) and content, using health assessment parameters. Results: The sharing of the dispensing location with other healthcare activities reï¬ected a health risk regarding structure. Waste management was the most cited process, surpassing those related to pharmaceutical assistance. As for monitoring, the document named Statement on Pharmaceutical Care proved to be a good instrument for recording the activities performed, while notifcations of adverse events and technical complaints did not appear as a routine. The decentralization in Visa actions is well established, but has evolved unevenly for regulated products and health activities, so that the RDC No. 44 of 2009 proved to be useful, but outdated in the impacting aspects to health services. Conclusions: The delimitation of health activities in pharmacies is a challenge for health surveillance, either by the adjustment of sanitary regulation, either by the technologies of products and services that are updated faster than the analysis of the risks involved in the its exposure to the population.
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Abstract The issue of risk management has gained attention in the field of administration due to the dissemination of international frameworks. In Brazilian federal public administration, risk management is a recent and expanding practice. This research analyzes how international corporate risk management frameworks have been adopted by the federal government through regulations and guidelines. The study adopts the concepts of coercive, normative, and mimetic forces from the neo-institutional theory, and examines the presence of international norms in the Brazilian regulations. Through a qualitative approach, content analysis in documents, norms, interviews, and seminars was used to identify traits of the COSO ERM and ISO 31000/2009 frameworks, which were chosen based on relevance. Results identify important actors pushing for the use of international frameworks, such as international organizations, professional associations, and public agencies, especially those related to government audits. Despite the strong international influence, the Brazilian norms are adapted to the organizations' context and allowing the maintenance of national autonomy.
Resumen El interés en la gestión de riesgos ha crecido de manera constante, fortalecido por la difusión de modelos internacionales. En la administración pública federal de Brasil, el uso de la gestión de riesgos es reciente y se está expandiendo. Esta investigación analiza cómo las normas y directrices del gobierno federal adoptan los modelos internacionales de gestión de riesgos corporativos. Siguiendo la teoría neoinstitucional, se investigó la exposición a fuerzas coercitivas, normativas y miméticas, y la presencia de conceptos de normas internacionales en la reglamentación brasileña. Se utilizó el análisis de contenido en documentos, normas, entrevistas y seminarios para identificar los rasgos de los modelos COSO ERM e ISO 31000/2009, adoptados por su relevancia. Los resultados identifican actores importantes que ejercen presión para la adopción de modelos internacionales, como organizaciones internacionales, asociaciones profesionales y agencias públicas, especialmente las vinculadas a la auditoría gubernamental. A pesar de la fuerte influencia, la estructuración de estándares permite el mantenimiento de la autonomía nacional y su personalización en el contexto de las organizaciones.
Resumo O interesse no gerenciamento de riscos tem crescido continuamente, fortalecido pela disseminação de modelos internacionais. Na administração pública federal brasileira, o uso da gestão de riscos é recente e encontra-se em expansão. Esta pesquisa analisou como modelos internacionais de gerenciamento de riscos corporativos são adotados pelas normas e orientações do Governo Federal. Aplicam-se os conceitos de forças coercitivas, normativas e miméticas da teoria neoinstitucional e observa-se a presença de conceitos das normas internacionais na normativa brasileira. Aplicou-se a análise de conteúdo em documentos, entrevistas, normas e palestras, a fim de identificar traços do modelo do Comitê das Organizações Patrocinadoras de Treadway (Committee of Sponsoring Organizations of the Treadway Commission [COSO]) para Gerenciamento de Riscos Corporativos (Enterprise Risk Management [ERM]), conhecido como modelo "COSO ERM", e do modelo da Organização Internacional de Normalização (International Organization for Standardization [ISO]), conhecido como Norma ISO 31000:2009, adotados por sua relevância. Os resultados identificam que importantes atores exercem pressões para adoção dos modelos internacionais, como os próprios organismos internacionais, associações profissionais e órgãos públicos, em especial aqueles ligados à auditoria governamental. Apesar da forte influência verificada, a estruturação das normas permite a manutenção da autonomia nacional e sua customização no contexto das organizações.
