Antiviral Agents ; therapeutic use ; Humans ; Influenza A Virus, H7N9 Subtype ; pathogenicity ; Influenza, Human ; drug therapy ; epidemiology ; virology

influenza virus can infect humans and cause disease. The clinical presentation of human infection is usually mild, but the infection caused by A(H5N1) avian influenza virus occurring initially in Hongkong in 1997 or the A(H7N9) virus isolated first at the beginning of this year in China is severe and characterized by high mortality. The mortality rate of adolescents and children caused by H5N1 avian influenza is lower than that of adults and the younger the child the lower the mortality rate. A few pediatric H7N9 avian influenza cases recovered soon after treatment. A child was determined to be a H7N9 avian influenza virus carrier. These findings suggested that the pediatric H7N9 avian influenza infection was mild. It is very important to start anti-virus treatment with oseltamivir as early as possible in cases of avian influenza infection is considered. Combined therapy, including respiratory and circulatory support and inhibiting immunological reaction, is emphasized in the treatment of severe cases.
Animals ; Birds ; virology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Influenza A Virus, H5N1 Subtype ; Influenza in Birds ; virology ; Influenza, Human ; diagnosis ; drug therapy ; epidemiology ; virology ; Time Factors

Disease Outbreaks ; prevention & control ; Humans ; Influenza, Human ; drug therapy ; epidemiology ; prevention & control

Animals ; Antiviral Agents ; therapeutic use ; Birds ; China ; Humans ; Influenza A Virus, H7N9 Subtype ; pathogenicity ; Influenza in Birds ; transmission ; Influenza, Human ; drug therapy ; epidemiology ; transmission ; Oseltamivir ; therapeutic use

OBJECTIVETo analyze the clinical characteristics of severely and critically ill children with 2009 influenza A (H1N1) infection.

METHODClinical data of 150 cases with 2009 influenza A (H1N1) virus infection confirmed with the use of a real-time polymerase-chain-reaction assay on nasopharyngeal swab specimens were analyzed.

RESULTAmong 150 severely and critically ill children with 2009 influenza A (H1N1) virus infection, 103 were male, 47 were female; the median age was 5 years, 81(55%) were 5 years of age or older; 21 (14%) had underlying chronic diseases. The most common presenting symptoms were fever (95%), cough (89%), vomiting (23%), wheezing (19%), abdominal pain (16%), lethargy (7%), seizures (6%), myalgia (6%), and diarrhea (6%). The common laboratory abnormalities were increased or decreased white blood cells counts (40%), elevated of CRP (33%), LDH (29%), CK (25%) and AST (19%). Clinical complications included pneumonia (65%), encephalopathy (12%), myocarditis (5%), encephalitis (1%) and myositis (1%). All patients had received antibiotics before admission or on admission; 73% of patients had received oseltamivir treatment, 23% of patients had received corticosteroids; 32 (21%) were admitted to an ICU, 13 patients were intubated and mechanically ventilated. Fourteen patients with dyspnea who were irresponsive to the treatment experienced bronchoalveolar lavage with flexible bronchoscopy, and the branching bronchial casts were removed in 5 patients. Totally 145 (97%) patients were discharged, five (3%) died, three previously healthy patients died from severe encephalopathy, one patient died from ARDS, one previously healthy patient died from secondary fungal meningitis.

CONCLUSIONSeverely and critically ill children with 2009 influenza A (H1N1) virus infection may occur mainly in older children without underlying chronic disease. The clinical spectrum and laboratory abnormality of the patients can have a wide range. Neurologic complications may be common and severe encephalopathy can lead to death in previously healthy children. Early use of bronchoalveolar lavage with flexible bronchoscopy may reduce death associated with pulmonary complications.

Child ; Child, Hospitalized ; Child, Preschool ; China ; epidemiology ; Critical Care ; Critical Illness ; Female ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; diagnosis ; drug therapy ; epidemiology ; pathology ; Male

OBJECTIVESince late March 2009, a novel influenza H1N1 strain emerged in humans in Mexico and the United States. It has rapidly spread to many countries on different continents, prompting unprecedented activation of pandemic preparedness plans. The present study aimed to investigate the characteristics of children with the novel influenza A (H1N1) virus infection.

METHODTwelve cases with influenza A (H1N1) infection were diagnosed according to the criteria of the Center for Disease Control and Prevention (CDC) of China during 1 May to 15 July 2009 in the Pediatric Hospital of Fudan University were analyzed. Influenza A (H1N1) RNA was detected by RT-PCR in CDC Shanghai China.

RESULTAll the 12 children with the novel influenza A (H1N1) virus infection were imported cases, aged from 11 months to 14 years 7 months, 7 of whom were boys, 5 were girls. Five cases contacted closely with influenza A (H1N1) patients; 12 cases had fever and no vomiting or diarrhea; 7 had cough or runny nose or anorexia. One had shortness of breath. Of the 11 cases who could tell about symptoms correctly, 6 had sore throat, 3 had stomachache, and none had muscle pain. Two of the 12 cases had pneumonia, and the disease in 1 of them was fatal and needed intensive care. One case was isolated and treated at home. The 11 cases hospitalized were treated according to the guidance of influenza A (H1N1) diagnosis and treatment issued by the Ministry of Health of China. Ten hospitalized cases were treated with oseltamivir. All the cases recovered completely. The median length of hospital stay was 8.1 days (range, 6 to 16), and the time of negative test results of influenza A (H1N1) RNA from illness onset to collection of samples for viral testing was from 5 to 15 days.

