Sample records for h1n1 virology update

  1. Pandemic influenza A (H1N1 2009 vaccine: An update

    M K Goel


    Full Text Available The world witnessed a the first influenza pandemic in this century and fourth overall since first flu pandemic was reported during the World War I. The past experiences with influenza viruses and this pandemic of H1N1 place a consider-able strain on health services and resulted in serious illnesses and a large number of deaths. Develop-ing countries were declared more likely to be at risk from the pandemic effects, as they faced the dual problem of highly vulnerable populations and limited resources to respond H1N1. The public health experts agreed that vaccination is the most effective ways to mitigate the negative effects of the pandemic. The vaccines for H1N1 virus have been used in over 40 coun-tries and administered to over 200 million people helped in a great way and on August 10, 2010, World Health Organization (WHO announced H1N1 to be in postpandemic period. But based on knowledge about past pandemics, the H1N1 (2009 virus is expected to continue to circulate as a seasonal virus and may undergo some agenic-variation. As WHO strongly recommends vaccination, vigilance for regular updating of the composition of influenza vaccines, based on an assessment of the future impact of circulating viruses along with safety surveillance of the vaccines is necessary. This review has been done to take a stock of the currently available H1N1 vaccines and their possible use as public health intervention in the postpandemic period.

  2. Update: novel influenza A (H1N1) virus infection - Mexico, March-May, 2009.


    On April 12, 2009, Mexico responded to a request for verification by the World Health Organization (WHO) of an outbreak of acute respiratory illness in the small community of La Gloria, Veracruz. During April 15-17, the Mexico Ministry of Health received informal notification of clusters of rapidly progressive severe pneumonia occurring mostly in Distrito Federal (metropolitan Mexico City) and San Luis Potosi. In response, on April 17, Mexico intensified national surveillance for acute respiratory illness and pneumonia. During April 22-24, novel influenza A (H1N1) virus infection, previously identified in two children in the United States, was confirmed in several patients. This report updates a previous report on the outbreak in Mexico and summarizes public health actions taken to date by Mexico to monitor and control the outbreak. During March 1-May 29, national surveillance identified 41,998 persons with acute respiratory illness; specimens from 25,127 (59.8%) patients were tested, of which 5,337 (21.2%) were positive for novel influenza A (H1N1) virus infection by real-time reverse transcription--polymerase chain reaction (rRT-PCR). As of May 29, 97 patients with laboratory-confirmed infection had died. Epidemiologic evidence to date suggests that the outbreak likely peaked nationally in late April, although localized cases continue to be identified.

  3. Epidemiological and virological characterization of 2009 pandemic influenza A virus subtype H1N1 in Madagascar.

    Orelle, Arnaud; Razanajatovo, Norosoa Harline; Rajatonirina, Soatiana; Hoffmann, Jonathan; Randrianasolo, Laurence; Razafitrimo, Girard Marcellin; Naidoo, Dhamari; Richard, Vincent; Heraud, Jean-Michel


    Madagascar was one of the first African countries to be affected by the 2009 pandemic of influenza A virus subtype H1N1 [A(H1N1)pdm2009] infection. The outbreak started in the capital city, Antananarivo, and then spread throughout the country from October 2009 through February 2010. Specimens from patients presenting with influenza-like illness were collected and shipped to the National Influenza Center in Madagascar for analyses, together with forms containing patient demographic and clinical information. Of the 2303 specimens tested, 1016 (44.1%) and 131 (5.7%) yielded A(H1N1)pdm09 and seasonal influenza virus, respectively. Most specimens (42.0%) received were collected from patients 50 years old to be infected with A(H1N1)pdm09 (odds ratio, 2.1; 95% confidence interval, 1.7-2.6; P Madagascar, no antigenic differences between A(H1N1)pdm09 viruses recovered in Madagascar and those that circulated worldwide were observed. The high proportion of respiratory specimens positive for A(H1N1)pdm09 is consistent with a widespread transmission of the pandemic in Madagascar. The age distribution of cases of A(H1N1)pdm09 infection suggests that children and young adults could be targeted for interventions that aim to reduce transmission during an influenza pandemic.

  4. [Virological surveillance of pandemic (H1N1) 2009 virus and its genetic characteristics in Hunan Province, 2009-2011].

    Zhang, Hong; Huang, Yi-Wei; Liu, Yun-Zhi; Li, Fang-Cai; Chen, Zhang; Li, Wen-Chao; Deng, Zhi-Hong; Hu, Shi-Xiong; Gao, Li-Dong


    To understand and master the dynamic variation of the pandemic influenza A (H1N1) 2009 in Hunan province from 2009 to 2011, and to know the genetic characteristics and drug resistance of the pandemic (H1N1) 2009 viruses. Throat swab specimens of influenza-like illness patients were collected from sentinel hospitals and tested for influenza by fluorescent PCR or virus isolation methods. Partial isolates were selected for sequencing. The sequences were used for phylogenetic analysis by MEGA 5. 05 software. From the 20th week of 2009 to the 52nd week of 2011, 17 773 specimens were tested. 3 831 specimens were influenza-positive with a positive rate of 21. 6%, of which 1 794 were positive specimens of pandemic (H1N1) 2009, accounting for 46. 8%00 of the influenza-positives. There were 2 epidemic peaks of pandemic (H1N1) 2009, which were in the 41st-53rd week of 2009 and the 1st-12nd week of 2011, respectively. The HA genes of 23 strains that were selected for sequencing had close relationship; the distribution of strains in the phylogenetic tree was basically in chronological order. The complete genome sequence analysis showed that all of 8 gene segments of 7 strains were homologous to the vaccine strain, and there was no gene reassortment. The HA amino acid sites of the 23 strains were highly similar to the vaccine strain (98. 2% - 100. 0% in homology), but all 23 strains had P83S, S203T and 1321V mutations. The 222 site mutation that may lead to enhanced virulence was found in the A/Hunan/YQ30/2009 strain. The mutation was D222E. There was no oseltamivir resistance mutation found in all strains. The pandemic (H1N1) 2009 in Hunan province from 2009 to 2011 had a bimodal distribution. There was no large-scale variation of virus genes. The clinical use of oseltamivir was still effective. Key words: Pandemic (H1N1) 2009; Surveillance; Genetic characteristics

  5. H1N1 Influenza

    ... Nutrient Shortfall Questionnaire Home Diseases and Conditions H1N1 Influenza H1N1 Influenza Condition Family HealthKids and Teens Share H1N1 ... Contents1. Overview2. Symptoms3. Prevention4. Treatment What is H1N1 influenza?H1N1 influenza (also known as swine flu) is an ...

  6. 2009 H1N1 Influenza 2009 H1N1 Influenza

    Seth J. Sullivan, MD; Robert M. Jacobson, MD; Walter R. Dowdle, PhD; and Gregory A. Poland


    Full Text Available Within 2 months of its discovery last spring, a novel influenza A (H1N1 virus, currently referred to as 2009 H1N1, caused the first influenza pandemic in decades. The virus has caused disproportionate disease among young people with early reports of virulence similar to that of seasonal influenza. This clinical review provides an update encompassing the virology, epidemiology, clinical manifestations, diagnosis, treatment, and prevention of the 2009 H1N1 virus. Because information about this virus, its prevention,and treatment are rapidly evolving, readers are advised to seek additional information. We performed a literature search of PubMed using the following keywords: H1N1, influenza, vaccine, pregnancy, children, treatment, epidemiology, and review. Studies were selected for inclusion in this review on the basis of their relevance. Recent studies and articles were preferred.

    El Editor de este número especial agradece la autorización expresa, mediante comunicación escrita en nuestro poder, de los autores del trabajo “2009 H1N1 Influenza”, así como de los editores de la revista Mayo Clinic Proceedings, para su reproducción, como publicación secundaria en Medisur, artículo de revisión seleccionado por nosotros, que resume buena parte de los nuevos conocimientos adquiridos a partir de la literatura médica reciente relacionada con esta pandemia, durante el año 2009.

    De este modo, el artículo que a continuación de reproduce para los lectores de Medisur, está basado íntegramente en el estudio previamente publicado como: Sullivan SJ, Jacobson RM, Dowdle WR, Poland GA. 2009 H1N1 Influenza. Mayo Clin Proc. 2010;85(1:64-76.

    A continuación el resumen:

    Within 2 months of its discovery last spring, a novel influenza A (H1N1 virus, currently referred to as 2009 H1N1, caused the first influenza pandemic in decades. The virus has caused disproportionate disease among young people with early reports of virulence similar

  7. Partial protection against 2009 pandemic influenza A (H1N1) of seasonal influenza vaccination and related regional factors: Updated systematic review and meta-analyses.

    Li, Zhi-yuan; Chen, Jin-yan; Zhang, Yan-ling; Fu, Wei-ming


    This updated systematic review and meta-analyses aims to systematically evaluate the cross-protection of seasonal influenza vaccines against the 2009 pandemic A (H1N1) influenza infection, and investigate the potential effect of the influenza strains circulating previous to the pandemic on the association between vaccine receipt and pandemic infection. In addition, subgroup analysis was performed based on the study locations and previous circulating influenza viruses. Relevant articles in English and Chinese from 2009 to October 2013 were systematically searched, and 21 eligible studies were included. For case-control studies, an insignificant 20% reduced risk for pandemic influenza infection based on combined national data (OR = 0.80; 95%CI: 0.60, 1.05) was calculated for people receiving seasonal influenza vaccination. However, for RCTs, an insignificant increase in the risk of seasonal influenza vaccines was observed (RR = 1.27; 95% CI: 0.46, 3.53). For the subgroup analysis, a significant 35% cross-protection was observed in the subgroup where influenza A outbreaks were detected before the 2009 pandemic. Moreover, the results indicated that seasonal influenza vaccination may reduce the risk of influenza-like illnesses (ILIs) (RR = 0.91; 95% CI: 0.84, 0.99). Our findings partially support the hypothesis that seasonal vaccines may offer moderate cross-protection for adults against laboratory-confirmed pandemic influenza A (H1N1) infection and ILIs. Further immunological studies are needed to understand the mechanism underlying these findings.

  8. 一起甲型H1N1流感暴发疫情的流行病学和病原学分析%The epidemiologic and virological analysis of an outbreak of influenza A/H1N1

    侯海燕; 杨鹏飞; 张敏会; 刘靓; 刘纯成; 时玉军


    Objective To study the epidemiological characters of an influenza A/H1N1 outbreak in a middle school in Huaian city,and to provide scientific measures for prevention and control of influenza A/ H1N1.Method The outbreak of influenza A/H1N1 was investigated through the field epidemiology.The samples were used for virus isolation.Nucleotide sequences of H1N1 HA1 region were determined by RT-nested-PCR and sequencing.H1N1 genotypes were analyzed using bioinformatic programs by MEGA 5.0 software,and phylogenetic tree was constructed.Result 51 cases were reported during 11 days,the attack rate was 2.49% (51/2051).The sequence analysis showed that the sequence homologous rates of H1N1 virus HA gene nucleotide were 99.6%-99.9% with H1N1 genotype in 2014,98.5%-98.8% in 2013,and lower than 98.4% in 2011.Conclusion The popularity of this outbreak was low.Timely isolation of H1 N1 patients and close contacts played an important role in control the epidemics.Implementation of health propaganda and immunization of influenza A/H1N1 should be strengthened.%目的 了解淮安市某中学甲型H1N1流感暴发的分子流行病学特征,为甲型H1N1流感疫情的控制提供依据.方法 采用现场流行病学方法,对甲型H1N1流感疫情进行调查分析;对病例标本进行病毒分离;采用巢式PCR扩增甲型H1N1流感病毒HA1基因的核苷酸序列,利用MEGA5.0分析软件,进行同源性分析和构建系统进化树.结果 疫情持续11天共确诊甲型H1N1流感样病例51例,罹患率为2.49% (51/2051).序列进化分析表明,本次疫情的病毒基因与2014年和2013年甲型H1N1流感病毒HA1基因核苷酸序列的同源性为分别为99.6% ~ 99.9%和98.5%~98.8%,与2011年之前分离的核苷酸同源性为98.4%.结论 此次疫情流行程度较低,及时隔离病人及密切接触者在控制疫情中起到了重要作用;病毒基因变异程度不高,加强健康教育和疫苗接种有助于预防流感.

  9. Cuba vs H1N1 Influenza

    Gail Reed


    Full Text Available El Comité Editorial de MediSur agradece a Gail Reed, editora de Medicc Review la autorización expresa, para reproducir el artículo titulado “Cuba vs H1N1 Influenza”. Este trabajo resume el esfuerzo realizado por todos los organismos en Cuba y en especial el Ministerio de Salud Pública en la lucha para disminuir los efectos de la influenza H1N1 en la población. El artículo original se puede encontrar en: Reed G. Faceoff: Cuba vs H1N1 Influenza. MEDICC Review. 2010; 12(1:6-12. Disponible en:

  10. Antiviral Prophylaxis and H1N1


    Dr. Richard Pebody, a consultant epidemiologist at the Health Protection Agency in London, UK, discusses the use of antiviral post-exposure prophylaxis and pandemic H1N1.  Created: 7/14/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 7/18/2011.

  11. Influenza Stigma during the 2009 H1N1 Pandemic.

    Earnshaw, Valerie A; Quinn, Diane M


    The current study examines the extent to which H1N1 was stigmatized at the height of the 2009 H1N1 pandemic in the U.S. and explores the role that H1N1 stigma played in people's desire for physical distance from others with H1N1. H1N1 was the most stigmatized disease, with participants endorsing greater prejudice towards people with H1N1 than people with cancer or HIV/AIDS. Further, H1N1 stigma partially mediated the relationship between participants' perceptions that H1N1 was threatening and their desire for physical distance from people with H1N1. Therefore, H1N1 stigma played a role in, but was not entirely responsible for, the relationship between perceptions that H1N1 was threatening and desire for distance from others with H1N1.

  12. Updates and achievements in virology.

    Buonaguro, Franco M; Campadelli-Fiume, Gabriella; De Giuli Morghen, Carlo; Palù, Giorgio


    The 4th European Congress of Virology, hosted by the Italian Society for Virology, attracted approximately 1300 scientists from 46 countries worldwide. It also represented the first conference of the European Society for Virology, which was established in Campidoglio, Rome, Italy in 2009. The main goal of the meeting was to share research activities and results achieved in European virology units/institutes and to strengthen collaboration with colleagues from both western and developing countries. The worldwide representation of participants is a testament to the strength and attraction of European virology. The 5-day conference brought together the best of current virology; topics covered all three living domains (bacteria, archaea and eucarya), with special sessions on plant and veterinary virology as well as human virology, including two oral presentations on mimiviruses. The conference included five plenary sessions, 31 workshops, one hepatitis C virus roundtable, ten special workshops and three poster sessions, as well as 45 keynote lectures, 191 oral presentations and 845 abstracts. Furthermore, the Gesellschaft fur Virologie Loeffler-Frosch medal award was given to Peter Vogt for his long-standing career and achievements; the Gardner Lecture of the European Society for Clinical Virology was presented by Yoshihiro Kawaoka, and the Pioneer in Virology Lecture of the Italian Society for Virology was presented by Ulrich Koszinowski.

  13. 2009 H1N1 Flu Vaccine Facts

    ... please turn Javascript on. Feature: Flu 2009 H1N1 Flu Vaccine Facts Past Issues / Fall 2009 Table of Contents ... the H1N1 flu vaccine. 1 The 2009 H1N1 flu vaccine is safe and well tested. Clinical trials conducted ...

  14. H1N1快速治疗计

    罗炯尧; 陈艳莲



  15. Pityriasis rosea following influenza (H1N1 vaccination

    Jeng-Feng Chen


    Full Text Available Pityriasis rosea is a distinct papulosquamous skin eruption that has been attributed to viral reactivation, certain drug exposures or rarely, vaccination. Herein, we reported a clinicopathlogically typical case of pityriasis rosea that developed after the H1N1 vaccination. With a global H1N1 vaccination program against the pandemic H1N1 influenza, patients should be apprised of the possibility of such rare but benign skin reaction to avoid unnecessary fear. Furthermore, a brief review of the current reported skin adverse events related to the novel H1N1 vaccination in Taiwan is presented here.

  16. H1N1: pandemia e perspectiva atual H1N1: overview and perspectives

    Nancy Bellei


    Full Text Available O vírus influenza de origem suína, A/California/04/2009 (H1N1, foi inicialmente detectado no México e determinou a pandemia de influenza de 2009. Em agosto de 2010, a Organização Mundial da Saúde (OMS declarou o início da fase pós-pandêmica. As características dessa última pandemia foram marcadamente diferentes das anteriores. O vírus emergiu de rearranjos genéticos originários em hospedeiro mamífero não humano, demonstrou transmissibilidade interespécies e afetou a população humana de forma diferente dos vírus pandêmicos anteriores (1918, 1957 e 1968 com maior morbidade e mortalidade em crianças e adultos jovens. Atualmente, o vírus apresenta padrão sazonal da mesma forma que o influenza A H3N2 e o influenza B, mantendo, até o momento, o mesmo perfil de patogenicidade, espectro clínico e sensibilidade a antivirais. A cepa foi incluída na vacina sazonal trivalente anual recomendada, principalmente para proteção dos grupos de risco mais vulneráveis a complicações pelas diferentes cepas de influenza.The swine origin influenza virus A/CALIFORNIA/04/2009 (H1N1 was first detected in Mexico and determined the 2009 influenza pandemic. In August 2010, World Health Organization (WHO declared the beginning of the post-pandemic period. This last pandemic was distinctly different from previous ones. The virus emerged from genetic rearrangement in non-human mammalian host. Moreover, its inter-species transmission is fully reported. However, it affected human population differently from previous pandemic viruses (1918, 1957, 1968, with increased morbidity and mortality among children and young adults. Currently, the virus has a seasonal pattern in the same way as influenza A H3N2 and influenza B, maintaining the same pathogenicity profile, clinical spectrum and sensitivity to antiviral agents. The strain was included in the annual trivalent seasonal vaccine formulation, mainly for risk groups, which are more vulnerable to

  17. 1918 pandemic H1N1 DNA vaccine protects ferrets against 2007 H1N1 virus infection

    Bragstad, Karoline; Martel, Cyril Jean-Marie; Aasted, Bent;

    of the H1N1 pandemic virus from 1918 induce protection in ferrets against infection with a H1N1 (A/New Caledonia/20/99(H1N1)) virus which was included in the conventional vaccine for the 2006-2007 season. The viruses are separated by a time interval of 89 years and differ by 21.2% in the HA1 protein...

  18. 甲型H1N1流感



    @@ 2009年3月以来,许多国家先后发生甲型H1N1流感.甲型H1N1流感原名猪流感,为避免"猪流感"一词对人们的误导,世界卫生组织将此前被称为猪流感的新型致命病毒更名为"AH1N1型流感"(influenza A (H1N1)),我国按惯例称为"甲型H1N1流感". 世卫组织已将该病警告级别提高到6级,表明它将会成为全球性流行病.

  19. Early Detection of Pandemic (H1N1) 2009, Bangladesh

    Rahman, Mustafizur; Al Mamun, Abdullah; Haider, Mohammad Sabbir; Zaman, Rashid Uz; Karmakar, Polash Chandra; Nasreen, Sharifa; Muneer, Syeda Mah-E; Homaira, Nusrat; Goswami, Doli Rani; Ahmed, Be-Nazir; Husain, Mohammad Mushtuq; Jamil, Khondokar Mahbuba; Khatun, Selina; Ahmed, Mujaddeed; Chakraborty, Apurba; Fry, Alicia; Widdowson, Marc-Alain; Bresee, Joseph; Azim, Tasnim; Alamgir, A.S.M.; Brooks, Abdullah; Hossain, Mohamed Jahangir; Klimov, Alexander; Rahman, Mahmudur; Luby, Stephen P.


    To explore Bangladesh’s ability to detect novel influenza, we examined a series of laboratory-confirmed pandemic (H1N1) 2009 cases. During June–July 2009, event-based surveillance identified 30 case-patients (57% travelers); starting July 29, sentinel sites identified 252 case-patients (1% travelers). Surveillance facilitated response weeks before the spread of pandemic (H1N1) 2009 infection to the general population. PMID:22257637

  20. ‘Presenting CXR phenotype of H1N1’ flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks’

    Minns, F.C., E-mail: [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Nimhuineachain, A, E-mail: [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Beek, E.J.R. van, E-mail: [Clinical Research Imaging Centre, University of Edinburgh, 47 Little France Crescent, Edinburgh, Midlothian EH16 4TJ (United Kingdom); Ritchie, G., E-mail: [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Hill, A., E-mail: [Department of Respiratory Medicine, New Royal Infirmary, Edinburgh (United Kingdom); Murchison, J.T., E-mail: [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom)


    Highlights: • Patients with H1N1 pneumonia demonstrated more opacified zones on chest x-ray than patients with non-H1N1 pneumonias. • A particular ‘phenotype’ of chest x-ray changes was identified in H1N1 patients. • This H1N1 ‘phenotype’ was the same for the two evaluated ‘flu seasons, during both pandemic and post pandemic stages. - Abstract: Aims: To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). Methods: We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were ‘blinded’ to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Results: Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p = 0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p = 0.001). H1N1 radiographs were more likely to be ‘patchy’ versus ‘confluent’ changes of non-H1N1 CAP (p = 0.03) and more often demonstrated peripheral distribution (p = 0.01). H1N1 patients tended to stay in hospital longer (not significant; p = 0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p = 0.02). The findings were the same for the two evaluated seasons. Conclusion: H1N1 patients demonstrated more extensive disease, which was more likely bilateral, ‘patchy’, and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients

  1. Assessing Google flu trends performance in the United States during the 2009 influenza virus A (H1N1 pandemic.

    Samantha Cook

    Full Text Available BACKGROUND: Google Flu Trends (GFT uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1 pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was developed using data from the beginning of pH1N1. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated the accuracy of each U.S. GFT model by comparing weekly estimates of ILI (influenza-like illness activity with the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet. For each GFT model we calculated the correlation and RMSE (root mean square error between model estimates and ILINet for four time periods: pre-H1N1, Summer H1N1, Winter H1N1, and H1N1 overall (Mar 2009-Dec 2009. We also compared the number of queries, query volume, and types of queries (e.g., influenza symptoms, influenza complications in each model. Both models' estimates were highly correlated with ILINet pre-H1N1 and over the entire surveillance period, although the original model underestimated the magnitude of ILI activity during pH1N1. The updated model was more correlated with ILINet than the original model during Summer H1N1 (r = 0.95 and 0.29, respectively. The updated model included more search query terms than the original model, with more queries directly related to influenza infection, whereas the original model contained more queries related to influenza complications. CONCLUSIONS: Internet search behavior changed during pH1N1, particularly in the categories "influenza complications" and "term for influenza." The complications associated with pH1N1, the fact that pH1N1 began in the summer rather than winter, and changes in health-seeking behavior each may have played a part. Both GFT models performed well prior to and during pH1

  2. Assessing Google Flu Trends Performance in the United States during the 2009 Influenza Virus A (H1N1) Pandemic

    Cook, Samantha; Conrad, Corrie; Fowlkes, Ashley L.; Mohebbi, Matthew H.


    Background Google Flu Trends (GFT) uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1) pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was developed using data from the beginning of pH1N1. Methodology/Principal Findings We evaluated the accuracy of each U.S. GFT model by comparing weekly estimates of ILI (influenza-like illness) activity with the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet). For each GFT model we calculated the correlation and RMSE (root mean square error) between model estimates and ILINet for four time periods: pre-H1N1, Summer H1N1, Winter H1N1, and H1N1 overall (Mar 2009–Dec 2009). We also compared the number of queries, query volume, and types of queries (e.g., influenza symptoms, influenza complications) in each model. Both models' estimates were highly correlated with ILINet pre-H1N1 and over the entire surveillance period, although the original model underestimated the magnitude of ILI activity during pH1N1. The updated model was more correlated with ILINet than the original model during Summer H1N1 (r = 0.95 and 0.29, respectively). The updated model included more search query terms than the original model, with more queries directly related to influenza infection, whereas the original model contained more queries related to influenza complications. Conclusions Internet search behavior changed during pH1N1, particularly in the categories “influenza complications” and “term for influenza.” The complications associated with pH1N1, the fact that pH1N1 began in the summer rather than winter, and changes in health-seeking behavior each may have played a part. Both GFT models performed well prior to and during pH1N1

  3. NovelH1N1inlfuenzaAvirusinfectioninapatient withacuterejectionafterlivertransplantation

    Jiang-Juan He; Sheng Yan; Min Zhang; Wei-Lin Wang; Shu-Sen Zheng


    BACKGROUND: The 2009 H1N1 inlfuenza A virus was ifrst identiifed in April 2009 and rapidly evolved into a pandemic. Recipients of solid-organ transplants have a higher risk for severe infection because of immunosuppression. There are limited reports of 2009 H1N1 inlfuenza in liver transplant recipients, especially in China. METHODS: We present a case of a 48-year-old male liver transplant recipient with 2009 H1N1 inlfuenza A virus. He received therapy for acute rejection after transplantation and was conifrmed with H1N1 virus infection. RESULTS:The patient was started on oseltamivir (75 mg, orally twice daily) and had a benign hospital course, with defervescence and resolution of symptoms within 72 hours. The follow-up chest radiograph after discharge was normal. CONCLUSIONS: The 2009 H1N1 inlfuenza in this hospitalized transplant recipient was relatively mild, and prolonged viral shedding was not noted. Oseltamivir can be a valid measure in immunocompromised individuals.

  4. H1N1 in dialysis units: Prevention and management

    Karkar Ayman


    Full Text Available Dialysis patients are at increased risk of contracting influenza A H1N1 and deve-loping serious illness. Increasing the awareness of dialysis patients and continuous education and training of medical staff on early recognition and management of influenza A H1N1 can help in saving the life of patients. Antiviral drugs and influenza vaccines are effective in providing ade-quate immunity in dialysis patients with strict implementation of infection control policies and procedures can help in preventing and controlling the dissemination of influenza A H1N1 in dia-lysis units. We report a case of a patient who presented with HINI influenza and developed acute kidney injury during his hospitalization and his course with disease.

  5. H1N1, globalization and the epidemiology of inequality.

    Sparke, Matthew; Anguelov, Dimitar


    This paper examines the lessons learned from the 2009 H1N1 pandemic in relation to wider work on globalization and the epidemiology of inequality. The media attention and economic resources diverted to the threats posed by H1N1 were significant inequalities themselves when contrasted with weaker responses to more lethal threats posed by other diseases associated with global inequality. However, the multiple inequalities revealed by H1N1 itself in 2009 still provide important insights into the future of global health in the context of market-led globalization. These lessons relate to at least four main forms of inequality: (1) inequalities in blame for the outbreak in the media; (2) inequalities in risk management; (3) inequalities in access to medicines; and (4) inequalities encoded in the actual emergence of new flu viruses.

  6. 1918 pandemic H1N1 DNA vaccine protects ferrets against 2007 H1N1 virus infection

    Bragstad, Karoline; Martel, Cyril Jean-Marie; Aasted, Bent

    of the H1N1 pandemic virus from 1918 induce protection in ferrets against infection with a H1N1 (A/New Caledonia/20/99(H1N1)) virus which was included in the conventional vaccine for the 2006-2007 season. The viruses are separated by a time interval of 89 years and differ by 21.2% in the HA1 protein......Influenza vaccines with the ability to induce immune responses cross-reacting with drifted virus variants would be of great advantage for vaccine development against seasonal and emerging new strains. We demonstrate that gene gun administrated DNA vaccine encoding HA and NA and/or NP and M proteins...

  7. Pneumococcal Pneumonia and Pandemic H1N1


    Dr. George Nelson, a CDC medical officer, discusses the relationship between pneumococcal pneumonia and Pandemic H1N1.  Created: 6/6/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/6/2012.

  8. H1N1 Message from the Acting Surgeon General


    In this podcast, Acting Surgeon General Dr. Steven Galson discusses what you can do to protect yourself from H1N1 flu.  Created: 5/13/2009 by U.S. Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC).   Date Released: 5/13/2009.

  9. Influenza A (H1N1) pneumonia: HRCT findings

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson, E-mail: [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); Zanetti, Glaucia [Escola de Medicina de Petropolis, RJ (Brazil); Hochhegger, Bruno [Santa Casa de Misericordia de Porto Alegre, RS (Brazil)


    Objective: to describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. Methods: we retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. Results: the most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. Conclusions: the most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or cranio caudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms. (author)

  10. H1N1 Influenza A hos mennesker og svin

    Larsen, Lars Erik


    Den nye pandemiske influenza A stamme H1N1 er hovedsagelig et nyt virus, som spredes mellem mennesker, men virusset er formodentlig opstået ved blanding af to svineinfluenza-virus og har derfor bibeholdt evnen til at kunne smitte fra mennesker til svin og fra svin til svin. Det er derfor vigtigt...

  11. H1N1 Influenza A hos mennesker og svin

    Larsen, Lars Erik


    Den nye pandemiske influenza A stamme H1N1 er hovedsagelig et nyt virus, som spredes mellem mennesker, men virusset er formodentlig opstået ved blanding af to svineinfluenza-virus og har derfor bibeholdt evnen til at kunne smitte fra mennesker til svin og fra svin til svin. Det er derfor vigtigt...

  12. H1N1 Flu and Antiviral Drugs


    This podcast discusses the use of antiviral drugs for treating and preventing the H1N1 flu virus.  Created: 5/2/2009 by Coordinating Center for Infectious Diseases, National Center for Immunization and Respiratory Diseases, Influenza Division (CCID/NCIRD/ID).   Date Released: 5/2/2009.

  13. Novel H1N1 Flu and Camp


    This podcast gives tips to stay healthy and help prevent infection with novel H1N1 flu if your child or someone you know is going to camp.  Created: 6/30/2009 by Centers for Disease Control and Prevention (CDC).   Date Released: 6/30/2009.

  14. Pandemic (H1N1) 2009 in captive cheetah.

    Crossley, Beate; Hietala, Sharon; Hunt, Tania; Benjamin, Glenn; Martinez, Marie; Darnell, Daniel; Rubrum, Adam; Webby, Richard


    We describe virus isolation, full genome sequence analysis, and clinical pathology in ferrets experimentally inoculated with pandemic (H1N1) 2009 virus recovered from a clinically ill captive cheetah that had minimal human contact. Evidence of reverse zoonotic transmission by fomites underscores the substantial animal and human health implications of this virus.

  15. Narcolepsy and H1N1 Influenza Vaccination

    J Gordon Millichap


    Full Text Available The incidence of narcolepsy between January 2000 and December 2010 in children in western Sweden and its relation to the Pandemrix H1N1 influenza vaccination were assessed by collection of data from hospital and clinic medical records and by parent telephone interviews.

  16. Stay Informed About Novel H1N1 Influenza


    This podcast discusses things you can do everyday to avoid getting sick from infectious diseases, such as the novel H1N1 flu.  Created: 5/4/2009 by National Center for Health Marketing.   Date Released: 5/4/2009.

  17. Mensajes importantes sobre la influenza H1N1: Higiene (H1N1 Flu Awareness: Hygiene)


    Este podcast aborda brevemente las formas de protegerse contra el virus nuevo de la influenza H1N1.  Created: 5/6/2009 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/6/2009.

  18. Mensajes importantes sobre la influenza H1N1: Comunidad (H1N1 Flu Awareness: Community)


    Este podcast aborda brevemente los planes de la comunidad frente al brote del virus nuevo de la influenza H1N1.  Created: 5/6/2009 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/6/2009.

  19. Influenza A (H1N1) 2009: a pandemic alarm

    Madhu Khanna; Neha Gupta; Ankit Gupta; V K Vijayan


    At this critical juncture when the world has not yet recovered from the threat of avian influenza, the virus has returned in the disguise of swine influenza, a lesser known illness common in pigs. It has reached pandemic proportions in a short time span with health personnel still devising ways to identify the novel H1N1 virus and develop vaccines against it. The H1N1 virus has caused a considerable number of deaths within the short duration since its emergence. Presently, there are no effective methods to contain this newly emerged virus. Therefore, a proper and clear insight is urgently required to prevent an outbreak in the future and make preparations that may be planned well in advance. This review is an attempt to discuss the historical perspective of the swine flu virus, its epidemiology and route of transmission to better understand the various control measures that may be taken to fight the danger of a global pandemic.

  20. Influenza A pandemic (H1N1) 2009 virus infection

    BAI Lu; CAO Bin; WANG Chen


    The clinical spectrum of the 2009 pandemic influenza A (H1N1) infection ranged from self-limited mild illness to progressive pneumonia,or even a fatal outcome.We summarize the clinical manifestations,risk factors for severe and fatal cases,pathologic findings and treatment of this disease in this paper based on current reports from different regions of the world.

  1. Spread of H1N1 within Households


    This podcast describes an investigation into how H1N1 was spreading within households during the initial days of the pandemic in Texas. CDC's Dr. Oliver Morgan discusses what investigators learned about the role that children played in introducing the virus into households and spreading flu.  Created: 3/29/2010 by Emerging Infectious Diseases.   Date Released: 3/29/2010.

  2. Illinois department of public health H1N1/A pandemic communications evaluation survey.

    Walsh, D.; Decision and Information Sciences


    Because of heightened media coverage, a 24-hour news cycle and the potential miscommunication of health messages across all levels of government during the onset of the H1N1 influenza outbreak in spring 2009, the Illinois Department of Public Health (IDPH) decided to evaluate its H1N1 influenza A communications system. IDPH wanted to confirm its disease information and instructions were helping stakeholders prepare for and respond to a novel influenza outbreak. In addition, the time commitment involved in preparing, issuing, monitoring, updating, and responding to H1N1 federal guidelines/updates and media stories became a heavy burden for IDPH staff. The process and results of the H1N1 messaging survey represent a best practice that other health departments and emergency management agencies can replicate to improve coordination efforts with stakeholder groups during both emergency preparedness and response phases. Importantly, the H1N1 survey confirmed IDPH's messages were influencing stakeholders decisions to activate their pandemic plans and initiate response operations. While there was some dissatisfaction with IDPH's delivery of information and communication tools, such as the fax system, this report should demonstrate to IDPH that its core partners believe it has the ability and expertise to issue timely and accurate instructions that can help them respond to a large-scale disease outbreak in Illinois. The conclusion will focus on three main areas: (1) the survey development process, (2) survey results: best practices and areas for improvement and (3) recommendations: next steps.

  3. Evolutionary pathways of the pandemic influenza A (H1N1 2009 in the UK.

    Monica Galiano

    Full Text Available The emergence of the influenza (H1N1 2009 virus provided a unique opportunity to study the evolution of a pandemic virus following its introduction into the human population. Virological and clinical surveillance in the UK were comprehensive during the first and second waves of the pandemic in 2009, with extensive laboratory confirmation of infection allowing a detailed sampling of representative circulating viruses. We sequenced the complete coding region of the haemagglutinin (HA segment of 685 H1N1 pandemic viruses selected without bias during two waves of pandemic in the UK (April-December 2009. Phylogenetic analysis showed that although temporal accumulation of amino acid changes was observed in the HA sequences, the overall diversity was less than that typically seen for seasonal influenza A H1N1 or H3N2. There was co-circulation of multiple variants as characterised by signature amino acid changes in the HA. A specific substitution (S203T became predominant both in UK and global isolates. No antigenic drift occurred during 2009 as viruses with greater than four-fold reduction in their haemagglutination inhibition (HI titre ("low reactors" were detected in a low proportion (3% and occurred sporadically. Although some limited antigenic divergence in viruses with four-fold reduction in HI titre might be related to the presence of 203T, additional studies are needed to test this hypothesis.

  4. Two Years after Pandemic Influenza A/2009/H1N1: What Have We Learned?

    Cheng, Vincent C. C.; To, Kelvin K. W.; Tse, Herman; Hung, Ivan F. N.


    Summary: The world had been anticipating another influenza pandemic since the last one in 1968. The pandemic influenza A H1N1 2009 virus (A/2009/H1N1) finally arrived, causing the first pandemic influenza of the new millennium, which has affected over 214 countries and caused over 18,449 deaths. Because of the persistent threat from the A/H5N1 virus since 1997 and the outbreak of the severe acute respiratory syndrome (SARS) coronavirus in 2003, medical and scientific communities have been more prepared in mindset and infrastructure. This preparedness has allowed for rapid and effective research on the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the disease, with impacts on its control. A PubMed search using the keywords “pandemic influenza virus H1N1 2009” yielded over 2,500 publications, which markedly exceeded the number published on previous pandemics. Only representative works with relevance to clinical microbiology and infectious diseases are reviewed in this article. A significant increase in the understanding of this virus and the disease within such a short amount of time has allowed for the timely development of diagnostic tests, treatments, and preventive measures. These findings could prove useful for future randomized controlled clinical trials and the epidemiological control of future pandemics. PMID:22491771

  5. Prediction of the epidemic trends of pandemic H1N1 2009, using SEIR model%应用SEIR模型预测2009年甲型H1N1流感流行趋势

    王小莉; 曹志冬; 曾大军; 杨鹏; 张奕; 钱海坤; 田丽丽; 黎新宇; 王全意


    目的 探讨SEIR模型预测甲型H1N1流感流行趋势的功效.方法 利用国庆前北京市流感样病例数、流感样病例中甲型H1N1流感阳性率及二级以上医院流感样病例就诊率等参数估算甲型H1N1流感实际感染人数,基于传染病传播动力学,建立SEIR模型,对国庆后甲型H1N1流感的流行趋势及高峰达到时间进行预测,与甲型H1N1流感病原学监测结果进行比较,评价模型的预测效果.结果 经SEIR模型估算,2009年北京市甲型H1N1流感的平均潜伏期约为1.51天,平均感染期为2.12天,基本再生数为1.28.病原学监测结果显示:2009年甲型H1N1流感于11月初达到高峰,而SEIR模型预测2009年甲型H1N1流感最晚将于12月4日达到高峰.结论 SEIR模型可根据流感流行的初期监测数据预测其未来流行趋势.%Objective To explore the efficiency of SEIR model(susceptible,exposed,infectious and recovered model) for predicting the trend of pandemic H1N1 2008.Methods Data of the number of influenza-like illness cases(ILIs),pandemic influenza A (H1N1) 2009 positive rate among ILIs and rate on clinical visit of ILIs before National Day ( October 1 ) were collected and analyzed to develop SEIR model for predicting the trend of pandemic H1N1 2009 after National Day,based on dynamics of infectious disease transmission.The results were compared with the results from and pandemic H1N1 2009 virologic surveillance data to evaluate the efficiency of SEIR model.Results The mean incubation period of pandemic H1N1 2009 was estimated 1.51 days,with a mean duration of infectiousness of 2.12 days,and a mean basic reproductive number of 1.28.As shown in the virologic surveillance data,pandemic H1N1 2009 peaked in early November.However,SEIR model predicted that pandemic H1N1 2009 would peak no later than December 4th.Conclusion SEIR model could be developed to predict the trend of pandemic influenza based on the early surveillance data.

  6. Underreporting of 2009 H1N1 Influenza Cases


    Influenza cases are difficult to track because many people don't go to the doctor or get tested for flu when they're sick. The first months of the 2009 H1N1 influenza pandemic were no different. In this podcast, CDC's Dr. Carrie Reed discusses a study in the December issue of Emerging Infectious Diseases that looked at the actual number of cases reported and estimated the true number of cases when correcting for underreporting.  Created: 12/8/2009 by Emerging Infectious Diseases.   Date Released: 12/8/2009.

  7. Subsisting H1N1 influenza memory responses are insufficient to protect from pandemic H1N1 influenza challenge in C57BL/6 mice

    Sage, Leo K.; Fox, Julie M.; Tompkins, Stephen M.; Ralph A. Tripp


    The 2009 swine-origin pandemic H1N1 (pH1N1) influenza virus transmitted and caused disease in many individuals immune to pre-2009 H1N1 influenza virus. Whilst extensive studies on antibody-mediated pH1N1 cross-reactivity have been described, few studies have focused on influenza-specific memory T-cells. To address this, the immune response in pre-2009 H1N1 influenza-immune mice was evaluated after pH1N1 challenge and disease pathogenesis was determined. The results show that despite homology ...

  8. Modified vaccinia virus Ankara expressing the hemagglutinin of pandemic (H1N1) 2009 virus induces cross-protective immunity against Eurasian 'avian-like' H1N1 swine viruses in mice.

    Castrucci, Maria R; Facchini, Marzia; Di Mario, Giuseppina; Garulli, Bruno; Sciaraffia, Ester; Meola, Monica; Fabiani, Concetta; De Marco, Maria A; Cordioli, Paolo; Siccardi, Antonio; Kawaoka, Yoshihiro; Donatelli, Isabella


    To examine cross-reactivity between hemagglutinin (HA) derived from A/California/7/09 (CA/09) virus and that derived from representative Eurasian "avian-like" (EA) H1N1 swine viruses isolated in Italy between 1999 and 2008 during virological surveillance in pigs. Modified vaccinia virus Ankara (MVA) expressing the HA gene of CA/09 virus (MVA-HA-CA/09) was used as a vaccine to investigate cross-protective immunity against H1N1 swine viruses in mice. Two classical swine H1N1 (CS) viruses and four representative EA-like H1N1 swine viruses previously isolated during outbreaks of respiratory disease in pigs on farms in Northern Italy were used in this study. Female C57BL/6 mice were vaccinated with MVA/HA/CA/09 and then challenged intranasally with H1N1 swine viruses. Cross-reactive antibody responses were determined by hemagglutination- inhibition (HI) and virus microneutralizing (MN) assays of sera from MVA-vaccinated mice. The extent of protective immunity against infection with H1N1 swine viruses was determined by measuring lung viral load on days 2 and 4 post-challenge. Systemic immunization of mice with CA/09-derived HA, vectored by MVA, elicited cross-protective immunity against recent EA-like swine viruses. This immune protection was related to the levels of cross-reactive HI antibodies in the sera of the immunized mice and was dependent on the similarity of the antigenic site Sa of H1 HAs. Our findings suggest that the herd immunity elicited in humans by the pandemic (H1N1) 2009 virus could limit the transmission of recent EA-like swine HA genes into the influenza A virus gene pool in humans. © 2013 The Authors Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  9. Pandemic (H1N1 influenza in Diyarbakir, 2009

    Meliksah Ertem


    Full Text Available  Objective: This study was conducted to evaluate the pandemic (H1N1 influenza outbreak in 2009. Method: Influenza like illness (ILI cases were reported between the 36th to 53rd weeks of the pandemic, from all health centres. 731 nasopharyngeal swabs were collected from ILI cases. Results: The first H1N1 confirmed case was reported at the 36th week and an increasing trend continued. At the 43rd week the outbreak reached its maximum level and at the 53rd week the level had decreased to the level at the start. During the outbreak 31117 cases were reported as ILI and 635 cases were hospitalized (hospitalization rate was 2.0% and 17 H1N1 laboratory confirmed cases died (mortality rate 11.5/1.000.000. Symptoms of laboratory confirmed cases were similar to seasonal influenza. Coughing (90.9%, fever (84.5%, running nose (69.5%, headache (73.4%, diarrhoea (17.5% were the some of the symptoms in laboratory confirmed cases. The median interval between the onset of symptoms and hospital admission was 3.5 days (min: 1, max: 11 days and this was 7.5 days for the occurrence of death. Conclusion: During 36th to 53rd week an important outbreak of ILI was occurred. The mortality rate was not so high as expected but the infectivity was high. The delay for hospital admission may lead to higher mortality particularly for pregnant women.Key Words: Pandemic influenza; H1N1; case fatality rate; hospitalization rateDiyarbakır’da pandemik (H1N1 influenza, 2009Amaç: Bu çalışmada 2009 yılında -Türkiye’de pandemik influenza salgınını değerlendirmek amaçlanmıştır. Yöntem: Diyarbakır ’da 36 ve 53. haftalar arasında tüm sağlık kuruluşlarından influenza benzeri hastalık rapor edilmiştir. 731 nazofaringeal sürüntü alınmıştır. Bulgular: İlk H1N1 doğrulanmış vaka 36.haftada rapor edilmiştir ve vaka sayıları zaman içinde artış göstermiştir. 43. haftada salgın başlamış ve 53. haftada başlangıç düzeyine inmiştir.Salgın s

  10. H1N1: pandemia e perspectiva atual


    O vírus influenza de origem suína, A/California/04/2009 (H1N1), foi inicialmente detectado no México e determinou a pandemia de influenza de 2009. Em agosto de 2010, a Organização Mundial da Saúde (OMS) declarou o início da fase pós-pandêmica. As características dessa última pandemia foram marcadamente diferentes das anteriores. O vírus emergiu de rearranjos genéticos originários em hospedeiro mamífero não humano, demonstrou transmissibilidade interespécies e afetou a população humana de form...

  11. Protective efficacy of an inactivated Eurasian avian-like H1N1 swine influenza vaccine against homologous H1N1 and heterologous H1N1 and H1N2 viruses in mice.

    Sui, Jinyu; Yang, Dawei; Qiao, Chuanling; Xu, Huiyang; Xu, Bangfeng; Wu, Yunpu; Yang, Huanliang; Chen, Yan; Chen, Hualan


    Eurasian avian-like H1N1 (EA H1N1) swine influenza viruses are prevalent in pigs in Europe and Asia, but occasionally cause human infection, which raises concern about their pandemic potential. Here, we produced a whole-virus inactivated vaccine with an EA H1N1 strain (A/swine/Guangxi/18/2011, SW/GX/18/11) and evaluated its efficacy against homologous H1N1 and heterologous H1N1 and H1N2 influenza viruses in mice. A strong humoral immune response, which we measured by hemagglutination inhibition (HI) and virus neutralization (VN), was induced in the vaccine-inoculated mice upon challenge. The inactivated SW/GX/18/11 vaccine provided complete protection against challenge with homologous SW/GX/18/11 virus in mice and provided effective protection against challenge with heterologous H1N1 and H1N2 viruses with distinctive genomic combinations. Our findings suggest that this EA H1N1 vaccine can provide protection against both homologous H1N1 and heterologous H1N1 or H1N2 virus infection. As such, it is an excellent vaccine candidate to prevent H1N1 swine influenza.

  12. Experimental infection with H1N1 European swine influenza virus protects pigs from an infection with the 2009 pandemic H1N1 human influenza virus.

