Clinical impact of pandemic influenza A H1N1 in a Chilean regional hospital

Abstract

Pandemic flu (H1N1 ) strongly affected southern Chile during 2009. To report the logistic and organizational changes implemented at a regional hospital to face the pandemic. All patients with flu like disease that were hospitalized, were prospectively enrolled at the Puerto Montt hospital. A nasopharyngeal aspirate was obtained in all for influenza virus A and B direct immunofluorescence and polymerase chain reaction (PCR). All epidemiological and clinical data of patients were recorded. Between May 29 and July 7, 2009, 184 adults were admitted to the hospital and in 117 patients aged 41 ± 18 years (56% females ), direct immunofluorescence was positive for influenza. In 67 of these patients PCR did not confirm the disease. These unconfirmed patients had a mean age of 49 ± 19 years (p < 0.01, compared with confirmed cases) and had a lower frequency of fever, rhinorrhea and chills. No significant differences in the incidence of community acquired pneumonia or chest X ray findings were observed between confirmed and unconfirmed cases. Hospital stay was over 15 days in 14% of confirmed cases and 5% of unconfirmed cases (p = 0.03). Fifteen patients, aged 53 ± 18 years, died. Low sensibility of direct immunofluorescence and delay in obtaining PCR confirmation of influenza posed a problem for the management of these patients.