Clinical and Laboratory Characteristics of Pandemic Influenza A/H1N1 2009 Infection among Patients with Malignancy in Korea / 감염과화학요법

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.

A Prediction Rule to Identify Severe Cases among Adult Patients Hospitalized with Pandemic Influenza A (H1N1) 2009

The purpose of this study was to establish a prediction rule for severe illness in adult patients hospitalized with pandemic influenza A (H1N1) 2009. At the time of initial presentation, the baseline characteristics of those with severe illness (i.e., admission to intensive care unit, mechanical ventilation, or death) were compared to those of patients with non-severe illnesses. A total of 709 adults hospitalized with pandemic influenza A (H1N1) 2009 were included: 75 severe and 634 non-severe cases. The multivariate analysis demonstrated that altered mental status, hypoxia (PaO2/FiO2 or = 65 yr) were independent risk factors for severe cases (all P or = 2 risk factors had a higher sensitivity, specificity, positive predictive value and negative predictive value than an APACHE II score of > or = 13. As a prediction rule, the presence of > or = 2 these risk factors is a powerful and easy-to-use predictor of the severity in adult patients hospitalized with pandemic influenza A (H1N1) 2009.

Serologic survey on pandemic influenza A (H1N1) virus among aged ≥3 years population from Jiangsu province in 2009, China / 中华流行病学杂志

Objective To understand the antibody levels against pandemic influenza A (H1N1) virus (2009 H1N1 ) among aged ≥3 years population in 2009, from Jiangsu province, and to describe the distribution of 2009 H1N1. Methods Serum specimens were collected from natural populations at four different periods in Jiangsu, and tested with hernagglutination-inhibition (HI)assays. Rates of protective antibody against 2009 H1N1 and Geometric mean titers (GMTs)were estimated. Results The rates of protective antibody against 2009 H1N1 rose with the and November, 2009. There were no significant differences on the rates of protective antibody between males and females at four different cross-sectional periods (P＞0.05), and no significant differences on GMTs were observed at different periods except for November 2009. Significant differences on rates of protective antibody and GMTs among various age groups were observed at four different periods (P＜0.05), and similar results were observed among different periods in various age groups (P＜0.05). There were significant differences on rates of protective antibody and GMTs among different areas (P＜0.05). Conclusion The 2009 H1N1 strain had been widely spread out in Jiangsu province since July 2009. People aged 12-17 years became the major victims after August. As of November 2009, the rate of protective antibody against 2009 H1N1 was still low, predicting that the epidemic might continue to exist for a certain period of time.

Management of Healthcare Workers and Patients on Exposure to Pandemic Influenza A (H1N1 2009) Virus in a Hospital / 병원감염관리

BACKGROUND: This study is aimed at describing the outcomes of the management of the patients, caregivers, and healthcare workers (HCWs) who are exposed to the pandemic influenza (H1N1 2009) virus and at evaluating the adequacy in exposure management and infection control. METHODS: From July 2009 to January 2010, for 7 a month period, we managed patients and healthcare workers without any respiratory protective devices, who came within 1 m distance of H1N1-positive individuals for more than 1 h and performed a 1-week follow-up. RESULTS: The total of 157 cases with exposure to pandemic influenza (H1N1 2009) virus and exposed individuals of 907 were reported. Of the exposed individuals who were under management, 15 were confirmed to be infected with the infection rate being 1.7%. The confirmed individuals did not have a secondary infection after the exposure. Rates of infection of the exposed patients and healthcare workers were 1.8% and 1.6%, respectively, and these figures were not statistically significant. CONCLUSION: The exposure management results at the hospital revealed that the infection had spread by contact with individuals who were positive for the infection. The high incidence of early exposure to the virus warrants the need to ensure the use of protective equipment and the adoption of assertive teaching methods that have long lasting effects.