tetano
Editor, Senior Moderator
PLoS One. 2011;6(9):e24734. Epub 2011 Sep 16.
Distinguishing Characteristics between Pandemic 2009-2010 Influenza A (H1N1) and Other Viruses in Patients Hospitalized with Respiratory Illness.
Chan PA, Mermel LA, Andrea SB, McCulloh R, Mills JP, Echenique I, Leveen E, Rybak N, Cunha C, Machan JT, Healey TT, Chapin KC.
Source
Division of Infectious Diseases, Rhode Island Hospital, Providence, Rhode Island, United States of America.
Abstract
BACKGROUND:
Differences in clinical presentation and outcomes among patients infected with pandemic 2009 influenza A H1N1 (pH1N1) compared to other respiratory viruses have not been fully elucidated.
METHODOLOGY/PRINCIPAL FINDINGS:
A retrospective study was performed of all hospitalized patients at the peak of the pH1N1 season in whom a single respiratory virus was detected by a molecular assay targeting 18 viruses/subtypes (RVP, Luminex xTAG). Fifty-two percent (615/1192) of patients from October, 2009 to December, 2009 had a single respiratory virus (291 pH1N1; 207 rhinovirus; 45 RSV A/B; 37 parainfluenza; 27 adenovirus; 6 coronavirus; and 2 metapneumovirus). No seasonal influenza A or B was detected. Individuals with pH1N1, compared to other viruses, were more likely to present with fever (92% & 70%), cough (92% & 86%), sore throat (32% & 16%), nausea (31% & 8%), vomiting (39% & 30%), abdominal pain (14% & 7%), and a lower white blood count (8,500/L & 13,600/L, all p-values<0.05). In patients with cough and gastrointestinal complaints, the presence of subjective fever/chills independently raised the likelihood of pH1N1 (OR 10). Fifty-five percent (336/615) of our cohort received antibacterial agents, 63% (385/615) received oseltamivir, and 41% (252/615) received steroids. The mortality rate of our cohort was 1% (7/615) and was higher in individuals with pH1N1 compared to other viruses (2.1% & 0.3%, respectively; p = 0.04).
CONCLUSIONS/SIGNIFICANCE:
During the peak pandemic 2009-2010 influenza season in Rhode Island, nearly half of patients admitted with influenza-like symptoms had respiratory viruses other than influenza A. A high proportion of patients were treated with antibiotics and pH1N1 infection had higher mortality compared to other respiratory viruses.
PMID:
21949746
[PubMed - in process]
PMCID: PMC3174965
Free full text
http://www.ncbi.nlm.nih.gov/pubmed/21949746
Distinguishing Characteristics between Pandemic 2009-2010 Influenza A (H1N1) and Other Viruses in Patients Hospitalized with Respiratory Illness.
Chan PA, Mermel LA, Andrea SB, McCulloh R, Mills JP, Echenique I, Leveen E, Rybak N, Cunha C, Machan JT, Healey TT, Chapin KC.
Source
Division of Infectious Diseases, Rhode Island Hospital, Providence, Rhode Island, United States of America.
Abstract
BACKGROUND:
Differences in clinical presentation and outcomes among patients infected with pandemic 2009 influenza A H1N1 (pH1N1) compared to other respiratory viruses have not been fully elucidated.
METHODOLOGY/PRINCIPAL FINDINGS:
A retrospective study was performed of all hospitalized patients at the peak of the pH1N1 season in whom a single respiratory virus was detected by a molecular assay targeting 18 viruses/subtypes (RVP, Luminex xTAG). Fifty-two percent (615/1192) of patients from October, 2009 to December, 2009 had a single respiratory virus (291 pH1N1; 207 rhinovirus; 45 RSV A/B; 37 parainfluenza; 27 adenovirus; 6 coronavirus; and 2 metapneumovirus). No seasonal influenza A or B was detected. Individuals with pH1N1, compared to other viruses, were more likely to present with fever (92% & 70%), cough (92% & 86%), sore throat (32% & 16%), nausea (31% & 8%), vomiting (39% & 30%), abdominal pain (14% & 7%), and a lower white blood count (8,500/L & 13,600/L, all p-values<0.05). In patients with cough and gastrointestinal complaints, the presence of subjective fever/chills independently raised the likelihood of pH1N1 (OR 10). Fifty-five percent (336/615) of our cohort received antibacterial agents, 63% (385/615) received oseltamivir, and 41% (252/615) received steroids. The mortality rate of our cohort was 1% (7/615) and was higher in individuals with pH1N1 compared to other viruses (2.1% & 0.3%, respectively; p = 0.04).
CONCLUSIONS/SIGNIFICANCE:
During the peak pandemic 2009-2010 influenza season in Rhode Island, nearly half of patients admitted with influenza-like symptoms had respiratory viruses other than influenza A. A high proportion of patients were treated with antibiotics and pH1N1 infection had higher mortality compared to other respiratory viruses.
PMID:
21949746
[PubMed - in process]
PMCID: PMC3174965
Free full text
http://www.ncbi.nlm.nih.gov/pubmed/21949746