Comparison of epidemiological and clinical characteristics of SARS, pandemic (H1N1) 2009 and COVID-19, and consideration on prevention and control strategies of COVID-19 / 中华预防医学杂志

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.

Comparative study of pandemic (H1N1) 2009, swine H1N1, and avian H3N2 influenza viral infections in quails

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.

Epidemiological characteristics on the clustering nature of pandemic (H1N1) 2009 in China / 中华流行病学杂志

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.

Comparison of secondary attack rates in ger and apartment areas, Mongolia, November 2009 / Монголын Анагаах Ухаан

Background: Since its first identification of Pandemic H1N1 2009 in Oct 12, 09 in Mongolia, the cases have increased dramatically spreading in much of cities and provinces of Mongolia. We aimed to identify and compare the transmissibility of the infection in different household settings, so to add understanding of special characteristics of this infection.Methods: We selected 20 laboratory confirmed 2009 H1N1 influenza as the index cases from the National Surveillance System. We searched for Influenza like illness (ILI) cases in the households by questioning index-cases and household-contacts. Secondary case was defined as household-contact who developed one of the signs such as fever, dry cough, sore throat, runny nose and diarrhea within one week of symptom onset in index case. We calculated and compared attack rates in ger and apartment areas.Results: Transmissibility of 2009 H1N1 influenza was studied in 20 households. Each half was from ger and apartment residency of Ulaanbaatar city, Mongolia. The study involved 20 indexcases and 72 household-contacts. Secondary transmission occurred in 13 (65%) households with 22 (30.5%) household cases of probable Pandemic H1N1 influenza virus infection. The incidence in ger and apartment areas was 36.1% and 25.0% relatively. Cases in ger residency were 1.2 times more likely than in apartment residency to develop ILI (RR = 1.2, 95%CI: 0.86- 1.60).Conclusions: Overall secondary attack rate in this study was 30.5%, which is similar to that of 30% secondary attack rate for laboratory-confirmed 2009 H1N1 influenza in tourist group members in China. Though statistically not significant, the risk estimation of secondary ILI compared in ger and apartment residency indicates ger area residents have 20% higher risk for ILI development after illness in index case.

Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1): An experience from a tertiary care center in north India.

Objectives To describe our experience in children hospitalized with the pandemic Influenza A (H1N1) from Northern India. Methods The retrospective case study was conducted at the Pediatric ward and Pediatric Intensive Care Unit (PICU) dedicated to the children (aged 18 years or younger) with influenza-like illness (ILI) with positive laboratory test results for pandemic H1N1 by reverse-transcriptase polymerasechain- reaction assay. Results Between August 2009 and January 2010, a total of 100 children were hospitalized with suspected 2009 H1N1 influenza with Category “C” as described by the Government of India. Twenty five patients were positive for H1N1 and 9 for seasonal influenza A. The most common presentation (H1N1 positive) was with fever (100%), cough (100%), coryza (52%), respiratory distress (88%), vomiting (28%) and diarrhea (16%). One child presented with hypernatremic dehydration and seizures (Serum sodium 174 meq/l). Of the H1N1 positive hospitalized children, 7 (28%) had respiratory failure and required PICU admission, 4 (16%) required mechanical ventilation, and 3 (12%) died. The major radiological findings were bilateral pulmonary infiltrates and consolidation. All patients were treated with oral Oseltamivir suspension or capsule as per appropriate weigh band and supportive care as required. Two deaths were caused by refractory hypoxemia and one by refractory shock. Conclusions The exact incidence of Pandemic 2009 H1N1 influenza on morbidity and mortality is difficult to calculate since only Category “C” patients were screened.

Radiological and Clinical Characteristics of a Military Outbreak of Pandemic H1N1 2009 Influenza Virus Infection

OBJECTIVE: To describe detailed clinical and radiological features of the pandemic H1N1 2009 influenza viral infection among healthy young males in a semi-closed institutionalized setting. MATERIALS AND METHODS: A total of 18 patients confirmed with the pandemic H1N1 2009 influenza virus infection from July 18 to July 30, 2009 were enrolled in this study. Each patient underwent an evaluation to determine detailed clinical and radiological features. RESULTS: All patients presented with high fever (> 38.0degrees C), with accompanying symptoms of cough, rhinorrhea, sore throat, myalgia and diarrhea, and increased C-reactive protein (CRP) values with no leukocytosis nor elevated erythrocyte sedimentation rate (ESR). All patients, including one patient who progressed into acute respiratory distress syndrome, were treated with oseltamivir phosphate and quickly recovered from their symptoms. Chest radiographs showed abnormalities of small nodules and lobar consolidation in only two out of 18 patients. However, six of 12 patients who underwent thin-section CT examinations showed abnormal findings for small ground-glass opacities (GGOs) in addition to poorly-defined nodules with upper lobe predominance. CONCLUSION: In a population of healthy young adults, elevated CRP with normal ESR and white blood cell levels combined with GGOs and nodules on thin-section CT scans may indicate early signs of infection by the pandemic H1N1 2009 influenza virus.

Infection Control Preparedness for Influenza A Pandemic (H1N1) 2009 in Healthcare Settings / 병원감염관리

BACKGROUND: This study aimed to assess the status of infection control during influenza A pandemic (H1N1) 2009. METHODS: A questionnaire survey was conducted in November 2009 at the 100 hospitals designated by the Korea Centers for Disease Control and Prevention (KCDC) as influenza A pandemic (H1N1) 2009-treatment institutions. RESULTS: In 32.3% of the hospitals, the ventilation system of the influenza A pandemic (H1N1) 2009 isolation ward was separated from the hospital's ventilation system. With regard to wearing personal protective equipment while caring for patients with H1N1 infection, during usual patient contact, masks were always worn by all medical staff at all the hospitals; however, medical staff at 38.7% and 51.6% of the hospitals did not wear gloves and gowns, respectively. During aerosol-generating procedures, some medical staff wore surgical masks, whereas medical staff at 10% and 23.3% of the hospitals did not wear gowns and protective goggles, respectively. In all, 64.5% of the hospitals responded that the contents of the guidelines established by the KCDC were insufficient for reference purposes in actual practice. CONCLUSION: Some of influenza A pandemic (H1N1) 2009-treatment institutions are believed to be inadequate in facilities, infection control during patient treatment, and administrative measures among their efforts to prevent transmission in hospital. In preparation against the outbreak of similar diseases in the future, the government needs to establish guidelines highly applicable by medical staff, to secure exclusive spaces and personnel for treating infectious disease patients, and to develop personal protective gear support and management systems.