CONCLUSIONSymptoms among children with the novel influenza A (H1N1) virus infection were classic and the majority of the cases we treated had a mild clinical course if they were isolated and treated promptly. Antivirals appears to have not had any major adverse effects. More data from different regions and large samples are needed to illuminate the characteristics of children with novel influenza A (H1N1) virus infection.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; drug therapy ; epidemiology ; virology ; Male

OBJECTIVES: This report describes the results of an investigation on an outbreak of novel influenza A (H1N1) in an English language Institute in Seoul, Korea in May 2009. METHODS: In this outbreak, novel influenza A (H1N1) was confirmed in 22 of 91 trainees, trainers and staff members. The trainees and 2 staff members were isolated in an assigned facility and the rest were isolated in their homes after we discovered the first patient with novel influenza A (H1N1). After the isolation, the people in the assigned facility were educated to use N95 respirators and they received oseltamivir for prophylaxis. RESULTS: The initial findings in this study suggest that the symptoms were mild and similar to those of seasonal influenza. The classmates and roommates of the infected patients were more likely to get infected with novel influenza A (H1N1) than the trainees who were not classmates or roommates of the patients (OR: 3.19, 95% CI=0.91 - 11.11 for classmates and OR: 40.0, 95% CI=7.4-215.7 for roommates). CONCLUSIONS: The public health response seems successful in terms of preventing the spread of this virus into the local community.
Adult ; *Disease Outbreaks ; Humans ; Influenza A Virus, H1N1 Subtype/*isolation & purification ; Influenza, Human/diagnosis/drug therapy/*epidemiology/physiopathology ; Republic of Korea/epidemiology ; *Schools ; Young Adult

This report describes the pattern of the spread of the pandemic H1N1 2009 and compares 3 monitoring tools until the 57th week or January 31, 2010. The 1st week was from December 28th, 2008 to January 3rd, 2009. A total of 740,835 patients were reported to be infected with pandemic H1N1 2009 and 225 patients were reported to have died of pandemic H1N1 2009. The number of patients aged from 7 to 12 was the largest (183,363 patients in total) but the virus spread and then was suppressed most quickly among the children between 13 and 18. The region-determinant incidence of patients showed diverse patterns according to regions. The peak of the ILI per thousand was at the 45th week, the number of antiviral prescriptions reached its peak at the 44th week, and the peak based on reported patients was the 46th week. As of February 3 2010, the outbreak passed through the peak and has gradually subsided. Now it is time for the government and the academic world to review this outbreak, efficacy of vaccination, and further preparation and response for the next pandemic.
Adolescent ; Adult ; Age Distribution ; Antiviral Agents/therapeutic use ; Child ; Child, Preschool ; *Disease Outbreaks ; Humans ; Infant ; Infant, Newborn ; Influenza A Virus, H1N1 Subtype/*pathogenicity ; Influenza Vaccines/therapeutic use ; Influenza, Human/drug therapy/*epidemiology/mortality ; Korea/epidemiology ; Middle Aged ; Sentinel Surveillance ; Young Adult

OBJECTIVES: To evaluate the policies on 2009 influenza pandemic in Korea at the end of first wave. METHODS: The main policies and the estimation of these were described according to the progress of 2009 influenza pandemic. RESULTS: The public health measures for containment were estimated to be successful in the early stage. The preparedness of antiviral agents and vaccines before the pandemic, risk-communication on pandemic influenza and policies of government including vaccines, and the education of health care worker and support of health care institutions was not enough to respond to the pandemic. CONCLUSIONS: The additional evaluation should be performed at the end of the pandemic in various aspects including health and socioeconomic effects.
Antiviral Agents/therapeutic use ; Disaster Planning/*organization & administration ; *Disease Outbreaks ; *Health Policy ; Humans ; *Influenza A Virus, H1N1 Subtype ; Influenza Vaccines ; Influenza, Human/drug therapy/*epidemiology/prevention & control ; Program Evaluation ; Republic of Korea/epidemiology

The national strategy against pandemic influenza essentially consists of 3 prongs: (i) effective surveillance, (ii) mitigation of the pandemic's impact, and (iii) render the population immune through vaccination. When the pandemic hits Singapore, the response plan aims to achieve the following 3 outcomes: (i) maintenance of essential services to limit social and economic disruption, (ii) reduction of morbidity and mortality through antiviral treatment, and (iii) slow and limit the spread of influenza to reduce the surge on healthcare services. The biggest challenge will come from managing the surge of demand on healthcare services. A high level of preparedness will help healthcare services better cope with the surge.
Antiviral Agents ; therapeutic use ; Communicable Disease Control ; Contact Tracing ; Disease Outbreaks ; prevention & control ; statistics & numerical data ; Global Health ; Humans ; Influenza Vaccines ; administration & dosage ; Influenza, Human ; drug therapy ; epidemiology ; Population Surveillance ; Quarantine ; Severe Acute Respiratory Syndrome ; epidemiology ; Singapore ; epidemiology