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Humans , Male , Female , Risk Management , Public Administration , Federal GovernmentABSTRACT
We compared the epidemiological and clinical characteristics of severe acute respiratory syndrome (SARS), pandemic (H1N1) 2009 and COVID-19 and found that COVID-19 was more contagious, more concealed in transmission, with greater infectious intensity and more severe clinical manifestations. If the COVID-19 epidemic is not effectively controlled, it will have a serious impact on human health, and even social development. Recognizing the characteristics of three diseases, especially COVID-19, and improving the disease awareness of COVID-19 will help better implement the guidelines of 'scientific prevention and treatment, precise implementation' and prevent and control COVID-19.
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Esse artigo busca analisar o padrão de consumo em diferentes arranjos domiciliares no Brasil, a partir de dados da Pesquisa de Orçamentos Familiares (POF) de 2008-2009. Para isso, foram estimadas curvas de Engel considerando o tipo de arranjo domiciliar, dentre outras variáveis demográficas. Os resultados indicaram a existência de diferenças no padrão de consumo das famílias associadas ao sexo do responsável pelo domicílio, sobretudo nos arranjos "monoparental" e "unipessoal". Essas diferenças são mais evidentes sobre as despesas com habitação, saúde e educação/recreação, em que os gastos mensais per capita são muito menores para os tipos "monoparental masculino" e "unipessoal masculino" em relação ao "monoparental feminino" e "unipessoal feminino". Além disso, verificou-se que a composição da família (presença de filhos, idosos) e o seu tamanho afetam as decisões de consumo das famílias, em que a existência de crianças aumenta os gastos per capita com habitação e saúde e a presença de idosos leva a uma expansão dos gastos com saúde. Quanto ao tamanho da família, há indícios de que as famílias maiores podem se beneficiar dos ganhos de economia de escala e consumo conjunto em relação às despesas com habitação, alimentação e transporte.
The goal of this article was to analyze the pattern of consumption in different household living arrangements in Brazil using data from the 2008-2009 Brazilian Family Budget Survey (POF). We estimated Engel Curves taking into account the type of household living arrangement, among other demographic variables. Results indicated the existence of differences in the patterns of consumption of families associated to the gender of the person in charge of the household, especially in "single parent type with children" and "one person households" living arrangements. These differences are most evident in expenditure on Housing, Health and Education-recreation, in which the monthly per capita expenditure is much lower for single fathers and men living alone relative to single mothers and women living alone. In addition, we verified that family composition (presence of children, seniors) and their size affect household consumption decisions, in which the existence of children increases per capita expenditures on Housing and Health and the presence of seniors leads to an expansion of Health spending. With regard to family size, there are indications that families can benefit from economies of scale and joint consumption gains relative to Housing, Food and Transportation.
El objetivo de este artículo fue analizar el patrón de consumo en diferentes tipos de arreglos domiciliarios en Brasil utilizando datos de la Encuesta de Presupuesto Familiar (POF) de 2008-2009. Para ello, fueron estimadas curvas de Engel tomando em consideración el tipo de arreglo domiciliario, entre otras variables demográficas. Los resultados indicaron diferencias en el patrón de consumo de las familias asociadas al sexo del responsable del domicilio, sobre todo en los hogares del tipo monoparental y unipersonal. Estas diferencias son más evidentes sobre los gastos de vivienda, salud y educación-recreación, em los que los gastos mensuales per cápita son mucho menores para el monoparental masculino y unipersonal masculino en relación con el monoparental femenino y el unipersonal femenino. Además, se verificó que la composición de la familia (presencia de hijos, ancianos) y su tamaño afectan las decisiones de consumo de las familias, en que la existencia de niños aumenta los gastos per cápita con vivienda y saludy la presencia de ancianos, que lleva a una expansión de los gastos de salud. En cuanto al tamaño de la familia, existen indicios de que las familias pueden beneficiarse de las ganancias de economía de escala y consumo conjunto en relación con los gastos de vivienda, alimentación, transporte.
