Hospitalised patients with suspected 2009 H1N1 Influenza A in a hospital in Norway, July - December 2009

BMC Infectious Diseases

Bente M Bergersen³  Anne-Marte B Kran¹  Harald Kjekshus²  Dag Berild³  Magnus Pillgram³  Bjorn J Brandsaeter³ 

[1] Oslo University Hospital Ulleval, Department of Microbiology, Kirkeveien 166, 0407 Oslo, Norway;Oslo University Hospital Aker, Department of Cardiology, Trondheimsveien 235, 0514 Oslo, Norway;Oslo University Hospital Aker, Department of Infectious Diseases, Trondheimsveien 235, 0514 Oslo, Norway

关键词: outcome;    isolation;    hypertension;    pandemic;    Influenza A H1N1;   

Others  :  1175774
DOI  :  10.1186/1471-2334-11-75

 received in 2010-09-28, accepted in 2011-03-24,  发布年份 2011

【 摘 要 】

Background

The main objective of this study was to describe the patients who were hospitalised at Oslo University Hospital Aker during the first wave of pandemic Influenza A (H1N1) in Norway.

Methods

Clinical data on all patients hospitalised with influenza-like illness from July to the end of November 2009 were collected prospectively. Patients with confirmed H1N1 Influenza A were compared to patients with negative H1N1 tests.

Results

182 patients were hospitalised with suspected H1N1 Influenza A and 64 (35%) tested positive. Seventeen patients with positive tests (27%) were admitted to an intensive care unit and four patients died (6%). The H1N1 positive patients were younger, consisted of a higher proportion of non-ethnic Norwegians, had a higher heart rate on admission, and fewer had pre-existing hypertension, compared to the H1N1 negative patients. However, hypertension was the only medical condition that was significantly associated with a more serious outcome defined as ICU admission or death, with a univariate odds ratio of the composite endpoint in H1N1 positive and negative patients of 6.1 (95% CI 1.3-29.3) and 3.2 (95% CI 1.2-8.7), respectively. Chest radiography revealed pneumonia in 24/59 H1N1 positive patients. 63 of 64 H1N1 positive patients received oseltamivir.

Conclusions

The extra burden of hospitalisations was relatively small and we managed to admit all the patients with suspected H1N1 influenza without opening new pandemic isolation wards. The morbidity and mortality were similar to reports from comparable countries. Established hypertension was associated with more severe morbidity and patients with hypertension should be considered candidates for vaccination programs in future pandemics.

【 授权许可】

   
2011 Brandsaeter et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Update: influenza activity--United States, August 30, 2009-January 9, 2010 MMWR Morb Mortal Wkly Rep 2010, 59:38-43. Ref ID: 145
• [2]Update: influenza activity--United States, April-August 2009 MMWR Morb Mortal Wkly Rep 2009, 58:1009-1012. Ref ID: 147
• [3]Swine-origin influenza A (H1N1) virus infections in a school - New York City, April 2009 MMWR Morb Mortal Wkly Rep 2009, 58:470-472. Ref ID: 148
• [4]Update: novel influenza A (H1N1) virus infections - worldwide, May 6, 2009 MMWR Morb Mortal Wkly Rep 2009, 58:453-458. Ref ID: 149
• [5]Update: swine influenza A (H1N1) infections--California and Texas, April 2009 MMWR Morb Mortal Wkly Rep 2009, 58:435-437. Ref ID: 150
• [6]Swine influenza A (H1N1) infection in two children--Southern California, March-April 2009 MMWR Morb Mortal Wkly Rep 2009, 58:400-402. Ref ID: 151
• [7]Pandemic alert level 6: scientific criteria for an influenza pandemic fulfilled Euro Surveill 2009, 14:19237. Ref ID: 128
• [8]New influenza A (H1N1) virus: WHO guidance on public health measures, 11 June 2009 Wkly Epidemiol Rec 2009, 84:261-264. Ref ID: 152
• [9]Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, et al.: Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009, 360:2605-2615. Ref ID: 1
• [10]Robert Koch-Institut BG: TagMan realtime PCR zur Detektion von porcinen Influenza A/H1N1-Viren. Empfehlung für den Nachweis der porcinen Influenza A/H1N1-Viren mittels real-time PCR. [http:/ / www.rki.de/ cln_160/ nn_200120/ DE/ Content/ InfAZ/ I/ Influenza/ IPV/ Schweinegrippe__PCR.html] webciteArticle in German 2010. Ref Type: Electronic Citation Ref ID: 138
• [11]Ward CL, Dempsey MH, Ring CJ, Kempson RE, Zhang L, Gor D, et al.: Design and performance testing of quantitative real time PCR assays for influenza A and B viral load measurement. J Clin Virol 2004, 29:179-188. Ref ID: 129
• [12]Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, et al.: Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 2009, 361:1935-1944. Ref ID: 134
• [13]Webb SA, Pettila V, Seppelt I, Bellomo R, Bailey M, Cooper DJ, et al.: Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 2009, 361:1925-1934. Ref ID: 132
• [14]Fajardo-Dolci G, Gutierrez-Vega R, rboleya-Casanova H, Villalobos A, Wilson KS, Garcia SG, et al.: Clinical characteristics of fatalities due to influenza A (H1N1) virus in Mexico. Thorax 2010, 65:505-509. Ref ID: 140
• [15]Wiwanitkit V: Hypertension as an underlying disorder in fatal cases of swine flu in Thailand: an observation. J Clin Hypertens (Greenwich) 2010, 12:540. Ref ID: 87
• [16]Hanshaoworakul W, Simmerman JM, Narueponjirakul U, Sanasuttipun W, Shinde V, Kaewchana S, et al.: Severe human influenza infections in Thailand: oseltamivir treatment and risk factors for fatal outcome. PLoS One 2009, 4:e6051. Ref ID: 139
• [17]Thomas RE, Jefferson T, Demicheli V, Rivetti D: Influenza vaccination for healthcare workers who work with the elderly. Cochrane Database Syst Rev 2006, 3:CD005187. Ref ID: 153