RESUMO
Eleven patients with drug-resistant pandemic (H1N1) 2009 were identified in South Korea during May 2009-January 2010. Virus isolates from all patients had the H275Y mutation in the neuraminidase gene. One isolate had the I117M mutation. Of the 11 patients, 6 were ≥ 59 months of age, and 5 had underlying immunosuppressive conditions.
Assuntos
Antivirais , Farmacorresistência Viral/genética , Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos , Vírus da Influenza A Subtipo H1N1/genética , Influenza Humana/tratamento farmacológico , Oseltamivir , Adolescente , Adulto , Antivirais/farmacologia , Antivirais/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Influenza Humana/complicações , Influenza Humana/mortalidade , Masculino , Pessoa de Meia-Idade , Mutação/genética , Oseltamivir/farmacologia , Oseltamivir/uso terapêutico , República da Coreia , Resultado do Tratamento , Proteínas Virais/genética , Adulto JovemRESUMO
The aim of this study was to describe the features of deaths associated with the 2009 pandemic influenza A (H1N1) by 26 November 2009 in Korea. We collected standardized case reports on 115 confirmed deaths through a nationwide enhanced influenza surveillance system. The median age was 61 yr (interquartile range [IQR], 0.2-97 yr) and 58 (50.4%) were females. The case fatality rate was estimated as 16 per 100,000 cases. The age-related mortality rate had a J-shaped curve. Eighty-three patients (72.2%) had at least 1 underlying medical disease. Bacterial co-infections were detected in the blood or sputum specimens from 34 patients. Of the 63 patients who were hospitalized in the intensive care unit (ICU), the median time from symptom onset to hospital admission was 2 days (IQR, 0-22 days), and the median time from hospitalization to ICU admission was 1 day (IQR, 0-17 days). Neuraminidase inhibitors were administered to 100 patients (87.0%), 36% of whom began treatment within 2 days. In conclusion, fatal cases from the 2009 influenza A (H1N1) infection in Korea are mainly aged individuals with underlying disease, and associated with pneumonia, bacterial co-infections, and multi-organ failure.
Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/mortalidade , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Infecções Bacterianas/complicações , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Influenza Humana/tratamento farmacológico , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Oseltamivir/uso terapêutico , República da CoreiaRESUMO
On July 6, 2009, an outbreak of gastroenteritis occurred among middle school students in Incheon. An investigation to identify the source and describe the extent of the outbreak was conducted. A retrospective cohort study among students, teachers, and food handlers exposed to canteen food in the middle school was performed. Using self-administered questionnaires, information was collected concerning on symptoms, days that canteen food was consumed, and food items consumed. Stool samples were collected from 66 patients and 11 food handlers. The catering kitchen was inspected and food samples were taken. Of the 791 people who ate canteen food, 92 cases became ill, representing an attack rate of 11.6%. Thirty-one (40.3%) of the 77 stool specimens were positive for Campylobacter jejuni. Interviews with kitchen staff indicated the likelihood that undercooked chicken was provided. This is the first recognized major C. jejuni outbreak associated with contaminated chicken documented in Korea.
Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter jejuni , Surtos de Doenças , Adolescente , Adulto , Animais , Galinhas , Estudos de Coortes , Eletroforese em Gel de Campo Pulsado , Exposição Ambiental , Feminino , Contaminação de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Microbiologia da ÁguaRESUMO
BACKGROUND: Novel influenza A (H1N1) virus infection has persisted mainly through person-to-person transmission in schools. However, data on critically ill patients infected with H1N1 are currently limited. This study was conducted to investigate the epidemiological characteristics, clinical features, treatment modalities, and clinical outcomes of pediatric patients critically ill with H1N1 infection. METHODS: Subjects included 30 critically ill pediatric patients reported to the Korea Centers for Disease Control and Prevention (KCDC) between June and November 2009. Data were obtained by medical record review and interviews with primary treating physician. RESULTS: Of the 30 patients, 14 died and 16 were discharged from the hospital with complete recovery. The median patient age was 7 years (range, 2 months to 18 years). Nineteen patients belonged to the high-risk group. Cough was the most common initial symptom, followed by fever. In most patients, serum levels of C-reactive protein and lactate dehydrogenase were elevated. Oseltamivir, an antiviral agent, was administered to 29 patients. The most common causes of death were encephalopathy and myocarditis, with a higher mortality rate in the high-risk group. Platelet counts were significantly lower than normal and serum aspartate aminotransferase levels significantly higher in the non-survivors. CONCLUSIONS: The results of this study suggest that Korean high-risk pediatric patients have an elevated mortality rate following infection with novel influenza A (H1N1) virus. Further studies involving high-risk pediatric patients classified using consistent criteria are needed to confirm our results.