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Humans , Research , Budgets , Demography , Family Characteristics , Recreation , Brazil , Health Expenditures , HousingABSTRACT
OBJECTIVE:To provide reference for improving related policy and list about medical insurance medicines in China. METHODS:The descriptive analysis method was used to compare 2017 and 2009 edition of Medicine List for National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance in respects of item,medicine classification (including classification code,grading and name),medicine types(including new type,removed type),dosage(including new dosage classification,adjusted dosage form),the limit of payment and use.The trend of its development and the existing problems were discussed. RESULTS:Compared with 2009 edition,2017 edition of medicine list added the item of"drug classification code"and removed the item of"English name". The grading of drug classification code was reduced from six grades to four grades. The code and name of four grades classification were in accordance with the first four grades classification rules of the anatomical-therapeutic-chemistry(ATC). A total of 2 535 types were included in 2017 edition,increasing by 362 types compared to 2009 edition(151 chemical medicines,211 Chinese patent medicines). 15 types of chemical medicines were removed,and 4 types were transferred to Chinese patent medicine list;11 types of Chinese patent medicines were removed,and one type was transferred to chemical medicine list. 2017 edition was actually 20 more dosage forms than 2009 edition,involving 31 types;dosage forms of 231 types were adjusted(143 chemical medicines,88 Chinese patent medicines). Chemical medicines of usage and payment restriction increased from 239 to 302,and Chinese patent medicines increased from 72 to 115,respectively. CONCLUSIONS:2017 edition of list increases the number of medicine,expands the scope of clinical medication and improves the classification structure of the list.The number of medical insurance cost control type shows a growing trend.
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PURPOSE: The purpose of this study is to estimate the clinical status of radiation therapy (RT) in Korea. MATERIALS AND METHODS: We analyzed open claims data from the Health Insurance Review and Assessment Service (HIRA). The subjects were patients with malignant neoplasms who had procedure codes concerning RT in 2009 and 2013. RESULTS: The total numbers of patients who underwent RT in 2009 and 2013 were 42,483 and 56,850, respectively. The numbers of men and women were 20,012 and 22,471 in 2009 and 26,936 and 29,914 in 2013, respectively. The five most frequent RT sites were metastatic, breast, gastrointestinal, thoracic, and gynecologic cancers in 2009, and metastatic, breast, gastrointestinal, thoracic and head and neck cancers in 2013. The three leading types of cancer among men were metastatic, gastrointestinal, and thoracic, and breast, metastatic, and gynecologic among women. According to age, the most common treatment site was the central nervous system for those aged 20 years or less, the breast for those in their 30s to 50s, and metastatic sites for those in their 60s or older. CONCLUSION: Data from this study provide an overview of the clinical status of RT in Korea.
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Female , Humans , Male , Breast , Central Nervous System , Head , Insurance, Health , Korea , Neck , RadiotherapyABSTRACT
background: Early management of myocardial infarction in the area of public health requires the integration of specific programs for the coordination of healthcare services. Objective: The aim of this study was to evaluate the impact on delay times and reperfusion rate of a comprehensive program for the reperfusion of myocardial infarction in a hospital network of the Southern Greater Buenos Aires. Methods: The network consists of six low-mid-complexity hospitals and a third-level referral center with 24-hour cath-lab. Stage 1 of the program (2009-2010) evaluated the existing barriers to reperfusion; Stage 2 (2011-2013) implemented the progressive incorpora-tion of improvements and Stage 3 assessed the program (2013-2014) complemented with fellows in each hospital. Program impact was evaluated by the proportion of patients reperfused and time to its implementation. results: A total of 432 patients referred from the network were hospitalized with diagnosis of ST-segment elevation myocardial infarction. Mean age was 56±9 years and 83.3% were men. The proportion of reperfused patients progressively increased: S1 60.7%, S2 69% and S3 78%, p for trend=0.01. Time to reperfusion decreased significantly between S1 and S3, from 120 minutes (IQR 55-240) to 90 minutes (IQR 35-150), p=0.04, with a median reduction of 30 minutes in the door-to-balloon and door-to-needle times. Conclusions: The application of a program for myocardial reperfusion based on the diagnosis of barriers was associated with 28.5% increase in reperfusion, and a significant reduction in the implementation times. This public network model built on algorithms adapted to local barriers may contribute to improve the care of myocardial infarction in our country.