    Busquets, Núria; Segalés, Joaquim; Córdoba, Lorena; Mussá, Tufaria; Crisci, Elisa; Martín-Valls, Gerard E; Simon-Grifé, Meritxell; Pérez-Simó, Marta; Pérez-Maíllo, Monica; Núñez, Jose I; Abad, Francesc X; Fraile, Lorenzo; Pina, Sonia; Majó, Natalia; Bensaid, Albert; Domingo, Mariano; Montoya, María


    The recent pandemic caused by human influenza virus A(H1N1) 2009 contains ancestral gene segments from North American and Eurasian swine lineages as well as from avian and human influenza lineages. The emergence of this A(H1N1) 2009 poses a potential global threat for human health and the fact that it can infect other species, like pigs, favours a possible encounter with other influenza viruses circulating in swine herds. In Europe, H1N1, H1N2 and H3N2 subtypes of swine influenza virus currently have a high prevalence in commercial farms. To better assess the risk posed by the A(H1N1) 2009 in the actual situation of swine farms, we sought to analyze whether a previous infection with a circulating European avian-like swine A/Swine/Spain/53207/2004 (H1N1) influenza virus (hereafter referred to as SwH1N1) generated or not cross-protective immunity against a subsequent infection with the new human pandemic A/Catalonia/63/2009 (H1N1) influenza virus (hereafter referred to as pH1N1) 21 days apart. Pigs infected only with pH1N1 had mild to moderate pathological findings, consisting on broncho-interstitial pneumonia. However, pigs inoculated with SwH1N1 virus and subsequently infected with pH1N1 had very mild lung lesions, apparently attributed to the remaining lesions caused by SwH1N1 infection. These later pigs also exhibited boosted levels of specific antibodies. Finally, animals firstly infected with SwH1N1 virus and latter infected with pH1N1 exhibited undetectable viral RNA load in nasal swabs and lungs after challenge with pH1N1, indicating a cross-protective effect between both strains.

  13. Influenza A (H1N1. Radiological Patterns Influenza A (H1N1. Patrones Radiológicos

    Martha Yudey Rodriguez Pino


    Full Text Available The influenza A (H1N1 has a wide radiological spectrum, difficult to differentiate from other epidemic respiratory diseases. One of the distinctive elements seems to be the quick evolution of the imagenologic lesions in the sick persons, as well as the slow resolution of these manifestations. The chest fillm is of vital importance to make a precise diagnosis, and it constitutes an indispensable tool for the identification of the cases according to the affection degree (light, moderate, and severe, besides contributing as an essential way to the classification of the patients according to a grade of uncertainty. Although as a confirmation complementary is not definitive, it is important in defining if a case is suspicious or probable.La influenza A (H1N1 tiene un espectro radiológico amplio, difícil de diferenciar de otras enfermedades respiratorias no epidémicas. Uno de los elementos distintivos parece estar en relación con la rápida evolución de las lesiones imagenológicas en los enfermos afectados, así como la lenta resolución de estas manifestaciones. La radiografía de tórax es de vital importancia para hacer un diagnóstico preciso, constituye una herramienta indispensable para la notificación de los casos según el grado de afección (leve, moderada, severa, además de contribuir de manera esencial a la clasificación de los pacientes según el grado de incertidumbre pues, aunque no es un complementario confirmatorio, sí es importante a la hora de definir si un caso es sospechoso o probable.

  14. Fatal acute myocarditis and fulminant hepatic failure in an infant with pandemic human influenza A, H1N1 (2009) virus infection

    Mortada H.F. El-Shabrawi; Bazaraa, Hafez M; Hanan Zekri; Hanaa I. Rady


    We report the clinical presentation of a 10 month-old infant who succumbed with acute myocarditis and fulminant hepatic failure associated with a virologically confirmed human influenza A, H1N1 (2009) virus infection. To date, this is the first pediatric patient presenting with this fatal combination of complications during the current H1N1 pandemic. Therefore, we recommend meticulous assessment and follow up of the cardiac status, liver enzymes and coagulation profile in all pediatric patien...

  15. Fatal acute myocarditis and fulminant hepatic failure in an infant with pandemic human influenza A, H1N1 (2009 virus infection

    Mortada H.F. El-Shabrawi


    Full Text Available We report the clinical presentation of a 10 month-old infant who succumbed with acute myocarditis and fulminant hepatic failure associated with a virologically confirmed human influenza A, H1N1 (2009 virus infection. To date, this is the first pediatric patient presenting with this fatal combination of complications during the current H1N1 pandemic. Therefore, we recommend meticulous assessment and follow up of the cardiac status, liver enzymes and coagulation profile in all pediatric patients with severe H1N1 influenza infection.

  16. Novel virus influenza A (H1N1sw in South-Eastern France, April-August 2009.

    Antoine Nougairède

    Full Text Available BACKGROUND: In April 2009, the first cases of pandemic (H1N1-2009 influenza [H1N1sw] virus were detected in France. Virological surveillance was undertaken in reference laboratories of the seven French Defence Zones. METHODOLOGY/PRINCIPAL FINDINGS: We report results of virological analyses performed in the Public Hospitals of Marseille during the first months of the outbreak. (i Nasal swabs were tested using rapid influenza diagnostic test (RIDT and two RT-PCR assays. Epidemiological characteristics of the 99 first suspected cases were analyzed, including detection of influenza virus and 18 other respiratory viruses. During three months, a total of 1,815 patients were tested (including 236 patients infected H1N1sw virus and distribution in age groups and results of RIDT were analyzed. (ii 600 sera received before April 2009 and randomly selected from in-patients were tested by a standard hemagglutination inhibition assay for antibody to the novel H1N1sw virus. (iii One early (May 2009 and one late (July 2009 viral isolates were characterized by sequencing the complete hemagglutinine and neuraminidase genes. (iiii Epidemiological characteristics of a cluster of cases that occurred in July 2009 in a summer camp were analyzed. CONCLUSIONS/SIGNIFICANCE: This study presents new virological and epidemiological data regarding infection by the pandemic A/H1N1 virus in Europe. Distribution in age groups was found to be similar to that previously reported for seasonal H1N1. The first seroprevalence data made available for a European population suggest a previous exposure of individuals over 40 years old to influenza viruses antigenically related to the pandemic (H1N1-2009 virus. Genomic analysis indicates that strains harbouring a new amino-acid pattern in the neuraminidase gene appeared secondarily and tended to supplant the first strains. Finally, in contrast with previous reports, our data support the use of RIDT for the detection of infection in

  17. The progress of research on influenza A(H1N1)%甲型H1N1流感的研究进展

    雷晓燕; 孙永红


    Influenza A(H1N1)virus is a re-mixed strains of human influenza virus genes,avian influenza virus gene and swine influenza virus gene.Influenza A(H1N1)pandemic influenza has spread around the world,which has drawn worldwide attention.In order to early discovery,early diagnosis,early treatment and effective prevention of Influenza A(H1N1),we describe the characteristics of linfluenza A(H1N1)virus,epidemiology,pathogenesis,clinical manifestations,laboratory examination and effective treatment and preventive measures.%甲型H1N1流感病毒是人流感病毒基因、禽流感病毒基因和猪流感病毒基因混合的重配株,其造成的疫情来势凶猛,引起世界各国的广泛关注.为了早发现、早诊断、早治疗及有效地预防甲型H1N1流感,本文综述了甲型H1N1流感病毒的特点、流行病学、致人发病的机制、甲型H1N1流感患者的临床表现、实验室检查及有效的治疗和预防措施.

  18. Factors Influencing School Closure and Dismissal Decisions: Influenza A (H1N1), Michigan 2009

    Dooyema, Carrie A.; Copeland, Daphne; Sinclair, Julie R.; Shi, Jianrong; Wilkins, Melinda; Wells, Eden; Collins, Jim


    Background: In fall 2009, many US communities experienced school closures during the influenza A H1N1 pandemic (pH1N1) and the state of Michigan reported 567 closures. We conducted an investigation in Michigan to describe pH1N1-related school policies, practices, and identify factors related to school closures. Methods: We distributed an online…

  19. Protection of mice against lethal challenge with 2009 H1N1 influenza A virus by 1918-like and classical swine H1N1 based vaccines.

    Balaji Manicassamy


    Full Text Available The recent 2009 pandemic H1N1 virus infection in humans has resulted in nearly 5,000 deaths worldwide. Early epidemiological findings indicated a low level of infection in the older population (>65 years with the pandemic virus, and a greater susceptibility in people younger than 35 years of age, a phenomenon correlated with the presence of cross-reactive immunity in the older population. It is unclear what virus(es might be responsible for this apparent cross-protection against the 2009 pandemic H1N1 virus. We describe a mouse lethal challenge model for the 2009 pandemic H1N1 strain, used together with a panel of inactivated H1N1 virus vaccines and hemagglutinin (HA monoclonal antibodies to dissect the possible humoral antigenic determinants of pre-existing immunity against this virus in the human population. By hemagglutinination inhibition (HI assays and vaccination/challenge studies, we demonstrate that the 2009 pandemic H1N1 virus is antigenically similar to human H1N1 viruses that circulated from 1918-1943 and to classical swine H1N1 viruses. Antibodies elicited against 1918-like or classical swine H1N1 vaccines completely protect C57B/6 mice from lethal challenge with the influenza A/Netherlands/602/2009 virus isolate. In contrast, contemporary H1N1 vaccines afforded only partial protection. Passive immunization with cross-reactive monoclonal antibodies (mAbs raised against either 1918 or A/California/04/2009 HA proteins offered full protection from death. Analysis of mAb antibody escape mutants, generated by selection of 2009 H1N1 virus with these mAbs, indicate that antigenic site Sa is one of the conserved cross-protective epitopes. Our findings in mice agree with serological data showing high prevalence of 2009 H1N1 cross-reactive antibodies only in the older population, indicating that prior infection with 1918-like viruses or vaccination against the 1976 swine H1N1 virus in the USA are likely to provide protection against the 2009

  20. Co-circulation of pandemic 2009 H1N1, classical swine H1N1 and avian-like swine H1N1 influenza viruses in pigs in China.

    Chen, Yan; Zhang, Jian; Qiao, Chuanling; Yang, Huanliang; Zhang, Ying; Xin, Xiaoguang; Chen, Hualan


    The pandemic A/H1N1 influenza viruses emerged in both Mexico and the United States in March 2009, and were transmitted efficiently in the human population. They were transmitted occasionally from humans to other mammals including pigs, dogs and cats. In this study, we report the isolation and genetic analysis of novel viruses in pigs in China. These viruses were related phylogenetically to the pandemic 2009 H1N1 influenza viruses isolated from humans and pigs, which indicates that the pandemic virus is currently circulating in swine populations, and this hypothesis was further supported by serological surveillance of pig sera collected within the same period. Furthermore, we isolated another two H1N1 viruses belonging to the lineages of classical swine H1N1 virus and avian-like swine H1N1 virus, respectively. Multiple genetic lineages of H1N1 viruses are co-circulating in the swine population, which highlights the importance of intensive surveillance for swine influenza in China.

  1. Transcriptomics and Proteomics in the Study of H1N1 2009

    Lijun Zhang; Xiaojun Zhang; Qing Ma; Fang Ma; Honghao Zhou


    Influenza A virus (HINI) 2009, a new swine-origin influenza A virus, has been spread worldwidely and causedgreat public fear. High-throughput transcriptomics and proteomies methods are now being used to identify H1N1and H1N1-host interaction. This article reviews recent transcriptomics and proteomics research in H1N1 diagnosis,treatment, and H1N1 virus-host interaction, to offer some help for further understanding the infection mechanismand controlling H1N1 transmission.

  2. Influenza virus A(H1N1)2009 antibody-dependent cellular cytotoxicity in young children prior to the H1N1 pandemic.

    Mesman, Annelies W; Westerhuis, Brenda M; Ten Hulscher, Hinke I; Jacobi, Ronald H; de Bruin, Erwin; van Beek, Josine; Buisman, Annemarie M; Koopmans, Marion P; van Binnendijk, Robert S


    Pre-existing immunity played a significant role in protection during the latest influenza A virus H1N1 pandemic, especially in older age groups. Structural similarities were found between A(H1N1)2009 and older H1N1 virus strains to which humans had already been exposed. Broadly cross-reactive antibodies capable of neutralizing the A(H1N1)2009 virus have been implicated in this immune protection in adults. We investigated the serological profile of a group of young children aged 9 years (n=55), from whom paired blood samples were available, just prior to the pandemic wave (March 2009) and shortly thereafter (March 2010). On the basis of A(H1N1)2009 seroconversion, 27 of the 55 children (49 %) were confirmed to be infected between these two time points. Within the non-infected group of 28 children (51 %), high levels of seasonal antibodies to H1 and H3 HA1 antigens were detected prior to pandemic exposure, reflecting past infection with H1N1 and H3N2, both of which had circulated in The Netherlands prior to the pandemic. In some children, this reactivity coincided with specific antibody reactivity against A(H1N1)2009. While these antibodies were not able to neutralize the A(H1N1)2009 virus, they were able to mediate antibody-dependent cellular cytotoxicity (ADCC) in vitro upon interaction with the A(H1N1)2009 virus. This finding suggests that cross-reactive antibodies could contribute to immune protection in children via ADCC.

  3. H1N1 influenza A virus neuraminidase modulates infectivity in mice.

    Ferraris, Olivier; Escuret, Vanessa; Bouscambert, Maude; Casalegno, Jean-Sébastien; Jacquot, Frédéric; Raoul, Hervé; Caro, Valérie; Valette, Martine; Lina, Bruno; Ottmann, Michèle


    In the 2years since the onset of the H1N1 2009 pandemic virus (H1N1pdm09), sporadic cases of oseltamivir-resistant viruses have been reported. We investigated the impact of oseltamivir-resistant neuraminidase from H1N1 Brisbane-like (seasonal) and H1N1pdm09 viruses on viral pathogenicity in mice. Reassortant viruses with the neuraminidase from seasonal H1N1 virus were obtained by co-infection of a H1N1pdm09 virus and an oseltamivir-resistant H1N1 Brisbane-like virus. Oseltamivir-resistant H1N1pdm09 viruses were also isolated from patients. After biochemical characterization, the pathogenicity of these viruses was assessed in a murine model. We confirmed a higher infectivity, in mice, of the H1N1pdm09 virus compared to seasonal viruses. Surprisingly, the oseltamivir-resistant H1N1pdm09 virus was more infectious than its sensitive counterpart. Moreover, the association of H1N1pdm09 hemagglutinin and an oseltamivir-resistant neuraminidase improved the infectivity of reassortant viruses in mice, regardless of the NA origin: seasonal (Brisbane-like) or pandemic strain. This study highlights the need to closely monitor the emergence of oseltamivir-resistant viruses. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Vitamin D Levels, Natural H1N1 Infection and Response to H1N1 Vaccine among HIV-Infected Individuals.

    Momplaisir, Florence; Frank, Ian; Meyer, Wa; Kim, Deborah; Kappes, Rosemary; Tebas, Pablo


    BACKGROUND: Beyond its role in calcium homeostasis, vitamin D plays a critical role in immunological responses to pathogens. We evaluated the relationship between 25-OH vitamin D levels and susceptibility to natural H1N1 infection and H1N1 vaccine responses in HIV infected individuals. METHODS: This was a sub study of an H1N1 vaccine trial conducted at the University of Pennsylvania in 2009/10. We compared the 25-OH vitamin D levels among individuals with and without baseline evidence of prior H1N1 infection and between vaccine responders and non-responders. RESULTS: 120 participants enrolled in the trial, 71% male, 68% African American, median age 46 years. The majority had controlled HIV disease. At baseline, 86% had 25-OH vitamin D levels < 30 ng/ml and 54% had levels < 20 ng/ml. Thirty participants (25%) had evidence of prior H1N1 exposure. There was no difference in mean 25-OH vitamin D levels among patients with or without prior natural H1N1 infection (21 ng/ml vs 20 ng/ml, p=0.72). Among participants without previous H1N1 exposure, only 61% developed protective antibody titers following vaccination. 25-OH vitamin D levels were similar between vaccine responders (20 ng/ml) and non-responders (20 ng/ml) (p=0.83). CONCLUSION: Although 25-OH vitamin D deficiency was very common among HIV-infected individuals, it was not associated with natural susceptibility to H1N1 or to vaccine responses.

  5. Genetic correlation between current circulating H1N1 swine and human influenza viruses.

    Lu, Lu; Yin, Yanbo; Sun, Zhongsheng; Gao, Lei; Gao, George F; Liu, Sidang; Sun, Lei; Liu, Wenjun


    H1N1 is the main subtype influenza A virus circulating in human and swine population, and has long been a threat to economy and public health. To explore the genetic correlation between current circulating H1N1 swine and human influenza viruses. Three new H1N1 swine influenza viruses (SIVs) were isolated and genomes sequencing were conducted followed by phylogenetic and molecular analysis of all swine and human H1N1 influenza viruses isolated in China in the past five years. Homology and phylogenetic analysis revealed that the three isolates possessed different characteristics: the genome of A/Swine/Shandong/1112/2008 was closely related to that of classical H1N1 SIV, while A/Swine/Shandong/1123/2008 was a reassortant with NS gene from the human-like H3N2 influenza virus and other genes from the classical H1N1 SIV, and A/Swine/Fujian/0325/2008 fell into a lineage of seasonal human H1N1 influenza viruses. Genetically, 2009 H1N1 influenza A viruses (2009 H1N1) in China were contiguous to the SIV lineages rather than the seasonal H1N1 human influenza virus's lineage. Furthermore, molecular analysis among human and swine influenza viruses provided more detail information for understanding their genetic correlation. These results suggested that in China in the past five years, the classical, avian-like and human-like H1N1 SIV existed in swine herds and the reassortment between H1N1 swine and H3N2 human influenza viruses was identified. In addition, the present data showed no evidence to support a strong correlation between the 2009 H1N1 and the swine influenza virus circulating in China. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Research progress of severe influenza A H1N1%重症甲型H1N1流感研究进展

    王涛; 高占成


    甲型H1N1流感最新疫情的突出特点是重症和死亡病例数显著增加,有关我国重症甲型H1N1流感患者的临床特征、预后、危险因素等方面的研究尚未见相关报道.本文拟对国外有关这方面的研究进行总结,为我国重症甲型H1N1流感的诊断及治疗提供借鉴.%The latest epidemic of influenza A H1N1 is characterized by the significant increase of severe and dead cases. The researches about clinical features, prognosis, risk factors and other aspects of Chinese patients with severe influenza A H1N1 have not been reported. This paper is to summarize foreign researches and provide a reference for the diagnosis and treatment of severe influenza A H1N1 in China.

  7. Predicting H1N1 vaccine uptake and H1N1-related health beliefs: the role of individual difference in consideration of future consequences.

    Nan, Xiaoli; Kim, Jarim


    This research examines the influence of individual difference in consideration of future consequences on H1N1 vaccine uptake and H1N1-related health beliefs (i.e., perceived susceptibility to and severity of the H1N1 flu, perceived efficacy and safety of the H1N1 vaccine, and perceived self-efficacy in obtaining the H1N1 vaccine). A survey of 411 college students showed that consideration of future consequences had no direct effect on vaccine uptake, but higher consideration of future consequences was associated with greater perceived severity of the flu, higher perceived effectiveness of the vaccine, and greater perceived self-efficacy. Additional analysis suggested that consideration of future consequences had a significant indirect effect on vaccine uptake through perceived vaccine efficacy. Results of the study also revealed gender and racial differences in some of the H1N1-related health beliefs. Implications of the findings for vaccine risk communication are discussed.

  8. North American triple reassortant and Eurasian H1N1 swine influenza viruses do not readily reassort to generate a 2009 pandemic H1N1-like virus.

    Ma, Wenjun; Liu, Qinfang; Qiao, Chuanling; del Real, Gustavo; García-Sastre, Adolfo; Webby, Richard J; Richt, Jürgen A


    The 2009 pandemic H1N1 virus (pH1N1) was derived through reassortment of North American triple reassortant and Eurasian avian-like swine influenza viruses (SIVs). To date, when, how and where the pH1N1 arose is not understood. To investigate viral reassortment, we coinfected cell cultures and a group of pigs with or without preexisting immunity with a Eurasian H1N1 virus, A/Swine/Spain/53207/2004 (SP04), and a North American triple reassortant H1N1 virus, A/Swine/Kansas/77778/2007 (KS07). The infected pigs were cohoused with one or two groups of contact animals to investigate viral transmission. In coinfected MDCK or PK15 continuous cell lines with KS07 and SP04 viruses, more than 20 different reassortant viruses were found. In pigs without or with preexisting immunity (immunized with commercial inactivated swine influenza vaccines) and coinfected with both viruses, six or seven reassortant viruses, as well as the parental viruses, were identified in bronchoalveolar lavage fluid samples from the lungs. Interestingly, only one or two viruses transmitted to and were detected in contact animals. No reassortant containing a gene constellation similar to that of pH1N1 virus was found in either coinfected cells or pigs, indicating that the reassortment event that resulted in the generation of this virus is a rare event that likely involved specific viral strains and/or a favorable, not-yet-understood environment. IMPORTANCE The 2009 pandemic-like H1N1 virus could not be reproduced either in cell cultures or in pigs coinfected with North American triple reassortant H1N1 and Eurasian H1N1 swine influenza viruses. This finding suggests that the generation of the 2009 pandemic H1N1 virus by reassortment was a rare event that likely involved specific viral strains and unknown factors. Different reassortant viruses were detected in coinfected pigs with and without preexisting immunity, indicating that host immunity plays a relevant role in driving viral reassortment of

  9. 直击甲型H1N1流感


    @@ 甲型H1N1流感是什么 甲型H1N1流感是一种由A型甲型H1N1流感病毒引起的猪呼吸系统疾病,该病毒可在猪群中造成流感暴发.这次在实验室已被证实的引发疫情的病毒是甲型H1N1流感病毒A(H1N1)亚型,是一种之前从未在人和猪身上出现过的新型甲型H1N1流感病毒;

  10. Challenge of N95 Filtering Facepiece Respirators with Viable H1N1 Influenza Aerosols (Postprint)



  11. 成人甲型H1N1流感的诊治



    成人甲型H1N1流感是由甲型H1N1流感病毒感染引起的新型呼吸道传染病。甲型H1N1流感病毒属于正黏病毒科(Orthomyxoviridae),甲型流感病毒属(Influenza virus A)。

  12. H1N1 viral proteome peptide microarray predicts individuals at risk for H1N1 infection and segregates infection versus Pandemrix(®) vaccination.

    Ambati, Aditya; Valentini, Davide; Montomoli, Emanuele; Lapini, Guilia; Biuso, Fabrizio; Wenschuh, Holger; Magalhaes, Isabelle; Maeurer, Markus


    A high content peptide microarray containing the entire influenza A virus [A/California/08/2009(H1N1)] proteome and haemagglutinin proteins from 12 other influenza A subtypes, including the haemagglutinin from the [A/South Carolina/1/1918(H1N1)] strain, was used to gauge serum IgG epitope signatures before and after Pandemrix(®) vaccination or H1N1 infection in a Swedish cohort during the pandemic influenza season 2009. A very narrow pattern of pandemic flu-specific IgG epitope recognition was observed in the serum from individuals who later contracted H1N1 infection. Moreover, the pandemic influenza infection generated IgG reactivity to two adjacent epitopes of the neuraminidase protein. The differential serum IgG recognition was focused on haemagglutinin 1 (H1) and restricted to classical antigenic sites (Cb) in both the vaccinated controls and individuals with flu infections. We further identified a novel epitope VEPGDKITFEATGNL on the Ca antigenic site (251-265) of the pandemic flu haemagglutinin, which was exclusively recognized in serum from individuals with previous vaccinations and never in serum from individuals with H1N1 infection (confirmed by RNA PCR analysis from nasal swabs). This epitope was mapped to the receptor-binding domain of the influenza haemagglutinin and could serve as a correlate of immune protection in the context of pandemic flu. The study shows that unbiased epitope mapping using peptide microarray technology leads to the identification of biologically and clinically relevant target structures. Most significantly an H1N1 infection induced a different footprint of IgG epitope recognition patterns compared with the pandemic H1N1 vaccine.

  13. Fasting plasma glucose is an independent predictor for severity of H1N1 pneumonia

    Sun Xiwen


    Full Text Available Abstract Background The pandemic influenza A (H1N1 virus emerged during 2009 and has spread worldwide. This virus can cause injuries to the lungs, liver, and heart. However, data regarding whether this influenza virus can affect pancreatic islets are limited. We investigated the effects of influenza A (H1N1 pneumonia on fasting plasma glucose (FPG and islet function, and evaluated possible correlations between biochemical test results and the severity of H1N1 pneumonia. Methods We performed a retrospective analysis of patients either diagnosed with or suspected of having H1N1 pneumonia who were admitted to our hospital in 2009. Possible associations between FPG levels and H1N1 virus infection were assessed by logistic regression. Correlation and regression analyses were used to assess relationships between FPG and biochemical test results. Associations between admission days and significant data were assessed by single factor linear regression. To evaluate effects of H1N1 on pancreatic β-cell function, results of a resistance index (homa-IR, insulin function index (homa-β, and insulin sensitivity index (IAI were compared between a H1N1 group and a non-H1N1 group by t-tests. Results FPG was significantly positively associated with H1N1 virus infection (OR = 1.377, 95%CI: 1.062-1.786; p = 0.016. FPG was significantly correlated with AST (r = 0.215; p = 0.039, LDH (r = 0.400; p = 0.000, BUN (r = 0.28; p = 0.005, and arterial Oxygen Saturation (SaO2; r = -0.416; p = 0.000 in the H1N1 group. H1N1 patients who were hypoxemic (SaO22 in the H1N1 group with hypoxia (SaO22 levels in patients with high FPG levels (≥7 mmol/L were significantly lower than those of H1N1 patients with low FPG levels ( Conclusions FPG on admission could be an independent predictor for the severity of H1N1 pneumonia. Elevated FPG induced by H1N1 pneumonia is not a result of direct damage to pancreatic β-cells, but arises from various factors' combinations caused by H1N1

  14. Reasons for Low Pandemic H1N1 2009 Vaccine Acceptance within a College Sample

    Russell D. Ravert


    Full Text Available This study examined health beliefs associated with novel influenza A (H1N1 immunization among US college undergraduates during the 2009-2010 pandemic. Undergraduates (ages 18–24 years from a large Midwestern University were invited to complete an online survey during March, 2010, five months after H1N1 vaccines became available. Survey items measured H1N1 vaccine history and H1N1-related attitudes based on the health belief literature. Logistic regression was used to identify attitudes associated with having received an H1N1 vaccine, and thematic analysis of student comments was conducted to further understand influences on vaccine decisions. Among the 296 students who participated in the survey, 15.2% reported having received an H1N1 vaccine. In regression analysis, H1N1 immunization was associated with seasonal flu vaccine history, perceived vaccine effectiveness, perceived obstacles to vaccination, and vaccine safety concerns. Qualitative results illustrate the relationship of beliefs to vaccine decisions, particularly in demonstrating that students often held concerns that vaccine could cause H1N1 or side effects. Vaccine safety, efficacy, and obstacles to immunization were major considerations in deciding whether to accept the H1N1 pandemic vaccine. Therefore, focusing on those aspects might be especially useful in future vaccine efforts within the college population.

  15. 中药治疗甲型H1N1流感浅见




  16. 儿童如何预防甲型H1N1流感




  17. Determinants of vaccine immunogenicity in HIV-infected pregnant women: analysis of B and T cell responses to pandemic H1N1 monovalent vaccine.

    Adriana Weinberg

    Full Text Available Influenza infections have high frequency and morbidity in HIV-infected pregnant women, underscoring the importance of vaccine-conferred protection. To identify the factors that determine vaccine immunogenicity in this group, we characterized the relationship of B- and T-cell responses to pandemic H1N1 (pH1N1 vaccine with HIV-associated immunologic and virologic characteristics. pH1N1 and seasonal-H1N1 (sH1N1 antibodies were measured in 119 HIV-infected pregnant women after two double-strength pH1N1 vaccine doses. pH1N1-IgG and IgA B-cell FluoroSpot, pH1N1- and sH1N1-interferon γ (IFNγ and granzyme B (GrB T-cell FluoroSpot, and flow cytometric characterization of B- and T-cell subsets were performed in 57 subjects. pH1N1-antibodies increased after vaccination, but less than previously described in healthy adults. pH1N1-IgG memory B cells (Bmem increased, IFNγ-effector T-cells (Teff decreased, and IgA Bmem and GrB Teff did not change. pH1N1-antibodies and Teff were significantly correlated with each other and with sH1N1-HAI and Teff, respectively, before and after vaccination. pH1N1-antibody responses to the vaccine significantly increased with high proportions of CD4+, low CD8+ and low CD8+HLADR+CD38+ activated (Tact cells. pH1N1-IgG Bmem responses increased with high proportions of CD19+CD27+CD21- activated B cells (Bact, high CD8+CD39+ regulatory T cells (Treg, and low CD19+CD27-CD21- exhausted B cells (Bexhaust. IFNγ-Teff responses increased with low HIV plasma RNA, CD8+HLADR+CD38+ Tact, CD4+FoxP3+ Treg and CD19+IL10+ Breg. In conclusion, pre-existing antibody and Teff responses to sH1N1 were associated with increased responses to pH1N1 vaccination in HIV-infected pregnant women suggesting an important role for heterosubtypic immunologic memory. High CD4+% T cells were associated with increased, whereas high HIV replication, Tact and Bexhaust were associated with decreased vaccine immunogenicity. High Treg increased antibody responses but

  18. H1N1 Influenza Flu:Report of 130 Cases%甲型H1N1流行性感冒临床分析

    吴传芬; 何爱民


    Objective To explore the diagnosis and treatment of H1N1 pandemic influenza. Methods Clinical characteristics and treatment of 130 cases of H1N1 influenza were retrospectively analyzed. Results Patients with mild H1N1 flu responsed to the supportive treatment by traditional Chinese medicine, Lianhuaqingwen capsule while severe patients with complicated infections responsed to combined anti - infection traditional Chinese medicine therapy , supportive treatment, and oseltamivir, an anti -influenza virus neuraminidase inhibitor. Comparison of WBC count, lymphocyte fraction, neutrophil fraction, and platelet count between hefore and after treatment showed significant differences ( P < 0.05 ) . Conclusion H1N1 pandemic influenza spread widely and rapidly, which were easily be infected. Combination of anti - infection traditional Chinese medicine therapy , supportive treatment, and oseltamivir is effective in treating H1N1 flu with complicated infections.%目的 探讨甲型H1N1流行性感冒(流感)的诊断、治疗要点.方法 回顾性分析130例甲型H1N1流感患者的临床特点、治疗方法.结果 病情轻的甲型H1N1流感患者给予中成药连花清瘟胶囊对症、支持治疗有效;病情重合并感染者给予抗感染中药对症、支持治疗基础上,加用神经氨酸酶抑制剂奥司他韦抗病毒治疗有效.130例患者治疗前后白细胞计数、淋巴细胞分数、中性粒细胞分数、血小板计数比较,差异均有统计学意义(P<0.05).结论 甲型H1N1流感传播广而迅猛,人群普遍易感.抗病毒(神经氨酸酶抑制剂奥司他韦)、中成药(连花清瘟胶囊)及对症支持治疗合并感染者有效.

  19. Molecular characterization and phylogenetic analysis of Middle East 2009 H1N1 pdm isolates

    Ghaleb Adwan


    Objective:To study hemagglutinin genetic evolution of some Middle East(ME) 2009 H1N1 pdm isolates and compared them with prototype vaccine strain [A/California/07/2009 (H1N1)], which is used as a vaccine strain in the Northern Hemisphere2010-2011.Methods: Nucleotide and/or amino acid sequences ofHA gene of fifty-fourME 2009 H1N1 pdm isolates were retrieved from GenBank Database by using BasicBLAST engine. Phylogenetic trees were established for both nucleotide and amino acid sequences using the muscle algorithm of the computer programCLC free workbench 5.6.1 JREsoftware. Amino acids alignment was also done to compare sequences HA1 domains of HA genes of ME 2009 H1N1 pdm isolates (n=39) with amino acid sequence of prototype vaccine strain A/California/07/2009 (H1N1).Results: Phylogenetic analysis of amino acids and nucleotides of theHA gene of theME 2009 H1N1 pdm isolates confirmed their evolutionary position in cluster with prototype vaccine strain (A/California/07/2009 (H1N1)) which is used as vaccine strain in the Northern Hemisphere2010-2011. Antigenically, theME 2009 H1N1pdm isolates were homogeneous and closely related to prototype vaccine. Only a few amino acid substitutions in the HA among the ME2009 H1N1 pdm isolates were analyzed.Conclusions:The current influenza vaccine is expected to provide a good protection againstME 2009 H1N1 pdm because it contains strains withH1 HA [A/California/07/2009 (H1N1)]-like strain.

  20. 科学面对甲型H1N1流感



    @@ 一、主题的提出 2009年10月,甲型H1N1流感在全国迅速蔓延,出现了一些死亡案例,每天新闻都播报全国甲型H1N1流感疫情,由于当时还没找到特别有效的防治办法,引起很多人的恐慌.为了帮助师生更好地面对甲型H1N1流感,我们开展了"科学面对甲型H1N1流感"综合实践活动. 二、活动背景 由国家卫生部发布的中国内地甲型H1N1流感疫情形势及活动前对学生的调查发现,部分初中学生缺乏对甲型H1N1流感的科学认识,对甲型H1N1流感普遍持恐慌心理;还有部分初中学生未意识到感染甲型H1N1流感的潜在危险,不知道感染甲型H1N1流感的危险行为.这样,他们就成了感染甲型H1N1流感的脆弱人群和预防甲型H1N1流感健康教育的重点人群,所以有必要对初中学生进行这方面的教育.

  1. 甲型H1N1流感患者的护理%Influenza A H1N1 influenza patient care




  2. 2009甲型H1N1流感研究进展%Progress in the 2009 H1N1 influenza A

    赵宇红; 申昆玲


    In March 2009,a new influenza A H1N1 virus was identified in Mexico.It is a quadruple-reassortant influenza A virus, which is composed of a combination of swine, avian strains and human. The clinical symptoms of the 2009 new influenza A (H1N1) are similar with the seasonal influenza.The severe illness could happened in youth and middle-aged without underlying diseases that differs from seasonal influenza. The risk groups are individuals with underlying diseases,pregnancy and obesity which has not been considered as risk factor in previous. Although oseltamivir-resistant variant influenza A ( H1N1 ) were reported, strain is susceptible to oseltamivir. This review summarizes the current information concerning viral genom,clinical features and treatment of the new pandemic influenza virus A H1N1 infection.%2009年3月在墨西哥出现了一种新型甲型H1N1流感病毒,这是一个四源重排的A型流感病毒:来源于猪流感病毒、禽流感病毒及人流感病毒.其临床特点与季节性流感相似,但重症病例可发生在无基础疾病的青壮年人,这与季节性流感不同,其高危人群为患有基础疾病者、孕妇及肥胖者.尽管已经出现了耐药毒株,但奥司他韦治疗仍然有效.该文主要对2009年流行的甲型H1N1流感病毒的基因特点、临床表现及治疗的最新进展进行综述.

  3. Influenza A(H1N1)pdm09 in critically ill children admitted to a ...

    Hospitalisation was identified as a major risk factor ... in the northern hemisphere countries took ..... Summary of characteristics of the patients with H1N1 influenza A who died (n=5) .... Pandemic H1N1 influenza in Brazil: Analysis of the first 34.

  4. Adoption of Preventive Measures and Attitudes toward the H1N1 Influenza Pandemic in Schools

    Pérez, Anna; Rodríguez, Tània; López, Maria José; Continente, Xavier; Nebot, Manel


    Background: This study describes the perceived impact of H1N1 influenza and the adoption of the recommended measures to address the pandemic in schools. Methods: A cross-sectional self-reported survey was conducted in 433 schools in Barcelona addressed to the school principal or the H1N1 influenza designated person. A descriptive analysis was…

  5. Oseltamivir-resistant influenza virus A (H1N1), Europe, 2007/08 season.

    Meijer, A.; Lackenby, A.; Hungnes, O.; Lina, B.; Werf, S. van der; Schweiger, B.; Opp, M.; Paget, J.; Kassteele, J. van de; Hay, A.; Zambon, M.


    In Europe, the 2007/08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country,

  6. Experience of influenza A H1N1 in a paediatric emergency unit.

    Biçer, Suat; Ercan Sariçoban, Hülya; Özen, Ahmet Oğuzhan; Saf, Coşkun; Ergenekon Ulutaş, Pinar; Gürol, Yeşim; Yilmaz, Gülden; Vitrinel, Ayça; Özelgün, Berna


    This study was carried out to evaluate symptoms, clinical findings, treatment options and complications of H1N1 influenza infection in patients who applied to our emergency unit during the influenza season in 2009. The clinical and laboratory findings of children with influenza A (H1N1) during the influenza season in 2009 were evaluated retrospectively. Influenza A was diagnosed by polymerase chain reaction and/or rapid antigen test. Clinical and laboratory findings of the patients with H1N1 (group I) and without H1N1 (group II) were compared. Fever and myalgia were noted to be higher in group I (p H1N1 (average of 39°C) and myalgia was present only in patients with H1N1. The lymphocyte count was significantly lower in patients with H1N1 than those without H1N1. While none of the patients required intensive care, three patients requiring hospitalization were discharged after referral and completion of their treatment.

  7. Pandemic H1N1 2009 virus in Danish pigs: Diagnosis and lack of surveillance

    Larsen, Lars Erik; Nielsen, L. P.; Breum, Solvej Østergaard

    the constraints put on the herd in case of a positive H1N1v result. In combination with the fact that Denmark does not have any formal surveillance program for swine influenza in place, we have currently no overview of the number of H1N1v positive swine in Denmark. However, the diagnosis of a positive herd...

  8. H1N1 'Swine Flu' Vaccine Unlikely to Raise Birth Defect Risk

    ... page: H1N1 'Swine Flu' Vaccine Unlikely to Raise Birth Defect ... Swedish researchers report that the vaccine against the H1N1 "swine flu" strain of influenza doesn't seem ...

  9. H1N1 Flu (Swine Flu) - Multiple Languages: MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → H1N1 Flu (Swine Flu) URL of this page: https:// ... V W XYZ List of All Topics All H1N1 Flu (Swine Flu) - Multiple Languages To use the ...

  10. H1N1 Flu & U.S. Schools: Answers to Frequently Asked Questions

    US Department of Education, 2009


    A severe form of influenza known as H1N1, commonly being called swine flu, has health officials around the world concerned. In the United States, the outbreak of H1N1 has prompted school closures and cancellation of school-related events. As the flu spreads, the Department of Education encourages school leaders, parents and students to know how to…

  11. Serologic Cross-Reactivity with Pandemic (H1N1) 2009 Virus in Pigs, Europe

    Kyriakis, Constantinos S.; Olsen, Christopher W.; Carman, Susy; Brown, Ian H.; Brookes, Sharon M.; Van Doorsselaere, Jan


    We tested serum samples from pigs infected or vaccinated with European swine influenza viruses (SIVs) in hemagglutination-inhibition assays against pandemic (H1N1) 2009 virus and related North American SIVs. We found more serologic cross-reaction than expected. Data suggest pigs in Europe may have partial immunity to pandemic (H1N1) 2009 virus. PMID:20031049

  12. Safety of pandemic H1N1 vaccines in children and adolescents

    E.G. Wijnans (Leonoor); S. de Bie (Sandra); J.P. Dieleman (Jeanne); J. Bonhoeffer (Jan); M.C.J.M. Sturkenboom (Miriam)


    textabstractDuring the 2009 influenza A (H1N1) pandemic several pandemic H1N1 vaccines were licensed using fast track procedures, with relatively limited data on the safety in children and adolescents. Different extensive safety monitoring efforts were put in place to ensure timely detection of adve

  13. Influenza A (H1N1) neuraminidase inhibitors from Vitis amurensis

    Nguyen, Ngoc Anh; Dao, Trong Tuan; Tung, Bui Thanh


    Recently, a novel H1N1 influenza A virus (H1N1/09 virus) was identified and considered a strong candidate for a novel influenza pandemic. As part of an ongoing anti-influenza screening programme on natural products, eight oligostilbenes were isolated as active principles from the methanol extract...... of Vitis amurensis. This manuscript reports the isolation, structural elucidation, and anti-viral activities of eight compounds on various neuraminidases from influenza A/PR/8/34 (H1N1), novel swine-origin influenza A (H1N1), and oseltamivir-resistant novel H1N1 (H274Y) expressed in 293T cells...... possibility for the control of influenza infections....

  14. 理性看待甲型H1N1流感疫情


    @@ 继墨西哥出现甲型H1N1流感疫情后,美国、英国、韩国等国相继出现甲型H1N1流感疫情.世卫组织警告:甲型H1N1流感比禽流感更可怕.甲型H1N1流感病毒早晚都会发生变异,使甲型H1N1流感能轻易在人与人之间传播,这只是个时间问题.一旦如此,那么它将给人类带来一场前所未有的大灾难.

  15. 理性看待甲型H1N1流感疫情




  16. Novel influenza A(H1N1) 2009 in vitro reassortant viruses with oseltamivir resistance.

    Ottmann, Michèle; Duchamp, Maude Bouscambert; Casalegno, Jean-Sébastien; Frobert, Emilie; Moulès, Vincent; Ferraris, Olivier; Valette, Martine; Escuret, Vanessa; Lina, Bruno


    With the recent emergence of the novel A(H1N1) virus in 2009, the efficacy of available drugs, such as neuraminidase (NA) inhibitors, is of great concern for good patient care. Influenza viruses are known to be able to acquire resistance. In 2007, A(H1N1) viruses related to A/Brisbane/59/2007 (H1N1) (A[H1N1] Brisbane-like virus), which are naturally resistant to oseltamivir, emerged. Resistance to oseltamivir can be acquired either by spontaneous mutation in the NA (H275Y in N1), or by reassortment with a mutated NA. It is therefore crucial to determine the risk of pandemic A(H1N1) 2009 virus acquiring resistance against oseltamivir by reassortment. We estimated the capacity of reassortment between the A(H1N1) 2009 virus and an oseltamivir-resistant A(H1N1) Brisbane-like virus by in vitro coinfections of influenza-permissive cells. The screening and the analysis of reassortant viruses was performed by specific reverse transcriptase PCRs and by sequencing. Out of 50 analysed reassortant viruses, two harboured the haemagglutinin (HA) segment from the pandemic A(H1N1) 2009 virus and the mutated NA originated from the A(H1N1) Brisbane-like virus. The replicating capacities of these viruses were measured, showing no difference as compared to the two parental strains, suggesting that acquisition of the mutated NA segment did not impair viral fitness in vitro. Our results suggest that the novel A(H1N1) 2009 virus can acquire by in vitro genetic reassortment the H275Y mutated NA segment conferring resistance to oseltamivir.

  17. Point of care strategy for rapid diagnosis of novel A/H1N1 influenza virus.

    Antoine Nougairede

    Full Text Available Within months of the emergence of the novel A/H1N1 pandemic influenza virus (nA/H1N1v, systematic screening for the surveillance of the pandemic was abandoned in France and in some other countries. At the end of June 2009, we implemented, for the public hospitals of Marseille, a Point Of Care (POC strategy for rapid diagnosis of the novel A/H1N1 influenza virus, in order to maintain local surveillance and to evaluate locally the kinetics of the pandemic.Two POC laboratories, located in strategic places, were organized to receive and test samples 24 h/24. POC strategy consisted of receiving and processing naso-pharyngeal specimens in preparation for the rapid influenza diagnostic test (RIDT and real-time RT-PCR assay (rtRT-PCR. This strategy had the theoretical capacity of processing up to 36 samples per 24 h. When the flow of samples was too high, the rtRT-PCR test was abandoned in the POC laboratories and transferred to the core virology laboratory. Confirmatory diagnosis was performed in the core virology laboratory twice a day using two distinct rtRT-PCR techniques that detect either influenza A virus or nA/N1N1v. Over a period of three months, 1974 samples were received in the POC laboratories, of which 111 were positive for nA/H1N1v. Specificity and sensitivity of RIDT were 100%, and 57.7% respectively. Positive results obtained using RIDT were transmitted to clinical practitioners in less than 2 hours. POC processed rtRT-PCR results were available within 7 hours, and rtRT-PCR confirmation within 24 hours.The POC strategy is of benefit, in all cases (with or without rtRT-PCR assay, because it provides continuous reception/processing of samples and reduction of the time to provide consolidated results to the clinical practitioners. We believe that implementation of the POC strategy for the largest number of suspect cases may improve the quality of patient care and our knowledge of the epidemiology of the pandemic.

  18. During the summer 2009 outbreak of "swine flu" in Scotland what respiratory pathogens were diagnosed as H1N1/2009?

    Carman William F


    Full Text Available Abstract Background During the April-July 2009 outbreak of H1N1/2009 in scotland the West of Scotland Specialist Virology Centre (WoSSVC in Glasgow tested > 16 000 clinical samples for H1N1/2009. Most were from patients clinically diagnosed with H1N1/2009. Out of these, 9% were positive. This study sought to determine what respiratory pathogens were misdiagnosed as cases of H1N1/2009 during this time. Methods We examined the results from 3247 samples which were sent to the laboratory during April-July 2009. All were from patients clinically diagnosed as having H1N1/2009 (based on accepted criteria and all were given a full respiratory screen using real time reverse transcriptase polymerase chain reaction (rtRT-PCR assays. Results In total, respiratory pathogens were detected in 27.9% (95% confidence interval, 26.3-29.5% of the samples submitted. Numerous pathogens were detected, the most common of which were rhinovirus (8.9% (95% confidence interval, 7.9-9.9%, parainfluenza 1 (1.9% (95% confidence interval, 1.4-2.4% and 3 (4.1% (95% confidence interval, 3.3-4.9%, and adenovirus ((3.5% (95% confidence interval, 2.9-4.2%. Conclusions This study highlights the problems of using a clinical algorithm to detect H1N1/2009. Clinicians frequently misdiagnosed common respiratory pathogens as H1N1/2009 during the spring/summer outbreak in Scotland. Many undesirable consequences would have resulted, relating to treatment, infection control, and public health surveillance.

