Abstract
BackgroundThe first human infections with influenza A(H1N1)pdm09 virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010.MethodsWe identified influenza A(H1N1)pdm09-associated pneumonia deaths from a national influenza surveillance system and performed detailed reviews of a subset.ResultsOf 198 deaths reported, 49% were male and the median age was 37 years; 146 (73%) were 20–60 years. Among 90 deaths with records available for review, 46% had no identified risk factors for severe influenza. Eighty-eight patients (98%) received antiviral treatment, but only 16 (18%) initiated therapy within 48 hours of symptom onset.ConclusionsMost influenza A(H1N1)pdm09 pneumonia fatalities in Thailand occurred in adults aged 20–60 years. Nearly half lacked high-risk conditions. Antiviral treatment recommendations may be especially important early in a pandemic before vaccine is available. Treatment should be considered as soon as influenza is suspected.
Highlights
The 2009 influenza pandemic virus, influenza A(H1N1)pdm09 was first confirmed in the United States by the Centers for Disease Control and Prevention (CDC) in April 2009 and rapidly spread worldwide [1,2,3,4]
The epidemiology of influenza A(H1N1)pdm09 deaths has been well-described in the United States, Mexico, and Europe [1,9,10], less is known about fatal cases in Thailand or other countries in Asia [11,12,13]
From May 2009 through January 2010, 27,254 cases and 198 fatal cases of laboratory-confirmed influenza A(H1N1)pdm09associated pneumonia were reported to the Ministry of Public Health (MOPH)-National Avian Influenza Surveillance (NAIS) system (0.7% case fatality proportion) (Figure 1)
Summary
The 2009 influenza pandemic virus, influenza A(H1N1)pdm was first confirmed in the United States by the Centers for Disease Control and Prevention (CDC) in April 2009 and rapidly spread worldwide [1,2,3,4]. The first two cases of laboratory-confirmed influenza A(H1N1)pdm infection in Thailand were reported on May 10, 2009, in exchange students who returned from Mexico. The epidemiology of influenza A(H1N1)pdm deaths has been well-described in the United States, Mexico, and Europe [1,9,10], less is known about fatal cases in Thailand or other countries in Asia [11,12,13]. We present epidemiological and clinical data on influenza A(H1N1)pdm09-associated deaths among persons hospitalized with pneumonia in Thailand, collected through retrospective review of medical records. The first human infections with influenza A(H1N1)pdm virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010
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