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Aims: To study the clinical and epidemiological features in the affected individuals from different areas of Kerala, India. Study design: Population based cross sectional study. Place and Duration of Study: Regional Facility for Molecular Diagnostics, Rajiv Gandhi Center for Biotechnology and Directorate of Health Services, Kerala, between August 2009 and September 2010. Methodology: We conducted active surveillance for referral hospitals with specialist inpatient care in Kerala during pandemic periods. Oropharyngeal or nasopharyngeal swabs were tested for influenza viruses by Real time reverse transcriptase PCR. Results: A total of 4252 samples were tested for H1N1 influenza virus, of which, 30.17% were positive for pandemic influenza A H1N1 and 10.49% were positive for Influenza A (seasonal flu). Severe disease and mortality in the pandemic influenza A (H1N1) 2009 infection predominantly affected relatively healthy adolescents and adults between the age of 10 and 50 years. Both Males (29.28%) and Females (31.15%) were equally effected even though we observed a significant difference (P=.02). 141 cases exhibited lower respiratory tract symptoms. Pneumonia alone accounted for 28% of complicated cases. It was observed that the majority of cases (29.28%) during the first outbreak season were imported from affected overseas regions. Conclusion: In this study, prevalence of Influenza A H1N1 was high in the healthy younger population and there wasn’t any sex related susceptibility for Influenza infection. Majority of districts showed a positivity of approximately 10-30%, few with high positivity of >30%. Our findings highlight the importance of regular influenza immunization as it is significant to understand that the H1N1 (2009) virus may still circulate for many years with similar high severity.
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Background: Recent studies on antiviral susceptibiliy from South-East Asia, Europe and the United States have shown sporadic neuraminidase inhibitor (NAI) resistance in A(H1N1)pdm09 viruses. We undertook a study to evaluate NAI resistance in these viruses isolated in India. Methods: Pandemic influenza viruses, isolated from 2009 to 2013, along with clincal samples were genetically analysed for known resistance markers in the neuraminidase (NA) gene. Clinical samples (n=1524) were tested for H275Y (N1 numbering; H274Y in N2 numbering) mutation by real time reverse transcriptase PCR (rRT-PCR). One hundred and ten randomly selected resistant and sensitive viruses were analysed by phenotypic assay. Results: All but one of the 2013 A(H1N1)pdm09 isolates were sensitive to oseltamivir. Genetic analysis of this isolate as well as the original clinical material showed that the presence of H275Y mutation was responsible for reduced susceptibility to oseltamivir in the patient. This was confirmed by phenotypic assay. Conclusion: The emergence of a pandemic influenza strain resistant to oseltamivir emphasizes the need for monitoring antiviral resistance as part of the National Influenza Programme in India.
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Introduction The year 2009 marked the beginning of a pandemic caused by a new variant of influenza A (H1N1). After spreading through North America, the pandemic influenza virus (H1N1) 2009 spread rapidly throughout the world. The aim of this study was to describe the clinical and epidemiological characteristics of cases of pandemic influenza in a tropical/semi-arid region of Brazil. Methods A retrospective study analyzed all suspected cases of pandemic influenza (H1N1) 2009 reported in the Ceará State through the National Information System for Notifiable Diseases during the pandemic period between 28 April, 2009 and November 25, 2010. Results A total of 616 suspected cases were notified, 58 (9.4%) in the containment phase and 558 (90.6%) in the mitigation phase. Most cases were of affected young people resident in the City of Fortaleza, the largest urban center in the State of Ceará. The most frequent symptoms presented by the cases with confirmed infection were fever, cough, myalgia, arthralgia, and nasal congestion. Mortality rate was 0.0009/1,000 inhabitants and lethality was 5.6%. Deaths were observed only in the mitigation phase. Mortality rates were similar for both sexes but were higher in the age group under 5 years. Conclusions The study suggests that the influenza A (H1N1) pandemic in this tropical/semi-arid region had a lower magnitude when compared to states in the Southern and Southeastern regions of Brazil. .
