Abstract
Primary influenza pneumonia has a high mortality rate during pandemics, not only in immunocompromised individuals and patients with underlying comorbid conditions, but also in young healthy adults. Clinicians should maintain a high index of suspicion for this diagnosis in patients presenting with influenza-like symptoms that progress quickly (2 to 5 days) to respiratory distress and extensive pulmonary involvement. The sensitivity of rapid diagnostic techniques in identifying infections with the pandemic 2009 H1N1v influenza strain is currently suboptimal. The most reliable real-time reverse transcriptase-polymerase chain reaction molecular testing is available in limited clinical settings. Despite 6 months of pandemic circulation, most novel H1N1v pandemic strains remain susceptible to oseltamivir. Ensuring an appropriate oxygenation and ventilation strategy, as well as prompt initiation of antiviral therapy, is essential in management.
Highlights
As the novel swine-origin influenza A (H1N1)v global pandemic is under way, the medical community has already experienced an increase in hospitalizations from influenzarelated complications in many geographic regions
Mortality is high but can be decreased with an optimal protective ventilatory strategy, as shown in Acute Respiratory Distress Syndrome Network clinical trials; this strategy is recommended in acute lung injury [38,39]
Primary influenza pneumonia caused by the 2009 pandemic influenza A H1N1v strain, though rare, carries a high mortality
Summary
As the novel swine-origin influenza A (H1N1)v global pandemic is under way, the medical community has already experienced an increase in hospitalizations from influenzarelated complications in many geographic regions. Primary influenza pneumonia has a high mortality rate during pandemics, in immunocompromised individuals and patients with underlying comorbid conditions, and in young healthy adults. While rare in seasonal influenza, have been frequently reported in infections with the 2009 pandemic influenza A H1N1v strain [10], in children.
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