  19. An analysis of peripheral blood cells in patients with influenza A (H1N1) virus infection or non-H1N1 virus infection%甲型H1N1流感病毒与非甲型H1N1流感病毒患者外周血象的对比分析

    王新华; 邵冬华; 梁国威; 曹清云



  20. 接种甲型H1N1流感疫苗后患甲型H1N1流感分析%H1N1 Influenza Infection after Injecting A/H1N1 Influenza Vaccine

    王韶辉; 沈忆光; 王彤; 梁雪梅; 赵金彩


    目的 分析接种甲型H1N1流感疫苗后发生甲型H1N1流感感染的病例,探讨发病原因,为进一步提高疫苗预防效果提供参考依据.方法 对接种甲型H1N1流感疫苗后发生甲型H1N1流感感染148例,进行回顾性调查分析.结果 接种甲型H1N1流感疫苗11176例.发生甲型H1N1感染148例,感染率1.32%,其中1~14 d感染81例,感染率0.72%,>15 d感染67例,感染率0.60%.结论 甲型H1N1流感病毒裂解疫苗是一种安全高效的疫苗,不足之处尚待进一步探讨、完善.

  1. Nosocomial swine influenza (H1N1) pneumonia: lessons learned from an illustrative case.

    Cunha, B A; Thekkel, V; Krilov, L


    In the spring of 2009, our institution found itself at the epicentre of the "herald wave" of the swine influenza (H1N1) pandemic in New York. We were inundated with hundreds of patients exhibiting influenza-like illnesses (ILIs), presenting for rapid influenza A testing. During this pandemic, an infant with newly diagnosed acute lymphatic leukaemia (ALL) was admitted for induction chemotherapy. After being in hospital for a week, she developed high fever and shortness of breath, although her chest X-ray was clear. She was admitted to the paediatric intensive care unit (PICU) for mechanical ventilation. As we were in the midst of the pandemic, diagnosis of H1N1 pneumonia was considered and reverse transcription-polymerase chain reaction for H1N1 was positive. Contact investigation revealed that none of her family members/visitors had been in recent/close contact with anyone with ILI/H1N1. The investigation also revealed that paediatric healthcare staff, in contact with H1N1 patients, had rotated into PICU to care for the patient. Although no specific individual could be identified, it seems likely that H1N1 was transmitted to the patient by a healthcare worker who worked both in the paediatric ward and the PICU. This is the first known case of nosocomial paediatric transmission of H1N1 pneumonia.

  2. Antigenic Patterns and Evolution of the Human Influenza A (H1N1) Virus.

    Liu, Mi; Zhao, Xiang; Hua, Sha; Du, Xiangjun; Peng, Yousong; Li, Xiyan; Lan, Yu; Wang, Dayan; Wu, Aiping; Shu, Yuelong; Jiang, Taijiao


    The influenza A (H1N1) virus causes seasonal epidemics that result in severe illnesses and deaths almost every year. A deep understanding of the antigenic patterns and evolution of human influenza A (H1N1) virus is extremely important for its effective surveillance and prevention. Through development of antigenicity inference method for human influenza A (H1N1), named PREDAC-H1, we systematically mapped the antigenic patterns and evolution of the human influenza A (H1N1) virus. Eight dominant antigenic clusters have been inferred for seasonal H1N1 viruses since 1977, which demonstrated sequential replacements over time with a similar pattern in Asia, Europe and North America. Among them, six clusters emerged first in Asia. As for China, three of the eight antigenic clusters were detected in South China earlier than in North China, indicating the leading role of South China in H1N1 transmission. The comprehensive view of the antigenic evolution of human influenza A (H1N1) virus can help formulate better strategy for its prevention and control.

  3. The Neurological Manifestations of H1N1 Influenza Infection; Diagnostic Challenges and Recommendations

    Ali Akbar Asadi-Pooya


    Full Text Available Background: World Health Organization declared pandemic phase of human infection with novel influenza A (H1N1 in April 2009. There are very few reports about the neurological complications of H1N1 virus infection in the literature. Occasionally, these complications are severe and even fatal in some individuals. The aims of this study were to report neurological complaints and/or complications associated with H1N1 virus infection. Methods: The medical files of all patients with H1N1 influenza infection admitted to a specified hospital in the city of Shiraz, Iran from October through November 2009 were reviewed. More information about the patients were obtained by phone calls to the patients or their care givers. All patients had confirmed H1N1 virus infection with real-time PCR assay. Results: Fifty-five patients with H1N1 infection were studied. Twenty-three patients had neurological signs and/or symptoms. Mild neurological complaints may be reported in up to 42% of patients infected by H1N1 virus. Severe neurological complications occurred in 9% of the patients. The most common neurological manifestations were headache, numbness and paresthesia, drowsiness and coma. One patient had a Guillain-Barre syndrome-like illness, and died in a few days. Another patient had focal status epilepticus and encephalopathy. Conclusions: The H1N1 infection seems to have been quite mild with a self-limited course in much of the world, yet there appears to be a subset, which is severely affected. We recommend performing diagnostic tests for H1N1influenza virus in all patients with respiratory illness and neurological signs/symptoms. We also recommend initiating treatment with appropriate antiviral drugs as soon as possible in those with any significant neurological presentation accompanied with respiratory illness and flu-like symptoms

  4. Genome evolution of novel influenza A (H1N1)viruses in humans

    KOU Zheng; HU SongNian; LI TianXian


    The epidemic situation of A H1N1 flu arose in North America in April 2009,which rapidly expanded to three continents of Europe,Asia and Africa,with the risk ranking up to 5.Until May 13th,the flu virus of A H1N1 had spread into 33 countries and regions,with a laboratory confirmed case number of 5728,including 61 deaths.Based on IRV and EpiFluDB database,425 parts of A H1N1 flu virus sequence were achieved,followed by sequenced comparison and evolution analysis.The results showed that the current predominant A H1N1 flu virus was a kind of triple reassortment A flu virus:(i) HA,NA,MP,NP and NS originated from swine influenza virus;PB2 and PA originated from bird influenza virus;PB1 originated from human influenza virus.(ii) The origin of swine influenza virus could be subdivided as follows:HA,NP and NS originated from classic swine influenza virus of H1N1 subtype;NA and MP originated from bird origin swine influenza virus of H1N1 subtype.(iii) A H1N1 flu virus experienced no significant mutation during the epidemic spread,accompanied with no reassortment of the virus genome.In the paper,the region of the representative strains for sequence analysis (A/California/04/2009 (H1N1) and A/Mexico/4486/2009 (H1N1)) included USA and Mexico and was relatively wide,which suggested that the analysis results were convincing.

  5. Transplantation of solid organs procured from influenza A H1N1 infected donors.

    Cockbain, Andrew J; Jacob, Matthew; Ecuyer, Clare; Hostert, Lutz; Ahmad, Niaz


    Following the influenza A H1N1 (swine flu) pandemic, there remains little evidence informing the safety of transplanting organs from donors suspected or diagnosed with H1N1. Limited guidelines from the major transplant societies leave the use of such organs at the discretion of individual transplant centres, and practice varies considerably both nationally and internationally. We present the largest published series of outcome following transplantation of organs from H1N1 positive donors and demonstrate that these organs can be transplanted safely and with good short-term outcome. We discuss our local policy for treatment of recipients with Oseltamivir.

  6. A(H1N1)Influenza Pneumonia with Acute Disseminated Encephalomyelitis: A Case Report



    @@ INTRODUCTION A 56-year-old Chinese female patient with A (H1N1) influenza pneumonia accompanied by acute disseminated encephalomyelitis (ADEM) of the Central Nervous System (CNS) is described in this article. The patient had typical clinical manifestation,and the diagnosis was reached after MRI and other examinations. From this case, we can conclude that the virus ofA (H1N1) influenza can infect CNS, and we should pay more attention to patients of A (H1N1)influenza pneumonia with neurological complications.

  7. 甲型H1N1流感防护手册



  8. H1N1病毒全球疫情防治


    1、H1N1全病毒灭活疫苗(SlV inactivated vaccines)在已研制的H1N1疫苗中,技术最成熟并用于生产的主要是H1NI型和H3N2亚型单价或双价H1N1全病毒灭活疫苗。其形式多为油佐剂疫苗,灭活剂一般采用甲醛或BEI。据报

  9. 甲型H1N1流感疫情问答


    @@ 1.问:什么是甲型H1N1流感? 答:美国疾病控制和预防中心专家解释说,甲型H1N1流感是由甲型H1N1流感病毒引起的一种急性呼吸道传染病,这种病在猪中经常发生,但很少导致猪的死亡.

  10. 预防甲型H1N1流感科普知识



    @@ 自2009年3~4月墨西哥、美国相继爆发甲型H1N1流感以来,世界正面临甲型H1N1流感大流行的威胁.目前,全世界已有100多个国家和地区出现甲型H1N1流感流行,确诊病例数已超过10万.

  11. 甲型H1N1流感病人的人文护理




  12. Acute kidney injury due to rhabdomyolysis in H1N1 influenza infection.

    Unverdi, Selman; Akay, Hatice; Ceri, Mevlut; Inal, Salih; Altay, Mustafa; Demiroz, Ali Pekcan; Duranay, Murat


    Acute kidney injury (AKI) is rarely reported in the clinical course of H1N1 infection and this condition is strongly related with increasing of mortality risk. However, there are no sufficient data about the development of AKI due to H1N1 infections. The recent reports were documented for elevation of creatinine phosphokinase levels in the course of influenza infection, but rhabdomyolysis was rarely reported. Herein, we present a 28-year-old female patient and a 19-year-old male patient with AKI in the course of H1N1 influenza infection due to rhabdomyolysis.

  13. Structural Basis of Preexisting Immunity to the 2009 H1N1 Pandemic Influenza Virus

    Xu, Rui; Ekiert, Damian C.; Krause, Jens C.; Hai, Rong; Crowe, Jr., James E.; Wilson, Ian A. (Sinai); (Scripps); (Vanderbilt)


    The 2009 H1N1 swine flu is the first influenza pandemic in decades. The crystal structure of the hemagglutinin from the A/California/04/2009 H1N1 virus shows that its antigenic structure, particularly within the Sa antigenic site, is extremely similar to those of human H1N1 viruses circulating early in the 20th century. The cocrystal structure of the 1918 hemagglutinin with 2D1, an antibody from a survivor of the 1918 Spanish flu that neutralizes both 1918 and 2009 H1N1 viruses, reveals an epitope that is conserved in both pandemic viruses. Thus, antigenic similarity between the 2009 and 1918-like viruses provides an explanation for the age-related immunity to the current influenza pandemic.

  14. H1N1 infection in emergency surgery: A cautionary tale.

    Galbraith, J G


    Pandemic 2009 influenza A H1N1 has spread rapidly since its first report in Mexico in March 2009. This is the first influenza pandemic in over 40 years and it atypically affects previously healthy young adults, with higher rates of morbidity and mortality. The medical literature has been inundated with reports of H1N1 infection, the majority found in critical care and internal medicine journals with a relative paucity in the surgical literature. Despite this, it remains an important entity that can impact greatly on acute surgical emergencies. We present a case of previously healthy 31-year-old male who underwent open appendectomy. His post-operative recovery was complicated by acute respiratory distress syndrome secondary to H1N1 infection. This case report highlights the impact that H1N1 virus can have on acute surgical emergencies and how it can complicate the post-operative course.

  15. Encephalitis in a child with H1N1 infection: First case report from India

    Rajesh Kulkarni


    Full Text Available Neurological complications have been described with seasonal influenza infection. We report encephalitis manifesting as seizures in a child with confirmed H1N1 infection. Treatment with oseltamivir was started. Child was discharged without any neurological sequelae.

  16. 甲型H1N1流感的研究进展



    @@ 2009年3~4月从墨西哥暴发的"猪流感"(Swine influenza,SI),后被更名为甲型H1N1流感[In-fluenza A(H1N1)],迅速在全世界范围内蔓延[1-2].研究表明这种病毒基因组由禽流感、猪流感和人流感病毒基因混合而成,是一种新型的甲型H1N1流感病毒(novel swine-origin influenza A H1N1 virus,S-OIV)[1,3].

  17. Chalcones as novel influenza A (H1N1) neuraminidase inhibitors from Glycyrrhiza inflata

    Dao, Trong Tuan; Nguyen, Phi Hung; Lee, Hong Sik


    The emergence of highly pathogenic influenza A virus strains, such as the new H1N1 swine influenza (novel influenza), represents a serious threat to global human health. During our course of an anti-influenza screening program on natural products, one new licochalcone G (1) and seven known (2......-8) chalcones were isolated as active principles from the acetone extract of Glycyrrhiza inflata. Compounds 3 and 6 without prenyl group showed strong inhibitory effects on various neuraminidases from influenza viral strains, H1N1, H9N2, novel H1N1 (WT), and oseltamivir-resistant novel H1N1 (H274Y) expressed...... in 293T cells. In addition, the efficacy of oseltamivir with the presence of compound 3 (5 μM) was increased against H274Y neuraminidase. This evidence of synergistic effect makes this inhibitor to have a potential possibility for control of pandemic infection by oseltamivir-resistant influenza virus....

  18. Pediatric Healthcare Response to Pandemic (H1N1) 2009 Influenza Stakeholder Meeting - Summary of Proceedings



    The goal of the meeting was to bring together subject matter experts to develop tools and resources for use by the pediatric healthcare community in response to 2009 (H1N1) pandemic influenza activity during the 2009 influenza season.

  19. 66例甲型H1N1流感的护理




  20. Peramivir获准紧急用于H1N1的治疗


    @@ FDA已于近期批准BioCryst制药公司开发的神经氨酸酶抑制剂peramivir用于H1N1流感的紧急治疗,并已将其列入与H1N1流感爆发有关的突发公共卫生事件的应急措施清单,与H1N1疫苗及已批准的抗病毒药--罗氏公司的达菲(奥塞米韦)和葛兰素史克公司的Relenza(扎那米韦)共同用于H1N1的防治.

  1. 66例甲型H1N1流感的护理




  2. The seroprevalence of pandemic influenza H1N1 (2009 virus in China.

    Cuiling Xu

    Full Text Available BACKGROUND: Mainland China experienced pandemic influenza H1N1 (2009 virus (pH1N1 with peak activity during November-December 2009. To understand the geographic extent, risk factors, and attack rate of pH1N1 infection in China we conducted a nationwide serological survey to determine the prevalence of antibodies to pH1N1. METHODOLOGY/PRINCIPAL FINDINGS: Stored serum samples (n = 2,379 collected during 2006-2008 were used to estimate baseline serum reactogenicity to pH1N1. In January 2010, we used a multistage-stratified random sampling method to select 50,111 subjects who met eligibility criteria and collected serum samples and administered a standardized questionnaire. Antibody response to pH1N1 was measured using haemagglutination inhibition (HI assay and the weighted seroprevalence was calculated using the Taylor series linearization method. Multivariable logistic regression analyses were used to examine risk factors for pH1N1 seropositivity. Baseline seroprevalence of pH1N1 antibody (HI titer ≥40 was 1.2%. The weighted seroprevalence of pH1N1 among the Chinese population was 21.5%(vaccinated: 62.0%; unvaccinated: 17.1%. Among unvaccinated participants, those aged 6-15 years (32.9% and 16-24 years (30.3% had higher seroprevalence compared with participants aged 25-59 years (10.7% and ≥60 years (9.9%, P<0.0001. Children in kindergarten and students had higher odds of seropositivity than children in family care (OR: 1.36 and 2.05, respectively. We estimated that 207.7 million individuals (15.9% experienced pH1N1 infection in China. CONCLUSIONS/SIGNIFICANCE: The Chinese population had low pre-existing immunity to pH1N1 and experienced a relatively high attack rate in 2009 of this virus. We recommend routine control measures such as vaccination to reduce transmission and spread of seasonal and pandemic influenza viruses.

  3. 2009 H1N1 influenza virus infection and necrotizing pneumonia treated with extracorporeal membrane oxygenation

    Suntae Ji


    Full Text Available A 3-year-old girl with acute respiratory distress syndrome due to a H1N1 2009 influenza virus infection was complicated by necrotizing pneumonia was successfully treated with extracorporeal membrane oxygenation (ECMO. This is the first reported case in which a pediatric patient was rescued with ECMO during the H1N1 influenza epidemic in Korea in 2009.

  4. Radiologic Findings of Influenza A (H1N1) Pneumonia: Report of Two Cases

    Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee; Park, Seog Hee; Park, Chan Kwon; Kim, Young Kyoon [Seoul St. Mary' s Hospital, Seoul (Korea, Republic of)


    Novel influenza A (H1N1) infection is a highly infectious disease, which has been rapidly spreading worldwide since it was first documented in March of 2009 in Mexico. We experienced and report two cases of Influenza A (H1N1) pneumonia, accompanied by chest radiographic and CT findings. The chest radiographs revealed diffuse haziness and extensive airspace consolidation, whereas the CT scans demonstrated multifocal areas of ground glass opacity and airspace consolidation with a CT halo sign.

  5. Kompliceret influenza A (H1N1) hos gravid i andet trimester

    Ersbøll, A.S.; Hedegaard, M.; Hesselvig, A.B.


    A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded...... and an emergency caesarean was performed at 26 weeks + 2 days of gestation. The neonatal period was uncomplicated. Influenza A (H1N1) is especially dangerous in pregnant women and vaccination is important....

  6. Blood libel rebooted : traditional scapegoats, online media, and the H1N1 epidemic

    Atlani Duault, Laëtitia (ed.); Mercier, A.; Rousseau, C; Guyot, P; Moatti, Jean-Paul


    This study of comments posted on major French print and TV media websites during the H1N1 epidemic illustrates the relationship between the traditional media and social media in responding to an emerging disease. A disturbing "geography of blame" was observed suggesting the metamorphosis of the folk-devil phenomenon to the Internet. We discovered a subterranean discourse about the putative origins and "objectives" of the H1N1 virus, which was absent from the discussions in mainstream televisi...

  7. Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, Mexico

    Ramirez-Gonzalez, José Ernesto; Gonzalez-Duran, Elizabeth; Alcantara-Perez, Patricia; Wong-Arambula, Claudia; Olivera-Diaz, Hiram; Cortez-Ortiz, Iliana; Barrera-Badillo, Gisela; Nguyen, Ha; Gubareva, Larisa; Lopez-Martinez, Irma; Díaz-Quiñonez, Jose Alberto; Lezana-Fernández, Miguel Angel; Gatell-Ramírez, Hugo Lopez; Villalobos, Jose Angel Cordova; Hernández-Avila, Mauricio


    During May 2009–April 2010, we analyzed 692 samples of pandemic (H1N1) 2009 virus from patients in Mexico. We detected the H275Y substitution of the neuraminidase gene in a specimen from an infant with pandemic (H1N1) 2009 who was treated with oseltamivir. This virus was susceptible to zanamivir and resistant to adamantanes and oseltamivir. PMID:21291607

  8. Respiratory failure presenting in H1N1 influenza with Legionnaires disease: two case reports

    Iannuzzi Michele


    Full Text Available Abstract Introduction Media sensationalism on the H1N1 outbreak may have influenced decisional processes and clinical diagnosis. Case Presentation We report two cases of patients who presented in 2009 with coexisting H1N1 virus and Legionella infections: a 69-year-old Caucasian man and a 71-year-old Caucasian woman. In our cases all the signs and symptoms, including vomiting, progressive respiratory disease leading to respiratory failure, refractory hypoxemia, leukopenia, lymphopenia, thrombocytopenia, and elevated levels of creatine kinase and hepatic aminotransferases, were consistent with critical illness due to 2009 H1N1 virus infection. Other infectious disorders may mimic H1N1 viral infection especially Legionnaires' disease. Because the swine flu H1N1 pandemic occurred in Autumn in Italy, Legionnaires disease was to be highly suspected since the peak incidence usually occurs in early fall. We do think that our immediate suspicion of Legionella infection based on clinical history and X-ray abnormalities was fundamental for a successful resolution. Conclusion Our two case reports suggest that patients with H1N1 should be screened for Legionella, which is not currently common practice. This is particularly important since the signs and symptoms of both infections are similar.

  9. Oseltamivir-resistant pandemic influenza a (H1N1) 2009 viruses in Spain.

    Ledesma, Juan; Vicente, Diego; Pozo, Francisco; Cilla, Gustavo; Castro, Sonia Pérez; Fernández, Jonathan Suárez; Ruiz, Mercedes Pérez; Navarro, José María; Galán, Juan Carlos; Fernández, Mirian; Reina, Jordi; Larrauri, Amparo; Cuevas, María Teresa; Casas, Inmaculada; Breña, Pilar Pérez


    Pandemic influenza A (H1N1) 2009 virus appeared in Spain on April 25, 2009 for the first time. This new virus was adamantane-resistant but it was sensitive to neuraminidase (NA) inhibitors oseltamivir and zanamivir. To detect oseltamivir-resistant pandemic influenza A (H1N1) 2009 viruses by the Spanish Influenza Surveillance System (SISS) and a possible spread of oseltamivir-resistant viruses in Spain since starting of the pandemic situation. A total of 1229 respiratory samples taken from 413 severe and 766 non-severe patients with confirmed viral detection of pandemic influenza A (H1N1) 2009 viruses from different Spanish regions were analyzed for the specific detection of the H275Y mutation in NA between April 2009 and May 2010. H275Y NA substitution was found in 8 patients infected with pandemic influenza A (H1N1) 2009 viruses collected in November and December 2009 and in January 2010. All oseltamivir-resistant viruses were detected in severe patients (8/413, 1.93%) who previously received treatment with oseltamivir. Six of these patients were immunocompromised. In Spain, the number of oseltamivir-resistant pandemic influenza A (H1N1) 2009 viruses is until now very low. No evidence for any spread of oseltamivir-resistant H1N1 viruses is achieved in our Country. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. 理性看待甲型H1N1流感疫情




  11. The investigation of Risk factors of influenza pandemic H1N1

    koorosh Holakooyi Naeini


    Full Text Available Introduction: Influenza pandemic H1N1 is an acute respiratory infectious disease that is combination of two types of influenza virus type A (H1N1. This study aimed to identify risk factors affecting influenza pandemic H1N1. Methods: In this case-control study, the cases were 18 positive cases of pandemic influenza H1N1 and the controls were the patients who were admitted during the same time as the cases to sections of Orthopedics, Urology, Surgery and Women of the same hospital for reasons other than influenza. The data were collected through a form by two experienced nurses and then were fed into SPSS, and were analyzed using independent T-test and chi-square. Results: A significant relationship was observed between pandemic H1N1 influenza infection and a history of domestic travel, contact with confirmed patients, respiratory diseases, and diabetes (P0.05. Conclusion: People with underlying diseases, especially respiratory diseases, diabetes, heart disease and a secondary infection and cardiovascular disease most likely are susceptible to influenza pandemic H1N1.

  12. Intense Seasonal A/H1N1 Influenza in Mexico, Winter 2013–2014

    Dávila-Torres, Javier; Chowell, Gerardo; Borja-Aburto, Víctor H.; Viboud, Cécile; Grajalez-Muñiz, Concepción; Miller, Mark. A.


    Background and Aims A recrudescent wave of pandemic influenza A/H1N1 affected Mexico during the winter of 2013–2014 following a mild 2012–2013 A/H3N2 influenza season. Methods We compared the demographic and geographic characteristics of hospitalizations and inpatient deaths for severe acute respiratory infection (SARI) and laboratory-confirmed influenza during the 2013–2014 influenza season compared to previous influenza seasons, based on a large prospective surveillance system maintained by the Mexican Social Security health care system. Results A total of 14,236 SARI hospitalizations and 1,163 inpatient deaths (8.2%) were reported between October 1, 2013 and March 31, 2014. Rates of laboratory-confirmed A/H1N1 hospitalizations and deaths were significantly higher among individuals aged 30–59 years and lower among younger age groups for the 2013–2014 A/H1N1 season compared to the previous A/H1N1 season in 2011–2012 (χ2 test, p <0.001). The reproduction number for the winter 2013–2014 influenza season in central Mexico was estimated at 1.3–1.4, in line with that reported for the 2011–2012 A/H1N1 season but lower than during the initial waves of pandemic A/H1N1 activity in 2009. Conclusions We documented a substantial increase in the number of A/H1N1-related hospitalizations and deaths during the period from October 2013–March 2014 in Mexico and a proportionate shift of severe disease to middle-aged adults, relative to the preceding A/H1N1 2011–2012 season. In the absence of clear antigenic drift in globally circulating A/H1N1 viruses in the post-2009 pandemic period, the gradual change in the age distribution of A/H1N1 infections observed in Mexico suggests a slow build-up of immunity among younger populations, reminiscent of the age profile of past pandemics. PMID:25446616

  13. Response to the challenges of pandemic H1N1 in a small island state: the Barbadian experience

    Ferdinand Elizabeth


    confirmed cases was small but the significant surge in ARI and SARI cases indicate that the impact of the virus on the island was moderate. As a result of 2009 H1N1, virological surveillance has improved significantly and local, regional and international partnerships have been strengthened.

  14. Close Relationship between the 2009 H1N1 Virus and South Dakota AIV Strains

    Cun Li; Xiao-ping An; Zhi-qiang Mi; Da-bin Liu; Huan-huan Jiang; Bo Pan; Sheng Wang; Bin Chen; Yi-gang Tong


    Although previous publications suggest the 2009 pandemic influenza A(H1N1)virus was reassorted from swine viruses of North America and Eurasia, the immediate ancestry still remains elusive due to the big evolutionary distance between the 2009 H1N1 virus and the previously isolated strains. Since the unveiling of the2009 H1N1 influenza, great deal of interest has been drawn to influenza, consequently a large number of influenza virus sequences have been deposited into the public sequence databases. Blast analysis demonstrated that the recently submitted 2007 South Dakota avian influenza virus strains and other North American avian strains contained genetic segments very closely related to the 2009 H1N1 virus, which suggests these avian influenza viruses are very close relatives of the 2009 H1N1 virus. Phylogenetic analyses also indicate that the2009 H1N1 viruses are associated with both avian and swine influenza viruses circulating in North America. Since the migrating wild birds are preferable to pigs as the carrier to spread the influenza viruses across vast distances, it is very likely that birds played an important role in the inter-continental evolution of the 2009 H1N1virus. It is essential to understand the evolutionary route of the emerging influenza virus in order to find a way to prevent further emerging cases. This study suggests the close relationship between 2009 pandemic virus and the North America avian viruses and underscores enhanced surveillance of influenza in birds for understanding the evolution of the 2009 pandemic influenza.

  15. Lessons Learned from H1N1 Epidemic: The Role of Mass Media in Informing Physicians.

    Gholami, Jaleh; Hosseini, Sayed Hamed; Ashoorkhani, Mahnaz; Majdzadeh, Reza


    Preparedness and response at the time of pandemic range from writing programs to conducting procedures as well as informing the target population. The present study was conducted to evaluate the awareness of general practitioners in Tehran, at the time of H1N1 pandemic. It also aimed to identify the main sources used for gathering information at each alert level. Two telephone surveys were conducted with a 4 month interval, at the beginning of H1N1 pandemic alert level 5 and 6, on 90 and 100 general practitioners, respectively. The knowledge of these physicians on the symptoms of H1N1 flu, the transmission methods, the preventative measures, and existing treatments along with the sources used for gathering information were assessed. While mass media was the main source of gathering information in the H1N1 pandemic alert level 5, more professional sources were used at the H1N1 pandemic alert level 6. Despite the acceptable improvement noted in the knowledge of the physicians during the two phases of the study, their understanding of the disease was believed to be less than the expected level based on H1N1 pandemic alert level. The routine use of mass media as one of the main sources of information gathering at the two stages of the study points out its importance in providing physicians with the required information at the time of H1N1 pandemic. Using adequate, up-to-date, but non-specialized media can fill the gap in information gathering, required for fighting pandemic.

  16. Clinical profile and outcome of critically ill pregnant females with H1N1 influenza

    Minal Shastri


    Full Text Available Background Record based review of the 2009 H1N1 Influenza pandemic suggests that pregnant women are at higher risk for hospitalization and death due to H1N1 Influenza. Aims To study the clinical profile and outcome of critically ill pregnant females admitted in intensive care unit (ICU with real-time recombinant polymerase chain reaction (rRT-PCR proven positive H1N1 cases. Methods A retrospective record-review based study was conducted at Sir SayajiRao General Hospital (SSGH and Medical College, Vadodara on data of confirmed rRT-PCR H1N1 pregnant females admitted during the pandemics of 2010and 2015. Demographics, clinical profile and laboratory investigations were recorded and outcomes (survived or expired were analysed. Results There were a total of 20 H1N1 positive pregnant females requiring ICU admission. With equal demographic distribution among rural and urban population, cough and fever were the most common presenting complaints. 65 per cent were in third trimester, the subgroup which also had the highest mortality. Mean days from onset until presentation was 5.05 days. 12 (60 per cent patients’ required invasive mode of ventilation and all died. Average hospital stay was 7 days. Foetus had favourable outcome in patients who recovered from H1N1 acute illness. Conclusion Pregnant females in our study had 60 per cent mortality. Thus, awareness, early diagnosis and treatment should be provided to them. Guidelines, policy changes and government protocols are required specifically for pregnant females with H1N1 Influenza A infection. Our study was an observational study and comparisons with non-pregnant females were not done, conclusions applicable to entire pregnant population was not derived.

  17. Pandemic influenza (H1N1 2009 is associated with severe disease in India.

    Akhilesh C Mishra

    Full Text Available BACKGROUND: Pandemic influenza A (H1N1 2009 has posed a serious public health challenge world-wide. In absence of reliable information on severity of the disease, the nations are unable to decide on the appropriate response against this disease. METHODS: Based on the results of laboratory investigations, attendance in outpatient department, hospital admissions and mortality from the cases of influenza like illness from 1 August to 31 October 2009 in Pune urban agglomeration, risk of hospitalization and case fatality ratio were assessed to determine the severity of pandemic H1N1 and seasonal influenza-A infections. RESULTS: Prevalence of pandemic H1N1 as well as seasonal-A cases were high in Pune urban agglomeration during the study period. The cases positive for pandemic H1N1 virus had significantly higher risk of hospitalization than those positive for seasonal influenza-A viruses (OR: 1.7. Of 93 influenza related deaths, 57 and 8 deaths from Pune (urban and 27 and 1 death from Pune (rural were from pandemic H1N1 positive and seasonal-A positive cases respectively. The case fatality ratio 0.86% for pandemic H1N1 was significantly higher than that of seasonal-A (0.13% and it was in category 3 of the pandemic severity index of CDC, USA. The data on the cumulative fatality of rural and urban Pune revealed that with time the epidemic is spreading to rural areas. CONCLUSIONS: The severity of the H1N1 influenza pandemic is less than that reported for 'Spanish flu 1918' but higher than other pandemics of the 20(th century. Thus, pandemic influenza should be considered as serious health threat and unprecedented global response seems justified.

  18. 甲型H1N1流感相关研究进展

    熊璐; 赵景民


    @@ 甲型H1N1 流感(influenza A,H1N1)是由变异后的新型甲型H1N1 流感病毒所引起的急性呼吸道传染病,原称人感染猪流感.为避免误导公众,WHO 2009 年4 月30 日在日内瓦宣布,将停止使用"swine influenza"这一称呼,改为"influenza A(H1N1)".卫生部迅速作出反应,将"人感染猪流感"更名为"甲型H1N1 流感"[1].其主要临床表现为流感样症状,患者病情多较轻,少数病例病情严重,进展迅速,严重者可以导致死亡.

  19. New Onset Refractory Status Epilepticus in a Young Man with H1N1 Infection

    Faisal Ibrahim


    Full Text Available Objective. To report a case of refractory status epilepticus (SE as an unusual early manifestation of H1N1 influenza infection. Introduction. H1N1 neurological complications have been reported and consist mainly of seizures or encephalopathy occurring in children. However, we only found a single report of an adult developing complex partial SE with H1N1 infection. Case Report. A 21-year-old previously healthy man was brought to the emergency room (ER after a witnessed generalized tonic clonic seizure (GTCS. He was fully alert and afebrile upon ER arrival, but a second GTCS prompted treatment with Lorazepam and Fosphenytoin. The initial EEG showed diffuse slowing, but a repeat one requested as the patient failed to regain consciousness revealed recurrent focal seizures of independent bihemispheric origin, fulfilling the criteria for nonconvulsive SE. Chest X-ray, followed by chest CT scan, showed a left upper lobe consolidation. H1N1 infection was confirmed with PCR on bronchoalveolar lavage material. Despite aggressive treatment with Midazolam, Propofol, and multiple high dose antiepileptic drugs, the electrographic seizures recurred at every attempt to reduce the intravenous sedative drugs. The patient died two weeks after his initial presentation. Conclusion. H1N1 should be added to the list of rare causes of refractory SE, regardless of the patient’s age.

  20. Framing of Influenza A (H1N1) pandemic in a Singaporean newspaper.

    Basnyat, Iccha; Lee, Seow Ting


    This study seeks to understand how public health messages provided by the government in Singapore during an Influenza A (H1N1) pandemic were framed by the news media for the public. News articles were analyzed to explore how the global pandemic was framed as a local event, providing a unique exploration of the dynamic involving public health communication, news media and the state. Thematic analysis (n = 309) included the government-issued press releases disseminating public health information about H1N1 that were directly linked to news stories (n = 56) and news stories about H1N1 generated by the newspaper (n = 253). Four themes were found: (i) imported disease, (ii) war/battle metaphors, (iii) social responsibility and (iv) lockdown policies. Frame analysis revealed that the news coverage during the H1N1 pandemic reflected how the newspaper framed and mediated the information flow, amplified a positive tone for the government response, emphasized individual responsibility and utilized gain frames to construct local messages about the global H1N1 pandemic that reified Singapore as a nation-state. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email:

  1. Influenza A(H1N1)pdm09 during air travel.

    Neatherlin, John; Cramer, Elaine H; Dubray, Christine; Marienau, Karen J; Russell, Michelle; Sun, Hong; Whaley, Melissa; Hancock, Kathy; Duong, Krista K; Kirking, Hannah L; Schembri, Christopher; Katz, Jacqueline M; Cohen, Nicole J; Fishbein, Daniel B


    The global spread of the influenza A(H1N1)pdm09 virus (pH1N1) associated with travelers from North America during the onset of the 2009 pandemic demonstrates the central role of international air travel in virus migration. To characterize risk factors for pH1N1 transmission during air travel, we investigated travelers and airline employees from four North American flights carrying ill travelers with confirmed pH1N1 infection. Of 392 passengers and crew identified, information was available for 290 (74%) passengers were interviewed. Overall attack rates for acute respiratory infection and influenza-like illness 1-7 days after travel were 5.2% and 2.4% respectively. Of 43 individuals that provided sera, 4 (9.3%) tested positive for pH1N1 antibodies, including 3 with serologic evidence of asymptomatic infection. Investigation of novel influenza aboard aircraft may be instructive. However, beyond the initial outbreak phase, it may compete with community-based mitigation activities, and interpretation of findings will be difficult in the context of established community transmission.

  2. Initial incursion of pandemic (H1N1) 2009 influenza A virus into European pigs.

    Welsh, M D; Baird, P M; Guelbenzu-Gonzalo, M P; Hanna, A; Reid, S M; Essen, S; Russell, C; Thomas, S; Barrass, L; McNeilly, F; McKillen, J; Todd, D; Harkin, V; McDowell, S; Choudhury, B; Irvine, R M; Borobia, J; Grant, J; Brown, I H


    The initial incursion of pandemic (H1N1) 2009 influenza A virus (pH1N1) into a European pig population is reported. Diagnosis of swine influenza caused by pandemic virus was made during September 2009 following routine submission of samples for differential diagnosis of causative agents of respiratory disease, including influenza A virus. All four pigs (aged six weeks) submitted for investigation from a pig herd of approximately 5000 animals in Northern Ireland, experiencing acute-onset respiratory signs in finishing and growing pigs, were positive by immunofluorescence for influenza A. Follow-up analysis of lung tissue homogenates by real-time RT-PCR confirmed the presence of pH1N1. The virus was subsequently detected on two other premises in Northern Ireland; on one premises, detection followed the pre-export health certification testing of samples from pigs presumed to be subclinically infected as no clinical signs were apparent. None of the premises was linked to another epidemiologically. Sequencing of the haemagglutinin and neuraminidase genes revealed high nucleotide identity (>99.4 per cent) with other pH1N1s isolated from human beings. Genotypic analyses revealed all gene segments to be most closely related to those of contemporary pH1N1 viruses in human beings. It is concluded that all three outbreaks occurred independently, potentially as a result of transmission of the virus from human beings to pigs.

  3. Influenza A viral loads in respiratory samples collected from patients infected with pandemic H1N1, seasonal H1N1 and H3N2 viruses

    Chuchottaworn Charoen


    Full Text Available Abstract Background Nasopharyngeal aspirate (NPA, nasal swab (NS, and throat swab (TS are common specimens used for diagnosis of respiratory virus infections based on the detection of viral genomes, viral antigens and viral isolation. However, there is no documented data regarding the type of specimen that yields the best result of viral detection. In this study, quantitative real time RT-PCR specific for M gene was used to determine influenza A viral loads present in NS, NPA and TS samples collected from patients infected with the 2009 pandemic H1N1, seasonal H1N1 and H3N2 viruses. Various copy numbers of RNA transcripts derived from recombinant plasmids containing complete M gene insert of each virus strain were assayed by RT-PCR. A standard curve for viral RNA quantification was constructed by plotting each Ct value against the log quantity of each standard RNA copy number. Results Copy numbers of M gene were obtained through the extrapolation of Ct values of the test samples against the corresponding standard curve. Among a total of 29 patients with severe influenza enrolled in this study (12 cases of the 2009 pandemic influenza, 5 cases of seasonal H1N1 and 12 cases of seasonal H3N2 virus, NPA was found to contain significantly highest amount of viral loads and followed in order by NS and TS specimen. Viral loads among patients infected with those viruses were comparable regarding type of specimen analyzed. Conclusion Based on M gene copy numbers, we conclude that NPA is the best specimen for detection of influenza A viruses, and followed in order by NS and TS.

  4. Influenza pandêmica A (H1N1) 2009: fatores de risco para o internamento Pandemic influenza A (H1N1) 2009: risk factors for hospitalization


    OBJETIVO: Avaliar os aspectos da influenza pandêmica A (H1N1) 2009 em pacientes hospitalizados a fim de identificar os fatores de risco para o internamento e, consequentemente, para o agravamento da doença. MÉTODOS: Estudo observacional e retrospectivo realizado entre março e dezembro de 2010. Os dados foram coletados a partir do Sistema Nacional de Agravos de Notificação do Ministério da Saúde. Foram incluídos somente os pacientes hospitalizados e não hospitalizados com confirmação laborator...

  5. Opinions on Influenza A (H1N1)%我的一点看法



    2009年4月,一场突如其来的疫情席卷全球,引起各国高度重视。这一疫情的命名经历了从“猪流感(swine influenza)”等词到“甲型H1N1流感(influenza A(H1N1))”的变化。本刊对此命名变化的来龙去脉以及“甲型H1N1流感”的含义进行了梳理与解读,并就命名问题征询了一些专家的意见。

  6. Outcomes of influenza A(H1N1)pdm09 virus infection

    Lynfield, Ruth; Davey, Richard; Dwyer, Dominic E


    BACKGROUND: Data from prospectively planned cohort studies on risk of major clinical outcomes and prognostic factors for patients with influenza A(H1N1)pdm09 virus are limited. In 2009, in order to assess outcomes and evaluate risk factors for progression of illness, two cohort studies were...... and/or death for outpatients, and hospitalization for >28 days, transfer to intensive care unit (ICU) if enrolled from general ward, and/or death for inpatients. Infection was confirmed by RT-PCR. 590 FLU 002 and 392 FLU 003 patients with influenza A (H1N1)pdm09 were enrolled from 81 sites in 17...... during the pandemic period had a poorer prognosis than in subsequent seasons. CONCLUSIONS: Patients with influenza A(H1N1)pdm09, particularly when requiring hospital admission, are at high risk for disease progression, especially if they are older, immunodeficient, or admitted late in infection...

  7. Neurological complications after H1N1 influenza vaccination: magnetic resonance imaging findings

    Ronaldo Lessa


    Full Text Available Objective: To report 4 different neurological complications of H1N1 virus vaccination. Method: Four patients (9, 16, 37 and 69 years of age had neurological symptoms (intracranial hypertension, ataxia, left peripheral facial palsy of abrupt onset, altered mental status, myelitis starting 4-15 days after H1N1 vaccination. MRI was obtained during the acute period. Results: One patient with high T2 signal in the cerebellum interpreted as acute cerebellitis; another, with left facial palsy, showed contrast enhancement within both internal auditory canals was present, however it was more important in the right side; one patient showed gyriform hyperintensities on FLAIR with sulcal effacement in the right fronto-parietal region; and the last one showed findings compatible with thoracic myelitis. Conclusion: H1N1 vaccination can result in important neurological complications probably secondary to post-vaccination inflammation. MRI detected abnormalities in all patients.

  8. Susceptibility of turkeys to pandemic-H1N1 virus by reproductive tract insemination

    Suarez David L


    Full Text Available Abstract The current pandemic influenza A H1N1 2009 (pH1N1 was first recognized in humans with acute respiratory diseases in April 2009 in Mexico, in swine in Canada in June, 2009 with respiratory disease, and in turkeys in Chile in June 2009 with a severe drop in egg production. Several experimental studies attempted to reproduce the disease in turkeys, but failed to produce respiratory infection in turkeys using standard inoculation routes. We demonstrated that pH1N1 virus can infect the reproductive tract of turkey hens after experimental intrauterine inoculation, causing decreased egg production. This route of exposure is realistic in modern turkey production because turkey hens are handled once a week for intrauterine insemination in order to produce fertile eggs. This understanding of virus exposure provides an improved understanding of the pathogenesis of the disease and can improve poultry husbandry to prevent disease outbreaks.

  9. Kompliceret influenza A (H1N1) hos gravid i andet trimester

    Ersbøll, A.S.; Hedegaard, M.; Hesselvig, A.B.


    A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded and an ...... and an emergency caesarean was performed at 26 weeks + 2 days of gestation. The neonatal period was uncomplicated. Influenza A (H1N1) is especially dangerous in pregnant women and vaccination is important.......A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded...

  10. Two cases of exudative retina detachment and uveitis following H1N1 influenza vaccination

    TAO Yong; CHANG Li-bing; ZHAO Min; LI Xiao-xin


    Uveitis was a rare adverse event of vaccination.We met two cases of acute uveitis with exudative retinal detachment following vaccination of H1N1 influenza.Case 1 was a 10-year-old boy who was admitted for bilateral blurred vision at 10 days after vaccination of H1N1 influenza.Vitreous opacity was obvious in both eyes.Broad exudative retinal detachment was observed in the right eye.Case 2 was a 47-year-old female who suffered from an acute high fever at 2 days after the vaccination of H1 N1 influenza.Later,she encountered bilateral headache and decreasing vision.In both eyes,mutton fat keratic precipitates,positive Tyndall phenomenon,congestion of optic disc and exudative retinal detachment were observed.

  11. Mongrelised genetics of H1N1 virus: A bird′s eyeview

    Nagarathna C


    Full Text Available H1N1 influenza, also known as "novel H1N1 virus" has led to a "global outcry." This virus is more virulent when compared with other seasonal flu viruses. Virulence may change as the adaptive mutation gene increases within the virus. A study at the US Centre for Disease Control and Prevention published in May 2009 found that children had no preexisting immunity to the new strain as they showed no cross-reactive antibody reaction when compared with adults aged 18-64 years, who showed a cross-reactive antibody reaction of 6-9% and older adults with 33% immunity. This review article depicts H1N1 virus, its virulence with genetic evolution potential and preventive protocol for the dental professionals. This would allow us to comprehend the changes in the disease process and contribute in its prevention as "prevention is better than cure."

  12. Nephrotic Syndrome Following H1N1 Influenza in a 3-Year-Old Boy

    Pio Liberatore


    Full Text Available Background: The pandemic influenza A/H1N1, spread through the world in 2009, producing a serious epidemic in Italy. Complications are generally limited to patients at the extremes of age (65years and those with comorbid medical illness. The most frequent complications of influenza involve the respiratory system.Case Presentation: A 3-year-old boy with a recent history of upper respiratory tract infection developed a nephrotic syndrome. Together with prednisone, furosemide and albumin bolus, a therapy with oseltamivir was started since the nasopharyngeal swab resulted positive for influenza A/H1N1. Clinical conditions andlaboratory findings progressively improved during hospitalization, becoming normal during a 2 month follow up.Conclusion: The possibility of a renal involvement after influenza A/H1N1 infection should be considered.

  13. Effect of the novel influenza A (H1N1 virus in the human immune system.

    Evangelos J Giamarellos-Bourboulis

    Full Text Available BACKGROUND: The pandemic by the novel H1N1 virus has created the need to study any probable effects of that infection in the immune system of the host. METHODOLOGY/PRINCIPAL FINDINGS: Blood was sampled within the first two days of the presentation of signs of infection from 10 healthy volunteers; from 18 cases of flu-like syndrome; and from 31 cases of infection by H1N1 confirmed by reverse RT-PCR. Absolute counts of subtypes of monocytes and of lymphocytes were determined after staining with monoclonal antibodies and analysis by flow cytometry. Peripheral blood mononuclear cells (PBMCs were isolated from patients and stimulated with various bacterial stimuli. Concentrations of tumour necrosis factor-alpha, interleukin (IL-1beta, IL-6, IL-18, interferon (FN-alpha and of IFN-gamma were estimated in supernatants by an enzyme immunoassay. Infection by H1N1 was accompanied by an increase of monocytes. PBMCs of patients evoked strong cytokine production after stimulation with most of bacterial stimuli. Defective cytokine responses were shown in response to stimulation with phytohemagglutin and with heat-killed Streptococcus pneumoniae. Adaptive immune responses of H1N1-infected patients were characterized by decreases of CD4-lymphocytes and of B-lymphocytes and by increase of T-regulatory lymphocytes (Tregs. CONCLUSIONS/SIGNIFICANCE: Infection by the H1N1 virus is accompanied by a characteristic impairment of the innate immune responses characterized by defective cytokine responses to S.pneumoniae. Alterations of the adaptive immune responses are predominated by increase of Tregs. These findings signify a predisposition for pneumococcal infections after infection by H1N1 influenza.