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Pandemics , Brazil/epidemiology , Geography, Medical , Influenza, Human/virology , Retrospective Studies , Tropical ClimateABSTRACT
OBJETIVO: Evaluar conocimientos, actitudes y prácticas respecto a la pandemia de influenza, con especial énfasis en la vacuna contra influenza estacional y pandémica. MATERIAL Y MÉTODOS: Estudio transversal con muestreo polietápico probabilístico, realizado durante diciembre de 2009 en residentes mayores de 18 años de la Ciudad de México (y área metropolitana), Monterrey, Guadalajara y Mérida. RESULTADOS: Se incluyeron 1 600 sujetos (48.9% masculino); 34% había recibido vacuna contra influenza estacional en años pasados, 90.6% estaba dispuesto a recibir la vacuna contra A(H1N1). La principal causa de rechazo a la vacunación fue no confiar en la vacuna (46.5%). Principales medidas preventivas identificadas por los encuestados: lavado de manos (47.5%), vacuna contra A(H1N1) (28%) y etiqueta respiratoria (19.4%). El nivel escolar (1.7, p=0.006) y edad (1.02, p<0.001) influyeron en el rechazo a la vacuna. El 82.9% de los encuestados calificó el manejo de la situación por el Gobierno Federal como bueno o muy bueno. CONCLUSIONES: La población refirió un alto porcentaje de aceptación para la vacuna de influenza pandémica durante el inicio de la campaña de vacunación en México, comparado con la reportada en otros países. La principal razón de aquéllos que la rechazan es la desconfianza hacia la vacuna.
OBJECTIVE: To assess knowledge, attitudes and practices regarding influenza pandemic, with special emphasis on issues related to influenza vaccine, seasonal and pandemic. MATERIALS AND METHODS: Cross-sectional study, probabilistic multistage sampling in patients over 18 years, residents of Mexico City (and metropolitan area), Monterrey, Guadalajara and Merida in December 2009. RESULTS: A total of 1.600 subjects (48.9% male) were interviewed, 34% had previously received seasonal flu vaccine, 90.6% were willing to be vaccinated against A(H1N1), 46.5% of those who would not receive the vaccine was because they did not trust A (H1N1), 68% considered influenza A (H1N1) as a risk for their family. Hand washing was the preventive measure most commonly reported (47.5%), secondly influenza vaccine (28%). Schooling (1.7, p=0.006) and age (1.02, p<0.001) influence rejection to get vaccine. 82.9% of respondents rate the federal government's management as good or very good. CONCLUSIONS: There was a high acceptance rate for the pandemic influenza vaccine in Mexico when compared to similar studies in other countries, the main reason for those who reject the vaccine was distrust in it.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Health Knowledge, Attitudes, Practice , Influenza A Virus, H1N1 Subtype , Influenza Vaccines , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics , Patient Acceptance of Health Care/statistics & numerical data , Cross-Sectional Studies , Health Surveys , Mexico/epidemiology , Surveys and QuestionnairesABSTRACT
The H1N1 2009 influenza pandemic took the health care workers by surprise in spite of warning about influenza pandemic. Influenza A virus has the ability to overcome immunity from previous infections through the acquisition of genetic changes by shift or drift. Thus, understanding the evolution of the viruses in human is important for the surveillance and the selection of vaccine strains. A total of 23 pandemic A/H1N1 2009 viral HA gene sequences were downloaded from NCBI submitted during March and May 2010 by NIV and were analysed. Along with that the vaccine strain A/California/07/2009 was also downloaded from NCBI. All the sequences were used to analyse the evolution of the haemagglutinin (HA) by phylogenetic analysis. The HA gene could be divided into four groups with shift from 1 to lV revealing that the HA genes of the influenza A viruses evolved in a sequential way, in comparison to vaccine strain A/California/07/2009. Amino acid sequence analysis of the HA genes of the A/H1N1 2009 isolates, revealed mutations at positions 100, 220 and additional mutations in different positions 114, 171, 179, 190, 208, 219, 222, 239, 240, 247, 251, 260 and 285 .The mutations identified showed the adaptation of the new virus to the host that could lead to genetic changes inherent to the virus resulting in a reassortant which could be catastrophic, hence continuous monitoring of strains is mandatory.
