Clinical Features of the Initial Cases of 2009 Pandemic Influenza A (H1N1) Virus Infection in China

Cao, Bin; Li, Xingwang; Yu, Mei; Wang, Jian; Lu, Hongzhou; Chen, Yu‐Sheng; Liang, Zhenglun; Liang, Lirong; Zhang, Sujuan; Zhang, Bin; Gu, Li; Lu, Lian-he; Wang, Dayan; Wang, Chen

doi:10.1056/nejmoa0906612

Cited by 530 publications

(532 citation statements)

References 10 publications

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“…In our present study, the shedding of 2009 H1N1 virus was assessed in 173 patients: after 5 days of oseltamivir treatment, 88 patients (50·8%) still had a positive RT‐PCR result. These results agree with those of recent studies that found that patients admitted to hospital with the pandemic influenza 2009 H1N1 virus had a longer duration of viral shedding than adults who were hospitalized with a seasonal influenza virus infection 12, 13, 14…”

Section: Discussionsupporting

confidence: 93%

“…These results agree with those of previous studies 13, 18. A recent Italian study19 has reported that the duration of viral shedding is significantly reduced when therapy is initiated within 2 days of symptom onset.…”

Section: Discussionsupporting

confidence: 92%

“…With regard to 2009 H1N1 influenza, Ling et al 18. have reported that younger immunocompetent adults show prolonged shedding, while Cao et al 13. have suggested that a delay from the onset of symptoms to oseltamivir therapy of >48 hours is associated with persistent RT‐PCR positivity (>5 days).…”

Section: Discussionmentioning

confidence: 99%

“…A pH1N1 infection was suspected if the patient had an influenza‐like illness, namely a temperature of ≥37·5°C and at least one of the following symptoms: sore throat, cough, rhinorrhea, or nasal congestion 13. RT‐PCR was performed within 12 hours of sampling (without freezing) using Real‐Time Ready Inf A/H1N1 detection kits (Roche Diagnostics, Rotkreuz, Switzerland) and multiwell plate‐based real‐time PCR platforms (LightCycler ® 480 Real‐Time PCR System; Roche Diagnostics) as previously described 14.…”

Section: Methodsmentioning

confidence: 99%

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Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Ryoo

Kim

Sohn

et al. 2012

Influenza Resp Viruses

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BackgroundThe duration of viral shedding is an important determinant of infectivity and transmissibility and provides vital information for effective infection prevention and control. However, few studies have evaluated viral shedding in patients admitted to hospital with 2009 H1N1 influenza and treated with oseltamivir.ObjectiveTo determine the incidence of prolonged 2009 H1N1 influenza viral shedding in patients treated for 5 days with oseltamivir and to identify factors that promote prolonged viral shedding.MethodsThis was a prospective, observational cohort study of 173 patients infected with 2009 H1N1 influenza (confirmed by RT‐PCR) who were admitted to isolation rooms in the emergency department of our hospital between August 25, 2009 and December 31, 2009. All of the patients were treated according to institutional protocols and received routine follow‐up RT‐PCR testing after 5 days of oseltamivir therapy. Prolonged viral shedding was defined as a positive follow‐up RT‐PCR result.ResultOf the 173 patients in our cohort, 88 (50·8%) showed persistent viral shedding after oseltamivir treatment. Viral shedding was significantly prolonged if antiviral therapy was started ≥2 days after symptom onset (OR 2·74, 95% CI 1·29–5·82), if there were major comorbidities (OR 3·07, 95% CI 1·29–7·32), and/or if respiratory symptoms were still present on the day 5 of antiviral treatment (OR 4·13, 95% CI 2·10–8·11).ConclusionsThe presence of major comorbidities, a delay in initiating antiviral treatment, and continuing respiratory symptoms after 5 days of antiviral treatment are associated with prolonged shedding of the 2009 H1N1 influenza virus.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Ryoo

Kim

Sohn

et al. 2012

Influenza Resp Viruses

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“…As has been previously reported, gastrointestinal symptoms are prominent and suggesting for the pandemic H1N1 2009 influenza infection 1 , 2 , 3 . In the present study, clinical manifestations of the pandemic H1N1 2009 influenza virus infection are similar to the report from China, 1 but different from U.S. and U.K reports. In addition, there are both positive and negative clinical predictors for pandemic H1N1 2009 influenza infection.…”

Section: Discussionsupporting

confidence: 81%

Clinical factors predictive of PCR positive in pandemic H1N1 2009 influenza virus infection

Phungoen

Sawanyawisuth

Engchanil

et al. 2011

Influenza and Other Respiratory Viruses

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Please cite this paper as: Phungoen et al. (2011) Clinical factors predictive of PCR positive in pandemic H1N1 2009 influenza virus infection. Influenza and Other Respiratory Viruses 5(6), e558–e562. Objective Pandemic H1N1 2009 influenza virus (H1N1) has been spreading globally. Clinical features might be predictive and may be different among countries. Even though the PCR test is a confirmatory test for this viral infection, it is expensive and limited in most Thai health care facilities. We studied predictive factors of PCR positive in H1N1 suspected patients. Methods Consecutive patients who had influenza‐like illness less than seven days and had been tested for H1N1 by the real‐time PCR method between May and July 2009 were enrolled. Clinical data was collected and compared between those who had positive and negative PCR tests. Results There were 6494 patients had flu‐like symptoms. Of those, 166 patients were done PCR test and 75 patients (45·18%) had positive PCR test. There were four predictors for positive PCR test including history of contact with confirmed H1N1 patients, headache, body temperature, and coryza with the adjusted odds ratio (95% confidence interval) of 2·84 (1·09–7·40), 6·25 (1·42–27·49), 1·69 (1·08–2·66), and 0·31 (0·12–0·79), respectively. Conclusions Clinical factors can be both suggestive and protective factors for H1N1 infection. These factors may be helpful in clinical practice to assess the possibility of the H1N1 infection in people who are at risk; particularly in resource‐limited health care facilities.

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Prevention of Novel Influenza Infection in Newborns in Hospital Settings: Considerations and Strategies During the 2009 H1N1 Pandemic

Zapata

Kendrick²,

Jamieson³

et al. 2012

Disaster med. public health prep.

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ABSTRACTDuring the 2009 influenza A (H1N1) pandemic, many pregnant women experienced severe illness and some gave birth while ill with suspected or confirmed pandemic (H1N1) 2009 influenza. Because of concerns about possible transmission of this novel virus to immunologically naïve newborns, and the absence of definitive studies regarding this risk, the Centers for Disease Control and Prevention (CDC) reviewed relevant literature to understand the potential burden of disease and routes of transmission affecting newborns. This report describes the issues considered during the 2009 H1N1 pandemic as CDC developed guidance to protect newborns in hospital settings. Also presented is a framework of protection efforts to prevent novel influenza infection in fetuses/newborns before birth and in hospital settings. Although developed specifically for the pandemic, the framework may be useful during future novel influenza outbreaks.(Disaster Med Public Health Preparedness. 2012;6:97-103)

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Clinical Features of the Initial Cases of 2009 Pandemic Influenza A (H1N1) Virus Infection in China

Cited by 530 publications

References 10 publications

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Clinical factors predictive of PCR positive in pandemic H1N1 2009 influenza virus infection

Prevention of Novel Influenza Infection in Newborns in Hospital Settings: Considerations and Strategies During the 2009 H1N1 Pandemic

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