  14. Neuronal Antibodies in Children with or without Narcolepsy following H1N1-AS03 Vaccination.

    Thebault, Simon; Waters, Patrick; Snape, Matthew D; Cottrell, Dominic; Darin, Niklas; Hallböök, Tove; Huutoniemi, Anne; Partinen, Markku; Pollard, Andrew J; Vincent, Angela


    Type 1 narcolepsy is caused by deficiency of hypothalamic orexin/hypocretin. An autoimmune basis is suspected, but no specific antibodies, either causative or as biomarkers, have been identified. However, the AS03 adjuvanted split virion H1N1 (H1N1-AS03) vaccine, created to protect against the 2009 Pandemic, has been implicated as a trigger of narcolepsy particularly in children. Sera and CSFs from 13 H1N1-AS03-vaccinated patients (12 children, 1 young adult) with type 1 narcolepsy were tested for autoantibodies to known neuronal antigens including the N-methyl-D-aspartate receptor (NMDAR) and contactin-associated protein 2 (CASPR2), both associated with encephalopathies that include disordered sleep, to rodent brain tissue including the lateral hypothalamus, and to live hippocampal neurons in culture. When sufficient sample was available, CSF levels of melanin-concentrating hormone (MCH) were measured. Sera from 44 H1N1-ASO3-vaccinated children without narcolepsy were also examined. None of these patients' CSFs or sera was positive for NMDAR or CASPR2 antibodies or binding to neurons; 4/13 sera bound to orexin-neurons in rat brain tissue, but also to other neurons. MCH levels were a marginally raised (n = 8; p = 0.054) in orexin-deficient narcolepsy patients compared with orexin-normal children (n = 6). In the 44 H1N1-AS03-vaccinated healthy children, there was no rise in total IgG levels or in CASPR2 or NMDAR antibodies three weeks following vaccination. In conclusion, there were no narcolepsy-specific autoantibodies identified in type 1 narcolepsy sera or CSFs, and no evidence for a general increase in immune reactivity following H1N1-AS03 vaccination in the healthy children. Antibodies to other neuronal specific membrane targets, with their potential for directing use of immunotherapies, are still an important goal for future research.

  15. Molecular epidemiology and complete genome characterization of H1N1pdm virus from India.

    Shashi Sharma

    Full Text Available BACKGROUND: Influenza A virus is one of world's major uncontrolled pathogen, causing seasonal epidemic as well as global pandemic. This was evidenced by recent emergence and continued prevalent 2009 swine origin pandemic H1N1 Influenza A virus, provoking first true pandemic in the past 40 years. In the course of its evolution, the virus acquired many mutations and multiple unidentified molecular determinants are likely responsible for the ability of the 2009 H1N1 virus to cause increased disease severity in humans. Availability of limited data on complete genome hampers the continuous monitoring of this type of events. Outbreaks with considerable morbidity and mortality have been reported from all parts of the country. METHODS/RESULTS: Considering a large number of clinical cases of infection complete genome based sequence characterization of Indian H1N1pdm virus and their phylogenetic analysis with respect to circulating global viruses was undertaken, to reveal the phylodynamic pattern of H1N1pdm virus in India from 2009-2011. The Clade VII was observed as a major circulating clade in phylogenetic analysis. Selection pressure analysis revealed 18 positively selected sites in major surface proteins of H1N1pdm virus. CONCLUSIONS: This study clearly revealed that clade VII has been identified as recent circulating clade in India as well globally. Few clade VII specific well identified markers undergone positive selection during virus evolution. Continuous monitoring of the H1N1pdm virus is warranted to track of the virus evolution and further transmission. This study will serve as a baseline data for future surveillance and also for development of suitable therapeutics.

  16. [Effect of Yunnan herb Laggera pterodonta against influenza A (H1N1) virus in vitro].

    Xia, Xiao-ling; Sun, Qiang-ming; Wang, Xiao-dan; Zhao, Yu-jiao; Yang, Zi-feng; Huang, Qing-hui; Jiang, Zhi-hong; Wang, Xin-hua; Zhang, Rong-ping


    Laggera pterodonta is commonly used for treating influenza in Southwest China, especially in Yunnnan province. The main clinical effects of L. pterodonta include anti-influenza, anti-microbial, anti-inflammatory. To investigate the anti-influenza A (H1N1) virus effect of L. pterodonta, neutralization inhibition and proliferation inhibition tests were performed. MDCK culture method was used to observe the cytopathic effect (CPE) of extracts from L. pterodonta in inhibiting influenza A (H1N1) virus and haemagglutination titre of H1N1 virus in vitro. The culture medium were collected at 24 h, 48 h, 72 h, 96 h, and detected by Real time RT-PCR, in order to compare the effect of different extracts from L. pterodonta on in vitro proliferation of H1N1, virus. The result of neutralization inhibition test showed that hemagglutination titer of ethyl acetate extract were 8 times lower at 72 h; in proliferation inhibition test, hemagglutination titer of ethyl acetate extracts reduced by 2 and 4 times. According to the results of Real time RT-PCR test, the H1N1 inhibition ratio of ethyl acetate extract was 72.5%, while the proliferation inhibition ratio of ethyl acetate extract was 25.3%; as for petroleum ether extracts, the H1N1 inhibition ratio was 60.2%, while the proliferation inhibition ratio was 81.4%. In conclusion, both ethyl acetate extract and petroleum ether extract of L. pterodonta have significant neutralization and direct proliferation inhibition effects on influenza A virus.

  17. Breve revisión de la influenza A H1N1



    La influenza H1N1 (conocida como "gripe porcina") es un nuevo virus de influenza que se detectó por primera vez en seres humanos en los Estados Unidos en abril del 2009; Este virus es muy diferente y se está propagando alrededor del mundo. Puede causar más enfermedades o enfermedades más graves de lo normal; Las personas que tienen mayor riesgo de infección por la influenza "2009 H1N1" incluyen niños, mujeres embarazadas y personas con problemas crónicos de salud como el asma, la diabetes y e...

  18. Influenza A H1N1/2009 Infection in Pediatric Solid Organ Transplant Recipients

    Cabral Galeano, Evelyn; Gavaldà i Santapau, Joan


    The aim of this study was to describe the clinical characteristics of pandemic influenza A H1N1 infection. A retrospective study was performed in pediatric patients with solid organ transplantation and confirmed influenza A H1N1/2009 infection from June to December 2009, diagnosed in two Spanish teaching. Forty-nine patients were included. Pneumonia was diagnosed in 4 patients (8.2%), and 3 of them required respiratory support. There were no related deaths. Antiviral treatment within 48 hours...

  19. 甲型H1N1流感的研究进展



    2009年3~4月从墨西哥暴发的“猪流感”(Swine influenza,SI),后被更名为甲型H1N1流感[In-fluenzaA(H1N1)],迅速在全世界范围内蔓延。研究表明这种病毒基因组由禽流感、猪流感和人流感病毒基因混合而成,

  20. [Influenza A H1N1v treated with extra-corporal membrane oxygenation.

    Jensen, Reinhold; Severinsen, Inge Krogh; Terp, Kim


    A 37-year-old woman with body mass index > 30 was admitted to hospital with severe pneumonia due to H1N1v. Thoracic X-ray showed bilateral, diffuse infiltrates. There was no sign of complicating bacterial infection and all microbiological tests of tracheal secretion, blood and urine were negative....... Polymerase chain reaction test for H1N1v was positive until day ten. No mutations were found in the virus. The patient was given oseltamivir tablets and inhalable zanamivir as well as antibiotics. The patient was treated with extra-corporal membrane oxygenation (EcmO) for 12 days followed by ventilator...

  1. Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage

    Paola Faverio


    Full Text Available We present the results of bronchoalveolar lavage (BAL performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS. Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear, plasmoblastic/plasmocytoid-like cells never described before. Via transmission electron microscopy, these cells were classified as atypical type II pneumocytes and some of them showed cytoplasmic vesicles and inclusions. We concluded that plasmoblastic/plasmocytoid-like type II pneumocytes might represent a morphologic marker of A/H1N1 influenza virus infection as well as reparative cellular activation after diffuse alveolar damage.

  2. How Does Influenza A (H1N1 Infection Proceed in Allogeneic Stem Cell Transplantation Recipients?

    Sinem Civriz Bozdağ


    Full Text Available Clinical course of H1N1 infection in Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT patients is contraversial. We report three AHSCT patients who were infected with Influenza A/H1N1 infection. All of the patients were diagnosed with different hematological diagnosis and were at different stages of transplantation.All of them were treated with oseltamivir,zanamivir was switched with oseltamivir in one patient. All of the three patients were survived without any complication. Swine flu, can display with different courses and progress with bacterial or other viral infections in immunsupressed patients.

  3. How Does Influenza A (H1N1 Infection Proceed in Allogeneic Stem Cell Transplantation Recipients?

    Sinem Civriz Bozdağ


    Full Text Available Clinical course of H1N1 infection in Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT patients is contraversial. We report three AHSCT patients who were infected with Influenza A/H1N1 infection. All of the patients were diagnosed with different hematological diagnosis and were at different stages of transplantation.All of them were treated with oseltamivir,zanamivir was switched with oseltamivir in one patient. All of the three patients were survived without any complication. Swine flu, can display with different courses and progress with bacterial or other viral infections in immunsupressed patients.

  4. A case of Pityriasis rosea concurrent with the novel influenza A (H1N1) infection.

    Mubki, Thamer F; Bin Dayel, Salaman A; Kadry, Razan


    Pityriasis rosea is a common skin disease with a self-limiting course. Multiple etiologies including viruses, bacteria, and fungi have been investigated in an attempt to confirm a casual association. Pityriasis rosea has not been associated with influenza virus, but has been associated with herpes simplex virus types 6 and 7. We encountered a case of a proven pandemic H1N1 infection associated with a clincopathological diagnosis of pityriasis rosea. We conclude that influenza A (H1N1) virus could either be a primary cause of pityriasis rosea or a trigger for reactivation of other viral causes. © 2011 Wiley Periodicals, Inc.

  5. Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage

    Faverio, Paola; Messinesi, Grazia; Brenna, Ambrogio; Pesci, Alberto


    We present the results of bronchoalveolar lavage (BAL) performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS). Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear, plasmoblastic/plasmocytoid-like cells never described before. Via transmission electron microscopy, these cells were classified as atypical type II pneumocytes and some of them showed cytoplasmic vesicles and inclusions. We concluded that plasmoblastic/plasmocytoid-like type II pneumocytes might represent a morphologic marker of A/H1N1 influenza virus infection as well as reparative cellular activation after diffuse alveolar damage. PMID:25383078

  6. [Influenza A H1N1v treated with extra-corporal membrane oxygenation.

    Jensen, Reinhold; Severinsen, Inge Krogh; Terp, Kim


    A 37-year-old woman with body mass index > 30 was admitted to hospital with severe pneumonia due to H1N1v. Thoracic X-ray showed bilateral, diffuse infiltrates. There was no sign of complicating bacterial infection and all microbiological tests of tracheal secretion, blood and urine were negative....... Polymerase chain reaction test for H1N1v was positive until day ten. No mutations were found in the virus. The patient was given oseltamivir tablets and inhalable zanamivir as well as antibiotics. The patient was treated with extra-corporal membrane oxygenation (EcmO) for 12 days followed by ventilator...

  7. Pulmonary Complication of Novel Influenza A (H1N1) Infection: Imaging Features in Two Patients

    Lee, Choong Wook; Seo, Joon Beom; Song, Jae Woo; Lee, Hyun Joo; Lee, Jin Seong; Kim, Mi Young; Chae, Eun Jin; Song, Jin Woo; Kim, Won Young [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    Novel influenza A (H1N1) virus is the pathogen of recent global outbreaks of febrile respiratory infection. We herein report the imaging findings of pulmonary complication in two patients with novel influenza A (H1N1) infection. The first patient without secondary infection showed the ill-defined ground-glass opacity nodules and patch areas of ground-glass opacities. The second patient with secondary pneumococcal pneumonia showed areas of lobar consolidation in the right middle lobe and left lower lobe and ground-glass opacities.

  8. International collaboration to assess the risk of Guillain Barre Syndrome following Influenza A (H1N1) 2009 monovalent vaccines

    Dodd, Caitlin N.; Romio, Silvana A.; Black, Steven; Vellozzi, Claudia; Andrews, Nick; Sturkenboom, Miriam; Zuber, Patrick; Hua, Wei; Bonhoeffer, Jan; Buttery, Jim; Crawford, Nigel; Deceuninck, Genevieve; de Vries, Corinne; De Wals, Philippe; Gutierrez-Gimeno, M. Victoria; Heijbel, Harald; Hughes, Hayley; Hur, Kwan; Hviid, Anders; Kelman, Jeffrey; Kilpi, Tehri; Chuang, S. K.; Macartney, Kristine; Rett, Melisa; Lopez-Callada, Vesta Richardson; Salmon, Daniel; Sanchez, Francisco Gimenez; Sanz, Nuria; Silverman, Barbara; Storsaeter, Jann; Thirugnanam, Umapathi; van der Maas, Nicoline; Yih, Katherine; Zhang, Tao; Izurieta, Hector


    Background: The global spread of the 2009 novel pandemic influenza A (H1N1) virus led to the accelerated production and distribution of monovalent 2009 Influenza A (H1N1) vaccines (pH1N1). This pandemic provided the opportunity to evaluate the risk of Guillain-Barre syndrome (GBS), which has been an

  9. Replication, Pathogenesis and Transmission of Pandemic (H1N1) 2009 Virus in Non-Immune Pigs

    Brookes, S.M.; Nunez, A.; Choudhury, B.; Matrosovich, M.; Essen, S.C.; Clifford, D.; Slomka, M.J.; Kuntz-Simon, G.; Garcon, F.; Nash, B.; Hanna, A.; Heegaard, P.M.H.; Queguiner, S.; Chiapponi, C.; Bublot, M.; Garcia, J.M.; Gardner, R.; Foni, E.; Loeffen, W.L.A.; Larsen, L.; Reeth, K.; Banks, J.; Irvine, R.M.; Brown, I.H.


    The declaration of the human influenza A pandemic (H1N1) 2009 (H1N1/09) raised important questions, including origin and host range [1,2]. Two of the three pandemics in the last century resulted in the spread of virus to pigs (H1N1, 1918; H3N2, 1968) with subsequent independent establishment and evo

  10. Full-Genome Sequence of a Reassortant H1N1 Swine Influenza Virus Isolated from Pigs in Italy.

    Chiapponi, Chiara; Baioni, Laura; Luppi, Andrea; Moreno, Ana; Castellan, Alberto; Foni, Emanuela


    In this study, the full-genome sequence of a novel reassortant H1N1 swine influenza virus (SIV) is reported. The isolate has a hemagglutinin (HA) gene of the pandemic H1N1 influenza virus, but it carries the seven genome segments of the avian-origin H1N1 SIV currently circulating in European pig farms.

  11. Replication, Pathogenesis and Transmission of Pandemic (H1N1) 2009 Virus in Non-Immune Pigs

    Brookes, Sharon M; Nunez, Alejandor; Choudhury, Bhudipa


    The declaration of the human influenza A pandemic (H1N1) 2009 (H1N1/09) raised important questions, including origin and host range [1,2]. Two of the three pandemics in the last century resulted in the spread of virus to pigs (H1N1, 1918; H3N2, 1968) with subsequent independent establishment...

  12. Information Entropy Analysis of the H1N1 Genetic Code

    Martwick, Andy


    During the current H1N1 pandemic, viral samples are being obtained from large numbers of infected people world-wide and are being sequenced on the NCBI Influenza Virus Resource Database. The information entropy of the sequences was computed from the probability of occurrence of each nucleotide base at every position of each set of sequences using Shannon's definition of information entropy, [ H=∑bpb,2( 1pb ) ] where H is the observed information entropy at each nucleotide position and pb is the probability of the base pair of the nucleotides A, C, G, U. Information entropy of the current H1N1 pandemic is compared to reference human and swine H1N1 entropy. As expected, the current H1N1 entropy is in a low entropy state and has a very large mutation potential. Using the entropy method in mature genes we can identify low entropy regions of nucleotides that generally correlate to critical protein function.

  13. Distribution and risk factors of 2009 pandemic influenza A (H1N1) in mainland China

    L-Q. Fang (Li-Qun); L-P. Wang (Li-Ping); S.J. de Vlas (Sake); S. Liang (Song); S-L. Tong (Shi-Lu); Y-L. Li (Yan-Li); Y-P. Li (Ya-Pin); Q. Qian (Quan); H. Yang (Hong); M-G. Zhou (Mai-Geng); X-F. Wang (Xiao-Feng); J.H. Richardus (Jan Hendrik); J-Q. Ma (Jia-Qi); W.C. Cao (Wu Chun)


    textabstractData from all reported cases of 2009 pandemic influenza A (H1N1) were obtained from the China Information System for Disease Control and Prevention. The spatiotemporal distribution patterns of cases were characterized through spatial analysis. The impact of travel-related risk factors on

  14. De Quervain thyroiditis in the course of H1N1 influenza infection

    Michas, G.; Alevetsovitis, G; Andrikou, I; Tsimiklis, S; Vryonis, E.


    Background/aim: Viral infections have been frequently associated with subacute (De Quervain) thyroiditis and autoimmune thyroid diseases. In the present case report we document a rare case of De Quervain thyroiditis in the course of H1N1 influenza infection.

  15. The hemagglutinin structure of an avian H1N1 influenza A virus

    Lin, Tianwei; Wang, Gengyan; Li, Anzhang; Zhang, Qian; Wu, Caiming; Zhang, Rongfu; Cai, Qixu; Song, Wenjun; Yuen, Kwok-Yung; (U. Hong Kong); (Inter. Inst. Infect. Imm.); (Xiamen)


    The interaction between hemagglutinin (HA) and receptors is a kernel in the study of evolution and host adaptation of H1N1 influenza A viruses. The notion that the avian HA is associated with preferential specificity for receptors with Sia{alpha}2,3Gal glycosidic linkage over those with Sia{alpha}2,6Gal linkage is not all consistent with the available data on H1N1 viruses. By x-ray crystallography, the HA structure of an avian H1N1 influenza A virus, as well as its complexes with the receptor analogs, was determined. The structures revealed no preferential binding of avian receptor analogs over that of the human analog, suggesting that the HA/receptor binding might not be as stringent as is commonly believed in determining the host receptor preference for some subtypes of influenza viruses, such as the H1N1 viruses. The structure also showed difference in glycosylation despite the preservation of related sequences, which may partly contribute to the difference between structures of human and avian origin.

  16. Online Flutracking Survey of Influenza-like Illness during Pandemic (H1N1) 2009, Australia

    Carlson, Sandra J.; Dalton, Craig B.; Fejsa, John


    We compared the accuracy of online data obtained from the Flutracking surveillance system during pandemic (H1N1) 2009 in Australia with data from other influenza surveillance systems. Flutracking accurately identified peak influenza activity timing and community influenza-like illness activity and was significantly less biased by treatment-seeking behavior and laboratory testing protocols than other systems. PMID:21122231

  17. Influenza A(H1N1pdm09-associated pneumonia deaths in Thailand.

    Charatdao Bunthi

    Full Text Available BACKGROUND: The first human infections with influenza A(H1N1pdm09 virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010. METHODS: We identified influenza A(H1N1pdm09-associated pneumonia deaths from a national influenza surveillance system and performed detailed reviews of a subset. RESULTS: Of 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. CONCLUSIONS: Most influenza A(H1N1pdm09 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.

  18. Determinants of Parental Acceptance of the H1N1 Vaccine

    Hilyard, Karen M.; Quinn, Sandra Crouse; Kim, Kevin H.; Musa, Don; Freimuth, Vicki S.


    Although designated as a high-risk group during the 2009-2010 H1N1 pandemic, only about 40% of U.S. children received the vaccine, a relatively low percentage compared with high-risk groups in seasonal influenza, such as the elderly, whose vaccine rates typically top 70%. To better understand parental decision making and predictors of acceptance…

  19. Antivirals Use During the Pandemic H1N1 2009 Outbreak


    Charisma Atkins, CDC public health analyst, discusses antiviral use during the 2009 H1N1 pandemic flu outbreak.  Created: 1/23/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/23/2012.

  20. A/H1N1研究进展



    @@ 2009年3以来,包括墨西哥、美国和加拿大在内的许多国家发生了甲型H1N1流感[Swine-origin Influenza A (A/H1N1)]疫情,WHO已于2009年6月20日将此次流感流行的预警级别提升至6级.现已基本明确,引起此次流感疫情的A/H1N1流感病毒是猪流感病毒(Swine Influenza Virus, SIV)的一种新型变异株.此次流感疫情的发生,再次使猪流感成为社会各界关注的焦点之一.本文就甲型H1N1流感的临床表现、病毒特征、相互关系及其对动物卫生监督工作的影响等作一综述.

  1. Immunization-Safety Monitoring Systems for the 2009 H1N1 Monovalent Influenza Vaccination Program

    Salmon, Daniel A.; Akhtar, Aysha; Mergler, Michelle J.; Vannice, Kirsten S.; Izurieta, Hector; Ball, Robert; Lee, Grace M.; Vellozzi, Claudia; Garman, Patrick; Cunningham, Francesca; Gellin, Bruce; Koh, Howard; Lurie, Nicole


    The effort to vaccinate the US population against the 2009 H1N1 influenza virus hinged, in part, on public confidence in vaccine safety. Early in the vaccine program, >20% of parents reported that they would not vaccinate their children. Concerns about the safety of the vaccines were reported by man

  2. Zoonoses: USDA ARS Lessons Learned During Novel Influenza H1N1 Investigations

    Influenza illness was first recognized in pigs during the 1918 human Spanish flu pandemic, and influenza A virus has since remained of importance to the swine industry as a primary respiratory pathogen. Influenza virus H1N1 remained relatively stable in U.S. swine for nearly 80 years following 1918...

  3. Outbreak of influenza A(H1N1) in a school in southern England.

    Goddard, N.; Paynter, S.; Paget, J.


    An outbreak of influenza A (subtype H1N1) has occurred in a primary school in West Sussex, southern England [1]. The first cases of illness occurred during the first week of May 2004. One child was admitted to hospital during that week with symptoms of fever, confusion, headache, and conjunctivitis.

  4. Altered response to A(H1N1)pnd09 vaccination in pregnant women

    Bischoff, Anne Louise; Følsgaard, Nilofar Vahman; Carson, Charlotte Giwercman


    BACKGROUND: Pregnant women were suspected to be at particular risk when H1N1pnd09 influenza became pandemic in 2009. Our primary objective was to compare the immune responses conferred by MF59®-adjuvanted vaccine (Focetria®) in H1N1pnd09-naïve pregnant and non-pregnant women. The secondary aims...... women after gestational week 20: (1) 7.5 µg H1N1pnd09 antigen with MF59-adjuvant (Pa7.5 µg); (2) 3.75 µg antigen half MF59-adjuvanted (Pa3.75 µg); (3) 15 µg antigen unadjuvanted (P15 µg); and in non-pregnant women receiving (4) 7.5 µg antigen full adjuvanted (NPa7.5 µg). Blood samples were collected......-pregnant (NPa7.5 µg) groups (OR = 0.49 [0.13-1.85], p = 0.29). CONCLUSION: Our study suggests the immune response to the 7.5 µg MF59-adjuvanted Focetria® H1N1pnd09 vaccine in pregnant women may be diminished compared with non-pregnant women. TRIAL REGISTRATION: NCT01012557....

  5. Development of a diagnostic kit for Tamiflu-resistant influenza A (H1N1)

    Jung, I. L.; Hong, S. W.


    Swine influenza A, which has been pandemic worldwide since 2009, is a new type virus derived from A type influenza. Although some drugs against the contageous disease, such as relenza and tamiflu, have been commercialized, those drug resistant viruses could be also followed by the wide usage of drugs. For examples, Tamiflu-resistant viruses, the mutant type viruses, can not be cured by the treatment of tamiflu anymore. Thus, a quick diagnosis for the wild type (tamiflu-sensitive) and mutant (tamiflu-resistant) virus would be essential in order to prevent the wide spread of viruses. In spite of that, unfortunately, very few studies have been conducted until now. If we could tell the differences between tamiflu-resistant and -sensitive patients using by the proper diagnostic kit, not only patient specific treatment would be possible, but also the spread of viruses would be effectively prevented. Currently used detection methods for the swine influenza A H1N1, which were originated from CDC, USA, can not detect the tamiflu-resistant swine influenza A H1N1, but only can detect tamiflu-sensitive wine influenza A H1N1. In this study, all the primers for the detection of swInfA, swH1, MP and NA (neuraminidase) have been developed in order to detect both tamiflu-resistant and tamiflu-sensitive swine influenza A H1N1s simultaneously, and then, new multiplex RT-PCR methods has been established.

  6. Course of pandemic influenza A(H1N1) 2009 virus infection in Dutch patients

    Friesema, Ingrid H. M.; Meijer, Adam; van Gageldonk-Lafeber, Arianne B.; van der Lubben, Mariken; van Beek, Janko; Donker, Ge A.; Prins, Jan M.; de Jong, Menno D.; Boskamp, Simone; Isken, Leslie D.; Koopmans, Marion P. G.; van der Sande, Marianne A. B.


    The clinical dynamics of influenza A(H1N1) 2009 infections in 61 laboratory-confirmed Dutch cases were examined. An episode lasted a median of 7 5 days of which 2 days included fever. Respiratory symptoms resolved slowly, while systemic symptoms peaked early in the episode and disappeared quickly. S

  7. Correlates of 2009 H1N1 Influenza Vaccine Acceptability among Parents and Their Adolescent Children

    Painter, Julia E.; Gargano, Lisa M.; Sales, Jessica M.; Morfaw, Christopher; Jones, LaDawna M.; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.


    School-aged children were a priority group for receipt of the pandemic (2009) H1N1 influenza vaccine. Both parental and adolescent attitudes likely influence vaccination behaviors. Data were collected from surveys distributed to middle- and high-school students and their parents in two counties in rural Georgia. Multivariable logistic regression…

  8. Design of multiligand inhibitors for the swine flu H1N1 neuraminidase binding site

    Narayanan MM


    Full Text Available Manoj M Narayanan,1,2 Chandrasekhar B Nair,2 Shilpa K Sanjeeva,2 PV Subba Rao,2 Phani K Pullela,1,2 Colin J Barrow11Centre for Chemistry and Biotechnology, Deakin University, Geelong, VIC, Australia; 2Bigtec Pvt Ltd, Rajajinagar, Bangalore, IndiaAbstract: Viral neuraminidase inhibitors such as oseltamivir and zanamivir prevent early virus multiplication by blocking sialic acid cleavage on host cells. These drugs are effective for the treatment of a variety of influenza subtypes, including swine flu (H1N1. The binding site for these drugs is well established and they were designed based on computational docking studies. We show here that some common natural products have moderate inhibitory activity for H1N1 neuraminidase under docking studies. Significantly, docking studies using AutoDock for biligand and triligand forms of these compounds (camphor, menthol, and methyl salicylate linked via methylene bridges indicate that they may bind in combination with high affinity to the H1N1 neuraminidase active site. These results also indicate that chemically linked biligands and triligands of these natural products could provide a new class of drug leads for the prevention and treatment of influenza. This study also highlights the need for a multiligand docking algorithm to understand better the mode of action of natural products, wherein multiple active ingredients are present.Keywords: neuraminidase, influenza, H1N1, multiligand, binding energy, molecular docking, virus

  9. How to Prevent Getting and Spreading Novel H1N1 Flu


    In this podcast, CDC's Dr. Joe Bresee describes how to prevent giving and getting novel H1N1 flu.  Created: 5/11/2009 by Centers for Disease Control and Prevention, Office of the Director.   Date Released: 5/11/2009.

  10. Manténgase Informado Sobre la Influenza H1N1


    Este podcast habla sobre las medidas básicas que usted puede tomar para protegerse de cualquier enfermedad infecciosa, incluido el nuevo virus de la influenza H1N1.  Created: 5/3/2009 by National Center for Health Marketing (NCHM).   Date Released: 5/3/2009.

  11. Early experience of the pandemic influenza H1N1 2009 epidemic in Taiwan

    Tzong-Hann Yang


    Conclusion: When a patient presents with influenza-like acute febrile respiratory illness symptoms and is young in age, has a travel history involving an affected area, and is suffering from myalgia or leukopenia, physicians should be alerted to the possibility of novel H1N1 virus infection.

  12. Narcolepsy as an autoimmune disease: the role of H1N1 infection and vaccination.

    Partinen, Markku; Kornum, Birgitte Rahbek; Plazzi, Giuseppe; Jennum, Poul; Julkunen, Ilkka; Vaarala, Outi


    Narcolepsy is a sleep disorder characterised by loss of hypothalamic hypocretin (orexin) neurons. The prevalence of narcolepsy is about 30 per 100 000 people, and typical age at onset is 12-16 years. Narcolepsy is strongly associated with the HLA-DQB1*06:02 genotype, and has been thought of as an immune-mediated disease. Other risk genes, such as T-cell-receptor α chain and purinergic receptor subtype 2Y11, are also implicated. Interest in narcolepsy has increased since the epidemiological observations that H1N1 infection and vaccination are potential triggering factors, and an increase in the incidence of narcolepsy after the pandemic AS03 adjuvanted H1N1 vaccination in 2010 from Sweden and Finland supports the immune-mediated pathogenesis. Epidemiological observations from studies in China also suggest a role for H1N1 virus infections as a trigger for narcolepsy. Although the pathological mechanisms are unknown, an H1N1 virus-derived antigen might be the trigger.

  13. Determinants of Parental Acceptance of the H1N1 Vaccine

    Hilyard, Karen M.; Quinn, Sandra Crouse; Kim, Kevin H.; Musa, Don; Freimuth, Vicki S.


    Although designated as a high-risk group during the 2009-2010 H1N1 pandemic, only about 40% of U.S. children received the vaccine, a relatively low percentage compared with high-risk groups in seasonal influenza, such as the elderly, whose vaccine rates typically top 70%. To better understand parental decision making and predictors of acceptance…

  14. Phylogenetic analysis of surface proteins of novel H1N1 virus isolated from 2009 pandemic.

    Danishuddin, Mohd; Khan, Shahper N; Khan, Asad U


    Swine Influenza Virus (H1N1) is a known causative agent of swine flu. Transmission of Swine Influenza Virus form pig to human is not a common event and may not always cause human influenza. The 2009 outbreak by subtype H1N1 in humans is due to transfer of Swine Influenza Virus from pig to human. Thus to analyze the origin of this novel virus we compared two surface proteins (HA and NA) with influenza viruses of swine, avian and humans isolates recovered from 1918 to 2008 outbreaks. Phylogenetic analyses of hemagglutinin gene from 2009 pandemic found to be clustered with swine influenza virus (H1N2) circulated in U.S.A during the 1999-2004 outbreaks. Whereas, neuraminidase gene was clustered with H1N1 strains isolated from Europe and Asia during 1992-2007 outbreaks. This study concludes that the new H1N1 strain appeared in 2009 outbreak with high pathogenicity to human was originated as result of re-assortment (exchange of gene). Moreover, our data also suggest that the virus will remain sensitive to the pre-existing therapeutic strategies.

  15. Novel H1N1 Flu - Creating a Safe and Healthy Workplace


    This podcast helps businesses understand how novel H1N1 flu can affect their business and how to keep their workers and worksites safe.  Created: 5/20/2009 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/20/2009.

  16. H1N1 Preventive Health Behaviors in a University Setting

    Katz, Rebecca; May, Larissa; Sanza, Megan; Johnston, Lindsay; Petinaux, Bruno


    Background: When H1N1 emerged in 2009, institutions of higher education were immediately faced with questions about how best to protect their community from the virus, yet limited information existed to help predict student preventive behaviors. Methods: The authors surveyed students at a large urban university in November 2009 to better…

  17. The Influenza A(H1N1)v Pandemic: An Exploratory System Dynamics Approach

    Pruyt, E.; Hamarat, C.


    This paper presents a small exploratory System Dynamics model related to the dynamics of the 2009 flu pandemic, also known as the Mexican flu, swine flu, or A(H1N1)v. The model was developed in May 2009 in order to quickly foster understanding about the possible dynamics of this new flu variant and

  18. Radiological findings in patients with H1N1 influenza pneumonia

    Magdy Abdelsalam


    Conclusion: The predominant radiological pattern in H1N1 pneumonia is bilateral GGO and alveolar consolidation. In the CXR, the opacities were basal and midzonal while in the chest CT were peripheral and peribronchovascular with diffuse zonal involvement. Chest CT is more sensitive than CXR in diagnosing doubtful cases and in showing different patterns of opacities.

  19. Polymyositis following Pandemic Influenza A (H1N1 and 2009-10 Seasonal Trivalent Vaccines

    Clodoveo Ferri


    Full Text Available Sporadic associations between inflammatory myopathies with vaccinations were described in the literature, raising the possible trigger value of vaccines in the development of these autoimmune disorders. Here, we reported the clinical history of 3 patients who developed polymyositis complicated by interstitial lung disease (2 cases and dermatomyositis (1 case, after influenza A (H1N1 vaccination.

  20. Was Mandatory Quarantine Necessary in China for Controlling the 2009 H1N1 Pandemic?

    Wenjun Geng


    Full Text Available The Chinese government enforced mandatory quarantine for 60 days (from 10 May to 8 July 2009 as a preventative strategy to control the spread of the 2009 H1N1 pandemic. Such a prevention strategy was stricter than other non-pharmaceutical interventions that were carried out in many other countries. We evaluated the effectiveness of the mandatory quarantine and provide suggestions for interventions against possible future influenza pandemics. We selected one city, Beijing, as the analysis target. We reviewed the epidemiologic dynamics of the 2009 H1N1 pandemic and the implementation of quarantine measures in Beijing. The infectious population was simulated under two scenarios (quarantined and not quarantined using a deterministic Susceptible-Exposed-Infectious-Recovered (SEIR model. The basic reproduction number R0 was adjusted to match the epidemic wave in Beijing. We found that mandatory quarantine served to postpone the spread of the 2009 H1N1 pandemic in Beijing by one and a half months. If mandatory quarantine was not enforced in Beijing, the infectious population could have reached 1,553 by 21 October, i.e., 5.6 times higher than the observed number. When the cost of quarantine is taken into account, mandatory quarantine was not an economically effective intervention approach against the 2009 H1N1 pandemic. We suggest adopting mitigation methods for an influenza pandemic with low mortality and morbidity.

  1. Narcolepsy and A(H1N1)pdm09 vaccination

    van der Most, Robbert; Van Mechelen, Marcelle; Destexhe, Eric; Wettendorff, Martine; Hanon, Emmanuel


    Epidemiological data from several European countries suggested an increased risk of the chronic sleep disorder narcolepsy following vaccination with Pandemrix™, an AS03-adjuvanted, pandemic A(H1N1)pdm09 influenza vaccine. Further research to investigate potential associations between Pandemrix™ vaccination, A(H1N1)pdm09 influenza infection and narcolepsy is required. Narcolepsy is most commonly caused by a reduction or absence of hypocretin produced by hypocretin-secreting neurons in the hypothalamus, and is tightly associated with HLA-II DQB1*06:02. Consequently, research focusing on CD4+ T-cell responses, building on the hypothesis that for disease development, T cells specific for antigen(s) from hypocretin neurons must be activated or reactivated, is considered essential. Therefore, the following key areas of research can be identified, (1) characterization of hypothetical narcolepsy-specific auto-immune CD4+ T cells, (2) mapping epitopes of such T cells, and (3) evaluating potential mechanisms that would enable such cells to gain access to the hypothalamus. Addressing these questions could further our understanding of the potential links between narcolepsy and A(H1N1)pdm09 vaccination and/or infection. Of particular interest is that any evidence of a mimicry-based mechanism could also explain the association between narcolepsy and A(H1N1)pdm09 influenza infection. PMID:24342916

  2. Transmission of Pandemic Influenza A (H1N1) Virus in a Train in China

    Cui, Fuqiang; Luo, Huiming; Zhou, Lei; Yin, Dapeng; Zheng, Canjun; Wang, Dingming; Gong, Jian; Fang, Gang; He, Jianfeng; McFarland, Jeffrey; Yu, Hongjie


    Background Pandemic influenza A (H1N1) virus emerged in North America in April 2009 and spread globally. We describe the epidemiology and public health response to the first known outbreak of 2009 H1N1 in a train, which occurred in June 2009 in China. Methods After 2 provinces provided initial reports of 2009 H1N1 infection in 2 persons who had travelled on the same train, we conducted a retrospective epidemiologic investigation to collect information from the passengers, crew members, contacts, and health care providers. We explored the source of infection and possible routes of transmission in the train. All cases were confirmed by real-time reverse transcription polymerase chain reaction testing. Results Train #1223 traveled 40 hours, made 28 stops in 4 Chinese provinces, and boarded 2555 passengers, who logged a total of 59 144 person-hours of travel time. Nineteen confirmed 2009 H1N1 cases were identified. Of these, 13 were infected and developed symptoms on the train and 6 occurred among contacts who developed illness during medical monitoring. In addition, 3 asymptomatic cases were identified based on RT-PCR testing of respiratory swabs from contacts. The attack rate among contacts of confirmed cases in the same car was higher than that among contacts in other cars (3.15% vs. 0%, P train. Trains may have played an important role in the 2009 influenza pandemic. PMID:21646746

  3. Experimental pandemic (H1N1) 2009 virus infection of cats

    J.M.A. van den Brand (Judith); K.J. Stittelaar (Koert); G. van Amerongen (Geert); M.W.G. van de Bildt (Marco); L.M.E. Leijten (Lonneke); T. Kuiken (Thijs); A.D.M.E. Osterhaus (Albert)


    textabstractTo demonstrate that pandemic (H1N1) 2009 virus may cause respiratory disease in cats, we intratracheally infected cats. Diffuse alveolar damage developed. Seroconversion of sentinel cats indicated cat-to-cat virus transmission. Unlike in cats infected with highly pathogenic avian influen

  4. Immunization-Safety Monitoring Systems for the 2009 H1N1 Monovalent Influenza Vaccination Program

    Salmon, Daniel A.; Akhtar, Aysha; Mergler, Michelle J.; Vannice, Kirsten S.; Izurieta, Hector; Ball, Robert; Lee, Grace M.; Vellozzi, Claudia; Garman, Patrick; Cunningham, Francesca; Gellin, Bruce; Koh, Howard; Lurie, Nicole

    The effort to vaccinate the US population against the 2009 H1N1 influenza virus hinged, in part, on public confidence in vaccine safety. Early in the vaccine program, >20% of parents reported that they would not vaccinate their children. Concerns about the safety of the vaccines were reported by

  5. Learning from Successful School-based Vaccination Clinics during 2009 pH1N1

    Klaiman, Tamar; O'Connell, Katherine; Stoto, Michael A.


    Background: The 2009 H1N1 vaccination campaign was the largest in US history. State health departments received vaccines from the federal government and sent them to local health departments (LHDs) who were responsible for getting vaccines to the public. Many LHD's used school-based clinics to ensure children were the first to receive limited…

  6. Positive Selection on Hemagglutinin and Neuraminidase Genes of H1N1 Influenza Viruses

    Li, Wenfu


    Abstract Background Since its emergence in March 2009, the pandemic 2009 H1N1 influenza A virus has posed a serious threat to public health. To trace the evolutionary path of these new pathogens, we performed a selection-pressure analysis of a large number of hemagglutinin (HA) and neuraminidase (NA) gene sequences of H1N1 influenza viruses from different hosts. Results Phylogenetic analysis revealed that both HA and NA genes have evolved into five distinct clusters, with further analyses indicating that the pandemic 2009 strains have experienced the strongest positive selection. We also found evidence of strong selection acting on the seasonal human H1N1 isolates. However, swine viruses from North America and Eurasia were under weak positive selection, while there was no significant evidence of positive selection acting on the avian isolates. A site-by-site analysis revealed that the positively selected sites were located in both of the cleaved products of HA (HA1 and HA2), as well as NA. In addition, the pandemic 2009 strains were subject to differential selection pressures compared to seasonal human, North American swine and Eurasian swine H1N1 viruses. Conclusions Most of these positively and\\/or differentially selected sites were situated in the B-cell and\\/or T-cell antigenic regions, suggesting that selection at these sites might be responsible for the antigenic variation of the viruses. Moreover, some sites were also associated with glycosylation and receptor-binding ability. Thus, selection at these positions might have helped the pandemic 2009 H1N1 viruses to adapt to the new hosts after they were introduced from pigs to humans. Positive selection on position 274 of NA protein, associated with drug resistance, might account for the prevalence of drug-resistant variants of seasonal human H1N1 influenza viruses, but there was no evidence that positive selection was responsible for the spread of the drug resistance of the pandemic H1N1 strains.

  7. French experience of 2009 A/H1N1v influenza in pregnant women.

    Grégory Dubar

    Full Text Available BACKGROUND: The first reports on the pandemic influenza 2009 A/H1N1v from the USA, Mexico, and Australia indicated that this disease was associated with a high mortality in pregnant women. The aim of this study was to describe and compare the characteristics of severe critically ill and non-severe pregnant women with 2009 A/H1N1v-related illness in France. METHODOLOGY/PRINCIPAL FINDINGS: A national registry was created to screen pregnant women with laboratory-confirmed 2009 A/H1N1v influenza. Three hundred and fifteen patients from 46 French hospitals were included: 40 patients were admitted to intensive care units (severe outcomes, 111 were hospitalized in obstetric or medical wards (moderate outcomes, and 164 were outpatients (mild outcomes. The 2009 A/H1N1v influenza illness occurred during all pregnancy trimesters, but most women (54%, notably the severe patients (70%, were in the third trimester. Among the severe patients, twenty (50% underwent mechanical ventilation, and eleven (28% were treated with extracorporeal membrane oxygenation. Three women died from A/H1N1v influenza. We found a strong association between the development of a severe outcome and both co-existing illnesses (adjusted odds ratio [OR], 5.1; 95% confidence interval [CI], 2.2-11.8 and a delay in oseltamivir treatment after the onset of symptoms (>3 or 5 days (adjusted OR, 4.8; 95% CI, 1.9-12.1 and 61.2, 95% CI; 14.4-261.3, respectively. Among the 140 deliveries after 22 weeks of gestation known to date, 19 neonates (14% were admitted to a neonatal intensive care unit, mainly for preterm delivery, and two neonates died. None of these neonates developed 2009 A/H1N1v infection. CONCLUSIONS: This series confirms the high incidence of complications in pregnant women infected with pandemic A/H1N1v observed in other countries but depicts a lower overall maternal and neonatal mortality and morbidity than indicated in the USA or Australia. Moreover, our data demonstrate the

  8. Calculating the potential for within-flight transmission of influenza A (H1N1

    Blower Sally


    Full Text Available Abstract Background Clearly air travel, by transporting infectious individuals from one geographic location to another, significantly affects the rate of spread of influenza A (H1N1. However, the possibility of within-flight transmission of H1N1 has not been evaluated; although it is known that smallpox, measles, tuberculosis, SARS and seasonal influenza can be transmitted during commercial flights. Here we present the first quantitative risk assessment to assess the potential for within-flight transmission of H1N1. Methods We model airborne transmission of infectious viral particles of H1N1 within a Boeing 747 using methodology from the field of quantitative microbial risk assessment. Results The risk of catching H1N1 will essentially be confined to passengers travelling in the same cabin as the source case. Not surprisingly, we find that the longer the flight the greater the number of infections that can be expected. We calculate that H1N1, even during long flights, poses a low to moderate within-flight transmission risk if the source case travels First Class. Specifically, 0-1 infections could occur during a 5 hour flight, 1-3 during an 11 hour flight and 2-5 during a 17 hour flight. However, within-flight transmission could be significant, particularly during long flights, if the source case travels in Economy Class. Specifically, two to five infections could occur during a 5 hour flight, 5-10 during an 11 hour flight and 7-17 during a 17 hour flight. If the aircraft is only partially loaded, under certain conditions more infections could occur in First Class than in Economy Class. During a 17 hour flight, a greater number of infections would occur in First Class than in Economy if the First Class Cabin is fully occupied, but Economy class is less than 30% full. Conclusions Our results provide insights into the potential utility of air travel restrictions on controlling influenza pandemics in the winter of 2009/2010. They show travel by one

  9. Communicating uncertainty - how Australian television reported H1N1 risk in 2009: a content analysis

    Blood R Warwick


    Full Text Available Abstract Background Health officials face particular challenges in communicating with the public about emerging infectious diseases of unknown severity such as the 2009 H1N1(swine 'flu pandemic (pH1N1. Statements intended to create awareness and convey the seriousness of infectious disease threats can draw accusations of scare-mongering, while officials can be accused of complacency if such statements are not made. In these communication contexts, news journalists, often reliant on official sources to understand issues are pivotal in selecting and emphasising aspects of official discourse deemed sufficiently newsworthy to present to the public. This paper presents a case-study of news communication regarding the emergence of pH1N1. Methods We conducted a content analysis of all television news items about pH1N1. We examined news and current affairs items broadcast on 5 free-to-air Sydney television channels between April 25 2009 (the first report and October 9 (prior to the vaccine release for statements about 1 the seriousness of the disease 2 how the public could minimise contagion 3 government responses to emerging information. Results pH1N1 was the leading health story for eight of 24 weeks and was in the top 5 for 20 weeks. 353 news items were identified, yielding 3086 statements for analysis, with 63.4% related to the seriousness of the situation, 12.9% providing advice for viewers and 23.6% involving assurances from government. Coverage focused on infection/mortality rates, the spread of the virus, the need for public calm, the vulnerability of particular groups, direct and indirect advice for viewers, and government reassurances about effective management. Conclusions Overall, the reporting of 2009 pH1N1 in Sydney, Australia was generally non-alarmist, while conveying that pH1N1 was potentially serious. Daily infection rate tallies and commentary on changes in the pandemic alert level were seldom contextualised to assist viewers in

  10. Impact of obesity in patients infected with 2009 influenza A(H1N1).

    Díaz, Emili; Rodríguez, Alejandro; Martin-Loeches, Ignacio; Lorente, Leonardo; Del Mar Martín, María; Pozo, Juan Carlos; Montejo, Juan Carlos; Estella, Angel; Arenzana, Ángel; Rello, Jordi


    A large proportion of patients infected with 2009 influenza A(H1N1) (A[H1N1]) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality. This was a prospective, observational, and multicenter study performed in 144 ICUs in Spain. Data were obtained from the Grupo de Trabajo en Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (GTEI/SEMICYUC) registry. Adult patients with A(H1N1) that was confirmed by real-time polymerase chain reaction were included in the analysis. Patients who were obese (BMI > 30) were compared with patients who were nonobese. Cox regression analysis was used to determine adjusted mortality. Differences of P 40). Mechanical ventilation (MV) was more frequently applied in patients who were obese (64% vs 52.4%, P < .01) Patients with obesity remained on MV longer than patients who were nonobese (6.5 ± 10.3 days vs 9.3 ± 9.7 days, P = .02), had longer ICU length of stay (10.8 ± 12.1 days vs 13.7 ± 11.7 days, P = .03), and had longer hospitalization (18.2 ± 14.6 days vs 22.2 ± 16.5 days, P = .02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality (hazard ratio, 1.1; 95% CI, 0.69-1.75; P = .68). In our cohort, patients who were obese and infected with A(H1N1) did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption.