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Cluster Analysis , Computational Biology/methods , Evolution, Molecular , Genetic Variation , Hemagglutinins, Viral/genetics , Humans , India , Influenza A Virus, H1N1 Subtype/classification , Influenza A Virus, H1N1 Subtype/genetics , Mutation, Missense , PhylogenyABSTRACT
Objective To study the epidemiological characteristics on the clustering nature of pandemic (H1N1) 2009 in China.Methods Time and place distribution of pandemic (H1N1) 2009on the nature of clustering through data from Public Health Emergency Management Information System were described.Results As of August 10,2010,2773 pandemic (H1N1) 2009 clusters,a total of 77363 cases (including 20 deaths) were reported in the mainland of China.The most reported number of clusters was from schools and kindergartens with the total number of 2498 (accounted for 90.08％ of the total number).Middle schools appeared the have the most clusters (1223,accounting for 48.96％ ).The number of clusters reported in the southern provinces (cities) accounted for 77.03％ of the total,and was more than that in the northern provinces (cities).Two reported peaks in the southern provinces (cities) were in June and November,2009,respectively.There was only one reported peakin the northern provinces in September,2009.Conclusion Time and place distribution characteristics on the clusters of pandemic (H1N1) 2009 were similar to the seasonal influenza,but the beginning of winter peak was much earlier and intensity of reporting was much higher on the clusters of pandemic (H1N1 ) 2009 than that of seasonal influenza.
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Quail has been proposed to be an intermediate host of influenza A viruses. However, information on the susceptibility and pathogenicity of pandemic H1N1 2009 (pH1N1) and swine influenza viruses in quails is limited. In this study, the pathogenicity, virus shedding, and transmission characteristics of pH1N1, swine H1N1 (swH1N1), and avian H3N2 (dkH3N2) influenza viruses in quails was examined. Three groups of 15 quails were inoculated with each virus and evaluated for clinical signs, virus shedding and transmission, pathological changes, and serological responses. None of the 75 inoculated (n = 45), contact exposed (n = 15), or negative control (n = 15) quails developed any clinical signs. In contrast to the low virus shedding titers observed from the swH1N1-inoculated quails, birds inoculated with dkH3N2 and pH1N1 shed relatively high titers of virus predominantly from the respiratory tract until 5 and 7 DPI, respectively, that were rarely transmitted to the contact quails. Gross and histopathological lesions were observed in the respiratory and intestinal tracts of quail inoculated with either pH1N1 or dkH3N2, indicating that these viruses were more pathogenic than swH1N1. Sero-conversions were detected 7 DPI in two out of five pH1N1-inoculated quails, three out of five quails inoculated with swH1N1, and four out of five swH1N1-infected contact birds. Taken together, this study demonstrated that quails were more susceptible to infection with pH1N1 and dkH3N2 than swH1N1.