  11. Descriptive epidemiology of novel influenza A (H1N1, Andhra Pradesh 2009-2010

    Ramesh R Allam


    Full Text Available Background: The first case of pandemic Influenza A (H1N1 in India was reported from Hyderabad, Andhra Pradesh on 16 th May 2009. Subsequently, all suspected cases seeking treatment from A (H1N1 treatment centers and their contacts were tested. Laboratory confirmed cases were hospitalized and treated with antivirals according to national guidelines. We reviewed the surveillance data to assess the morbidity and mortality due to A (H1N1 in the state of Andhra Pradesh (population-76,210,007 during the period from May 2009 to December 2010. Materials and Methods: We obtained the line-list of suspected (influenza like illness as per World Health Organization case definition and laboratory confirmed cases of A (H1N1 from the state unit of integrated disease surveillance project. We analyzed the data to describe the distribution of case-patients by time, place and person. Results: During May 2009 to December 2010, a total of 6527 suspected (attack rate: 8.6/100,000 and 1480 (attack rate: 1.9/100,000 laboratory confirmed cases were reported from the State. Nearly 90% of the suspected and 93% of the confirmed cases was from nine districts of Telangana region, which includes Hyderabad. Nearly 65% of total confirmed cases were reported from Hyderabad. The attack rate was maximum (2.6/100,000 in the age group of 25-49 years. The cases peaked during August-October. 109 case-patients died (Case fatality ratio: 7% and most (80% of these patients had comorbid conditions such as diabetes (24%, chronic obstructive pulmonary disease (20%, hypertension (11% and pregnancy (11%. Case fatality was higher (16% among patients who were older than 60 years of age compared with other age groups. Conclusions: In Andhra Pradesh, H1N1 transmission peaked during August-October months and predominately affected adults. Case fatality was higher in patients older than 60 years with comorbid conditions.

  12. Genetic characterization of the influenza A pandemic (H1N1 2009 virus isolates from India.

    Varsha A Potdar

    Full Text Available BACKGROUND: The Influenza A pandemic H1N1 2009 (H1N1pdm virus appeared in India in May 2009 and thereafter outbreaks with considerable morbidity and mortality have been reported from many parts of the country. Continuous monitoring of the genetic makeup of the virus is essential to understand its evolution within the country in relation to global diversification and to track the mutations that may affect the behavior of the virus. METHODS: H1N1pdm viruses were isolated from both recovered and fatal cases representing major cities and sequenced. Phylogenetic analyses of six concatenated whole genomes and the hemagglutinin (HA gene of seven more isolates from May-September 2009 was performed with reference to 685 whole genomes of global isolates available as of November 24, 2009. Molecular characterization of all the 8 segments was carried out for known pathogenic markers. RESULTS: The first isolate of May 2009 belonged to clade 5. Although clade 7 was the dominant H1N1pdm lineage in India, both clades 6 and 7 were found to be co-circulating. The neuraminidase of all the Indian isolates possessed H275, the marker for sensitivity to the neuraminidase inhibitor Oseltamivir. Some of the mutations in HA are at or in the vicinity of antigenic sites and may therefore be of possible antigenic significance. Among these a D222G mutation in the HA receptor binding domain was found in two of the eight Indian isolates obtained from fatal cases. CONCLUSIONS: The majority of the 13 Indian isolates grouped in the globally most widely circulating H1N1pdm clade 7. Further, correlations of the mutations specific to clade 7 Indian isolates to viral fitness and adaptability in the country remains to be understood. The D222G mutation in HA from isolates of fatal cases needs to be studied for pathogenicity.

  13. Swine flu (H1N1 infection: An autoimmune endocrine condition in pregnant females

    Shilpa Shah


    Full Text Available Background: H1N1 infection tends to be more severe in pregnant than nonpregnant women. It is not known whether this is due to hormonal changes during pregnancy and/or immune responses to hormones. Aims: Whether the effect of pregnancy on responses to the H1N1 pandemic is mediated by the effects of immune responses to hormones resulting in anti-hormone antibody production requires investigation. Settings and Design: A prospective study was designed, and H1N1-infected pregnant women were recruited from the Intensive Care Unit of a hospital during the period 2009-2010. Materials and Methods: Differences in the levels of anti-estrogen and anti-progesterone antibodies were determined in H1N1-infected pregnant patients and healthy pregnant and healthy non-pregnant women, using the Enzyme-Linked Immunosorbent Assay technique. Statistical Analysis: Statistical Package for the Social Sciences 16.0 (SPSS inc, Chicago, USA software was used for all statistical procedures. Results: Pregnant women showed nonsignificant trends for higher immunoglobulin G (IgG and IgM anti-estrogen-antibodies as compared to the healthy non-pregnant women. IgG, IgM, and IgE anti-progesterone-antibodies were also higher in pregnant women than in nonpregnant women, with marginally significant effects for IgG and IgE. H1N1 infection was associated with increased anti-estrogen IgG and IgA relative to healthy pregnant females. Conclusion: Findings about elevated anti-estrogen and anti-progesterone antibodies might improve our understanding of higher susceptibility of pregnant females to swine flu, and thereby lead to better management of this disease.

  14. 甲型H1N1流感患者的护理现状与发展

    陈玉华; 杨桂红



  15. The Genomic Contributions of Avian H1N1 Influenza A Viruses to the Evolution of Mammalian Strains.

    Koçer, Zeynep A; Carter, Robert; Wu, Gang; Zhang, Jinghui; Webster, Robert G


    Among the influenza A viruses (IAVs) in wild aquatic birds, only H1, H2, and H3 subtypes have caused epidemics in humans. H1N1 viruses of avian origin have also caused 3 of 5 pandemics. To understand the reappearance of H1N1 in the context of pandemic emergence, we investigated whether avian H1N1 IAVs have contributed to the evolution of human, swine, and 2009 pandemic H1N1 IAVs. On the basis of phylogenetic analysis, we concluded that the polymerase gene segments (especially PB2 and PA) circulating in North American avian H1N1 IAVs have been reintroduced to swine multiple times, resulting in different lineages that led to the emergence of the 2009 pandemic H1N1 IAVs. Moreover, the similar topologies of hemagglutinin and nucleoprotein and neuraminidase and matrix gene segments suggest that each surface glycoprotein coevolved with an internal gene segment within the H1N1 subtype. The genotype of avian H1N1 IAVs of Charadriiformes origin isolated in 2009 differs from that of avian H1N1 IAVs of Anseriformes origin. When the antigenic sites in the hemagglutinin of all 31 North American avian H1N1 IAVs were considered, 60%-80% of the amino acids at the antigenic sites were identical to those in 1918 and/or 2009 pandemic H1N1 viruses. Thus, although the pathogenicity of avian H1N1 IAVs could not be inferred from the phylogeny due to the small dataset, the evolutionary process within the H1N1 IAV subtype suggests that the circulation of H1N1 IAVs in wild birds poses a continuous threat for future influenza pandemics in humans.

  16. Persistence of the 2009 pandemic influenza A (H1N1) virus on N95 respirators.

    Coulliette, A D; Perry, K A; Edwards, J R; Noble-Wang, J A


    In the United States, the 2009 pandemic influenza A (H1N1) virus (pH1N1) infected almost 20% of the population and caused >200,000 hospitalizations and >10,000 deaths from April 2009 to April 2010. On 24 April 2009, the CDC posted interim guidance on infection control measures in health care settings explicitly for pH1N1 and recommended using filtering face respirators (FFRs) when in close contact with a suspected- or confirmed-to-be-infected individual, particularly when performing aerosol-generating procedures. The persistence and infectivity of pH1N1 were evaluated on FFRs, specifically N95 respirators, under various conditions of absolute humidity (AH) (4.1 × 10(5) mPa, 6.5 × 10(5) mPa, and 14.6 × 10(5) mPa), sample matrices (2% fetal bovine serum [FBS], 5 mg/ml mucin, and viral medium), and times (4, 12, 24, 48, 72, and 144 h). pH1N1 was distributed onto N95 coupons (3.8 to 4.2 cm(2)) and extracted by a vortex-centrifugation-filtration process, and the ability of the remaining virus to replicate was quantified using an enzyme-linked immunosorbent assay (ELISA) to determine the log10 concentration of the infectious virus per coupon. Overall, pH1N1 remained infectious for 6 days, with an approximately 1-log10 loss of virus concentrations over this time period. Time and AH both affected virus survival. We found significantly higher (P ≤ 0.01) reductions in virus concentrations at time points beyond 24 to 72 h (-0.52-log10 reduction) and 144 h (-0.74) at AHs of 6.5 × 10(5) mPa (-0.53) and 14.6 × 10(5) mPa (-0.47). This research supports discarding respirators after close contact with a person with suspected or confirmed influenza infection due to the virus's demonstrated ability to persist and remain infectious.

  17. Vaccine Narratives and Public Health: Investigating Criticisms of H1N1 Pandemic Vaccination.

    Abeysinghe, Sudeepa


    Vaccine hesitancy is often understood and explored on the level of individual decision-making. However, questions surrounding the risk and efficacy of vaccination are evident in wider public discourse; social narratives of vaccination inform and impact on the individual level. This paper takes a narrative analysis approach from the sociology of health to examine data drawn from a wider study on global public health responses to the H1N1 pandemic. The paper concentrates upon criticisms to mass vaccination as recounted within the Council of Europe's debate of the handling of H1N1. It shows that three narratives were particularly dominant: problematizing the use of vaccination as a public health response; criticising the efficacy of the vaccines; and, questioning the safety of the strategy. This debate presents an important case study in understanding the way in which vaccines are problematized within the public discourse.

  18. Acute necrotizing encephalopathy in a child with H1N1 influenza infection

    Lyon, Jane B. [Driscoll Children' s Hospital, Department of Radiology, Corpus Christi, TX (United States); Remigio, Cheryl [Pediatric Residency Program, Department of Medical Education, Corpus Christi, TX (United States); Milligan, Thomas [Driscoll Children' s Hospital, Department of Pathology, Corpus Christi, TX (United States); Deline, Carol [Driscoll Children' s Hospital, Division of Neurology, Corpus Christi, TX (United States)


    Since the World Health Organization declared a global pandemic of novel influenza A H1N1 in June 2009, there has been a sustained rise in the number of cases of this strain of influenza. Although most cases are mild with complete and uneventful recovery, multiple cases of severe infection with complications including death have been reported. To the best of our knowledge, the majority of fatal outcomes in the United States have been related to pulmonary complications. We report a 12-year-old girl infected with influenza A H1N1 whose clinical course was complicated by rapid progressive neurologic deterioration and striking CT and MRI findings consistent with acute necrotizing encephalopathy (ANE). To our knowledge this has not been reported in the pediatric radiology literature. We hope this case will alert radiologists to this complication and familiarize radiologists with imaging findings that herald ANE. (orig.)

  19. Learning from the 2009 H1N1 pandemic: prospects for more broadly effective influenza vaccines

    Ethan C. Settembre; Philip R. Dormitzer; Rino Rappuoli


    Calls to develop a universal influenza vaccine have increased in the wake of the 2009 H1 N1 influenza pandemic. This demand comes at a time when analyses of the human antibody repertoire, informed by structures of complexes between broadly neutralizing antibodies and influenza hemagglutinin, have revealed the target of a class of broadly neutralizing antibodies. Recent studies suggest a path forward to more broadly protective influenza vaccines.%@@ Calls to develop a universal influenza vaccine have increased in the wake of the 2009 H1 N1 influenza pandemic.This demand comes at a time when analyses of the human antibody repertoire, informed by structures of complexes between broadly neutralizing antibodies and influenza hemagglutinin, have revealed the target of a class of broadly neutralizing antibodies.Recent studies suggest a path forward to more broadly protective influenza vaccines.

  20. Computed tomography findings in patients with H1N1 influenza A infection

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson, E-mail: [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Zanetti, Glaucia [Faculdade de Medicina de Petropolis (FMP), RJ (Brazil)


    The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their non specificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease. (author)

  1. Outcomes of influenza A(H1N1)pdm09 virus infection

    Lynfield, Ruth; Davey, Richard; Dwyer, Dominic E


    BACKGROUND: Data from prospectively planned cohort studies on risk of major clinical outcomes and prognostic factors for patients with influenza A(H1N1)pdm09 virus are limited. In 2009, in order to assess outcomes and evaluate risk factors for progression of illness, two cohort studies were...... initiated: FLU 002 in outpatients and FLU 003 in hospitalized patients. METHODS AND FINDINGS: Between October 2009 and December 2012, adults with influenza-like illness (ILI) were enrolled; outpatients were followed for 14 days and inpatients for 60 days. Disease progression was defined as hospitalization...... and/or death for outpatients, and hospitalization for >28 days, transfer to intensive care unit (ICU) if enrolled from general ward, and/or death for inpatients. Infection was confirmed by RT-PCR. 590 FLU 002 and 392 FLU 003 patients with influenza A (H1N1)pdm09 were enrolled from 81 sites in 17...


    Eduarda Alexandra Gonçalves de Oliveira


    Full Text Available Swine influenza A (H1N1 or Swine Flu is a highly contagious acute respiratory disease caused by one of several swine influenza virus A. Morbidity tends to be high while low mortality. Pigs are important hosts of H1N1 influenza (swine-like influenza A virus and susceptible to infection by influenza viruses of avian origin and human. These animals have an important role in viral transmission between species and the epidemiology of human influenza because it can harbor a virus that undergoes genetic recombination and mutation may therefore be more virulent or not. On April 24, 2009, there was a first alert from WHO (World Health Organization on the appearance of the disease. The spread of the H1N1 caused alarm because it could be quickly and become unmanageable, since its symptoms are similar to those of a common flu and could be easily confused and camouflage a possible pandemic. Considering the great impact of the recent epidemic H1N1 influenza virus, according to their potential risk, this article intends to clarify how to recognize, diagnose and prevent, to better understand the relationships between exposure to pigs and possible infection. Influenza suína (H1N1 ou Gripe Suína é uma doença respiratória aguda altamente contagiosa, causada por um dos diversos vírus da influenza suína A. A morbidade tende a ser alta, enquanto a mortalidade baixa. Os suínos são importantes hospedeiros do vírus Influenza H1N1(swine-like Influenza A e susceptíveis às infecções por vírus Influenza de origem aviária e humana. Estes animais possuem importante papel na transmissão viral entre espécies e na epidemiologia da influenza humana, pois pode abrigar um vírus que sofre recombinação genética e por consequência mutação que pode ficar ou não mais virulento. Em 24 de abril de 2009, houve o primeiro alerta da OMS (Organização Mundial da Saúde sobre o surgimento desta doença. O contágio pelo H1N1 causou alarme, pois poderia ser rápido e

  3. Passive immunity to pandemic H1N1 2009 by swine flu parties.

    Aggarwal, Nitish; Aggarwal, Pushkar


    The general population is concerned about the probable devastating effects of pandemic H1N1 2009. Based upon the 1918 Spanish flu pandemic, scientific publications and theories, the idea of swine flu parties to achieve passive immunity against pandemic H1N1 2009 has been proposed. Public health officials have asked the general public not to resort to this method. However, no concrete evidence of the reasoning behind the recommendation has been given. In this paper, we have dynamically modeled the effect of swine flu parties on the immunity achieved and associated mortality for a period of two years. The simulations show that the public should not organize or participate in swine flu parties as they will likely increase swine flu-associated mortality.

  4. Blood libel rebooted: traditional scapegoats, online media, and the H1N1 epidemic.

    Atlani-Duault, L; Mercier, A; Rousseau, C; Guyot, P; Moatti, J P


    This study of comments posted on major French print and TV media websites during the H1N1 epidemic illustrates the relationship between the traditional media and social media in responding to an emerging disease. A disturbing "geography of blame" was observed suggesting the metamorphosis of the folk-devil phenomenon to the Internet. We discovered a subterranean discourse about the putative origins and "objectives" of the H1N1 virus, which was absent from the discussions in mainstream television channels and large-circulation print media. These online rumours attributed hidden motives to governments, pharmaceutical companies, and figures of Otherness that were scapegoated in the social history of previous European epidemics, notably Freemasons and Jews.

  5. Factors associated with vaccination against Influenza A (H1N1 in the elderly

    Janaína Fonseca Victor


    Full Text Available This study aimed to investigate the sociodemographic, clinical and behavioral factors and receiving information about the vaccine against pandemic influenza A (H1N1 associated with vaccination of elderly people. Study of quantitative and transversal nature, in which 286 elderly residents in Fortaleza, CE, Brazil participated. The association between variables was analyzed by the Pearson chi-square test, considering a 95% confidence interval and significance level (p≤0.05. The results revealed that, unlike the sociodemographic characteristics, many clinical, behavioral and informational aspects correlated significantly with adherence to Influenza A (H1N1 vaccination. It is believed that the findings can be used in strategies to control and prevent infection by viral subtypes within the elderly population, extensible even to other vaccine-preventable diseases, especially in light of possible future pandemics.

  6. Inpatient capacity at children's hospitals during pandemic (H1N1) 2009 outbreak, United States.

    Sills, Marion R; Hall, Matthew; Fieldston, Evan S; Hain, Paul D; Simon, Harold K; Brogan, Thomas V; Fagbuyi, Daniel B; Mundorff, Michael B; Shah, Samir S


    Quantifying how close hospitals came to exhausting capacity during the outbreak of pandemic influenza A (H1N1) 2009 can help the health care system plan for more virulent pandemics. This ecologic analysis used emergency department (ED) and inpatient data from 34 US children's hospitals. For the 11-week pandemic (H1N1) 2009 period during fall 2009, inpatient occupancy reached 95%, which was lower than the 101% occupancy during the 2008-09 seasonal influenza period. Fewer than 1 additional admission per 10 inpatient beds would have caused hospitals to reach 100% occupancy. Using parameters based on historical precedent, we built 5 models projecting inpatient occupancy, varying the ED visit numbers and admission rate for influenza-related ED visits. The 5 scenarios projected median occupancy as high as 132% of capacity. The pandemic did not exhaust inpatient bed capacity, but a more virulent pandemic has the potential to push children's hospitals past their maximum inpatient capacity.


    Andrés G. Seguel


    Full Text Available The aim of the present paper is to present the symbolic features that are exposed by the concept of artefact in the context of a pandemic alarm, such as the A (H1N1 influenza. The symbolic qualities entailed by the notion of artefact are well-known within the Social Sciences: Sociology, Anthropology, Archaeology, and Linguistics. The artefact is basically not an object, but an action aimed at designing, simulating or creating a simile by means of material, technological or linguistic structures. The purpose of the present work is to unveil the symbolic dimensions that are activated by the A (H1N1 influenza as a Pandemic Artefact: a the assumption of separating information from matter; b the need for a material support to enable the exchange; c the sociological reflexivity of the artefact and its agency; d the arbitrariness of its social use, that detaches it from the design as intention.

  8. Difficult airway in a patient with H1N1 pneumonia in intensive care unit

    Meltem Türkay


    Full Text Available The difficult airway is a frequent problem among adult patients in intensive care unit. All critical patients should initially be evaluated as a potential difficult airway cases. Development of a serious desaturation should be considered since these patients have less physiological reserve compared to those with difficult airway due to elective surgery. Development of respiratory failure with H1N1 associated pneumonia is likely and support of intubation and mechanic ventilator shall be needed. The objective of this report is to present the management of a patient with H1N1 associated pneumonia who required intubation however could not be intubated due to difficult airway. J Clin Exp Invest 2014; 5 (4: 617-619

  9. Critical influenza (H1N1) pneumonia: imaging manifestations and histopathological findings

    LI Hong-jun; CHENG Jing-liang; LI Ning; LI Yun-fang; ZHANG Hui-mao


    Background The global outbreak of influenza A (H1N1 ) has led to the Ministry of Health of China listing it as one of the A-class infectious diseases.Pneumonia is the most serious complication of influenza A,commonly causing death.Populations are ordinarily susceptible to influenza A.This study aimed to investigate the imaging manifestation features of cdtical influenza A (H1 N1 ) pneumonia and to improve its diagnostic techniques.Methods A total of seven death cases from critical influenza A (H1 N1 ) pneumonia were retrospectively analyzed on their imaging manifestations and autopsy data.Pulmonary CT scanning was performed for five cases,with one receiving additional chest X-ray and chest CT scanning,and chest postero-anterior position X-ray examination was performed for other two.Autopsy was performed for five cases and postmortem examinations were performed for other two cases.Results The seven cases of influenza A showed critical manifestations in 4-7 days after symptoms onset,with two having basic diseases of diabetes and one being pregnant.Extensive blurry high-density shadows of bilateral lungs were found in three cases,which were most obvious in middle and infedor parts of lungs.Pulmonary CT scanning revealed bilateral flaky parenchymal shadows in peripheral,dorsal and fundus segments of the middle-inferior parts of lungs,with one case of complicated pneumothorax,atelectasis and pleural effusion and another case of thin-walled cavity and dilated bronchi shadows in the superior parts of lungs.Conclusions Diagnostic imaging is an important assessing tool for cdtical influenza A (H1N1) pneumonia The imaging manifestations are characteristic instead of being specific.The definitive diagnosis can be made in combination with clinical examinations and laboratory tests.

  10. Pandemic (H1N1 2009 influenza: Experience from a critical care unit in India

    Sahoo Jyoti


    Full Text Available This case series details our experience with seven patients with pandemic (H1N1 2009 influenza from an intensive care unit in India. All the patients had respiratory failure requiring ventilation except one; two patients developed pneumothorax. Of the seven patients, two died (28.5% and five recovered. Four patients had co-morbid conditions and one was morbidly obese; all the five patients were discharged alive.

  11. Seroprevalence study in Vojvodina (Serbia following 2009 pandemic influenza A(H1N1v

    Petrović Vladimir


    Full Text Available Introduction. The seroprevalence study was performed in Vojvodina during May and June 2010 in order to asses the effects of the 2009 pandemic influenza A(H1N1v epidemic on herd immunity. It was a part of the Serbian Ministry of Health funded nationwide study. Objective. Prevalence of antibodies against 2009 pandemic influenza A(H1N1v was determined in a 1% sample of the population monitored for influenza-like illness and acute respiratory infections in Vojvodina through sentinel surveillance system. Methods. The study sample involved a total of 1004 inhabitants of Vojvodina. The control group consisted of randomly selected and age-adjusted 1054 sera collected in the pre-pandemic period. Sera were tested by the reaction of hemagglutination inhibition using influenza A/California/7/2009 (H1N1 antigen in dilution from 1:8 to 1:256. Antibody titers ≥1:32 and ≥1:8 were considered protective and diagnostic, respectively. Results. The differences between control and study sera in all age groups were significant for both diagnostic ≥1/8 and protective titres ≥1/32 of hemagglutination inhibition antibodies (chi square test, p<0.001. The highest percentage of seropositive subjects was registered in the age group 15-19 years followed by children aged 5-14 years. Both diagnostic and protective titres were about twice higher in the vaccinated as compared to the non-vaccinated group. There were no statistically significant differences in seroprevalence between seven districts of Vojvodina. Conclusion. The 2009 pandemic influenza A(H1N1v epidemic significantly influenced the herd immunity in our population regardless of low immunization coverage with highest immunity levels in adolescents aged 15-19 years and with similar herd immunity levels in all the regions in the province six months after the outbreak.


    Avtar Singh


    Full Text Available BACKGROUND : Pune served as hub of H1N1 and recorded maximum deaths in India during 2009 pandemic. Teachers form important part of society which can greatly influence population. AIM: To study knowledge , attitude and practices on H1N1 amongst school teachers in Pune. Study endeavors to bring forth positive practices , which besides benefitting teachers would also translate into disseminating knowledge to students and families , resulting in maximum benefit to society. SETTINGS AND DESIGN: C ross sectional , KAP study amongst school teachers taken was undertaken METHODS: A questionnaire based , cross sectional KAP study was undertaken on 96 teachers from a public school in Pune during June - September 2010. Epi Info version – 2006 was used for data analysis . RESULTS : While most were well aware of H1N1 basics , 40% didn’t know danger signs/ complications. Knowledge on prevention demanded attention. 45% believed that H1N1 isn’t a big problem. About 1/3 rd couldn’t appreciate importance of isolation or use of mask. Only 6 4.6% would stay home on having flu. One fifth believed in wearing mask at workplace and about half in keeping distance of 1m from patients. About 60% didn’t believe in avoiding crowed places. 15% won’t wash hands. About 17% wouldn’t stay home or visit doct or if suffering from cold. Half would not take medicines. CONCLUSION: Fact that ‘good’ knowledge dwindled to ‘fair’ attitudes , which in turn didn’t translate into desirable robust practices , is alarming. Efforts must be directed towards enhancing knowledge , improving attitudes and imparting behavior changes for desirable practices , which will bring change in society. It’s recommended that IEC emphasizing prevention must be undertaken immediately.

  13. Mechanical ventilation in patients with most severe forms of influenza a H1N1

    Romić Predrag


    Full Text Available Background/Aim. Pandemic of A H1N1 influenza is noted for its rapid spreading and life-threatening consequences like acute respiratory distress syndrome (ARDS which requires mechanical ventilation (MV and intensive therapy (IT. The aim of the study was to determine the significance of mechanical ventilation application in the presence of comorbidities on the outcome of the disease and patients with severe forms of acute influenza caused by A H1N1 virus. Methods. Five patients with acute respiratory failure caused by A H1N1 influenza that required MV were included in the study. Course and outcome of the treatment were monitored in relation to age and sex of the patients, concomitant diseases, time of influenza beginning, a time of admittance in an intensive care unit, a time of an endotracheal intubation and MV beginning, MV duration and occurrence of secondary infections. Results. Three patients were on a very prolonged MV (39, 43 and 20 days, respectively and they all survived. Two patients with a significantly shorter duration of MV (14 and 12 days, respectively died because of a very severe clinical course and concomitant diseases. Unexpectedly, we found a positive correlation between duration of MV and survival although two patients, who were on MV for the longest period of time (43 and 39 days, respectively, developed, as a complication, secondary bacterial pneumonia. Conclusion. Intensive therapy of patients with ARDS due to A H1N1 influenza virus requires MV which should be carried out according to guidelines of international expert forums. That is in accordance with our unexpected observation on negative correlation between duration of MV and fatal outcome. Intensive treatment of these patients, specially MV, can be very prolonged and, therefore, requires specialized teams of anesthesiologists, separate, isolated intensive therapy units and high level of medical staff protection, as was the case in this study, so no member of medical

  14. Analysis of a pandemic in the Italian newspapers: the A(H1N1 experience

    Alessandro Zanetti


    Full Text Available

    Background: in 2009 a novel infective agent, a(H1n1, was recognized by the World Health organization (WHo as a pandemic virus. Like most European countries, Italy experienced a single pandemic wave during fall-winter 2009. The objective of our study was to evaluate the news reports and the representation of the a(H1n1 pandemic in the Italian newspapers both quantitatively and qualitatively.

    Methods: from april 24th, 2009 to February 28th, 2010, seven national newspapers were monitored for the quantitative reporting of a(H1n1. In a three month sample period, reports were evaluated quali- tatively by considering their front page presence, tones used for headlines, and images and figures dedicated to the topic.

    Results: in a ten month window, a total of 1220 articles were published. The reporting period showed four peaks and one hollow, with a similar pattern for all the newspapers. during the three-month sample period, we found a total of 382 articles, 98.4% of which appeared on front pages, 33.8% of which contained headlines using alarming tones, and 47.8% which contained info-graphic elements.

    Conclusions: the a(H1n1 2009 pandemic in Italy was mild; nonetheless, newspapers devoted great attention to the new influenza and used alarmist tones. In similar situations, there are several areas where scientists should play a greater role. scientists should support journalists in understanding scientific issues and help them translate scientific information into news items. scientists should also help to contain the anxiety aroused in lay people by a pandemic, and support vaccination efforts dedicated to it....

  15. Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song [Dankook University College of Medicine, Dankook University Hospital, Cheonan (Korea, Republic of)


    The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

  16. Intravenous ketamine for refractory bronchospasm precipitated by H1N1 infection

    Amit eAgrawal


    Full Text Available Acute severe bronchospasm is an emergency situation and sometimes these children may fail to respond to conventional treatment and deteriorate rapidly to respiratory failure requiring mechanical ventilation. We present a case of 2-year-old girl, who presented with severe bronchospasm resulting in respiratory failure not responding to conventional management including mechanical ventilation and was found to be H1N1 positive. She was treated with ketamine infusion, which led to prompt improvement in airway obstruction.

  17. Modeling of the influence of humidity on H1N1 flu in China

    PEI, Y.; Tian, H.; Xu, B.


    In 2009, a heavy Flu hit the whole world. It was caused by the virus H1N1. The influenza first broke out in Mexico in March and the United States in April, 2009. The World Health Organization (WHO) announced that the H1N1 influenza became pandemic, alert to a warning phase of six. By the end of 2011, 181302 H1N1 cases were reported in mainland China. To improve our understanding on the impact of environmental factors on the disease transmission, we constructed an SIR (Susceptible - Infectious - Recovered) model incorporating environmental factors. It was found that the absolute humidity was a dominant environmental factor. The study interpolated the humidity data monitored with 340 weather stations from 1951 to 2011 in mainland China. First, the break point of the trend for the absolutely humidity was detected by the BFAST (Break For Additive Season and Trend) method. Then, the SIR model with and without the absolutely humidity incorporated in the model was built and tested. Finally, the results with the two scenarios were compared. Results indicate that lower absolutely humidity may promote the transmission of the H1N1 cases. The calculated basic reproductive number ranges from 1.65 to 3.66 with a changing absolute humidity. This is consistent with the former study result with basic reproductive number ranging from 2.03 to 4.18. The average recovery duration was estimated to be 5.7 days. The average duration to get immunity from the influenza is 399.02 days. A risk map is also produced to illustrate the model results.

  18. A candidate H1N1 pandemic influenza vaccine elicits protective immunity in mice.

    Julia Steitz

    Full Text Available BACKGROUND: In 2009 a new pandemic disease appeared and spread globally. The recent emergence of the pandemic influenza virus H1N1 first isolated in Mexico and USA raised concerns about vaccine availability. We here report our development of an adenovirus-based influenza H1N1 vaccine tested for immunogenicity and efficacy to confer protection in animal model. METHODS: We generated two adenovirus(Ad5-based influenza vaccine candidates encoding the wildtype or a codon-optimized hemagglutinin antigen (HA from the recently emerged swine influenza isolate A/California/04/2009 (H1N1pdm. After verification of antigen expression, immunogenicity of the vaccine candidates were tested in a mouse model using dose escalations for subcutaneous immunization. Sera of immunized animals were tested in microneutalization and hemagglutination inhibition assays for the presence of HA-specific antibodies. HA-specific T-cells were measured in IFNgamma Elispot assays. The efficiency of the influenza vaccine candidates were evaluated in a challenge model by measuring viral titer in lung and nasal turbinate 3 days after inoculation of a homologous H1N1 virus. CONCLUSIONS/SIGNIFICANCE: A single immunization resulted in robust cellular and humoral immune response. Remarkably, the intensity of the immune response was substantially enhanced with codon-optimized antigen, indicating the benefit of manipulating the genetic code of HA antigens in the context of recombinant influenza vaccine design. These results highlight the value of advanced technologies in vaccine development and deployment in response to infections with pandemic potential. Our study emphasizes the potential of an adenoviral-based influenza vaccine platform with the benefits of speed of manufacture and efficacy of a single dose immunization.

  19. Designing inhibitors of M2 proton channel against H1N1 swine influenza virus.

    Qi-Shi Du

    Full Text Available BACKGROUND: M2 proton channel of H1N1 influenza A virus is the target protein of anti-flu drugs amantadine and rimantadine. However, the two once powerful adamantane-based drugs lost their 90% bioactivity because of mutations of virus in recent twenty years. The NMR structure of the M2 channel protein determined by Schnell and Chou (Nature, 2008, 451, 591-595 may help people to solve the drug-resistant problem and develop more powerful new drugs against H1N1 influenza virus. METHODOLOGY: Docking calculation is performed to build the complex structure between receptor M2 proton channel and ligands, including existing drugs amantadine and rimantadine, and two newly designed inhibitors. The computer-aided drug design methods are used to calculate the binding free energies, with the computational biology techniques to analyze the interactions between M2 proton channel and adamantine-based inhibitors. CONCLUSIONS: 1 The NMR structure of M2 proton channel provides a reliable structural basis for rational drug design against influenza virus. 2 The channel gating mechanism and the inhibiting mechanism of M2 proton channel, revealed by the NMR structure of M2 proton channel, provides the new ideas for channel inhibitor design. 3 The newly designed adamantane-based inhibitors based on the modeled structure of H1N1-M2 proton channel have two pharmacophore groups, which act like a "barrel hoop", holding two adjacent helices of the H1N1-M2 tetramer through the two pharmacophore groups outside the channel. 4 The inhibitors with such binding mechanism may overcome the drug resistance problem of influenza A virus to the adamantane-based drugs.

  20. Community-based measures for mitigating the 2009 H1N1 pandemic in China.

    Sanyi Tang

    Full Text Available Since the emergence of influenza A/H1N1 pandemic virus in March-April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains elusive. We sought to investigate the effectiveness of Fengxiao that may inform policy decisions on improving community-based interventions for management of on-going outbreaks in China, in particular during the Spring Festival in mid-February 2010 when nationwide traveling will be substantially increased. We obtained data on initial laboratory-confirmed cases of H1N1 in the province of Shaanxi and used Markov-chain Monte-Carlo (MCMC simulations to estimate the reproduction number. Given the estimates for the exposed and infectious periods of the novel H1N1 virus, we estimated a mean reproduction number of 1.68 (95% CI 1.45-1.92 and other A/H1N1 epidemiological parameters. Our results based on a spatially stratified population dynamical model show that the early implementation of Fengxiao can delay the epidemic peak significantly and prevent the disease spread to the general population but may also, if not implemented appropriately, cause more severe outbreak within universities/colleges, while late implementation of Fengxiao can achieve nothing more than no implementation. Strengthening local control strategies (quarantine and hygiene precaution is much more effective in mitigating outbreaks and inhibiting the successive waves than implementing Fengxiao. Either strong mobility or high transport-related transmission rate during the Spring Festival holiday will not reverse the ongoing outbreak, but both will result in a large new wave. The findings suggest that Fengxiao and travel precautions should not be relaxed unless strict measures of quarantine, isolation, and hygiene precaution practices are put in place. Integration and prompt implementation of

  1. Antiviral Medications for Treatment of 2009 H1N1 Influenza and Pregnancy


    This podcast features CDC's Dr. Sonja Rasmussen discussing the latest guidelines related to antiviral medications for treatment of 2009 H1N1 Influenza. Excerpt from a CDC-Medscape video series for physicians, nurses, pharmacists, and other healthcare professionals.  Created: 11/9/2009 by National Center for Health Marketing (NCHM); National Center on Birth Defects and Developmental Disabilities (NCBDDD).   Date Released: 1/21/2010.

  2. Melting muscles: novel H1N1 influenza A associated rhabdomyolysis.

    D'Silva, Dimple; Hewagama, Saliya; Doherty, Richard; Korman, Tony M; Buttery, Jim


    We report the first case of myositis and rhabdomyolysis after infection with novel influenza A (H1N1/09) virus. The case demonstrates the novel virus' capacity for causing significant disease. Myositis and the possibility of rhabdomyolysis should be considered in any individual presenting with influenza-like symptoms in which severe myalgia or muscle weakness is apparent. It is likely that we will see severe clinical manifestations of infection with this novel influenza virus in the coming respiratory virus season.

  3. Subacute thyroiditis in the course of novel H1N1 influenza infection.

    Dimos, Georgios; Pappas, Georgios; Akritidis, Nikolaos


    To describe the first documented case of subacute (De Quervain) thyroiditis in the course of novel H1N1 influenza infection. This is a case report of a patient diagnosed at the General Hospital "G. Hatzikosta" of Ioannina, Greece. A 55-year-old previously healthy male developed an influenza-like syndrome that was accompanied by severe neck pain, palpitations, weight loss, and disproportionately increased erythrocyte sedimentation rate. Polymerase chain reaction assay of pharyngeal swabs confirmed the diagnosis of novel H1N1 influenza infection. Serum thyroid-stimulating hormone was suppressed to zero and levels of free thyroxine and particularly triiodothyronine were increased. Technetium-99m-pertechnetate scintigraphy showed diffuse and inhomogeneous very low technetium trapping. The patient was treated with non-steroidal anti-inflammatory drugs and thyroid function gradually normalized without evolving to a hypothyroid phase. This is the first case of subacute thyroiditis associated with novel H1N1 influenza infection. Furthermore, this is the first case to definitely demonstrate active influenza infection of any type concurrent with thyroiditis, and one of the very rare similar cases for any active viral disease etiologically implicated in the pathogenesis of subacute thyroiditis.

  4. Radiographic study of severe Influenza-A (H1N1) disease in children

    Zhao Cailei, E-mail: [Department of Radiology, Shenzhen Children' s Hospital, No. 7019, Yitian Road, Futian District, Shenzhen 518026 (China); Gan Yungen, E-mail: [Department of Radiology, Shenzhen Children' s Hospital, No. 7019, Yitian Road, Futian District, Shenzhen 518026 (China); Sun Jie, E-mail: [Department of Radiology, Shenzhen Children' s Hospital, No. 7019, Yitian Road, Futian District, Shenzhen 518026 (China)


    Objective: To characterize the radiographic findings of pediatric patients with severe Influenza-A (H1N1) disease. Methods: A retrospective study of data from chest X-ray, CT and MRI exam of 29 pediatric patients treated in intensive care unit for severe Influenza-A (H1N1) disease. Results: Disease developed quickly at early stage. Here are four types of radiographic findings. The disease continued to progress for 2-3 days and X-ray showed that all 29 patients had increased solid lesions with the existence of interstitial lesions. Four days later, all lung lesions showed absorption to certain degree. Fifteen days later, X-ray and CT showed complete or significant absorption in 19 cases (85.5%); delayed recovery was identified in 8 cases (27.6%), pulmonary fibrosis was found in 3 cases (10.3%), and 3 patients (10.3%) died. But the latter identified more lesions. Cranial CT and MRI were performed for 8 patients who had neurological symptoms. Of them, 3 cases (10.3%) were abnormal, showed symmetrical long T1 and T2 signal shadow in bilateral thalamus and longer T1 and T2 signals in the between. 3 cases had autopsy completed. Conclusion: The severe Influenza-A (H1N1) among children progression was generally rapid in the first 3 days. The overall radiographic findings are similar to acute respiratory distress syndrome (ARDS). A small portion of the patients occurred acute necrotizing encephalopathy and plastic bronchitis.

  5. Prediction of biological functions on glycosylation site migrations in human influenza H1N1 viruses.

    Sun, Shisheng; Wang, Qinzhe; Zhao, Fei; Chen, Wentian; Li, Zheng


    Protein glycosylation alteration is typically employed by various viruses for escaping immune pressures from their hosts. Our previous work had shown that not only the increase of glycosylation sites (glycosites) numbers, but also glycosite migration might be involved in the evolution of human seasonal influenza H1N1 viruses. More importantly, glycosite migration was likely a more effectively alteration way for the host adaption of human influenza H1N1 viruses. In this study, we provided more bioinformatics and statistic evidences for further predicting the significant biological functions of glycosite migration in the host adaptation of human influenza H1N1 viruses, by employing homology modeling and in silico protein glycosylation of representative HA and NA proteins as well as amino acid variability analysis at antigenic sites of HA and NA. The results showed that glycosite migrations in human influenza viruses have at least five possible functions: to more effectively mask the antigenic sites, to more effectively protect the enzymatic cleavage sites of neuraminidase (NA), to stabilize the polymeric structures, to regulate the receptor binding and catalytic activities and to balance the binding activity of hemagglutinin (HA) with the release activity of NA. The information here can provide some constructive suggestions for the function research related to protein glycosylation of influenza viruses, although these predictions still need to be supported by experimental data.

  6. Protecting the Public from H1N1 through Points of Dispensing (PODs).

    Rinchiuso-Hasselmann, Anne; McKay, Ryan L; Williams, Christopher A; Starr, David T; Morgenthau, Beth Maldin; Zucker, Jane R; Raphael, Marisa


    In fall 2009, the New York City Department of Health and Mental Hygiene (DOHMH) operated 58 points of dispensing (PODs) over 5 weekends to provide influenza A (H1N1) 2009 monovalent vaccination to New Yorkers. Up to 7 sites were opened each day across the 5 boroughs, with almost 50,000 New Yorkers being vaccinated. The policies and protocols used were based on those developed for New York City's POD Plan, the cornerstone of the city's mass prophylaxis planning. Before the H1N1 experience, NYC had not opened more than 5 PODs simultaneously and had only experienced the higher patient volume seen with the H1N1 PODs on 1 prior occasion. Therefore, DOHMH identified factors that contributed to the success of POD operations, as well as areas for improvement to inform future mass prophylaxis planning and response. Though this was a relatively small-scale, preplanned operation, during which a maximum of 7 PODs were operated on a given day, the findings have implications for larger-scale mass prophylaxis planning for emergencies.

  7. Entry screening to delay local transmission of 2009 pandemic influenza A (H1N1

    Wong Helen WC


    Full Text Available Abstract Background After the WHO issued the global alert for 2009 pandemic influenza A (H1N1, many national health agencies began to screen travelers on entry in airports, ports and border crossings to try to delay local transmission. Methods We reviewed entry screening policies adopted by different nations and ascertained dates of official report of the first laboratory-confirmed imported H1N1 case and the first laboratory-confirmed untraceable or 'local' H1N1 case. Results Implementation of entry screening policies was associated with on average additional 7-12 day delays in local transmission compared to nations that did not implement entry screening, with lower bounds of 95% confidence intervals consistent with no additional delays and upper bounds extending to 20-30 day additional delays. Conclusions Entry screening may lead to short-term delays in local transmission of a novel strain of influenza virus. The resources required for implementation should be balanced against the expected benefits of entry screening.

  8. Information Needs and Seeking Behavior During the H1N1 Virus Outbreak

    Majid, Shaheen


    Full Text Available Timely access to quality healthcare information during an outbreak plays an important role in curtailing its spread. The aim of this study was to investigate the information needs and seeking behavior of the general public in Singapore during the H1N1 pandemic. A pre-tested questionnaire was used for data collection. The convenience snowball sampling method was used and 260 working adults and tertiary-level students participated in this study. The most crucial information needs of a majority of the participants were: symptoms of H1N1, causes of the infection, preventive measures, and possible treatments. Data analysis also revealed that mass media such as television, newspapers, and radio were most frequently used for seeking the needed information. The use of human information sources was also quite high while only a small number of the respondents accessed online news and healthcare websites. About three-quarters of the participants indicated that the gathered information helped them to stay vigilant and take necessary precautionary measures. A major problem identified by the participants in using H1N1 information was the lack of understanding of certain terms used in public communications. This paper suggests certain measures for strengthening health information communication during future outbreaks.

  9. H1N1 Influenza Patient Saved by Extracorporeal Membrane Oxygenation: First Report from Iran

    Alireza Jahangirifard


    Full Text Available Respiratory failure is a serious complication of H1N1 influenza that, if not properly managed, can cause death. When mechanical ventilation is not effective, the only way to save the patient’s life is extracorporeal membrane oxygenation (ECMO. A prolonged type of cardiopulmonary bypass, ECMO is a high-cost management modality compared to other conventional types and its maintenance requires skilled personnel. Such staff usually comprises the members of open-heart surgical teams.  Herein, we describe a patient with H1N1 influenza and severe respiratory failure not improved by mechanical ventilation who was admitted to Masih Daneshvari Medical Center in March 2015. She was placed on ECMO, from which she was successfully weaned 9 days later. The patient was discharged from the hospital after 52 days. Follow-up till 11 months after discharge revealed completely active life with no problem. There should be a close collaboration among infectious disease specialists, cardiac anesthetists, cardiac surgeons, and intensivists for the correct timing of ECMO placement, subsequent weaning, and care of the patient. This team work was the key to our success story. This is the first patient to survive H1N1 with the use of ECMO in Iran. 

  10. Meteorological Influence on the 2009 Influenza A (H1N1) Pandemic in Mainland China.

    Zhao, X.; Cai, J.; Feng, D.; Bai, Y.; Xu, B.


    Since May 2009, a novel influenza A (H1N1) pandemic has spread rapidly in mainland China from Mexico. Although there has been substantial analysis of this influenza, reliable work estimating its spatial dynamics and determinants remain scarce. The survival and transmission of this pandemic virus not only depends on its biological properties, but also a correlation with external environmental factors. In this study, we collected daily influenza A (H1N1) cases and corresponding annual meteorological factors in mainland China from May 2009 to April 2010. By analyzing these data at county-level, a similarity index, which considered the spatio-temporal characteristics of the disease, was proposed to evaluate the role and lag time of meteorological factors in the influenza transmission. The results indicated that the influenza spanned a large geographical area, following an overall trend from east to west across the country. The spatio-temporal transmission of the disease was affected by a series of meteorological variables, especially absolute humidity with a 3-week lag. These findings confirmed that the absolute humidity and other meteorological variables contributed to the local occurrence and dispersal of influenza A (H1N1). The impact of meteorological variables and their lag effects could be involved in the improvement of effective strategies to control and prevent disease outbreaks.

  11. Origins of the 2009 H1N1 influenza pandemic in swine in Mexico.

    Mena, Ignacio; Nelson, Martha I; Quezada-Monroy, Francisco; Dutta, Jayeeta; Cortes-Fernández, Refugio; Lara-Puente, J Horacio; Castro-Peralta, Felipa; Cunha, Luis F; Trovão, Nídia S; Lozano-Dubernard, Bernardo; Rambaut, Andrew; van Bakel, Harm; García-Sastre, Adolfo


    Asia is considered an important source of influenza A virus (IAV) pandemics, owing to large, diverse viral reservoirs in poultry and swine. However, the zoonotic origins of the 2009 A/H1N1 influenza pandemic virus (pdmH1N1) remain unclear, due to conflicting evidence from swine and humans. There is strong evidence that the first human outbreak of pdmH1N1 occurred in Mexico in early 2009. However, no related swine viruses have been detected in Mexico or any part of the Americas, and to date the most closely related ancestor viruses were identified in Asian swine. Here, we use 58 new whole-genome sequences from IAVs collected in Mexican swine to establish that the swine virus responsible for the 2009 pandemic evolved in central Mexico. This finding highlights how the 2009 pandemic arose from a region not considered a pandemic risk, owing to an expansion of IAV diversity in swine resulting from long-distance live swine trade.

  12. Information Needs and Seeking Behavior During the H1N1 Virus Outbreak

    Nor Ain Rahmat


    Full Text Available Timely access to quality healthcare information during an outbreak plays an important role in curtailing its spread. The aim of this study was to investigate the information needs and seeking behavior of the general public in Singapore during the H1N1 pandemic. A pre-tested questionnaire was used for data collection. The convenience snowball sampling method was used and 260 working adults and tertiary-level students participated in this study. The most crucial information needs of a majority of the participants were: symptoms of H1N1, causes of the infection, preventive measures, and possible treatments. Data analysis also revealed that mass media such as television, newspapers, and radio were most frequently used for seeking the needed information. The use of human information sources was also quite high while only a small number of the respondents accessed online news and healthcare websites. About three-quarters of the participants indicated that the gathered information helped them to stay vigilant and take necessary precautionary measures. A major problem identified by the participants in using H1N1 information was the lack of understanding of certain terms used in public communications. This paper suggests certain measures for strengthening health information communication during future outbreaks.

  13. Affective language during the H1N1 influenza health crisis

    Morant Marco, Ricard


    Full Text Available In this article we analyze the effects that, as seen through the written press, the arrival of H1N1 had on certain affective behaviors in society. After the spread of H1N1, health authorities recommended maintaining physical distance in social settings and, among other measures, advised against kissing. At first, this show of affection became a victim of the pandemic, especially in certain activities and rituals. However, once the media impact of swine flu had subsided, kissing recovered its habitual place and frequency, demonstrating that customs which are socially and culturally entrenched are resistant to change.

    El presente artículo analiza los efectos que según la prensa escrita tuvo la llegada de la gripe A en ciertos comportamientos afectivos de la población. Las autoridades sanitarias, tras la expansión del virus H1N1, recomendaron aumentar la distancia social y aconsejaron, entre otras medidas, evitar los besos. Esta manifestación afectiva, en un primer momento, notó los efectos de la pandemia, sobre todo en ciertas actividades y rituales. Sin embargo, una vez pasado el impacto mediático de la gripe A, recuperó su uso y frecuencia habitual, demostrando que las costumbres fuertemente enraizadas se resisten a cambiar.

  14. C反应蛋白在甲型H1N1流感中的变化

    梁燕; 平芬; 张小平; 高爱武


    目的 本研究目的 在于探讨患者血中C-反应蛋白(CRP)浓度对诊断甲型H1N1流感的价值,观察甲型H1N1流感中CRP的变化.方法 选取20例确诊为甲型H1N1流感患者作为甲型H1N1流感组,选取20例上感患者排除甲型H1N1流感患者作为非H1N1流感组,分别测定其急性期CRP浓度,并进行比较.结果 甲型H1N1流感组的CRP浓度(94±17)mg/L明显高于非H1N1流感组(56±10)mg/L(P<0.05).结论 CRP浓度可以作为诊断甲型H1N1流感患者的敏感指标,有助于甲型H1N1流感患者的预后和治疗效果的评价.

  15. Influenza pandêmica A (H1N1 2009: fatores de risco para o internamento Pandemic influenza A (H1N1 2009: risk factors for hospitalization

    Luana Lenzi


    Full Text Available OBJETIVO: Avaliar os aspectos da influenza pandêmica A (H1N1 2009 em pacientes hospitalizados a fim de identificar os fatores de risco para o internamento e, consequentemente, para o agravamento da doença. MÉTODOS: Estudo observacional e retrospectivo realizado entre março e dezembro de 2010. Os dados foram coletados a partir do Sistema Nacional de Agravos de Notificação do Ministério da Saúde. Foram incluídos somente os pacientes hospitalizados e não hospitalizados com confirmação laboratorial da infecção durante o período de estudo. As variáveis referentes às características demográficas e clínicas foram avaliadas estatisticamente a fim de comparar as taxas de internamento na presença ou na ausência desses fatores. Os fatores de risco foram identificados por regressão logística. RESULTADOS: Foram incluídos no estudo 4.740 pacientes com confirmação laboratorial da infecção. Desses, 1.911 foram internados, e 258 (13,5% foram a óbito. Os fatores de risco para o internamento foram idade (faixa etária de 20 a 29 anos, etnia negra ou indígena, presença de algumas comorbidades (cardiopatias, pneumopatias, nefropatias, hemoglobinopatia, imunodepressão, diabetes, obesidade, puerpério e tabagismo, número alto de comorbidades associadas, e alguns sintomas (dispneia, diarreia, vômito, dor torácica, hemoptise, pneumonia e sibilos. Níveis maiores de escolaridade e uso precoce do oseltamivir foram relacionados a fatores de proteção. A hospitalização contribuiu para o aumento da sobrevida. CONCLUSÕES: O conhecimento das características epidemiológicas que podem estar associadas a internação, gravidade da doença e mortalidade podem ser úteis na adoção de medidas preventivas e no diagnóstico e tratamento precoce da doença, colaborando para a diminuição dos óbitos e da necessidade de hospitalização.OBJECTIVE: To evaluate pandemic influenza A (H1N1 2009 in hospitalized patients in order to identify risk

  16. Cross-neutralizing antibodies to pandemic 2009 H1N1 and recent seasonal H1N1 influenza A strains influenced by a mutation in hemagglutinin subunit 2.

    Wei Wang


    Full Text Available Pandemic 2009 H1N1 influenza A virus (2009 H1N1 differs from H1N1 strains that circulated in the past 50 years, but resembles the A/New Jersey/1976 H1N1 strain used in the 1976 swine influenza vaccine. We investigated whether sera from persons immunized with the 1976 swine influenza or recent seasonal influenza vaccines, or both, neutralize 2009 H1N1. Using retroviral pseudovirions bearing hemagglutinins on their surface (HA-pseudotypes, we found that 77% of the sera collected in 1976 after immunization with the A/New Jersey/1976 H1N1 swine influenza vaccine neutralized 2009 H1N1. Forty five percent also neutralized A/New Caledonia/20/1999 H1N1, a strain used in seasonal influenza vaccines during the 2000/01-2006/07 seasons. Among adults aged 48-64 who received the swine influenza vaccine in 1976 and recent seasonal influenza vaccines during the 2004/05-2008/09 seasons, 83% had sera that neutralized 2009 H1N1. However, 68% of age-matched subjects who received the same seasonal influenza vaccines, but did not receive the 1976 swine influenza vaccine, also had sera that neutralized 2009 H1N1. Sera from both 1976 and contemporary cohorts frequently had cross-neutralizing antibodies to 2009 H1N1 and A/New Caledonia/20/1999 that mapped to hemagglutinin subunit 2 (HA2. A conservative mutation in HA2 corresponding to a residue in the A/Solomon Islands/3/2006 and A/Brisbane/59/2007 H1N1 strains that circulated in the 2006/07 and 2007/08 influenza seasons, respectively, abrogated this neutralization. These findings highlight a cross-neutralization determinant influenced by a point mutation in HA2 and suggest that HA2 may be evolving under direct or indirect immune pressure.

  17. 应用CUSUM和EWMA模型探测甲型H1N1流感流行起始的预警研究%Study on early detection of the onset of the epidemic of pandemic H1N1 2009, using CUSUM and EWMA

    王小莉; 张奕; 杨鹏; 钱海坤; 张莉; 田丽丽; 黎新宇; 王全意


    Objects To explore the efficiency of Cumulative Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) for detecting the onset of the epidemic of pandemic H1N1 2008.Methods Influenza like-illness (ILI) surveillance data was analyzed to detect the onset week of the epidemic of pandemic H1N1 2009,using the model of CUSUM and EWMA.The results were compared with the gold standard at different combination of parameter values.Results The 41 st week was considered as onset of the epidemic of pandemic H1N1 2009 according to the gold standard based on the results from influenza virologic surveillance data.Both CUSUM and EWMA triggered the signal before the 42nd week.Differences in performances were observed as parameter values changed.Conclusions The parameter values of CUSUM and EWMA had a correlation to their performances.CUSUM and EWMA could be used for detecting the onset of the epidemic of pandemic H1N1 2008.%目的 探讨累计和( CUSUM)和指数加权移动平均(EWMA)模型探测甲型H1 N1流感流行起始的功效.方法 利用北京市2009年流感样病例监测数据,分别采用CUSUM和EWMA模型对数据进行分析,与流感病原学监测数据进行对比,分析了不同参数组合下2种模型探测甲型H1N1流感流行起始的效果.结果 流感病原学监测显示2009年北京市甲型H1N1流感流行的起始时间为第41周,而CUSUM和EWMA模型均能在第42周之前发出预警信号;参数不同,CUSUM和EWMA模型的预警功效亦不同.结论 CUSUM和EWMA模型参数值与其预警功效有关,CUSUM和EWMA模型可用于探测甲型H1N1流感流行的起始.

  18. Pandemic influenza A/H1N1pdm in Italy: age, risk and population susceptibility.

    Stefano Merler

    Full Text Available BACKGROUND: A common pattern emerging from several studies evaluating the impact of the 2009 A/H1N1 pandemic influenza (A/H1N1pdm conducted in countries worldwide is the low attack rate observed in elderly compared to that observed in children and young adults. The biological or social mechanisms responsible for the observed age-specific risk of infection are still to be deeply investigated. METHODS: The level of immunity against the A/H1N1pdm in pre and post pandemic sera was determined using left over sera taken for diagnostic purposes or routine ascertainment obtained from clinical laboratories. The antibody titres were measured by the haemagglutination inhibition (HI assay. To investigate whether certain age groups had higher risk of infection the presence of protective antibody (≥1∶40, was calculated using exact binomial 95% CI on both pre- and post- pandemic serological data in the age groups considered. To estimate age-specific susceptibility to infection we used an age-structured SEIR model. RESULTS: By comparing pre- and post-pandemic serological data in Italy we found age- specific attack rates similar to those observed in other countries. Cumulative attack rate at the end of the first A/H1N1pdm season in Italy was estimated to be 16.3% (95% CI 9.4%-23.1%. Modeling results allow ruling out the hypothesis that only age-specific characteristics of the contact network and levels of pre-pandemic immunity are responsible for the observed age-specific risk of infection. This means that age-specific susceptibility to infection, suspected to play an important role in the pandemic, was not only determined by pre-pandemic levels of H1N1pdm antibody measured by HI. CONCLUSIONS: Our results claim for new studies to better identify the biological mechanisms, which might have determined the observed pattern of susceptibility with age. Moreover, our results highlight the need to obtain early estimates of differential susceptibility with age in

  19. Planning for the next influenza H1N1 season: a modelling study

    Pelat Camille


    Full Text Available Abstract Background The level of herd immunity before and after the first 2009 pandemic season is not precisely known, and predicting the shape of the next pandemic H1N1 season is a difficult challenge. Methods This was a modelling study based on data on medical visits for influenza-like illness collected by the French General Practitioner Sentinel network, as well as pandemic H1N1 vaccination coverage rates, and an individual-centred model devoted to influenza. We estimated infection attack rates during the first 2009 pandemic H1N1 season in France, and the rates of pre- and post-exposure immunity. We then simulated various scenarios in which a pandemic influenza H1N1 virus would be reintroduced into a population with varying levels of protective cross-immunity, and considered the impact of extending influenza vaccination. Results During the first pandemic season in France, the proportion of infected persons was 18.1% overall, 38.3% among children, 14.8% among younger adults and 1.6% among the elderly. The rates of pre-exposure immunity required to fit data collected during the first pandemic season were 36% in younger adults and 85% in the elderly. We estimated that the rate of post-exposure immunity was 57.3% (95% Confidence Interval (95%CI 49.6%-65.0% overall, 44.6% (95%CI 35.5%-53.6% in children, 53.8% (95%CI 44.5%-63.1% in younger adults, and 87.4% (95%CI 82.0%-92.8% in the elderly. The shape of a second season would depend on the degree of persistent protective cross-immunity to descendants of the 2009 H1N1 viruses. A cross-protection rate of 70% would imply that only a small proportion of the population would be affected. With a cross-protection rate of 50%, the second season would have a disease burden similar to the first, while vaccination of 50% of the entire population, in addition to the population vaccinated during the first pandemic season, would halve this burden. With a cross-protection rate of 30%, the second season could be

  20. Viral shedding in Chinese young adults with mild 2009 H1N1 influenza

    JIA Ning; GAO Yan; SUO Ji-jiang; XIE Li-jun; YAN Zhong-qiang; XING Yu-bin; HE Lei; LIU Yun-xi


    Background The duration of viral shedding and the transmission of 2009 H1N1 influenza among individuals, especially among the younger population with mild illness, are not well understood now. The aim of this study was to determine the viral shedding of the young adult patients with mild 2009 H1N1 influenza in China.Methods From September 2009 to January 2010, the clinical data and serial nasopharyngeal swabs of 67 patients with 2009 H1N1 influenza and 37 patients with seasonal influenza aged from 18 years to 35 years were collected. The nasopharyngeal swab samples were detected by real time RT-PCR to determine the viral shedding. All the patients did not receive the antiviral therapy but Chinese medicine for detoxicating.Results Among the patients with H1N1 virus infection, 82.1% (55/67) patients presented with fever symptom, while more patients with high fever (≥39℃) were found in seasonal influenza patients (P<0.05). For the H1N1 patients, the median interval between the symptom onset and the undetectable RNA was six days (4-10 days). But viral shedding was still found in 31.3% patients after 7 days following illness onset. The median interval between disappearance of fever and an undetectable viral RNA level was three days (2-8 days), and 17.9% patients were found to be viral shedding 6 days later after normalization of body temperature. For the seasonal influenza patients, 94.6% patients were detected out viral RNA within 7 days. The median interval of seasonal influenza between the symptom onset and the undetectable RNA was four days (3-8 days). The median interval between disappearance of fever and an undetectable viral RNA level was three days (2-6 days).Conclusion It suggests that 7 days isolation period from the illness onset or 24 hours after the resolution of fever and respiratory symptoms are not long enough to cut off the transmission among Chinese young adults with mild illness.




    Full Text Available Influenza virus causes mild-to-severe acute respiratory illness. H1N1 bronchopneumonia carries a higher mortality. MATERIALS AND METHODS Study was a prospective observational study conducted in a 24 bedded multidisciplinary ICU from January 2010 to December 2010. We included all adult patients admitted to our intensive care unit presenting with clinical features/suspicion of H1N1 bronchopneumonia and respiratory failure. These patients also subsequently tested positive for H1N1 Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR assay. Data was collected on demography, co-morbid illness, APACHE II and SOFA scores, organ failure and support. Outcome data on mortality, ICU LOS and ventilator days was also collected. RESULTS 28 patients with H1N1 bronchopneumonia required intensive care treatment. Majority of patients were females 60.7 % (n=17; of these 17 patients 7 patients were pregnant. Mean age of our patients was 50.6 (±19.1 years. Most common co-existing illnesses were diabetes mellitus (32.1% and hypertension (32.1% followed by bronchial asthma (10.7%; 85.7% patients had at least one organ dysfunction on admission, of which respiratory system was involved in 96.5% followed by renal system 57.1%. Patients were sick on admission as indicated by high APACHE II (17.75±6.5 and SOFA (5.25±1.8 scores. Mean PaO2/FiO2 on admission was 148.9±77.2. Severe ARDS (PaO2/FiO2 <100 was seen in 39.35% of patients. Of the 28 patients, 27 patients required ventilator support; 17 patients died out of 28 patients (mortality rate 60.7%. Higher APACHE II, SOFA scores and low PaO2/FiO2 on admission were identified as significant risk factors for mortality. CONCLUSION Critically ill H1N1 pneumonia patients present with multisystem involvement and they had a high mortality in our study.

  2. Community responses to communication campaigns for influenza A (H1N1: a focus group study

    Gray Lesley


    Full Text Available Abstract Background This research was a part of a contestable rapid response initiative launched by the Health Research Council of New Zealand and the Ministry of Health in response to the 2009 influenza A pandemic. The aim was to provide health authorities in New Zealand with evidence-based practical information to guide the development and delivery of effective health messages for H1N1 and other health campaigns. This study contributed to the initiative by providing qualitative data about community responses to key health messages in the 2009 and 2010 H1N1 campaigns, the impact of messages on behavioural change and the differential impact on vulnerable groups in New Zealand. Methods Qualitative data were collected on community responses to key health messages in the 2009 and 2010 Ministry of Health H1N1 campaigns, the impact of messages on behaviour and the differential impact on vulnerable groups. Eight focus groups were held in the winter of 2010 with 80 participants from groups identified by the Ministry of Health as vulnerable to the H1N1 virus, such as people with chronic health conditions, pregnant women, children, Pacific Peoples and Māori. Because this study was part of a rapid response initiative, focus groups were selected as the most efficient means of data collection in the time available. For Māori, focus group discussion (hui is a culturally appropriate methodology. Results Thematic analysis of data identified four major themes: personal and community risk, building community strategies, responsibility and information sources. People wanted messages about specific actions that they could take to protect themselves and their families and to mitigate any consequences. They wanted transparent and factual communication where both good and bad news is conveyed by people who they could trust. Conclusions The responses from all groups endorsed the need for community based risk management including information dissemination. Engaging

  3. Neutralization and Binding Profile of Monoclonal Antibodies Generated Against Influenza A H1N1 Viruses.

    Shembekar, Nachiket; Mallajosyula, Vamsee V Aditya; Malik, Ankita; Saini, Ashok; Varadarajan, Raghavan; Gupta, Satish Kumar


    Monoclonal antibodies (MAbs) provide scope for the development of better therapeutics and diagnostic tools. Herein, we describe the binding and neutralization profile(s) for a panel of murine MAbs generated against influenza A H1N1 viruses elicited by immunization with pandemic H1 recombinant hemagglutinin (rHA)/whole virus or seasonal H1 rHA. Neutralizing MAbs, MA-2070 and MA-M, were obtained after pandemic A/California/07/2009 (H1N1) virus/rHA immunization(s). Both MAbs reacted specifically with rHA from A/California/07/2009 and A/England/195/2009 in ELISA. MA-2070 bound rHA of A/California/07/2009 with high affinity (KD = 51.36 ± 9.20 nM) and exhibited potent in vitro neutralization (IC50 = 2.50 μg/mL). MA-2070 bound within the stem domain of HA. MA-M exhibited both hemagglutination inhibition (HI, 1.50 μg/mL) and in vitro neutralization (IC50 = 0.66 μg/mL) activity against the pandemic A/California/07/2009 virus and showed higher binding affinity (KD = 9.80 ± 0.67 nM) than MA-2070. MAb, MA-H generated against the seasonal A/Solomon Islands/03/2006 (H1N1) rHA binds within the head domain and bound the seasonal H1N1 (A/Solomon Islands/03/2006 and A/New Caledonia/20/1990) rHAs with high affinity (KD; 0.72-8.23 nM). MA-H showed high HI (2.50 μg/mL) and in vitro neutralization (IC50 = 2.61 μg/mL) activity against the A/Solomon Islands/03/2006 virus. All 3 MAbs failed to react in ELISA with rHA from various strains of H2N2, H3N2, H5N1, H7N9, and influenza virus B, suggesting their specificity for either pandemic or seasonal H1N1 influenza virus. The MAbs reported here may be useful in developing diagnostic assays.

  4. Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza.

    Gustavo Palacios

    Full Text Available BACKGROUND: Initial reports in May 2009 of the novel influenza strain H1N1pdm estimated a case fatality rate (CFR of 0.6%, similar to that of seasonal influenza. In July 2009, however, Argentina reported 3056 cases with 137 deaths, representing a CFR of 4.5%. Potential explanations for increased CFR included virus reassortment or genetic drift, or infection of a more vulnerable population. Virus genomic sequencing of 26 Argentinian samples representing both severe and mild disease indicated no evidence of reassortment, mutations associated with resistance to antiviral drugs, or genetic drift that might contribute to virulence. Furthermore, no evidence was found for increased frequency of risk factors for H1N1pdm disease. METHODS/PRINCIPAL FINDINGS: We examined nasopharyngeal swab samples (NPS from 199 cases of H1N1pdm infection from Argentina with MassTag PCR, testing for 33 additional microbial agents. The study population consisted of 199 H1N1pdm-infected subjects sampled between 23 June and 4 July 2009. Thirty-nine had severe disease defined as death (n = 20 or hospitalization (n = 19; 160 had mild disease. At least one additional agent of potential pathogenic importance was identified in 152 samples (76%, including Streptococcus pneumoniae (n = 62; Haemophilus influenzae (n = 104; human respiratory syncytial virus A (n = 11 and B (n = 1; human rhinovirus A (n = 1 and B (n = 4; human coronaviruses 229E (n = 1 and OC43 (n = 2; Klebsiella pneumoniae (n = 2; Acinetobacter baumannii (n = 2; Serratia marcescens (n = 1; and Staphylococcus aureus (n = 35 and methicillin-resistant S. aureus (MRSA, n = 6. The presence of S. pneumoniae was strongly correlated with severe disease. S. pneumoniae was present in 56.4% of severe cases versus 25% of mild cases; more than one-third of H1N1pdm NPS with S. pneumoniae were from subjects with severe disease (22 of 62 S. pneumoniae-positive NPS, p = 0.0004. In subjects 6 to 55 years of age, the adjusted odds ratio

  5. Clinical and radiological features of pandemic H1N1 2009 influenza virus infection manifesting as acute febrile respiratory illness at their initial presentations: comparison with contemporaneous non-H1N1 patients

    Yun, Tae Jin (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)); Park, Chang Min; Choi, Seung Hong; Lee, Hyun Ju; Goo, Jin Mo (Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email:; Kwon, Gu Jin (Dept. of Family Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Family Medicine, Gangneung Asan Hospital, Gangneung (Korea, Republic of)); Woo, Sung Koo (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of)); Park, Seung Hoon (Dept. of Internal Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of))


    Background Since the first outbreak caused by the pandemic H1N1 2009 influenza in Mexico, the virus has spread widely across the world with meaningful morbidity and mortality. However, there are few data on the comparative investigations to assess the clinical and radiological features between the H1N1 patient and non-H1N1 patients. Purpose To assess the clinical and radiological features of patients infected by the pandemic H1N1 2009 flu virus at their initial presentation and to compare them with contemporaneous non-H1N1 patients with acute febrile respiratory illness. Material and Methods This retrospective study was approved by the ethics committee of the Armed Forces Medical Command, South Korea. From August to September 2009, 337 consecutive patients presented with an acute febrile respiratory illness in a tertiary military hospital. Reverse-transcriptase polymerase-chain-reaction tests were performed in 62 of these patients under the impression of H1N1 infection. Clinical and radiological features at their initial presentation were described for the H1N1 group (n = 35) and non-H1N1 group (n = 27) and compared between the two groups. Results Increased C-reactive protein level (97%) without leukocytosis (9%) or increased erythrocyte sedimentation rate (0%) was common in the H1N1 group at their initial presentation. On chest radiographs, 12 of 35 (34%) H1N1 patients had abnormal findings; nodules in 10 patients (83%) and consolidations in two (17%). Of the 28 H1N1 patients who underwent thin-section CT 16 patients (57%) showed abnormal findings; ground-glass opacities (GGOs) in 15 (94%), and nodules in 13 (81%). However, there were no significant differences between the H1N1 group and non-H1N1 group in terms of symptoms, laboratory results, or radiological findings (P > 0.05). Conclusion Patients with H1N1 infection show consistent clinical and radiological features at their initial presentation, however, clinical and radiological features of the H1N1 group are

  6. 甲型流感H1N1病毒遗传进化关系分析%Analysis of the Variation and Evolution of Influenza A (H1N1)

    常彦磊; 石磊



  7. Immune Activation and Viral Replication after Vaccination with an Influenza A H1N1 2009 Vaccine in HIV-Infected Children Receiving Antiretroviral Therapy

    Nattawat Onlamoon


    Full Text Available Immunization with a pandemic influenza A H1N1 2009 was recommended for HIV-infected patients. However, there is limited information concerning the impact of immunization with this vaccine on immune activation and HIV viral replication. In this study, 45 HIV-infected children and adolescents receiving antiretroviral therapy were immunized with a 2-dose series of nonadjuvated monovalent influenza A H1N1 2009 vaccine upon enrollment and approximately 1 month later. Immunogenicity was determined by haemagglutination inhibition assay. The level of immune activation was determined by identification of CD38 and HLA-DR on CD8+ T cells. Patients were divided into 2 groups which include patients who had an undetectable HIV viral load (HIV detectable group and patients who show virological failure (HIV nondetectable group. The results showed seroconversion rate of 55.2% in HIV nondetectable group, whereas 31.3% was found in HIV detectable group. Both groups of patients showed no major increase in immune activation after immunization. Interestingly, a decrease in the frequency of CD8+ T cells that coexpressed CD38 and HLA-DR was observed after immunization in both groups of patients. We suggested that immunization with influenza A H1N1 2009 vaccine can induce immune response to the pandemic virus without major impact on HIV viral replication and immune activation.

  8. Attack rates assessment of the 2009 pandemic H1N1 influenza A in children and their contacts: a systematic review and meta-analysis.

    Aharona Glatman-Freedman

    Full Text Available BACKGROUND: The recent H1N1 influenza A pandemic was marked by multiple reports of illness and hospitalization in children, suggesting that children may have played a major role in the propagation of the virus. A comprehensive detailed analysis of the attack rates among children as compared with their contacts in various settings is of great importance for understanding their unique role in influenza pandemics. METHODOLOGY/PRINCIPAL FINDINGS: We searched MEDLINE (PubMed and Embase for published studies reporting outbreak investigations with direct measurements of attack rates of the 2009 pandemic H1N1 influenza A among children, and quantified how these compare with those of their contacts. We identified 50 articles suitable for review, which reported school, household, travel and social events. The selected reports and our meta-analysis indicated that children had significantly higher attack rates as compared to adults, and that this phenomenon was observed for both virologically confirmed and clinical cases, in various settings and locations around the world. The review also provided insight into some characteristics of transmission between children and their contacts in the various settings. CONCLUSION/SIGNIFICANCE: The consistently higher attack rates of the 2009 pandemic H1N1 influenza A among children, as compared to adults, as well as the magnitude of the difference is important for understanding the contribution of children to disease burden, for implementation of mitigation strategies directed towards children, as well as more precise mathematical modeling and simulation of future influenza pandemics.

  9. Illness representation on H1N1 influenza and preventive behaviors in the Hong Kong general population.

    Mo, Phoenix K H; Lau, Joseph T F


    This study examined illness representations of new influenza Human Swine Influenza A (H1N1) and association with H1N1 preventive behaviors among 300 Chinese adults using a population-based randomized telephone survey. Results showed that relatively few participants thought H1N1 would have serious consequences (12%-15.7%) and few showed negative emotional responses toward H1N1 (9%-24.7%). The majority of the participants thought H1N1 could be controlled by treatment (70.4%-72.7%). Multiple logistic regression analyses showed that treatment control (odds ratio = 1.78) and psychological attribution (odds ratio = .75) were associated with intention to take up influenza vaccination. Emotional representations were associated with lower likelihood of wearing face mask (odds ratio = .77) and hand washing (odds ratio = .67). Results confirm that illness representation variables are associated with H1N1 preventive behaviors.

  10. Phylodynamics of H1N1/2009 influenza reveals the transition from host adaptation to immune-driven selection.

    Su, Yvonne C F; Bahl, Justin; Joseph, Udayan; Butt, Ka Man; Peck, Heidi A; Koay, Evelyn S C; Oon, Lynette L E; Barr, Ian G; Vijaykrishna, Dhanasekaran; Smith, Gavin J D


    Influenza A H1N1/2009 virus that emerged from swine rapidly replaced the previous seasonal H1N1 virus. Although the early emergence and diversification of H1N1/2009 is well characterized, the ongoing evolutionary and global transmission dynamics of the virus remain poorly investigated. To address this we analyse >3,000 H1N1/2009 genomes, including 214 full genomes generated from our surveillance in Singapore, in conjunction with antigenic data. Here we show that natural selection acting on H1N1/2009 directly after introduction into humans was driven by adaptation to the new host. Since then, selection has been driven by immunological escape, with these changes corresponding to restricted antigenic diversity in the virus population. We also show that H1N1/2009 viruses have been subject to regular seasonal bottlenecks and a global reduction in antigenic and genetic diversity in 2014.

  11. High burden of non-influenza viruses in influenza-like illness in the early weeks of H1N1v epidemic in France.

    Nathalie Schnepf

    Full Text Available BACKGROUND: Influenza-like illness (ILI may be caused by a variety of pathogens. Clinical observations are of little help to recognise myxovirus infection and implement appropriate prevention measures. The limited use of molecular tools underestimates the role of other common pathogens. OBJECTIVES: During the early weeks of the 2009-2010 flu pandemic, a clinical and virological survey was conducted in adult and paediatric patients with ILI referred to two French University hospitals in Paris and Tours. Aims were to investigate the different pathogens involved in ILI and describe the associated symptoms. METHODS: H1N1v pandemic influenza diagnosis was performed with real time RT-PCR assay. Other viral aetiologies were investigated by the molecular multiplex assay RespiFinder19®. Clinical data were collected prospectively by physicians using a standard questionnaire. RESULTS: From week 35 to 44, endonasal swabs were collected in 413 patients. Overall, 68 samples (16.5% were positive for H1N1v. In 13 of them, other respiratory pathogens were also detected. Among H1N1v negative samples, 213 (61.9% were positive for various respiratory agents, 190 in single infections and 23 in mixed infections. The most prevalent viruses in H1N1v negative single infections were rhinovirus (62.6%, followed by parainfluenza viruses (24.2% and adenovirus (5.3%. 70.6% of H1N1v cases were identified in patients under 40 years and none after 65 years. There was no difference between clinical symptoms observed in patients infected with H1N1v or with other pathogens. CONCLUSION: Our results highlight the high frequency of non-influenza viruses involved in ILI during the pre-epidemic period of a flu alert and the lack of specific clinical signs associated with influenza infections. Rapid diagnostic screening of a large panel of respiratory pathogens may be critical to define and survey the epidemic situation and to provide critical information for patient management.

  12. 滕州市积极应对甲型H1N1流感疫情



  13. Functional Evolution of Influenza Virus NS1 Protein in Currently Circulating Human 2009 Pandemic H1N1 Viruses.

    Clark, Amelia M; Nogales, Aitor; Martinez-Sobrido, Luis; Topham, David J; DeDiego, Marta L


    In 2009, a novel H1N1 influenza virus emerged in humans, causing a global pandemic. It was previously shown that the NS1 protein from this human 2009 pandemic H1N1 (pH1N1) virus was an effective interferon (IFN) antagonist but could not inhibit general host gene expression, unlike other NS1 proteins from seasonal human H1N1 and H3N2 viruses. Here we show that the NS1 protein from currently circulating pH1N1 viruses has evolved to encode 6 amino acid changes (E55K, L90I, I123V, E125D, K131E, and N205S) with respect to the original protein. Notably, these 6 residue changes restore the ability of pH1N1 NS1 to inhibit general host gene expression, mainly by their ability to restore binding to the cellular factor CPSF30. This is the first report describing the ability of the pH1N1 NS1 protein to naturally acquire mutations that restore this function. Importantly, a recombinant pH1N1 virus containing these 6 amino acid changes in the NS1 protein (pH1N1/NSs-6mut) inhibited host IFN and proinflammatory responses to a greater extent than that with the parental virus (pH1N1/NS1-wt), yet virus titers were not significantly increased in cell cultures or in mouse lungs, and the disease was partially attenuated. The pH1N1/NSs-6mut virus grew similarly to pH1N1/NSs-wt in mouse lungs, but infection with pH1N1/NSs-6mut induced lower levels of proinflammatory cytokines, likely due to a general inhibition of gene expression mediated by the mutated NS1 protein. This lower level of inflammation induced by the pH1N1/NSs-6mut virus likely accounts for the attenuated disease phenotype and may represent a host-virus adaptation affecting influenza virus pathogenesis.IMPORTANCE Seasonal influenza A viruses (IAVs) are among the most common causes of respiratory infections in humans. In addition, occasional pandemics are caused when IAVs circulating in other species emerge in the human population. In 2009, a swine-origin H1N1 IAV (pH1N1) was transmitted to humans, infecting people then and up

  14. The 2009 Influenza A(H1N1) ’Swine Flu’ Outbreak: U.S. Responses to Global Human Cases


    treatable with two antiviral drugs, oseltamivir ( brand name Tamiflu®) and zanamivir ( brand name Relenza®), though there is no available vaccine. csr /disease/swineflu/en/ index.html and CRS Report R40554, The 2009 H1N1 “Swine Flu” Outbreak: An Overview, by Sarah A. Lister and C...the virus 5 See WHO, Swine influenza - update 3, April 27, 2009, csr /don

  15. Extreme evolutionary conservation of functionally important regions in H1N1 influenza proteome.

    Samantha Warren

    Full Text Available The H1N1 subtype of influenza A virus has caused two of the four documented pandemics and is responsible for seasonal epidemic outbreaks, presenting a continuous threat to public health. Co-circulating antigenically divergent influenza strains significantly complicates vaccine development and use. Here, by combining evolutionary, structural, functional, and population information about the H1N1 proteome, we seek to answer two questions: (1 do residues on the protein surfaces evolve faster than the protein core residues consistently across all proteins that constitute the influenza proteome? and (2 in spite of the rapid evolution of surface residues in influenza proteins, are there any protein regions on the protein surface that do not evolve? To answer these questions, we first built phylogenetically-aware models of the patterns of surface and interior substitutions. Employing these models, we found a single coherent pattern of faster evolution on the protein surfaces that characterizes all influenza proteins. The pattern is consistent with the events of inter-species reassortment, the worldwide introduction of the flu vaccine in the early 80's, as well as the differences caused by the geographic origins of the virus. Next, we developed an automated computational pipeline to comprehensively detect regions of the protein surface residues that were 100% conserved over multiple years and in multiple host species. We identified conserved regions on the surface of 10 influenza proteins spread across all avian, swine, and human strains; with the exception of a small group of isolated strains that affected the conservation of three proteins. Surprisingly, these regions were also unaffected by genetic variation in the pandemic 2009 H1N1 viral population data obtained from deep sequencing experiments. Finally, the conserved regions were intrinsically related to the intra-viral macromolecular interaction interfaces. Our study may provide further insights

  16. Brotes escolares de gripe (H1N1 2009 en Cataluña

    Nuria Torner


    Full Text Available A pesar de los avances en el conocimiento del virus de la gripe (H1N1 2009, la eficacia de su transmision entre contactos, asi como la eficacia de las intervenciones no farmacologicas es poco conocida. El objetivo de este trabajo es caracterizar la ocurrencia de brotes confirmados de virus (H1N1 2009 en Cataluna en el ambito escolar durante el periodo pandemico y evaluar las actuaciones llevadas a cabo para su control. Metodos: Se estudio la incidencia de brotes de VGA(H1N12009 de mayo a diciembre 2009. Se calcularon las tasas de ataque en funcion de emision de recomendaciones preventivas y ejecucion de intervenciones. La asociacion entre variables se calculo mediante ¿Ô2, comparacion de medias mediante t-Student y comparacion de proporciones mediante estadistico z , estableciendo el grado de significacion estadistica en ¿¿=0,05. Resultados: En total se notificaron 238 brotes. La TA global fue del 15,5%. Del total de brotes solo se conoce la tasa de ataque de 173 (72,7%, de los cuales 142 (82,1%; p<0,001 tuvieron una TA inferior al 25%. El principal ambito de transmision fue el escolar, donde se produjeron 209 (88%; p<0,001 brotes, de los cuales 187 (78,6%; p<0,001 correspondian a centros educativos. La duracion media de los brotes fue significativamente menor en funcion de la emision de recomendaciones (p=0,04. Conclusiones: El estudio de los brotes de gripe A/H1N1 2009 permite evidenciar que la adopcion de medidas preventivas y de higiene es de vital importancia para el control de la transmision en centros educativos.

  17. H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities

    Yoo, S.-Y. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, J.H., E-mail: jhkate@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Y.-J. [Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Aim: To describe the frequency, pattern, and outcome of chest radiographic abnormalities in children with H1N1 influenza infection. Materials and methods: Three hundred and fourteen paediatric patients with confirmed H1N1 influenza infection who underwent chest radiography at presentation at a single institution during the outbreak in 2009 were retrospectively reviewed. Abnormal chest radiographic findings related to acute infection were analysed in terms of frequency, pattern, and distribution. Medical records and follow-up radiographs were also reviewed to assess clinical features and outcomes. Results: Chest lesions suggesting acute infection were identified in 49 (16%) patients (mean age 8.2 years, range approximately 1.8-18.5 years). The most common finding was prominent peribronchial marking (71%), followed by air-space opacity (51%) with or without volume decrease, generalized hyperinflation (24%), and pleural effusion (20%). Other minor findings included pneumomediastinum (n = 2) and a nodule (n = 1). Distributions were bilateral (55%) or unilateral (45%) with frequent involvement of lower (78%), and middle (59%) lung zones. Thirty-nine patients (80%) were hospitalized and six (12%) required mechanical ventilation, followed by recovery. Thirty-one out of the 33 patients that underwent follow-up radiography showed marked resolution of all radiographic abnormalities. Conclusion: The frequency of a chest radiographic abnormality was found to be low in children with H1N1 influenza infection. Although typical radiographic findings of a viral lower respiratory infection were more common, unilateral involvement and air-space opacity were common, often with pleural effusion. Furthermore, pulmonary lesions showed near complete resolution on follow-up radiographs in the majority of patients.

  18. Mass vaccination for the 2009 H1N1 pandemic: approaches, challenges, and recommendations.

    Rambhia, Kunal J; Watson, Matthew; Sell, Tara Kirk; Waldhorn, Richard; Toner, Eric


    The 2009 H1N1 pandemic stimulated a nationwide response that included a mass vaccination effort coordinated at the federal, state, and local levels. This article examines a sampling of state and local efforts during the pandemic in order to better prepare for future public health emergencies involving mass distribution, dispensing, and administration of medical countermeasures. In this analysis, the authors interviewed national, state, and local leaders to gain a better understanding of the accomplishments and challenges of H1N1 vaccination programs during the 2009-10 influenza season. State and local health departments distributed and administered H1N1 vaccine using a combination of public and private efforts. Challenges encountered during the vaccination campaign included the supply of and demand for vaccine, prioritization strategies, and local logistics. To improve the response capabilities to deal with infectious disease emergencies, the authors recommend investing in technologies that will assure a more timely availability of the needed quantities of vaccine, developing local public health capacity and relationships with healthcare providers, and enhancing federal support of state and local activities. The authors support in principle the CDC recommendation to vaccinate annually all Americans over 6 months of age against seasonal influenza to establish a standard of practice on which to expand the ability to vaccinate during a pandemic. However, expanding seasonal influenza vaccination efforts will be an expensive and long-term investment that will need to be weighed against anticipated benefits and other public health needs. Such investments in public health infrastructure could be important for building capacity and practice for distributing, dispensing, and administering countermeasures in response to a future pandemic or biological weapons attack.

  19. Molecular characterization of H1N1 influenza A viruses from human cases in North America

    WU Bin; WANG ChengMin; DONG GuoYing; LUO Jing; ZHAO BaoHua; HE HongXuan


    Subtypes of H1N1 influenza virus can be found in humans in North America,while they are also associated with the infection of swine.Characterization of the genotypes of viral strains in human populations is important to understand the source and distribution of viral strains.Genomic and protein sequences of 10 isolates of the 2009 outbreak of influenza A (H1N1) virus in North America were obtained from GenBank database.To characterize the genotypes of these viruses,phylogenetic trees of genes PB2,PB1,PA,HA,NP,NA,NS and M were constructed by Phylip3.67 program and N-Linked glycosylation sites of HA,NA,PB2,NS1 and M2 proteins were analyzed online by NetNGIyc1.0 program.Phylogenetic analysis indicated that these isolates are virtually identical but may be recombinant viruses because their genomic fragments come from different viruses.The isolates also contain a characteristic lowly pathogenic amino acid motif at their HA cleavage sites (IPSIQSR↓GL),and an E residue at position 627 of the PB2 protein which shows its high affinity to humans.The homologous model of M proteins showed that the viruses had obtained the ability of anti-amantadine due to the mutation at the drug-sensitive site,while sequence analysis of NA proteins indicated that the viruses are still susceptible to the neuraminidase inhibitor drug (i.e.oseltamivir and zanamivir) because no mutations have been observed.Our results strongly suggested that the viruses responsible for the 2009 outbreaks of influenza A (H1N1) virus have the ability to cross species barriers to infect human and mammalian animals based on molecular analysis.These findings may further facilitate the therapy and prevention of possible transmission from North America to other countries.

  20. Imaging Findings in Patients With H1N1 Influenza A Infection

    Mehrdad Bakhshayeshkaram


    Full Text Available Background: Swine influenza (H1N1 is a very contagious respiratory infection and World Health Organization (WHO has raised the alert level to phase 6 (pandemic. The study of clinical and laboratory manifestations as well as radiologic imaging findings helps in its early diagnosis.Objectives: The aim of this study was to evaluate the imaging findings of patients with documented H1N1 infection referred to our center.Patients and Methods: Thirty-one patients (16 men with documented H1N1 infection were included in our study. The initial radiography obtained from the patients was reviewed regarding pattern (consolidation, ground glass, nodules and reticulation, distribution (focal, multifocal, and diffuse and the lung zones involved. Computed tomography (CT scans were also reviewed for the same abnormalities. The patient files were studied for their possible underlying diseases.Results: The mean age was 37.97 ± 13.9 years. Seventeen (54.8% patients had co-existing condition (eight respiratory, five cardiovascular, two immunodeficiency, two cancer, four others. Twelve (38.7% patients required intensive care unit (ICU admission. Five (16.1% patients died. (25.8% had normal initial radiographs. The most common abnormality was consolidation (12/31; 38.7% in the peripheral region (11/31; 35.5% followed by peribronchovascular areas (10/31; 32.3% which was most commonly observed in the lower zone. The patients admitted to the ICU were more likely to have two or more lung zones involved (P = 0.005.Conclusions: In patients with the novel swine flu infection, the most common radiographic abnormality observed was consolidation in the lower lung zones. Patients admitted to ICU were more likely to have two or more lung zones involved.

  1. Narcolepsy and influenza A(H1N1) pandemic 2009 vaccination in the United States.

    Duffy, Jonathan; Weintraub, Eric; Vellozzi, Claudia; DeStefano, Frank


    To assess the occurrence of narcolepsy after influenza vaccines used in the United States that contained the influenza A(H1N1)pdm09 virus strain. A population-based cohort study in the Vaccine Safety Datalink with an annual population of more than 8.5 million people. All persons younger than 30 years who received a 2009 pandemic or a 2010-2011 seasonal influenza vaccine were identified. Their medical visit history was searched for a first-ever occurrence of an ICD-9 narcolepsy diagnosis code through the end of 2011. Chart review was done to confirm the diagnosis and determine the date of symptom onset. Cases were patients who met the International Classification of Sleep Disorders, 2nd edition, narcolepsy diagnostic criteria. We compared the observed number of cases after vaccination to the number expected to occur by chance alone. The number vaccinated with 2009 pandemic vaccine was 650,995 and with 2010-2011 seasonal vaccine was 870,530. Among these patients, 70 had a first-ever narcolepsy diagnosis code after vaccination, of which 16 had a chart-confirmed incident diagnosis of narcolepsy. None had their symptom onset during the 180 days after receipt of a 2009 pandemic vaccine compared with 6.52 expected, and 2 had onset after a 2010-2011 seasonal vaccine compared with 8.83 expected. Influenza vaccines containing the A(H1N1)pdm09 virus strain used in the United States were not associated with an increased risk of narcolepsy. Vaccination with the influenza A(H1N1)pdm09 vaccine viral antigens does not appear to be sufficient by itself to increase the incidence of narcolepsy in a population. © 2014 American Academy of Neurology.

  2. An Influenza A/H1N1/2009 Hemagglutinin Vaccine Produced in Escherichia coli

    Aguilar-Yáñez, José M.; Portillo-Lara, Roberto; Mendoza-Ochoa, Gonzalo I.; García-Echauri, Sergio A.; López-Pacheco, Felipe; Bulnes-Abundis, David; Salgado-Gallegos, Johari; Lara-Mayorga, Itzel M.; Webb-Vargas, Yenny; León-Angel, Felipe O.; Rivero-Aranda, Ramón E.; Oropeza-Almazán, Yuriana; Ruiz-Palacios, Guillermo M.; Zertuche-Guerra, Manuel I.; DuBois, Rebecca M.; White, Stephen W.; Schultz-Cherry, Stacey; Russell, Charles J.; Alvarez, Mario M.