Subject(s)
Birds , Influenza A virus , Influenza, Human , Orthomyxoviridae , Pandemics , Quail , Respiratory System , Swine , Virus Shedding , VirusesABSTRACT
BACKGROUND/AIMS: There was a spiking incidence of acute hepatitis A (AHA) in 2009 summer, but it went down drastically after an outbreak of influenza A (H1N1). We assessed the relationship between 2009 H1N1 pandemic and AHA prevalence from August to December 2009. METHODS: We compared AHA cases nationwide and in our hospital for the period from the latter half of 2008 to the end of 2010. H1N1 cases in our hospital from August 2009 to December 2009 were included in the study and the correlation between 2009 H1N1 pandemic and AHA prevalence was assessed. RESULTS: The national surveillance system reported 2,233, 7,895, 15,231 and 7,660 AHA cases from 2007 to 2010, respectively. A similar trend was noted in our hospital in the same periods. Although the national total incidence was increased in 2009, it showed steep decreasing trend line in the final 21 weeks of 2009 (weeks 32-52), as compared with 2008 and 2010. The mean weekly incidence percentage (AHA cases in a week/total in a year) in weeks 32-52 of 2009 was 1.17+/-0.55%, significantly lower than that in 2008 and 2010 (1.61+/-0.43% and 1.56+/-0.51%; p<0.001). Furthermore, we found a significant negative correlation between 2009 H1N1 pandemic and AHA in our hospital for weeks 32-52 of 2009 (r=-0.597; p<0.001). CONCLUSIONS: The widespread occurrence of 2009 H1N1 pandemic highlighted the benefits of health care and good hygiene, such as effective hand washing and wearing of masks, which may have also interrupted hepatitis A virus transmission.
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Humans , Acute Disease , Hepatitis A/epidemiology , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/epidemiology , Pandemics , Prevalence , Republic of Korea/epidemiology , SeasonsABSTRACT
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.
Subject(s)
Child , Humans , Bronchitis , Cross Infection , Encephalitis , Influenza, Human , Medical Records , Meningitis , Pandemics , Pericarditis , Pneumonia , Respiratory Tract Infections , Retrospective Studies , Risk Factors , Seasons , Ventilators, MechanicalABSTRACT
BACKGROUND: Patients with malignancy are considered to be at high risk of severe pandemic influenza A/H1N1 2009. This study was conducted to identify the severity of pandemic influenza A/H1N1 2009 among patients with malignancy. MATERIALS AND METHODS: Between August 2009 and December 2009, we reviewed clinical data and medical records of 31 patients with malignancy and 63 hospitalized patients without malignancy. RESULTS: Eighty-three patients with laboratory-confirmed pandemic influenza A/H1N1 2009 were admitted. The rate of ICU admission was higher among patients with malignancy (without malignancy 13% vs with malignancy 35%, P=0.024). The mortality rate was higher among patients with malignancy (without malignancy 6% vs with malignancy 25%, P=0.033). Patients using immunosuppressants showed a higher rate of lower respiratory tract infection (83% vs 24%, P=0.013). CONCLUSIONS: Pandemic influenza A/H1N1 2009 in patients with malignancy was more severe than in patients without malignancy.
Subject(s)
Humans , Immunosuppressive Agents , Influenza, Human , Korea , Medical Records , Pandemics , Respiratory Tract InfectionsABSTRACT
PURPOSE: Rapid antigen test (RAT) is used to screen influenza rapidly. The clinical sensitivity of RAT was poor for 2009 H1N1 influenza. The aim of this study was to identify the correlation of time gap (TG) between fever onset and the sensitivity of RAT for 2009 H1N1 influenza. METHODS: Data were collected retrospectively during the pandemic H1N1 2009 influenza season between October 2009 and February 2010. The RAT was done by using SD Bioline influenza antigen (Standard Diagnostics Inc.) in nasopharyngeal swab. The 2009 H1N1 influenza was confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens were categorized according to the TG between fever onset and performance of RAT. They were classified into 120 hours (TG6). RESULTS: The overall sensitivity of RAT was 69.9%. The TG dependent sensitivity of RAT at TG1, TG2, TG3, TG4, TG5, and TG6 was 64.3%, 73.3%, 61.1%, 88.9%, 83.3%, and 61.1% respectively. The sensitivity of RAT was the highest when the TG was 72 to 96 hours. But this result was not statistically significant. CONCLUSION: Correlation of TG between fever onset and the sensitivity of RAT for 2009 H1N1 influenza was not statistically significant. But our study suggested that 72 to 96 hours after fever onset is the most sensitive time of RAT. Timely optimal performance of the RAT could have a significant impact on improving results. Further evaluation for better sensitivity would be needed.