    Background The A/H1N1/2009 influenza pandemic made evident the need for faster and higher-yield methods for the production of influenza vaccines. Platforms based on virus culture in mammalian or insect cells are currently under investigation. Alternatively, expression of fragments of the hemagglutinin (HA) protein in prokaryotic systems can potentially be the most efficacious strategy for the manufacture of large quantities of influenza vaccine in a short period of time. Despite experimental evidence on the immunogenic potential of HA protein constructs expressed in bacteria, it is still generally accepted that glycosylation should be a requirement for vaccine efficacy. Methodology/Principal Findings We expressed the globular HA receptor binding domain, referred to here as HA63–286-RBD, of the influenza A/H1N1/2009 virus in Escherichia coli using a simple, robust and scalable process. The recombinant protein was refolded and purified from the insoluble fraction of the cellular lysate as a single species. Recombinant HA63–286-RBD appears to be properly folded, as shown by analytical ultracentrifugation and bio-recognition assays. It binds specifically to serum antibodies from influenza A/H1N1/2009 patients and was found to be immunogenic, to be capable of triggering the production of neutralizing antibodies, and to have protective activity in the ferret model. Conclusions/Significance Projections based on our production/purification data indicate that this strategy could yield up to half a billion doses of vaccine per month in a medium-scale pharmaceutical production facility equipped for bacterial culture. Also, our findings demonstrate that glycosylation is not a mandatory requirement for influenza vaccine efficacy. PMID:20661476

  3. An influenza A/H1N1/2009 hemagglutinin vaccine produced in Escherichia coli.

    José M Aguilar-Yáñez

    Full Text Available BACKGROUND: The A/H1N1/2009 influenza pandemic made evident the need for faster and higher-yield methods for the production of influenza vaccines. Platforms based on virus culture in mammalian or insect cells are currently under investigation. Alternatively, expression of fragments of the hemagglutinin (HA protein in prokaryotic systems can potentially be the most efficacious strategy for the manufacture of large quantities of influenza vaccine in a short period of time. Despite experimental evidence on the immunogenic potential of HA protein constructs expressed in bacteria, it is still generally accepted that glycosylation should be a requirement for vaccine efficacy. METHODOLOGY/PRINCIPAL FINDINGS: We expressed the globular HA receptor binding domain, referred to here as HA(63-286-RBD, of the influenza A/H1N1/2009 virus in Escherichia coli using a simple, robust and scalable process. The recombinant protein was refolded and purified from the insoluble fraction of the cellular lysate as a single species. Recombinant HA(63-286-RBD appears to be properly folded, as shown by analytical ultracentrifugation and bio-recognition assays. It binds specifically to serum antibodies from influenza A/H1N1/2009 patients and was found to be immunogenic, to be capable of triggering the production of neutralizing antibodies, and to have protective activity in the ferret model. CONCLUSIONS/SIGNIFICANCE: Projections based on our production/purification data indicate that this strategy could yield up to half a billion doses of vaccine per month in a medium-scale pharmaceutical production facility equipped for bacterial culture. Also, our findings demonstrate that glycosylation is not a mandatory requirement for influenza vaccine efficacy.

  4. Long-term respiratory follow-up of H1N1 infection

    Kerenidi Theodora


    Full Text Available Abstract Background The first case of 2009 pandemic influenza A (H1N1 virus infection was documented in our Hospital on 10th August 2009. Metdods and findings Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR testing was used to confirm the diagnosis. All patients were treated with oseltamivir from the first day of hospitalization. Upon admission 12/44 had local patchy shadowing in their chest x-ray and additionally antibiotic regimen was added to these patients as pneumonia was suspected based on clinical evidence. In total 44 patients were hospitalized 15/44 had asthma, 6/44 COPD, 5/44 leukemia. Lung function was evaluated with forced vital capacity, forced expiratory volume in 1 sec and diffused carbon monoxide upon discharge and every 3 months, until 6 months of observation was completed after discharge. The purpose of this retrospective cohort study was to evaluate whether influenza A (H1N1 had an impact on the respiratory capacity of the infected patients. Conclusions An improvement of pulmonary function tests was observed between the first two measurements, implicating an inflammatory pathogenesis of influenza A (H1N1 to the respiratory tract. This inflammation was not associated with the severity or clinical outcome of the patients. All patients had a mild clinical course and their respiratory capacity was stable between the second and third measurement, suggesting that the duration of respiratory inflammation was two months. Early treatment with antiviral agents and vaccination represent the mainstay of management.

  5. 当我们与H1N1狭路相逢

    《家庭科学·新健康》编辑部; 李蕙君


    @@ 世界卫生组织将甲型H1N1流感大流行警戒级别提升至最高的第六级,这意味着宣布"甲流"进入全球大流行阶段,这是41年来首次宣布全球流感大流行.世卫驻华代表称甲流大流行可能感染遍布100个国家和地区的4亿人--

  6. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis [General Hospital, PET/CT Unit, Athens (Greece)


    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed{sup 18}F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  7. Development of a diagnostic kit for Tamiflu-resistant influenze A (H1N1)

    Jung, I. L.


    Using by pre-developed multiplex RT-PCR kit that is able to diagnosis Tamiflu-sensitive and -resistant Swine Influenza A (H1N1) in the 1st research year, reproducibility and sentitivity of the kit has been investigated in this year. The optimum concentration of reverse transcriptase has also been determined and the economic evaluation has been carried out in this year. Based on the results, a international patent has been applied and a domestic patent has been registered in this year.


    Alberto Malvar Pintos


    Full Text Available Fundamento: En Galicia no existe red centinela de vigilancia epidemiológica por lo que se utilizan sistemas alternativos de vigilancia. El objetivo de este trabajo es describirlos y presentar los resultados observados durante la pandemia de gripe (H1N1 2009. Métodos: Los sistemas utilizados fueron llamadas recibidas por gripe (H1N1 2009 e infección respiratoria aguda en el 061, sistema de notificación de enfermedades obligatorias (SXNOE, vigilancia virológica, registros de atención primaria e ingresos hospitalarios. Los datos se analizaron con Excell. Resultados: La primera onda por virus A(H1N1v se registró a través del 061 entre las semanas 39/2009 y 49/2009, alcanzando el pico en la 44/2009 con la mayor tasa de llamadas acumuladas en el grupo de 5-19 años. SXNOE proporcionó una onda (semanas 39/2009 a 49/2009 con pico en la 44/2009. Microbiológicamente se estudiaron con RT-PRC 6.181 muestras (31% positivas y pico en la semana 44/2009. Los registros de Atención Primaria proporcionaron una onda (semanas 39/2009 a 49/2009 con pico en la semana 44/2009 con la mayor tasa de consultas para los de 5-19 años. Entre las semanas 26/2009 y 17/2010, ingresaron 698 personas con gripe (H1N1 2009, con mayor número de hospitalizaciones en la 44/2009. Conclusiones: Los sistemas descritos quedan avalados por la homogeneidad de los resultados, ya que dibujan la misma onda (semanas 39/2009 a 49/2009 y coinciden en el pico (semana 44/2009 donde se observa la mayor tasa de consultas entre 5-19 años. El 061 aparece como el sistema más operativo al proporcionar datos diarios.

  9. H1N1-infected patients in ICU and their clinical outcome

    Nagesh Kumar Chandrashekar Talkad


    Full Text Available Background: The swine flu (H1N1 with rapid spread and panic in population is truly global pandemic, affected mainly younger population. There is need to accumulate evidence regarding patient′s intensive care parameters for effective management of newer strains of influenza viral infections. Hence an observed retrospective record analysis of confirmed H1N1 patients admitted to intensive care unit (ICU of a tertiary care centre is done. Aims: The study was designed to study the profile and pattern of H1N1 patients admitted to ICU and to study the distribution and associated factors with treatment outcomes. Materials and Methods: The demographic, clinical, and laboratory data of 32 (RT-PCR confirmed H1N1cases were collected and analyzed using Fischer′s exact test/paired t test between survivors and nonsurvivors to know their significance. This data included criteria for admission to ICU, type of lung injury, mode of oxygenation, antiviral, and other drugs used. Results: There were 11 males and 21 female. Age ranged from 19 to 72 years. Age group of 15-45 years had most cases (78% and mortality (60%. Most common symptoms were fever and breathlessness (100%. The mean duration of breathlessness was statistically significant (P = 0.037 between two groups. Most common signs were tachycardia and tachypnea. The 75% cases developed acute respiratory distress syndrome (ARDS, of this 16% survived. Among these fatal cases nine were positive for procalcitonin (PCT (P = 0.006. The rest of 25% developed acute lung injury (ALI and recovered completely (P = 0.0001. Conclusion: Fever and breathlessness were the main presenting complaints. Tachypnea and tachycardia as clinical signs predict development of respiratory complications. Arterial blood gas analysis (ABG and PaO 2 /FiO 2 were important in deciding severity of lung injury and mode of ventilation. ARDS was observed to be the main cause of mortality in this study. Serum PCT level estimation is useful in

  10. 植物阿魏可抗H1N1



    随着甲型H1N1流感疫情的进一步蔓延,开发有效药物成为科学家们的迫切任务。近日,《天然产物杂志》刊登论文,台湾高雄医科大学的研究人员从一种被称为阿魏(Ferula assa—foetida)的植物萃取物中找到了新的希望。

  11. Influenza pandêmica A (H1N1) 2009: fatores de risco para o internamento


    OBJETIVO: Avaliar os aspectos da influenza pandêmica A (H1N1) 2009 em pacientes hospitalizados a fim de identificar os fatores de risco para o internamento e, consequentemente, para o agravamento da doença. MÉTODOS: Estudo observacional e retrospectivo realizado entre março e dezembro de 2010. Os dados foram coletados a partir do Sistema Nacional de Agravos de Notificação do Ministério da Saúde. Foram incluídos somente os pacientes hospitalizados e não hospitalizados com confirmação laborator...

  12. Oseltamivir-resistant influenza A(H1N1pdm09 virus in southern Brazil

    Camila Marx


    Full Text Available The neuraminidase (NA genes of A(H1N1pdm09 influenza virus isolates from 306 infected patients were analysed. The circulation of oseltamivir-resistant viruses in Brazil has not been reported previously. Clinical samples were collected in the state of Rio Grande do Sul (RS from 2009-2011 and two NA inhibitor-resistant mutants were identified, one in 2009 (H275Y and the other in 2011 (S247N. This study revealed a low prevalence of resistant viruses (0.8% with no spread of the resistant mutants throughout RS.

  13. Identification of the First Chinese Cases of H1N1 Flu


    In this podcast, Dr. Scott Dowell discusses the first cases of the new H1N1 influenza virus in China in May 2009, which occurred in three students who had been studying in North America during the early days of the pandemic and returned home to visit their friends and family. Chinese health officials acted swiftly to investigate and determine whether the students had spread their illness to others. The article, which appears in the September 2009 issue of Emerging Infectious Diseases, details what they found.  Created: 8/4/2009 by Emerging Infectious Diseases.   Date Released: 8/4/2009.

  14. Pathological Analysis of Influenza A(H1N1) and How to Prevent It%甲型H1N1流感的病原学分析及防治措施

    马洁华; 林彩美



  15. Properly folded bacterially expressed H1N1 hemagglutinin globular head and ectodomain vaccines protect ferrets against H1N1 pandemic influenza virus.

    Surender Khurana

    Full Text Available BACKGROUND: In the face of impending influenza pandemic, a rapid vaccine production and mass vaccination is the most effective approach to prevent the large scale mortality and morbidity that was associated with the 1918 "Spanish Flu". The traditional process of influenza vaccine production in eggs is time consuming and may not meet the demands of rapid global vaccination required to curtail influenza pandemic. METHODOLOGY/PRINCIPAL FINDINGS: Recombinant technology can be used to express the hemagglutinin (HA of the emerging new influenza strain in a variety of systems including mammalian, insect, and bacterial cells. In this study, two forms of HA proteins derived from the currently circulating novel H1N1 A/California/07/2009 virus, HA1 (1-330 and HA (1-480, were expressed and purified from E. coli under controlled redox refolding conditions that favoured proper protein folding. However, only the recombinant HA1 (1-330 protein formed oligomers, including functional trimers that bound receptor and caused agglutination of human red blood cells. These proteins were used to vaccinate ferrets prior to challenge with the A/California/07/2009 virus. Both proteins induced neutralizing antibodies, and reduced viral loads in nasal washes. However, the HA1 (1-330 protein that had higher content of multimeric forms provided better protection from fever and weight loss at a lower vaccine dose compared with HA (1-480. Protein yield for the HA1 (1-330 ranged around 40 mg/Liter, while the HA (1-480 yield was 0.4-0.8 mg/Liter. CONCLUSIONS/SIGNIFICANCE: This is the first study that describes production in bacterial system of properly folded functional globular HA1 domain trimers, lacking the HA2 transmembrane protein, that elicit potent neutralizing antibody responses following vaccination and protect ferrets from in vivo challenge. The combination of bacterial expression system with established quality control methods could provide a mechanism for rapid large

  16. The economic impact of H1N1 on Mexico's tourist and pork sectors.

    Rassy, Dunia; Smith, Richard D


    By examining tourist arrivals and pork output and trade statistics, this analysis estimates the economic impact to the Mexican tourism and pork sectors because of the H1N1 influenza pandemic. It also assesses the role of the international response in the context of this economic impact. For tourism, losing almost a million overseas visitors translated into losses of around $US2.8bn, which extended over a five-month period, mostly because of the slow return of European travellers. For the pork industry, temporal decreases in output were observed in most of the country and related to H1N1 incidence (p = 0.048, r = 0.37). By the end of 2009, Mexico had a pork trade deficit of $US27m. The losses derived from this pandemic were clearly influenced by the risk perception created in tourist-supplying and pork trade partners. Results suggest that the wider economic implications of health-related emergencies can be significant and need to be considered in preparedness planning. For instance, more effective surveillance and data gathering would enable policy to target emergency funding to the sectors and regions hardest hit. These results also stress the importance of being familiar with trade networks so as to be able to anticipate the international response and respond accordingly. Copyright © 2012 John Wiley & Sons, Ltd.

  17. [Epidemiology of influenza A (H1N1) worldwide and in Spain].

    Vaqué, Josep


    On June 11, 2009, the World Health Organization declared an established pandemic due to a new influenza virus A (H1N1) of swine origin. Initial cases were detected in Mexico in March and within 6 weeks the virus had spread worldwide. The transmissibility of influenza A (H1NA) is slightly higher than that of the seasonal virus, but its pathogenicity and virulence are low. The main target groups of this new virus have been children and young adults under 30 years old. Mortality has affected mainly persons aged between 20 and 50 years old. In areas with temperate climates, two epidemic waves have occurred. The first one, from mid-April to mid-August, affected Mexico, the United States and, consecutively, Spain, England, Japan, and other countries in the northern hemisphere. A few weeks later, coinciding with the beginning of the influenza season, the H1N1 epidemic started in the southern hemisphere countries, especially Argentina, Chile, Australia and New Zealand; in these countries, the epidemic finished at the end of September or October. The second wave affected the northern hemisphere, starting in the United States and Mexico at the beginning of September, and a few weeks later in European countries. In mid-December, this wave was considered to have ended, although some influenza activity persists. The intensity of this second wave was higher compared to the first one.

  18. The pandemic (H1N1 2009 influenza virus is resistant to mannose-binding lectin

    Ushirogawa Hiroshi


    Full Text Available Abstract Background Mannose-binding lectin (MBL is an important component of innate immunity because it promotes bacterial clearance and neutralization of human influenza A viruses. Since a majority of humans have no neutralizing antibody against the pandemic (H1N1 2009 influenza (pandemic 2009 virus, innate immunity may be crucial and MBL susceptibility may therefore influence viral pathogenesis. Results We examined MBL susceptibility of influenza A viruses and observed that the pandemic 2009 virus was resistant to MBL, whereas all seasonal influenza A viruses tested were susceptible. The mortality of mice infected with a seasonal H1N1 influenza virus was evidently enhanced on transient blockage of MBL activity by simultaneous inoculation of mannan, whereas mannan inoculation had no effect on mice infected with a pandemic 2009 virus. This indicates that MBL protects mice against infection with the seasonal virus but not against that with the pandemic 2009 virus. Conclusions These results indicate that the pandemic 2009 virus is not susceptible to MBL, an important component of innate immunity.

  19. Initial psychological responses to Influenza A, H1N1 ("Swine flu"

    Neto Felix


    Full Text Available Abstract Background The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork. We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu" in the six days following the WHO pandemic alert level 5, and regional differences in these responses. Methods 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180 or Europe (N = 148. Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption Results 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p Conclusion Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

  20. Household responses to pandemic (H1N1) 2009-related school closures, Perth, Western Australia.

    Effler, Paul V; Carcione, Dale; Giele, Carolien; Dowse, Gary K; Goggin, Leigh; Mak, Donna B


    School closure is often purported to reduce influenza transmission, but little is known about its effect on families. We surveyed families affected by pandemic (H1N1) 2009-related school closures in Perth, Western Australia, Australia. Surveys were returned for 233 (58%) of 402 students. School closure was deemed appropriate by 110 parents (47%); however, 91 (45%) parents of 202 asymptomatic students reported taking >or=1 day off work to care for their child, and 71 (35%) had to make childcare arrangements because of the class closures. During the week, 172 (74%) students participated in activities outside the home on >or=1 occasion, resulting in an average of 3.7 out-of-home activities for each student. In our survey, activities outside the home were commonly reported by students affected by school closure, the effect on families was substantial, and parental opinion regarding school closures as a means to mitigate the outbreak of pandemic (H1N1) 2009 was divided.

  1. Antiviral activity of silver nanoparticle/chitosan composites against H1N1 influenza A virus

    Mori, Yasutaka; Ono, Takeshi; Miyahira, Yasushi; Nguyen, Vinh Quang; Matsui, Takemi; Ishihara, Masayuki


    Silver nanoparticle (Ag NP)/chitosan (Ch) composites with antiviral activity against H1N1 influenza A virus were prepared. The Ag NP/Ch composites were obtained as yellow or brown floc-like powders following reaction at room temperature in aqueous medium. Ag NPs (3.5, 6.5, and 12.9 nm average diameters) were embedded into the chitosan matrix without aggregation or size alternation. The antiviral activity of the Ag NP/Ch composites was evaluated by comparing the TCID50 ratio of viral suspensions treated with the composites to untreated suspensions. For all sizes of Ag NPs tested, antiviral activity against H1N1 influenza A virus increased as the concentration of Ag NPs increased; chitosan alone exhibited no antiviral activity. Size dependence of the Ag NPs on antiviral activity was also observed: antiviral activity was generally stronger with smaller Ag NPs in the composites. These results indicate that Ag NP/Ch composites interacting with viruses exhibit antiviral activity.

  2. Initial psychological responses to Influenza A, H1N1 ("Swine flu").

    Goodwin, Robin; Haque, Shamsul; Neto, Felix; Myers, Lynn B


    The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses. 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p Malaysia, 22% Europe, p Malaysia, 17% Europe, p Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

  3. Profile of Brazilian scientific production on A/H1N1 pandemic influenza.

    Luchs, Adriana


    In the last few years, bibliometric studies have proliferated, seeking to provide data on world research. This study analyzes the profile of the Brazilian scientific production in the A (H1N1) influenza field between 2009 and 2011. The research was conducted in MEDLINE, SciELO and LILACS databases, selecting papers in which the term "H1N1" and "Brazil" were defined as the main topics. The data were analyzed taking into consideration the Brazilian state and institution in which the articles were produced, the impact factor of the journal and the language. The research revealed 40 documents (27 from MEDLINE, 16 from SciELO and 24 from LILACS). The journal impact factor ranged from 0.0977 to 8.1230. A similar amount of articles were written in English and Portuguese and São Paulo was the most productive state in the country, with 95% of the Brazilian production originating from the Southern and Southeastern regions. Linguistic data indicate that previous efforts made in order to improve the scientific production of Brazilian researchers making their observations attain a broader scientific audience produced results. It is necessary to assess the scientific studies, especially those conducted with public funds, in order to ensure that the results will benefit society.

  4. Reassortment Networks and the evolution of pandemic H1N1 swine-origin influenza.

    Bokhari, Shahid H; Pomeroy, Laura W; Janies, Daniel A


    Prior research developed Reassortment Networks to reconstruct the evolution of segmented viruses under both reassortment and mutation. We report their application to the swine-origin pandemic H1N1 virus (S-OIV). A database of all influenza A viruses, for which complete genome sequences were available in Genbank by October 2009, was created and dynamic programming was used to compute distances between all corresponding segments. A reassortment network was created to obtain the minimum cost evolutionary paths from all viruses to the exemplar S-OIV A/California/04/2009. This analysis took 35 hours on the Cray Extreme Multithreading (XMT) supercomputer, which has special hardware to permit efficient parallelization. Six specific H1N1/H1N2 bottleneck viruses were identified that almost always lie on minimum cost paths to S-OIV. We conjecture that these viruses are crucial to S-OIV evolution and worthy of careful study from a molecular biology viewpoint. In phylogenetics, ancestors are typically medians that have no functional constraints. In our method, ancestors are not inferred, but rather chosen from previously observed viruses along a path of mutation and reassortment leading to the target virus. This specificity and functional constraint render our results actionable for further experiments in vitro and in vivo.

  5. Dialysis for acute kidney injury associated with influenza a (H1N1 infection

    Augusto Vallejos


    Full Text Available In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1, pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy. Serious cases were admitted to the intensive care unit (ICU, particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI and required renal replacement therapy (RRT. The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.

  6. Dialysis for acute kidney injury associated with influenza a (H1N1) infection.

    Vallejos, Augusto; Arias, Marcelo; Cusumano, Ana; Coste, Eduardo; Simon, Miguel; Martinez, Ricardo; Mendez, Sandra; Raño, Miguel; Sintado, Luis; Lococo, Bruno; Blanco, Carlos; Cestari, Jorge


    In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1), pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy). Serious cases were admitted to the intensive care unit (ICU), particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI) and required renal replacement therapy (RRT). The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.

  7. Heterogeneous virulence of pandemic 2009 influenza H1N1 virus in mice

    Farooqui Amber


    Full Text Available Abstract Background Understanding the pathogenesis of influenza infection is a key factor leading to the prevention and control of future outbreaks. Pandemic 2009 Influenza H1N1 infection, although frequently mild, led to a severe and fatal form of disease in certain cases that make its virulence nature debatable. Much effort has been made toward explaining the determinants of disease severity; however, no absolute reason has been established. Results This study presents the heterogeneous virulence of clinically similar strains of pandemic 2009 influenza virus in human alveolar adenocarcinoma cells and mice. The viruses were obtained from patients who were admitted in a local hospital in China with a similar course of infection and recovered. The A/Nanchang/8002/2009 and A/Nanchang/8011/2009 viruses showed efficient replication and high lethality in mice while infection with A/Nanchang/8008/2009 was not lethal with impaired viral replication, minimal pathology and modest proinflammatory activity in lungs. Sequence analysis displayed prominent differences between polymerase subunits (PB2 and PA of viral genomes that might correlate with their different phenotypic behavior. Conclusions The study confirms that biological heterogeneity, linked with the extent of viral replication, exists among pandemic H1N1 strains that may serve as a benchmark for future investigations on influenza pathogenesis.

  8. The knowledge of the importance on the influenza virus a (H1N1: experience report

    Jaine Kareny da Silva


    Full Text Available Background and Objectives: Although infection rates by influenza A H1N1, present reduction since 2010 through immunization, it is still notorious some cases and outbreaks of the disease in the country. To minimize such cases it is important, among other measures, the qualification of the health worker. In this sense, the objective was to describe the level of awareness of nursing professionals in a hospital Bahia interior, on the transmission of the H1N1 virus, symptoms and what PPE is needed in assisting patients with suspected or diagnostic confirmation. Methods: This is an experience report experienced by nursing students at the State University of Bahia, who developed curricular component activities Caring Process: Rationale and practice in a public hospital in Bahia. The report data is from the collection conducted with the nurses, addressing aspects of symptoms, transmission and personal protective equipment. Each professional nursing spontaneously answered the questions and the end was discussed each item aiming answer questions by promoting thus an educational activity based on the knowledge of professionals. Results: Although most participants recognize the personal protective equipment and the symptoms of the viral disease, some are still unaware of the transmission routes. Most received no training on the subject. Conclusion: It is necessary to implement a Center for Continuing Education to answer questions about this and other topics, but are not limited to specific actions and seeking partnerships with higher education institutions. KEYWORDS: Education, Continuing. Education, Nursing. Disease Transmission, Infectious. Communicable Disease Control

  9. Streptococcus pneumoniae Coinfection Is Correlated with the Severity of H1N1 Pandemic Influenza

    Cisterna, Daniel; Savji, Nazir; Bussetti, Ana Valeria; Kapoor, Vishal; Hui, Jeffrey; Tokarz, Rafal; Briese, Thomas; Baumeister, Elsa; Lipkin, W. Ian


    Background Initial reports in May 2009 of the novel influenza strain H1N1pdm estimated a case fatality rate (CFR) of 0.6%, similar to that of seasonal influenza. In July 2009, however, Argentina reported 3056 cases with 137 deaths, representing a CFR of 4.5%. Potential explanations for increased CFR included virus reassortment or genetic drift, or infection of a more vulnerable population. Virus genomic sequencing of 26 Argentinian samples representing both severe and mild disease indicated no evidence of reassortment, mutations associated with resistance to antiviral drugs, or genetic drift that might contribute to virulence. Furthermore, no evidence was found for increased frequency of risk factors for H1N1pdm disease. Methods/Principal Findings We examined nasopharyngeal swab samples (NPS) from 199 cases of H1N1pdm infection from Argentina with MassTag PCR, testing for 33 additional microbial agents. The study population consisted of 199 H1N1pdm-infected subjects sampled between 23 June and 4 July 2009. Thirty-nine had severe disease defined as death (n = 20) or hospitalization (n = 19); 160 had mild disease. At least one additional agent of potential pathogenic importance was identified in 152 samples (76%), including Streptococcus pneumoniae (n = 62); Haemophilus influenzae (n = 104); human respiratory syncytial virus A (n = 11) and B (n = 1); human rhinovirus A (n = 1) and B (n = 4); human coronaviruses 229E (n = 1) and OC43 (n = 2); Klebsiella pneumoniae (n = 2); Acinetobacter baumannii (n = 2); Serratia marcescens (n = 1); and Staphylococcus aureus (n = 35) and methicillin-resistant S. aureus (MRSA, n = 6). The presence of S. pneumoniae was strongly correlated with severe disease. S. pneumoniae was present in 56.4% of severe cases versus 25% of mild cases; more than one-third of H1N1pdm NPS with S. pneumoniae were from subjects with severe disease (22 of 62 S. pneumoniae-positive NPS, p = 0

  10. Pandemic H1N1 (2009) and renal failure: the experience of the Irish national tertiary referral centre.

    O Brien, F J


    H1N1 influenza A, was first described in April 2009. A significant cohort of patients from this outbreak developed acute respiratory distress syndrome or pneumonia. H1N1 has since been transmitted across the world. Little has been described on the renal complications of this illness.

  11. Correlates of 2009 Pandemic H1N1 Influenza Vaccine Acceptance among Middle and High School Teachers in Rural Georgia

    Gargano, Lisa M.; Painter, Julia E.; Sales, Jessica M.; Morfaw, Christopher; Jones, LaDawna M.; Weiss, Paul; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.


    Background: Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School-aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study…

  12. Effectiveness of A(H1N1)pdm09 influenza vaccine in adults recommended for annual influenza vaccination

    Gefenaite, Giedre; Tacken, Margot; Bos, Jens; Stirbu-Wagner, Irina; Korevaar, Joke C.; Stolk, Ronald P.; Wolters, Bert; Bijl, Marc; Postma, Maarten J.; Wilschut, Jan; Nichol, Kristin L.; Hak, Eelko


    INTRODUCTION: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness. METHODS: VE against influenza and/or pneumonia was ass

  13. Effectiveness of A(H1N1)pdm09 influenza vaccine in adults recommended for annual influenza vaccination.

    Gefenaite, G.; Tacken, M.; Bos, J.; Stirbu-Wagner, I.; Korevaar, J.C.; Stolk, R.P.; Wolters, B.; Bijl, M.; Postma, M.J.; Wilschut, J.; Nichol, K.L.; Hak, E.


    Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness. Methods: VE against influenza and/or pneumonia was ass

  14. Novel triple-reassortant H1N1 swine influenza viruses in pigs in Tianjin, Northern China.

    Sun, Ying-Feng; Wang, Xiu-Hui; Li, Xiu-Li; Zhang, Li; Li, Hai-Hua; Lu, Chao; Yang, Chun-Lei; Feng, Jing; Han, Wei; Ren, Wei-Ke; Tian, Xiang-Xue; Tong, Guang-Zhi; Wen, Feng; Li, Ze-Jun; Gong, Xiao-Qian; Liu, Xiao-Min; Ruan, Bao-Yang; Yan, Ming-Hua; Yu, Hai


    Pigs are susceptible to both human and avian influenza viruses and therefore have been proposed to be mixing vessels for the generation of pandemic influenza viruses through reassortment. In this study, for the first time, we report the isolation and genetic analyses of three novel triple-reassortant H1N1 swine influenza viruses from pigs in Tianjin, Northern China. Phylogenetic analysis showed that these novel viruses contained genes from the 2009 pandemic H1N1 (PB2, PB1, PA and NP), Eurasian swine (HA, NA and M) and triple-reassortant swine (NS) lineages. This indicated that the reassortment among the 2009 pandemic H1N1, Eurasian swine and triple-reassortant swine influenza viruses had taken place in pigs in Tianjin and resulted in the generation of new viruses. Furthermore, three human-like H1N1, two classical swine H1N1 and two Eurasian swine H1N1 viruses were also isolated during the swine influenza virus surveillance from 2009 to 2013, which indicated that multiple genetic lineages of swine H1N1 viruses were co-circulating in the swine population in Tianjin, China. The emergence of novel triple-reassortant H1N1 swine influenza viruses may be a potential threat to human health and emphasizes the importance of further continuous surveillance.

  15. Effectiveness of A(H1N1)pdm09 influenza vaccine in adults recommended for annual influenza vaccination.

    Gefenaite, G.; Tacken, M.; Bos, J.; Stirbu-Wagner, I.; Korevaar, J.C.; Stolk, R.P.; Wolters, B.; Bijl, M.; Postma, M.J.; Wilschut, J.; Nichol, K.L.; Hak, E.


    Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness. Methods: VE against influenza and/or pneumonia was

  16. Immunosensor based on the ZnO nanorod networks for the detection of H1N1 swine influenza virus.

    Jang, Yunseok; Park, Jungil; Pak, Youngmi Kim; Pak, James Jungho


    This paper presents an immunosensor fabricated on patterned zinc oxide nanorod networks (ZNNs) for detecting the H1N1 swine influenza virus (H1N1 SIV). Nanostructured ZnO with a high isoelectric point (IEP, approximately 9.5) possesses good absorbability for proteins with low IEPs. Hydrothermally grown ZNNs were fabricated on a patterned Au electrode (0.02 cm2) through a lift-off process. To detect the H1N1 SIV, the sandwich enzyme-linked immunosorbent assay (ELISA) method was employed in the immunosensor. The immunosensor was evaluated in an acetate buffer solution containing 3,3',5,5'-tetramethylbenzidine (TMB) via cyclic voltammetry at various H1N1 SIV concentrations (1 pg/mL-5 ng/mL). The measurement results of the fabricated immunosensor showed that the reduction currents of TMB at 0.25 V logarithmically increased from 259.37 to 577.98 nA as the H1N1 SIV concentration changed from 1 pg/mL to 5 ng/mL. An H1N1 SIV immunosensor, based on the patterned ZNNs, was successfully realized for detecting 1 pg/mL-5 ng/mL H1N1 SIV concentrations, with a detection limit of 1 pg/mL for H1N1 SIV.

  17. Possible basis for the emergence of H1N1 viruses with pandemic potential from avian hosts.

    Koçer, Zeynep A; Krauss, Scott; Zanin, Mark; Danner, Angela; Gulati, Shelly; Jones, Jeremy C; Friedman, Kimberly; Graham, Allison; Forrest, Heather; Seiler, Jon; Air, Gillian M; Webster, Robert G


    Influenza A viruses of the H1N1 subtype have emerged from the avian influenza gene pool in aquatic birds and caused human pandemics at least twice during the past century. Despite this fact, surprisingly little is known about the H1N1 gene pool in the aquatic bird reservoir. A preliminary study showed that an H1N1 virus from a shorebird of the Charadriiformes order was transmitted between animals through the airborne route of infection, whereas an H1N1 virus from a bird of the Anseriformes order was not. Here we show that two of the three H1N1 viruses isolated from Charadriiformes species in 2009 were transmitted between animals through the airborne route of infection, and five H1N1 isolates from Anseriformes species were not. The one H1N1 virus from a Charadriiformes species that failed to transmit through the airborne route was a reassortant possessing multiple internal gene segments from Anseriformes species. The molecular differences between the airborne-transmissible and non-airborne-transmissible H1N1 viruses were multigenic, involving the selection of virus with human-like receptor-binding specificity (α2-6 sialic acid) and multiple differences in the polymerase complex, mainly in the PB2, PB1-F2, and nonstructural genes.

  18. [Immune Protection against H9N2 Provided by H1N1 Pre-infection in Pigs].

    Wang, Jia; Wu, Maocai; Hong, Wenshan; Zheng, Zuoyi; Chen, Rirong


    To explore the impact of the history of infection by the influenza A virus subtype H1N1 on secondary infection by the influenza A virus subtype H9N2, pigs non-infected and pre-infected with H1N1 were inoculated with H9N2 in parallel to compare nasal shedding and seroconversion patterns. Unlike pigs without a background of H1N1 infection, nasal shedding was not detected in pigs pre-infected with H1N1. Both groups generated antibodies against H9N2. However, levels of H1N1 antibodies in pigs pre-infected with H1N1 increased quickly and dramatically after challenge with H9N2. Cross-reaction was not observed between H1N1 antibodies and H9N2 viruses. These findings suggest that circulation of the H1N1 virus might be a barrier to the introduction and transmission of the avian H9N2 virus, thereby delaying its adaptation in pigs.

  19. High rate of A(H1N1pdm09 infections among rural Thai villagers, 2009-2010.

    Benjawan Khuntirat

    Full Text Available Pandemic influenza A(H1N1pdm09 emerged in Thailand in 2009. A prospective longitudinal adult cohort and household transmission study of influenza-like illness (ILI was ongoing in rural Thailand at the time of emergence. Symptomatic and subclinical A(H1N1pdm09 infection rates in the cohort and among household members were evaluated.A cohort of 800 Thai adults underwent active community-based surveillance for ILI from 2008-2010. Acute respiratory samples from ILI episodes were tested for A(H1N1pdm09 by qRT-PCR; acute and 60-day convalescent blood samples were tested by A(H1N1pdm09 hemagglutination inhibition assay (HI. Enrollment, 12-month and 24-month follow-up blood samples were tested for A(H1N1pdm09 seroconversion by HI. Household members of influenza A-infected cohort subjects with ILI were enrolled in household transmission investigations in which day 0 and 60 blood samples and acute respiratory samples were tested by either qRT-PCR or HI for A(H1N1pdm09. Seroconversion between annual blood samples without A(H1N1pdm09-positive ILI was considered as subclinical infection.The 2-yr cumulative incidence of A(H1N1pdm09 infection in the cohort in 2009/2010 was 10.8% (84/781 with an annual incidence of 1.2% in 2009 and 9.7% in 2010; 83.3% of infections were subclinical (50% in 2009 and 85.9% in 2010. The 2-yr cumulative incidence was lowest (5% in adults born ≤ 1957. The A(H1N1pdm09 secondary attack rate among household contacts was 47.2% (17/36; 47.1% of these infections were subclinical. The highest A(H1N1pdm09 secondary attack rate among household contacts (70.6%, 12/17 occurred among children born between 1990 and 2003.Subclinical A(H1N1pdm09 infections in Thai adults occurred frequently and accounted for a greater proportion of all A(H1N1pdm09 infections than previously estimated. The role of subclinical infections in A(H1N1pdm09 transmission has important implications in formulating strategies to predict and prevent the spread of A(H1N1pdm

  20. C-Methylated Flavonoids from Cleistocalyx operculatus and Their Inhibitory Effects on Novel Influenza A (H1N1) Neuraminidase

    Dao, Trong-Tuan; Tung, Bui-Thanh; Nguyen, Phi-Hung


    As part of an ongoing study focused on the discovery of anti-influenza agents from plants, four new (1-4) and 10 known (5-14) C-methylated flavonoids were isolated from a methanol extract of Cleistocalyx operculatus buds using an influenza H1N1 neuraminidase inhibition assay. Compounds 4, 7, 8......, and 14, with a chalcone skeleton, showed significant inhibitory effects on the viral neuraminidases from two influenza viral strains, H1N1 and H9N2. Compound 4 showed the strongest inhibitory activity against the neuraminidases from novel influenza H1N1 (WT) and oseltamivir-resistant novel H1N1 (H274Y...... as neuraminidase inhibitors for novel influenza H1N1....

  1. 甲型H1N1流感医院感染预防和控制




  2. 生物技术能应对甲型H1N1流感吗?




  3. 防控甲型H1N1流感戳记(续)



  4. Molecular epidemiology study of swine influenza virus revealing a reassorted virus H1N1 in swine farms in Cuba.

    Pérez, Lester J; Perera, Carmen Laura; Coronado, Liani; Rios, Liliam; Vega, Armando; Frías, Maria T; Ganges, Llilianne; Núñez, José Ignacio; Díaz de Arce, Heidy


    In this report, we describe the emergence of reassorted H1N1 swine influenza virus, originated from a reassortment event between the H1N1 pandemic influenza virus (H1N1p/2009) and endemic swine influenza virus in Cuban swine population. In November 2010, a clinical respiratory outbreak was reported on a pig fattening farm in Cuba. Phylogenetic analysis showed that all the genes of one of the isolate obtained, with the exception of neuraminidase, belonged to the H1N1p/2009 cluster. This finding suggests that H1N1pdm has been established in swine and has become a reservoir of reassortment that may produce new viruses with both animal and public health risks.

  5. Associations between health communication behaviors, neighborhood social capital, vaccine knowledge, and parents' H1N1 vaccination of their children.

    Jung, Minsoo; Lin, Leesa; Viswanath, K


    During the H1N1 pandemic in 2009-10, the vaccination behavior of parents played a critical role in preventing and containing the spread of the disease and the subsequent health outcomes among children. Several studies have examined the relationship between parents' health communication behaviors and vaccinations for children in general. Little is known, however, about the link between parents' health communication behaviors and the vaccination of their children against the H1N1 virus, and their level of vaccine-related knowledge. We drew on a national survey among parents with at least one child less than 18 years of age (n=639) to investigate Parents' H1N1-related health communication behaviors including sources of information, media exposure, information-seeking behaviors, H1N1-related knowledge, and neighborhood social capital, as well as the H1N1 vaccination rates of their children. Findings showed that there is a significant association between the degree at which parents obtained H1N1 vaccination for their children and health communication variables: watching the national television news and actively seeking H1N1 information. And this association was moderated by the extent of the parents' H1N1-related knowledge. In addition, the parents' degree of neighborhood social capital mediated the association between H1N1 knowledge of the parents and H1N1 vaccination acceptance for their children. We found, compared to those with a low-level of neighborhood social capital, parents who have a high-level of neighborhood social capital are more likely to vaccinate their children. These findings suggest that it is necessary to design a strategic health communication campaign segmented by parent health communication behaviors.

  6. Did socio-ecological factors drive the spatiotemporal patterns of pandemic influenza A (H1N1)?

    Hu, Wenbiao; Williams, Gail; Phung, Hai; Birrell, Frances; Tong, Shilu; Mengersen, Kerrie; Huang, Xiaodong; Clements, Archie


    Pandemic influenza A (H1N1) has a significant public health impact. This study aimed to examine the effect of socio-ecological factors on the transmission of H1N1 in Brisbane, Australia. We obtained data from Queensland Health on numbers of laboratory-confirmed daily H1N1 in Brisbane by statistical local areas (SLA) in 2009. Data on weather and socio-economic index were obtained from the Australian Bureau of Meteorology and the Australian Bureau of Statistics, respectively. A Bayesian spatial conditional autoregressive (CAR) model was used to quantify the relationship between variation of H1N1 and independent factors and to determine its spatiotemporal patterns. Our results show that average increase in weekly H1N1 cases were 45.04% (95% credible interval (CrI): 42.63-47.43%) and 23.20% (95% CrI: 16.10-32.67%), for a 1 °C decrease in average weekly maximum temperature at a lag of one week and a 10mm decrease in average weekly rainfall at a lag of one week, respectively. An interactive effect between temperature and rainfall on H1N1 incidence was found (changes: 0.71%; 95% CrI: 0.48-0.98%). The auto-regression term was significantly associated with H1N1 transmission (changes: 2.5%; 95% CrI: 1.39-3.72). No significant association between socio-economic indexes for areas (SEIFA) and H1N1 was observed at SLA level. Our results demonstrate that average weekly temperature at lag of one week and rainfall at lag of one week were substantially associated with H1N1 incidence at a SLA level. The ecological factors seemed to have played an important role in H1N1 transmission cycles in Brisbane, Australia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Severe swine influenza A (H1N1) versus severe human seasonal influenza A (H3N2): clinical comparisons.

    Cunha, Burke A; Pherez, Francisco M; Strollo, Stephanie; Syed, Uzma; Laguerre, Marianne


    At the beginning of the swine influenza (H1N1) pandemic in the spring of 2009, there were still stories of human seasonal influenza A circulating in the New York area. Adult patients admitted with influenza-like illnesses (ILIs) (fever > 102°F, dry cough, and myalgias) presented diagnostic problems. First, clinicians had to differentiate ILIs from influenza, and then differentiate human seasonal influenza A from H1N1 in hospitalized adults with ILIs and negative chest films (no focal segmental/lobar infiltrates). Human seasonal influenza A was diagnosed by rapid influenza diagnostic tests (RIDTs), but H1N1 was often RIDT negative. Reverse transcriptase-polymerase chain reaction for H1N1 was restricted or not available. The Winthrop-University Hospital Infectious Disease Division developed clinical diagnostic criteria (a diagnostic weighted point score system) to rapidly and clinically diagnose H1N1 in patients with negative RIDTs. The point score system was modified and shortened for ease of use, that is, the diagnostic H1N1 triad (any 3 of 4) (ILI, see above) plus thrombocytopenia, relative lymphopenia, elevated serum transaminases, or an elevated creatine phosphokinase. Our clinical experience during the pandemic allowed us to develop the swine diagnostic H1N1 triad. In the process, similarities and differences between human seasonal influenza A and H1N1 were noted. We present 2 illustrative cases of severe influenza, one due to human seasonal influenza A and one due to H1N1, for clinical consideration reflective of our experiences early in the H1N1 pandemic in 2009.

  8. 一起家庭甲型H1N1流行性感冒暴发疫情流行病学调查%Epidemiological Survey on a Household Outbreak of Influenza A (H1N1)



    目的 调查分析一起家庭甲型H1N1流感暴发疫情的原因和特征,为今后预防控制工作提供科学依据.方法 对流感暴发家庭进行现场流行病学调查,采集患者咽拭子,采用荧光定量PCR方法检测甲型H1N1流感病毒核酸,根据调查结果分析甲型H1N1流感家庭暴发疫情特征,讨论甲型H1N1流感的发病规律和流行因素.结果 本起甲型H1N1流感暴发疫情为一起家庭甲型H1N1流感暴发疫情,4名家庭成员3人发病,其中1例死亡.结论 本起甲型H1N1流感暴发疫情主要是因家庭近距离密切接触传播引起,甲流H1N1病毒对某些患有基础性疾病的个体有较强的致病性,易感人群以青壮年为主,传染来源为社区感染后引入家庭,首发患者没有及时隔离治疗是造成家庭内暴发的主要原因.尽早发现与报告传染源,严格执行甲型H1N1流感患者居家隔离治疗措施,对于控制甲型H1N1流感传染源、切断传播途径,积极主动地预防控制疫情暴发流行,都是非常关键有效的防控措施.%Objective To investigate and analyze the causes and characteristics of a household outbreak of influenza A (H1N1), so as to provide a scientific basis for future prevention and control. Methods Field epidemiological investigations were conducted on a family with an influenza A (H1N1) outbreak. Throat swabs were collected from the patients and nucleic acid of H1N1 influenza virus was detected by fluorescence quantitative PCR. Characteristics of the household outbreak of influenza A (H1N1) were analyzed and its occurrence regularity and epidemic factors were explored. Results This influenza A (H1N1) epidemic was a household outbreak. Three out of four household members were diseased and one died. Conclusions The household outbreak of influenza A (H1N1) is mainly caused by close contact with household members. Influenza A (H1N1) virus is more pathogenic to individuals with underlying diseases. Susceptible populations

  9. 344例甲型H1N1流感轻症的临床特征分析%Epidemiological and clinical features of 344 influenza A (H1N1)cases with light symptoms

    李际强; 卢传坚; 罗翌; 温泽淮; 李晓彦; 郑丹文; 邓庆平


    Objective To investigate the epidemiological and clinical features of 344 influenza A (H1N1)case with light symptoms. Methods The clinical data of 344 influenza A (H1N1)cases confirmed by pathogenic diagnosis were retrospectively analyzed including clinical features,results of physical examination and laboratory tests and compared with those negative for influenza A virus (H1N1). Results Compared with those negative for influenza A virus (H1N1)the symptoms of cough and with phlegm was obviously observed in influenza A (H1N1)patients,showing significant differences (P<0.01). The percentage of throat congestion and antiadoncus was significantly higher in the influenza A(H1N1)cases than that of those negative for influenza A virus (H1N1)(P<0.01 ). The WBC count,neutrophil count and lymphocyte count in patients positive for influenza A virus cnucleic acid were significantly lower than those of the negative group (P<0.01 and P<0.05). There 72.09% of the confirmed influenza A (H1N1)cases wer in the age group of 18-30 years. Conclusion Most of the influenza A (H1N1 )cases were those at their prime of life and clinical manifestations/signs and hematological test results were the basis for early diagnosis of the disease.%目的 探讨甲型H1N1流感轻症患者流行病学和临床特征.方法对病原学诊断为甲型H1N1流感的患者344例的临床资料进行回顾性分析,对其主要临床表现、体格检查、血细胞计数等项目与甲型H1N1流感病毒检测阴性的患者进行比较.结果 临床表现方面,病原学诊断为甲型H1N1流感的患者与甲型H1N1流感病毒检测阴性的患者相比,咳嗽与咯痰症状比较突出(P<0.01);咽部充血与扁桃体肿大所占比例亦高于阴性组(P<0.01);甲型H1N1病毒核酸阳性组的白细胞计数、中性粒细胞计数明显低于阴性病人(P<0.01),淋巴细胞计数亦低于阴性组(P<0.05).确诊甲型H1N1流感患者中,发病年龄以18~30岁所占比例最大,共248

  10. Clinical features and prevention & control strategy of influenza A H1N1%甲型H1N1流行性感冒的临床特征与防控策略



    @@ 甲型H1N1流感(influenza A H1N1 virus)于2009年3月18日首先在墨西哥出现,疫情迅速蔓延,席卷全球[1].经美国疾病预防与控制中心(centers for disease control and prevention,CDC)鉴定,致病源为甲型流感病毒的核酸序列发生基因重排(reassortment),同时含人、禽和猪流感病毒核酸序列的新型H1N1甲型流感病毒(novel swine-origin influenza A H1N1 virus,S-OIV)[2-4].2009年5月11日我国内地首例甲型H1N1流感病例的确诊,意味着甲型H1N1流感已突破前哨闯入中国,也标志着我国防控甲型H1N1流感的阵地战已经打响.

  11. Changes in the viral distribution pattern after the appearance of the novel influenza A H1N1 (pH1N1 virus in influenza-like illness patients in Peru.

    Victor Alberto Laguna-Torres

    Full Text Available BACKGROUND: We describe the temporal variation in viral agents detected in influenza like illness (ILI patients before and after the appearance of the ongoing pandemic influenza A (H1N1 (pH1N1 in Peru between 4-January and 13-July 2009. METHODS: At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chain-reaction (rRT-PCR. RESULTS: We enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5% from EW 19-28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle cities during our study period. The city of Iquitos (Jungle had the highest number of influenza B cases and only one pH1N1 case. CONCLUSIONS: The viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses.

  12. Burden of the 1999-2008 seasonal influenza epidemics in Italy: comparison with the H1N1v (A/California/07/09) pandemic.

    Lai, Piero Luigi; Panatto, Donatella; Ansaldi, Filippo; Canepa, Paola; Amicizia, Daniela; Patria, Antonio Giuseppe; Gasparini, Roberto


    Despite preventive efforts, seasonal influenza epidemics are responsible for substantial morbidity and mortality every year worldwide, including developed countries. The A/H1N1v pandemic imposed a considerable healthcare and economic burden. In order to obtain an accurate estimate of the economic burden of influenza, and hence to guide policymakers effectively, systematic studies are necessary. To this end, data from epidemiological surveillance are essential. To estimate the impact of the 1999-2008 seasonal influenza epidemics and the H1N1v pandemic, we analyzed data from the Italian Influenza Surveillance System (CIRI NET). In the period 1999-2008, the Italian surveillance network consisted of sentinel general practitioners and pediatricians, who reported cases of Influenza-Like Illness (ILI) and Acute Respiratory Infections (ARI ) observed during their clinical practice from mid-October to late April each year; reports were sent to the Center for Research on Influenza and other Viral Infections (CIRI -IV). CIRI -IV receives data from 9 of the 20 Italian regions: Liguria, Abruzzo, Calabria, Friuli Venezia Giulia, Lombardy, Puglia, Sicily, Tuscany and Umbria. Previous estimates of influenza case costs were used in economic evaluations. Clinical-epidemiological and virological surveillance of the seasonal epidemics from 1999-2008 showed that the highest epidemic period was 2004-2005, when a new variant of the H3N2 influenza virus subtype emerged (A/California/07/04). Indeed, the highest peak of morbidity in the decade occurred in February 2005 (12.6 per 1,000 inhabitants). In 1999-2008, H1N1 subtype strains circulated and co-circulated with strains belonging to the H3N2 subtype and B type. Regarding B viruses in 2001-02, viruses belonged to the B/Victoria/02/07 lineage re-emerged, and in subsequent years co-circulated with viruses belonging to the B/Yamagata/lineage. The estimated costs of seasonal epidemics from 1999-2008 in Italy ranged from €15 to €20

  13. Assessment of epicutaneous testing of a monovalent Influenza A (H1N1 2009 vaccine in egg allergic patients

    Pitt Tracy


    Full Text Available Abstract Background H1N1 is responsible for the first influenza pandemic in 41 years. In the fall of 2009, an H1N1 vaccine became available in Canada with the hopes of reducing the overall effect of the pandemic. The purpose of this study was to assess the safety of administering 2 different doses of a monovalent split virus 2009 H1N1 vaccine in egg allergic patients. Methods Patients were skin tested to the H1N1 vaccine in the outpatient paediatric and adult allergy and immunology clinics of the Health Sciences Centre and Children's Hospital of Winnipeg, Manitoba Canada. Individuals Results A total of 61 patients with egg allergy (history of an allergic reaction to egg with either positive skin test &/or specific IgE to egg >0.35 Ku/L were referred to our allergy clinics for skin testing to the H1N1 vaccine. 2 patients were excluded, one did not have a skin prick test to the H1N1 vaccine (only vaccine administration and the other passed an egg challenge during the study period. Ages ranged from 1 to 27 years (mean 5.6 years. There were 41(69.5% males and 18(30.5% females. All but one patient with a history of egg allergy, positive skin test to egg and/or elevated specific IgE level to egg had negative skin tests to the H1N1 vaccine. The 58 patients with negative skin testing to the H1N1 vaccine were administered the vaccine and observed for 30 minutes post vaccination with no adverse results. The patient with the positive skin test to the H1N1 vaccine was also administered the vaccine intramuscularly with no adverse results. Conclusions Despite concern regarding possible anaphylaxis to the H1N1 vaccine in egg allergic patients, in our case series 1/59(1.7% patients with sensitization to egg were also sensitized to the H1N1 vaccine. Administration of the H1N1 vaccine in egg allergic patients with negative H1N1 skin tests and observation is safe. Administering the vaccine in a 1 or 2 dose protocol without skin testing is a reasonable alternative

  14. Persistence of pandemic influenza H1N1 virus in young patients after oseltamivir therapy in the 2009-2010 season: a comparison with seasonal H1N1 with or without H275Y mutation.

    Kawai, Naoki; Ikematsu, Hideyuki; Iwaki, Norio; Kondou, Kunio; Hirotsu, Nobuo; Kawashima, Takashi; Maeda, Tetsunari; Tanaka, Osame; Doniwa, Ken-ichi; Iwakuni, Osamu; Egashira, Keisuke; Yamaji, Kouzaburo; Kashiwagi, Seizaburo


    Comparison of the viral persistence of pandemic H1N1 (H1N1pdm) and seasonal H1N1 with or without H275Y mutation after oseltamivir therapy has not been adequately done. Virus was isolated before and on days 4-6 from the start of oseltamivir treatment for 158 cases of seasonal (2007-2008 and 2008-2009 seasons) or pandemic (2009-2010 season) H1N1 influenza. Sequence analysis was done for each season and NA inhibition assay (IC(50)) was done in the 2009-2010 season. H275Y mutation before therapy was 0% in the 2007-2008 and 2009-2010 seasons, but 100% in the 2008-2009 season. Fever and other symptoms were noticeably prolonged after oseltamivir therapy for children with H275Y mutated seasonal H1N1 (2008-2009 season), but not in patients with seasonal H1N1 without mutation (2007-2008) or H1N1pdm (2009-2010). The viral persistence rate was significantly higher for patients 15 years or younger than for those 16 years and older with H275Y mutated seasonal H1N1 (46.2% and 10.5%, respectively) or with H1N1pdm (43.3% and 11.5%, respectively). The H275Y mutation emerged after oseltamivir treatment in 2.4% (2/82) of all patients with H1N1pdm. In two children, the H275Y mutation emerged after therapy and the IC(50) increased more than 200 fold; however, the prolongation of fever was not so prominent. In conclusion, oseltamivir was effective for fever and other clinical symptoms; however, the virus persisted longer than expected after treatment in H1N1pdm influenza-infected children in the 2009-2010 season, similar to seasonal H1N1 with H275Y mutation in the 2008-2009 season.

  15. Analysis of Epidemic Characteristics on Influenza A (H1N1)%国内外甲型H1N1流感流行特征分析

    伊怀文; 黄吉城; 夏文英



  16. 江阴市2009年甲型H1N1流感疫情分析%Epidemic features and influential factors of influenza A(H1N1)in Jiangyin in 2009



    目的 探讨江阴市甲型H1N1流感流行特征并提出防治措施.方法 对江阴市2009年甲型H1N1流感疫情资料进行分析.结果 2009年累计确诊甲型H1N1流感病人22例,其中重症病例3例、危重2例、死亡1例,发病率为1.25/10万.发生2起暴发疫情,均发生在学校.检测流感样病人咽拭子标本124份,甲型H1N1流感核酸阳性率为11.29%.结论江阴市采取的一系列甲型H1N1流感防控措施整体上显著有效,2009年江阴市甲型H1N1流感疫情处于低流行水平.%Aim To survey the epidemic features of influenza A (H1N1 ) in Jiang yin City. Methods Epidemic data of influenza A(H1N1 ) in Jiangyin of Jiangsu Province in 2009 were analyzed. Results In 2009, a total of 22 influenza A (H1N1) cases were confirmed,among them there were 5 severe cases,1 deaths.The morbidity rate was 1.25/100000 population. There were 2 outbreaks all in schools. 124 nasopharyngeal swab samples of Influenza-like patients were tested.The positive rate of nucleic acid influenza A (H1N1) was 11.29%. Conclusion The control measuers in combot against influenza A(H1N1 ) in Jiangyin is effective and the epidemic of influenza A(H1N1 ) in Jiangyin is at a low level n 2009.

  17. Fitness of Pandemic H1N1 and Seasonal influenza A viruses during Co-infection: Evidence of competitive advantage of pandemic H1N1 influenza versus seasonal influenza.

    Perez, Daniel Roberto; Sorrell, Erin; Angel, Matthew; Ye, Jianqiang; Hickman, Danielle; Pena, Lindomar; Ramirez-Nieto, Gloria; Kimble, Brian; Araya, Yonas


    On June 11, 2009 the World Health Organization (WHO) declared a new H1N1 influenza pandemic. This pandemic strain is as transmissible as seasonal H1N1 and H3N2 influenza A viruses. Major concerns facing this pandemic are whether the new virus will replace, co-circulate and/or reassort with seasonal H1N1 and/or H3N2 human strains. Using the ferret model, we investigated which of these three possibilities were most likely favored. Our studies showed that the current pandemic virus is more transmissible than, and has a biological advantage over, prototypical seasonal H1 or H3 strains.

  18. Student behavior during a school closure caused by pandemic influenza A/H1N1.

    Joel C Miller

    Full Text Available BACKGROUND: Many schools were temporarily closed in response to outbreaks of the recently emerged pandemic influenza A/H1N1 virus. The effectiveness of closing schools to reduce transmission depends largely on student/family behavior during the closure. We sought to improve our understanding of these behaviors. METHODOLOGY/PRINCIPAL FINDINGS: To characterize this behavior, we surveyed students in grades 9-12 and parents of students in grades 5-8 about student activities during a week long closure of a school during the first months after the disease emerged. We found significant interaction with the community and other students-though less interaction with other students than during school-with the level of interaction increasing with grade. CONCLUSIONS: Our results are useful for the future design of social distancing policies and to improving the ability of modeling studies to accurately predict their impact.

  19. The epidemic wave of influenza A (H1N1) in Brazil, 2009.

    Codeço, Cláudia Torres; Cordeiro, Josiane da Silva; Lima, Arthur Weiss da Silva; Colpo, Rodrigo Amarante; Cruz, Oswaldo Gonçalves; Coelho, Flavio Codeço; Luz, Paula Mendes; Struchiner, Claudio José; Barros, Fernando Ribeiro de


    This study describes the main features of pandemic influenza A (H1N1) in Brazil during 2009. Brazil is a large country that extends roughly from latitudes 5ºN to 34ºS. Brazil has tropical and sub-tropical climates, a heterogeneous population distribution, and intense urbanization in the southern portions of the country and along its Atlantic coast. Our analysis points to a wide variation in infection rates throughout the country, and includes both latitudinal effects and strong variations in detection rates. Two states (out of a total of 23) were responsible for 73% of all cases reported. Real time reproduction numbers demonstrate that influenza transmission was sustained in the country, beginning in May of 2009. Finally, this study discusses the challenges in understanding the infection dynamics of influenza and the adequacy of Brazil's influenza monitoring system.

  20. Epidemics and the politics of knowledge: contested narratives in Egypt's H1N1 response.

    Leach, Melissa; Tadros, Mariz


    This article explores the politics of knowledge involved in understanding and responding to epidemics in an era of global health governance and biosecurity. It develops and applies an approach focused on how multiple, competing narratives about epidemics are constructed, mobilized and interact, and selectively justify pathways of intervention and response. A detailed ethnographic case study of national and local responses to H1N1 influenza, so-called swine flu, in Egypt reveals how global narratives were reworked by powerful actors in a particular political context, suppressing and delegitimizing the alternative narratives of the Zabaleen (Coptic Christian) people whose lives and livelihoods centered on raising pigs and working with them to control urban waste. The case study illustrates important ways in which geographies and politics of blame around epidemics emerge and are justified, their political contexts and consequences, and how they may feed back to shape the dynamics of disease itself.

  1. Possible computational filter to detect proteins associated to influenza A subtype H1N1.

    Polanco, Carlos; Buhse, Thomas; Castañón-González, Jorge Alberto; Samaniego, José Lino


    The design of drugs with bioinformatics methods to identify proteins and peptides with a specific toxic action is increasingly recurrent. Here, we identify toxic proteins towards the influenza A virus subtype H1N1 located at the UniProt database. Our quantitative structure-activity relationship (QSAR) approach is based on the analysis of the linear peptide sequence with the so-called Polarity Index Method that shows an efficiency of 90% for proteins from the Uniprot Database. This method was exhaustively verified with the APD2, CPPsite, Uniprot, and AmyPDB databases as well as with the set of antibacterial peptides studied by del Rio et al. and Oldfield et al.

  2. Influenza A (H1N1 Pneumonia. Three cases in children.

    Ariel Efrén Uriarte Méndez


    Full Text Available It is made a report of three cases of pneumonia due to Influenza A (H1N1 with satisfactory evolution, assisted in the Intensive Care Unit of the Cienfuegos’s Pediatric Hospital Paquito González Cueto, and whose diagnosis were confirmed for the test Reaction in Chain of the Reverse "Polimerase-Transcriptase" (RCP-TR in nasopharyngeal samples. The X-rays and the laboratory exams are shown. The films reveal alveolar multifocal infiltrates, different from the interstitial pattern that commonly appears in viral pneumonias. It was significant the trombocitopenia proved in one of the patients, a fact that has been rarely reported. This work try to contribute to the best knowledge of the disease in children.

  3. Influenza A (H(1)N(1)) Antiviral and Cytotoxic Agents from Ferula assa-foetida.

    Lee, Chia-Lin; Chiang, Lien-Chai; Cheng, Li-Hung; Liaw, Chih-Chuang; Abd El-Razek, Mohamed H; Chang, Fang-Rong; Wu, Yang-Chang


    Two new sesquiterpene coumarins, designated 5'-acetoxy-8'-hydroxyumbelliprenin (1) and 10'R-acetoxy-11'-hydroxyumbelliprenin (2), and a new diterpene, 15-hydroxy-6-en-dehydroabietic acid (3), along with 27 known compounds, were isolated from a CHCl(3)-soluble extract of Ferula assa-foetida through bioassay-guided fractionation. The structures of the new metabolites 1-3 were identified by spectroscopic data interpretation and by the Mosher ester method. Compounds 4 and 6-13 showed greater potency against influenza A virus (H(1)N(1)) (IC(50) 0.26-0.86 microg/mL) than amantadine (IC(50) 0.92 microg/mL), and 11 exhibited the best potency (IC(50) 0.51, 2.6, and 3.4 microg/mL) of these compounds against the HepG2, Hep3B, and MCF-7 cancer cell lines, respectively.

  4. Homology modelling and insilico analysis of neuraminidase protein in H1N1 Influenza A virus

    Abhilash Manohar


    Full Text Available In this work, modelling of Neuraminidase protein of Influenza A virus (A/Himeji/1/2009(H1N1 neuraminidase (NA protein was done using Modeller 9V2. Modelled structure was submitted to protein model database and could be downloaded using accession number PM0075830. The modelled protein structure was subjected to In silco analysis using various bioinformatics tools. Two anti-influenza drugs currently being used to treat infected patients are oseltamivir (Tamiflu and zanamivir (Relenza, both of which target the neuraminidase enzyme of the virus. Reports of the emergence of drug resistance make the development of new anti-influenza molecules a priority. Hence the modelled structure of H1NI Neuraminidase could be very useful for in silico analysis of potential neuraminidase inhibitors.

  5. Investigation of Hospitalized Patients with New Influenza A(H1N1) in Hangzhou%杭州新型甲型H1N1流感住院病例调查

    赵磊; 王先开; 周逸丹


    [目的]研究杭州地区新型甲型H1N1流感的临床表现和流行病学特点.[方法]用统计指标和图表来描述杭州地区104例新型甲型H1N1流感住院病例的临床表现和血液化验数据,比较各年龄组和不同时间段组的新型甲型H1N1流感的临床表现.[结果]在104例病例中20岁及20岁以下的人群占57.7%.20岁及20岁以下与20岁以上的新型甲型H1N1流感病人的病程长短和白细胞计数的差异没有统计学意义(P>0.05),不同时期发病的新型甲型H1N1流感病人的病程长短和白细胞计数的差异没有统计学意义(P>0.05).[结论]杭州地区的新型甲型H1N1流感青少年、学生较多,65岁以上老年人较少;重症和死亡病人较少,咳嗽是新型甲型H1N1流感的主要症状,各年龄层次新型甲型H1N1流感的临床表现差异不大.%[Objective] To study the clinical and epidemiological characteristics of new influenza A(H1N1 ). [Methods] We described the clinical manifestation and the data of blood test of 104 patients who have caught New Influenza A(H1N1) with statistical indexes, tables and charts. And we contrasted the clinical manifestation of New Influenza A(H1N1) of the groups with different age and period. [Results] Of the 104 patients,57. 7% were 20 years of age or younger,and nobody was 65 years of age or older. The differences of the duration and the leucocyte count of new influenza A(H 1N1) between the age of 20 years or under it and 20 years older were not statistically significant(P>0. 05) ; The differences of the duration and the leucocyte count of new infuenza A(H1N1) between two periods of morbidity were not statistically significant(P>0. 05). [Conclusion] The majority of the patients catching new influenza A(H1N1) recently were adolescent or students;the minor were 65 years of age older;few patients were serious or died.Cough was the major symptom of new influenza A(H1N1). The differences of the clinical manifestation about new

  6. Protection against divergent influenza H1N1 virus by a centralized influenza hemagglutinin.

    Eric A Weaver

    Full Text Available Influenza poses a persistent worldwide threat to the human population. As evidenced by the 2009 H1N1 pandemic, current vaccine technologies are unable to respond rapidly to this constantly diverging pathogen. We tested the utility of adenovirus (Ad vaccines expressing centralized consensus influenza antigens. Ad vaccines were produced within 2 months and protected against influenza in mice within 3 days of vaccination. Ad vaccines were able to protect at doses as low as 10(7 virus particles/kg indicating that approximately 1,000 human doses could be rapidly generated from standard Ad preparations. To generate broadly cross-reactive immune responses, centralized consensus antigens were constructed against H1 influenza and against H1 through H5 influenza. Twenty full-length H1 HA sequences representing the main branches of the H1 HA phylogenetic tree were used to create a synthetic centralized gene, HA1-con. HA1-con minimizes the degree of sequence dissimilarity between the vaccine and existing circulating viruses. The centralized H1 gene, HA1-con, induced stronger immune responses and better protection against mismatched virus challenges as compared to two wildtype H1 genes. HA1-con protected against three genetically diverse lethal influenza challenges. When mice were challenged with 1934 influenza A/PR/8/34, HA1-con protected 100% of mice while vaccine generated from 2009 A/TX/05/09 only protected 40%. Vaccination with 1934 A/PR/8/34 and 2009 A/TX/05/09 protected 60% and 20% against 1947 influenza A/FM/1/47, respectively, whereas 80% of mice vaccinated with HA1-con were protected. Notably, 80% of mice challenged with 2009 swine flu isolate A/California/4/09 were protected by HA1-con vaccination. These data show that HA1-con in Ad has potential as a rapid and universal vaccine for H1N1 influenza viruses.

  7. Modelling during an emergency: the 2009 H1N1 influenza pandemic.

    Lee, B Y; Haidari, L A; Lee, M S


    During the 2009 H1N1 pandemic, decision-makers had access to mathematical and computational models that were not available in previous pandemics in 1918, 1957, and 1968. How did models contribute to policy and action during the 2009 H1N1 pandemic? Modelling encountered six primary challenges: (i) expectations of modelling were not clearly defined; (ii) appropriate real-time data were not readily available; (iii) modelling results were not generated, shared, or disseminated in time; (iv) decision-makers could not always decipher the structure and assumptions of the models; (v) modelling studies varied in intervention representations and reported results; and (vi) modelling studies did not always present the results or outcomes that are useful to decision-makers. However, there were also seven general successes: (i) modelling characterized the role of social distancing measures such as school closure; (ii) modelling helped to guide data collection; (iii) modelling helped to justify the value of the vaccination programme; (iv) modelling helped to prioritize target populations for vaccination; (v) modelling addressed the use of antiviral medications; (vi) modelling helped with health system preparedness planning; and (vii) modellers and decision-makers gained a better understanding of how to work with each other. In many ways, the 2009 pandemic served as practice and a learning opportunity for both modellers and decision-makers. Modellers can continue working with decision-makers and other stakeholders to help overcome these challenges, to be better prepared when the next emergency inevitably arrives. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  8. Immunogenicity of Virus Like Particle Forming Baculoviral DNA Vaccine against Pandemic Influenza H1N1.

    Yong-Dae Gwon

    Full Text Available An outbreak of influenza H1N1 in 2009, representing the first influenza pandemic of the 21st century, was transmitted to over a million individuals and claimed 18,449 lives. The current status in many countries is to prepare influenza vaccine using cell-based or egg-based killed vaccine. However, traditional influenza vaccine platforms have several limitations. To overcome these limitations, many researchers have tried various approaches to develop alternative production platforms. One of the alternative approach, we reported the efficacy of influenza HA vaccination using a baculoviral DNA vaccine (AcHERV-HA. However, the immune response elicited by the AcHERV-HA vaccine, which only targets the HA antigen, was lower than that of the commercial killed vaccine. To overcome the limitations of this previous vaccine, we constructed a human endogenous retrovirus (HERV envelope-coated, baculovirus-based, virus-like-particle (VLP-forming DNA vaccine (termed AcHERV-VLP against pandemic influenza A/California/04/2009 (pH1N1. BALB/c mice immunized with AcHERV-VLP (1×107 FFU AcHERV-VLP, i.m. and compared with mice immunized with the killed vaccine or mice immunized with AcHERV-HA. As a result, AcHERV-VLP immunization produced a greater humoral immune response and exhibited neutralizing activity with an intrasubgroup H1 strain (PR8, elicited neutralizing antibody production, a high level of interferon-γ secretion in splenocytes, and diminished virus shedding in the lung after challenge with a lethal dose of influenza virus. In conclusion, VLP-forming baculovirus DNA vaccine could be a potential vaccine candidate capable of efficiently delivering DNA to the vaccinee and VLP forming DNA eliciting stronger immunogenicity than egg-based killed vaccines.

  9. Caveolin-1 influences human influenza A virus (H1N1 multiplication in cell culture

    Hemgård Gun-Viol


    Full Text Available Abstract Background The threat of recurring influenza pandemics caused by new viral strains and the occurrence of escape mutants necessitate the search for potent therapeutic targets. The dependence of viruses on cellular factors provides a weak-spot in the viral multiplication strategy and a means to interfere with viral multiplication. Results Using a motif-based search strategy for antiviral targets we identified caveolin-1 (Cav-1 as a putative cellular interaction partner of human influenza A viruses, including the pandemic influenza A virus (H1N1 strains of swine origin circulating from spring 2009 on. The influence of Cav-1 on human influenza A/PR/8/34 (H1N1 virus replication was determined in inhibition and competition experiments. RNAi-mediated Cav-1 knock-down as well as transfection of a dominant-negative Cav-1 mutant results in a decrease in virus titre in infected Madin-Darby canine kidney cells (MDCK, a cell line commonly used in basic influenza research as well as in virus vaccine production. To understand the molecular basis of the phenomenon we focussed on the putative caveolin-1 binding domain (CBD located in the lumenal, juxtamembranal portion of the M2 matrix protein which has been identified in the motif-based search. Pull-down assays and co-immunoprecipitation experiments showed that caveolin-1 binds to M2. The data suggest, that Cav-1 modulates influenza virus A replication presumably based on M2/Cav-1 interaction. Conclusion As Cav-1 is involved in the human influenza A virus life cycle, the multifunctional protein and its interaction with M2 protein of human influenza A viruses represent a promising starting point for the search for antiviral agents.

  10. Clinical profile of the first 1000 fatalities for influenza A (H1N1 in Mexico

    Germ and aacute;n Fajardo-Dolci


    Full Text Available Background: Influenza is an acute respiratory disease responsible for several episodes of high mortality throughout human history. In 2009, Mexico experienced an atypical influenza outbreak caused by a mutant strain of the influenza A (H1N1 subtype, which generated significant mortality. The aim of this paper was to analyze the clinical and sociodemographic conditions of the first 1000 fatalities recorded during this outbreak. Methods: We conducted a study based on an analysis of the clinical files of patients positive for influenza A (H1N1 using Real-Time-Polymerase Chain Reaction (RT-PCR to conduct an analysis of deaths compared to deaths in the general population. Results: The majority of deaths occurred in patients aged 35-84 years (65.8%. Average time between symptom onset and death was 13.8 days, with an average of 7.8 days from time of hospitalization until death. Ca. 25% of deaths occurred in residents from Mexico City and from the nearby State of Mexico. In the majority of cases, we found that patients who died had a low educational and socioeconomic status along with co-morbidities such as metabolic syndrome and its individual components, as well as respiratory illnesses. In 80% of cases, patients received mechanical ventilation, and a similar percentage received antiviral therapy (oseltamivir, zanamivir. Conclusions: The primary-care level was not utilized by patients who died from influenza. The higher prevalence of chronic degenerative diseases among deaths compared with the general population indicates that these groups of patients should be considered and prioritized in the event of future outbreaks. [Int J Res Med Sci 2015; 3(11.000: 3008-3014

  11. Computed Tomography Findings in New Swine Flu Influenza A (H1N1 Infection

    Mehrdad Bakhshayeshkaram


    Full Text Available Background/Objective: The aim of this study was to"nevaluate the computed tomography scan of patients"nwith documented influenza A (H1N1."nPatients and Methods: Thirteen patients (six men,"nseven women, with documented H1N1 infection"nconfirmed by RT-PCR from November 2009 to January"n2010 were included in this study. The computed"ntomography scans of the patients were reviewed"nregarding pattern (consolidation, ground glass, nodules"nand reticulation, distribution (focal, multifocal and"ndiffuse and the lung zones involved. The patients'"nfiles were studied for their possible underlying disease."nLDH and CPK level was available for nine and ten"npatients, respectively."nResults: The mean age was 35.54 years. Eight patients"nhad a co-existing condition (two respiratory, two"ncardiovascular, one immunodeficiency, one cancer"nand three others. Six (46.2% patients required ICU"nadmission. Three (23.1% patients died. The most"ncommon radiographic abnormality was ground glass"nopacities (10/13; 76.9% followed by consolidation"n(6/13; 46.2% in the peribronchovascular region (8/13;"n61.5% which was most commonly observed in the"nupper zones (left 76.9%; right 76.9%. Six (46.2%"npatients had more than three lung zones involved."nSeven (53.8% patients had pleural thickening or"neffusion. Two (15.4% patients had hilar or mediastinal"nadenopathy. CPK was high in 3/10 and LDH in 9/10."nConclusion: In patients with the novel swine flu"ninfection the most common computed tomography"nmanifestation in our center was ground glass opacities"nin the upper lung zones.

  12. A case with myocarditis secondary to Influenza virus (H1N1

    Fesih Aktar


    Full Text Available Although influenza is an acute and uncomplicated disease, that limits itself in the healthy children, it may lead to death by rarely forming the sickness. The most common complication of influenza is pneumonia and it is a rare complication which is developed together with myocarditis by influenza A and B viruses. A 32 months-old male patient was admitted for rapidly developed respiratory distress and tachycardia after fever, cough, vomiting, malaise and runny nose. His general status was medium, he had conscious and had hepatomegaly, tachycardia, dyspnea, tachypnea, intercostal-subcostal retractions and bilateral rhonchus. Cardiac enzyme levels and other laboratory parameters were found normal. Myocarditis and ejection fraction was determined as 42% in echocardiography. However, hospitalization hours between 24 and 48, the patient, whose significant respiratory compromise developed, was intubated and fastened to a mechanical ventilator. H1N1 is produce in nasopharyngeal swab culture at the sixth day of follow-up. Because we think H1N1 virus was responsible from current myocarditis, oseltamivir treatment was initiated. In the fourth day of the treatment the patient’s fever returned to normal, in the ninth day a dramatic recovery was observed. In tracking echocardiography, a significant improvement was observed in the ejection fraction and myocarditis picture compared with admission time. This case was presented in order to remind that in a patients, who present with influenza findings but have respiratory distress and tachycardia in addition to lower respiratory tract infection, myocarditis should also be considered in the differential diagnosis and to remind that promising results could be obtained with the early diagnosis and treatment.

  13. Human Dendritic Cell Response Signatures Distinguish 1918, Pandemic, and Seasonal H1N1 Influenza Viruses.

    Hartmann, Boris M; Thakar, Juilee; Albrecht, Randy A; Avey, Stefan; Zaslavsky, Elena; Marjanovic, Nada; Chikina, Maria; Fribourg, Miguel; Hayot, Fernand; Schmolke, Mirco; Meng, Hailong; Wetmur, James; García-Sastre, Adolfo; Kleinstein, Steven H; Sealfon, Stuart C


    Influenza viruses continue to present global threats to human health. Antigenic drift and shift, genetic reassortment, and cross-species transmission generate new strains with differences in epidemiology and clinical severity. We compared the temporal transcriptional responses of human dendritic cells (DC) to infection with two pandemic (A/Brevig Mission/1/1918, A/California/4/2009) and two seasonal (A/New Caledonia/20/1999, A/Texas/36/1991) H1N1 influenza viruses. Strain-specific response differences included stronger activation of NF-κB following infection with A/New Caledonia/20/1999 and a unique cluster of genes expressed following infection with A/Brevig Mission/1/1918. A common antiviral program showing strain-specific timing was identified in the early DC response and found to correspond with reported transcript changes in blood during symptomatic human influenza virus infection. Comparison of the global responses to the seasonal and pandemic strains showed that a dramatic divergence occurred after 4 h, with only the seasonal strains inducing widespread mRNA loss. Continuously evolving influenza viruses present a global threat to human health; however, these host responses display strain-dependent differences that are incompletely understood. Thus, we conducted a detailed comparative study assessing the immune responses of human DC to infection with two pandemic and two seasonal H1N1 influenza strains. We identified in the immune response to viral infection both common and strain-specific features. Among the stain-specific elements were a time shift of the interferon-stimulated gene response, selective induction of NF-κB signaling by one of the seasonal strains, and massive RNA degradation as early as 4 h postinfection by the seasonal, but not the pandemic, viruses. These findings illuminate new aspects of the distinct differences in the immune responses to pandemic and seasonal influenza viruses. Copyright © 2015, American Society for Microbiology. All

  14. Pandemic H1N1 influenza A directly induces a robust and acute inflammatory gene signature in primary human bronchial epithelial cells downstream of membrane fusion

    Paquette, Stéphane G. [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Banner, David [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Chi, Le Thi Bao [Department of Microbiology, Hue University of Medicine and Pharmacy, Thua Thien Hue (Viet Nam); Carlo Urbani Centre, Hue University of Medicine and Pharmacy, Thua Thien Hue (Viet Nam); Leon, Alberto J. [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); International Institute of Infection and Immunity, Shantou University Medical College, Shantou, Guangdong (China); Xu, Luoling; Ran, Longsi [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Huang, Stephen S.H. [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Farooqui, Amber [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); International Institute of Infection and Immunity, Shantou University Medical College, Shantou, Guangdong (China); and others


    Pandemic H1N1 influenza A (H1N1pdm) elicits stronger pulmonary inflammation than previously circulating seasonal H1N1 influenza A (sH1N1), yet mechanisms of inflammatory activation in respiratory epithelial cells during H1N1pdm infection are unclear. We investigated host responses to H1N1pdm/sH1N1 infection and virus entry mechanisms in primary human bronchial epithelial cells in vitro. H1N1pdm infection rapidly initiated a robust inflammatory gene signature (3 h post-infection) not elicited by sH1N1 infection. Protein secretion inhibition had no effect on gene induction. Infection with membrane fusion deficient H1N1pdm failed to induce robust inflammatory gene expression which was rescued with restoration of fusion ability, suggesting H1N1pdm directly triggered the inflammatory signature downstream of membrane fusion. Investigation of intra-virion components revealed H1N1pdm viral RNA (vRNA) triggered a stronger inflammatory phenotype than sH1N1 vRNA. Thus, our study is first to report H1N1pdm induces greater inflammatory gene expression than sH1N1 in vitro due to direct virus–epithelial cell interaction. - Highlights: • We investigated H1N1pdm/sH1N1 infection in primary epithelial cells. • H1N1pdm directly initiated a robust inflammatory gene signature, sH1N1 did not. • H1N1pdm viral RNA triggered a stronger response than sH1N1. • H1N1pdm induces greater response due to direct virus–cell interaction. • These results have potential to impact vaccine and therapeutic development.

  15. Influenza virus H1N1 activates platelets through FcγRIIA signaling and thrombin generation.

    Boilard, Eric; Paré, Guillaume; Rousseau, Matthieu; Cloutier, Nathalie; Dubuc, Isabelle; Lévesque, Tania; Borgeat, Pierre; Flamand, Louis


    Platelets play crucial functions in hemostasis and the prevention of bleeding. During H1N1 influenza A virus infection, platelets display activation markers. The platelet activation triggers during H1N1 infection remain elusive. We observed that H1N1 induces surface receptor activation, lipid mediator synthesis, and release of microparticles from platelets. These activation processes require the presence of serum/plasma, pointing to the contribution of soluble factor(s). Considering that immune complexes in the H1N1 pandemic were reported to play a pathogenic role, we assessed their contribution in H1N1-induced platelet activation. In influenza-immunized subjects, we observed that the virus scaffolds with immunoglobulin G (IgG) to form immune complexes that promote platelet activation. Mechanistically, this activation occurs through stimulation of low-affinity type 2 receptor for Fc portion of IgG (FcγRIIA), a receptor for immune complexes, independently of thrombin. Using a combination of in vitro and in vivo approaches, we found that the antibodies from H3N2-immunized mice activate transgenic mouse platelets that express FcγRIIA when put in the presence of H1N1, suggesting that cross-reacting influenza antibodies suffice. Alternatively, H1N1 can activate platelets via thrombin formation, independently of complement and FcγRIIA. These observations identify both the adaptive immune response and the innate response against pathogens as 2 intertwined processes that activate platelets during influenza infections.

  16. 甲型H1N1流感患者的护理现状与发展

    陈玉华; 杨桂红



  17. 中西医结合防控甲型H1N1流感疫情




  18. Willingness to accept H1N1 pandemic influenza vaccine: A cross-sectional study of Hong Kong community nurses

    Wong Carmen


    Full Text Available Abstract Background The 2009 pandemic of influenza A (H1N1 infection has alerted many governments to make preparedness plan to control the spread of influenza A (H1N1 infection. Vaccination for influenza is one of the most important primary preventative measures to reduce the disease burden. Our study aims to assess the willingness of nurses who work for the community nursing service (CNS in Hong Kong on their acceptance of influenza A (H1N1 influenza vaccination. Methods 401 questionnaires were posted from June 24, 2009 to June 30, 2009 to community nurses with 67% response rate. Results of the 267 respondents on their willingness to accept influenza A (H1N1 vaccine were analyzed. Results Twenty-seven percent of respondents were willing to accept influenza vaccination if vaccines were available. Having been vaccinated for seasonable influenza in the previous 12 months were significantly independently associated with their willingness to accept influenza A (H1N1 vaccination (OR = 4.03; 95% CI: 2.03-7.98. Conclusions Similar to previous findings conducted in hospital healthcare workers and nurses, we confirmed that the willingness of community nurses to accept influenza A (H1N1 vaccination is low. Future studies that evaluate interventions to address nurses' specific concerns or interventions that aim to raise the awareness among nurses on the importance of influenza A (H1N1 vaccination to protect vulnerable patient populations is needed.

  19. Experience with high frequency oscillation ventilation during the 2009 H1N1 influenza pandemic in Australia and New Zealand.

    Boots, R J; Lipman, J; Lassig-Smith, M; Stephens, D P; Thomas, J; Shehabi, Y; Bass, F; Anthony, A; Long, D; Seppelt, I M; Weisbrodt, L; Erickson, S; Beca, J; Sherring, C; McGuiness, S; Parke, R; Stachowski, E R; Boyd, R; Howet, B


    During the 2009 H1N1 pandemic, large numbers of patients had severe respiratory failure. High frequency oscillation ventilation was used as a salvage technique for profound hypoxaemia. Our aim was to compare this experience with high frequency oscillation ventilation during the 2009 H1N1 pandemic with the same period in 2008 by performing a three-month period prevalence study in Australian and New Zealand intensive care units. The main study end-points were clinical demographics, care delivery and survival. Nine intensive care units contributed data. During 2009 there were 22 H1N1 patients (17 adults, five children) and 10 non-H1N1 patients (five adults, five children), while in 2008, 18 patients (two adults, 16 children) received high frequency oscillation ventilation. The principal non-H1N1 high frequency oscillation ventilation indication was bacterial or viral pneumonia (56%). For H1N1 patients, the median duration of high frequency oscillation ventilation was 3.7 days (interquartile range 1.8 to 5) with concomitant therapies including recruitment manoeuvres (22%), prone ventilation (41%), inhaled prostacyclins (18%) and inhaled nitric oxide (36%). Seven patients received extracorporeal membrane oxygenation, six having H1N1. Three patients had extracorporeal membrane oxygenation concurrently, two as salvage therapy following the commencement of high frequency oscillation ventilation. In 2008, no high frequency oscillation ventilation patient received extracorporeal membrane oxygenation. Overall hospital survival was 77% in H1N1 patients, while survival in patients having adjunctive extracorporeal membrane oxygenation was similar to those receiving high frequency oscillation ventilation alone (65% compared to 71%, P = 1.00). Survival rates were comparable to published extracorporeal membrane oxygenation outcomes. High frequency oscillation ventilation was used successfully as a rescue therapy for severe respiratory failure. High frequency oscillation ventilation

  20. 甲型H1N1流感的病原学及其治疗药物

    凌云; 狄亚敏


    目的 介绍甲型H1N1流感[Influenza A(H1N1)]的病原学特征及其治疗药物,为甲型H1N1流感的临床治疗提供依据.方法 收集专业书刊和网站资料,介绍卫牛部制定的甲型H1N1流感诊疗方案,综合分析抗甲型H1N1流感病毒药物.结果 此次疫情是由变异后的甲型H1N1流感病毒[Influenza virus A(H1N1)]引起,该毒株是猪流感、禽流感和人流感3种病毒的基因重组;只要及时服用抗流感病毒药物达菲(Tamiflu),患者可以基本治愈.结论 甲型H1N1流感远没有非典和禽流感那么可怕,我们即有防控非典的经验,又有疗效确切的抗病毒药,所以甲型H1N1流感是可防、可控、可治的.

  1. Development and characterization of a panel of cross-reactive monoclonal antibodies generated using H1N1 influenza virus.

    Guo, Chun-yan; Tang, Yi-gui; Qi, Zong-li; Liu, Yang; Zhao, Xiang-rong; Huo, Xue-ping; Li, Yan; Feng, Qing; Zhao, Peng-hua; Wang, Xin; Li, Yuan; Wang, Hai-fang; Hu, Jun; Zhang, Xin-jian


    To characterize the antigenic epitopes of the hemagglutinin (HA) protein of H1N1 influenza virus, a panel consisting of 84 clones of murine monoclonal antibodies (mAbs) were generated using the HA proteins from the 2009 pandemic H1N1 vaccine lysate and the seasonal influenza H1N1(A1) vaccines. Thirty-three (39%) of the 84 mAbs were found to be strain-specific, and 6 (7%) of the 84 mAbs were subtype-specific. Twenty (24%) of the 84 mAbs recognized the common HA epitopes shared by 2009 pandemic H1N1, seasonal A1 (H1N1), and A3 (H3N2) influenza viruses. Twenty-five of the 84 clones recognized the common HA epitopes shared by the 2009 pandemic H1N1, seasonal A1 (H1N1) and A3 (H3N2) human influenza viruses, and H5N1 and H9N2 avian influenza viruses. We found that of the 16 (19%) clones of the 84 mAbs panel that were cross-reactive with human respiratory pathogens, 15 were made using the HA of the seasonal A1 (H1N1) virus and 1 was made using the HA of the 2009 pandemic H1N1 influenza virus. Immunohistochemical analysis of the tissue microarray (TMA) showed that 4 of the 84 mAb clones cross-reacted with human tissue (brain and pancreas). Our results indicated that the influenza virus HA antigenic epitopes not only induce type-, subtype-, and strain-specific monoclonal antibodies against influenza A virus but also cross-reactive monoclonal antibodies against human tissues. Further investigations of these cross-reactive (heterophilic) epitopes may significantly improve our understanding of viral antigenic variation, epidemics, pathophysiologic mechanisms, and adverse effects of influenza vaccines.

  2. Clinical characteristics and outcomes among pediatric patients hospitalized with pandemic influenza A/H1N1 2009 infection

    Eun Lee


    Full Text Available Purpose : The purpose of this article is to describe the clinical and epidemiologic features and outcomes among children hospitalized with pandemic influenza A/H1N1 2009 infection. Methods : We retrospectively reviewed the charts of hospitalized pediatric patients (&lt;18 years diagnosed with pandemic influenza A/H1N1 2009 infection by reverse-transcriptase polymerase chain reaction at a tertiary hospital in Seoul, Korea, between September 2009 and February 2010. Results : A total of 72 children were hospitalized with pandemic influenza A/H1N1 2009 infection (median age, 6.0 years; range, 2 months to 18 years. A total of 40% had at least 1 underlying medical condition, including asthma (17%, malignancies (19%, and heart diseases (17%. Of the 72 patients, 54 (76% children admitted with H1N1 infection showed radiographic alterations compatible with pneumonia. There was no significant difference in pre-existing conditions between pandemic influenza A/H1N1 infected patients with or without pneumonia. Children with pandemic influenza A/ H1N1 pneumonia were more likely to have a lower lymphocyte ratio (P=0.02, higher platelet count (P=0.02, and higher level of serum glucose (P=0.003, and more commonly presented with dyspnea than did those without pneumonia (P=0.04. Conclusion : No significant differences in age, sex, or presence of preexisting conditions were found between children hospitalized with pandemic influenza A/H1N1 H1N1 influenza infection with pneumonia and those without pneumonia. Higher leukocyte count, higher glucose level, and a lower lymphocyte ratio were associated with the development of pandemic A/H1N1 2009 influenza pneumonia.

  3. 孕妇对甲型H1N1流感的认知态度调查%Study on the cognitive situation of influenza A(H1N1) among antenatal-checkup pregnant women

    郑冬燕; 曹敏; 王丹凤


    目的:了解在我院进行产检孕妇对甲型H1N1流感的基本认知和态度,为制定有效的防控措施,开展相关的健康教育提供依据.方法:采用自行设计的调查问卷,采用随机抽样的方法,对我院产检的孕妇进行自填式问卷调查.结果:孕妇对甲型H1N1流感相关知识的知晓率为99.64%;文化程度越高的孕妇越能正确面对甲型H1N1流感(P<0.05);孕妇获取甲型H1N1流感相关知识的主要途径为电视、报纸.结论:我院产检孕妇对甲型H1N1流感的知晓率较高;文化程度越高的孕妇,对甲型H1N1流感的知识越关注,越能正确的面对;孕妇获取甲型H1N1流感相关知识的主要途径是媒体宣传.%Objective:To study the cognitive situation and attitude of influenza A( H1N1 ) among pregnant women that Antenatal checkup in our hospital to help making plan for influenza A( H1N1 ) prevention and providing relative health education.Methods: Self - made questionnaire was used for the random sampling investigation of pregnant women that Antenatal checkup in our hospital.Results:99.64% pregnant women had relative knowledge of influenza A ( H1N1 ); Pregnant women with higher education background had better Cognitive Situation of influenza A( H1N1 )( P < 0.05 ); The main approaches of acknowledgment of relative knowledge of influenza A ( H1N1 ) were by TV ( 90.58% )and newspaper ( 62.68% ).Conclusion:Most of pregnant women that Antenatal checkup in our hospital had relative knowledge of influenza A( H1N1 ).Pregnant women with higher education background paid more attention to influenza A( H1N1 ) and had better cognizance of influenza A( H1N1 ).The main approaches of acknowledgment of influenza A( H1N1 ) relative knowledge was by media.

  4. 关于甲型H1N1流感病毒预防及控制措施%Prevention and Control Measures on H1N1 Influenza Virus


    H1N1 influenza virus is a kind of world infectious diseases, and we should strengthen the flu virus prevention and control, so it’s very important. In this paper, at first the influenza H1N1 influenza virus is analyzed and introduced, and then puts forward the virus prevention and control measures.%  甲型H1N1流感病毒是一种世界性的传染病,加强该流感病毒的预防和控制是十分重要的。本文首先对甲型H1N1流感病毒进行了分析介绍,然后提出了该病毒的预防和控制措施。

  5. INFLUENZA A H1N1 DE ORIGEN PORCINO: Métodos diagnósticos Influenza A H1N1 swine origin: diagnostic methods

    Manuel Antonio Vargas-Córdoba


    Full Text Available El diagnóstico de la infección por virus influenza reposa sobre técnicas virológicas directas e indirectas. Las diferentes pruebas diagnósticas poseen niveles de sensibilidad y especificidad variables que dependen en gran parte de las características genéticas y antigénicas del virus circulante. En el caso de la aparición de una nueva variante viral las pruebas disponibles en el mercado deben ser validadas para comprobar su eficiencia de detección para el nuevo virus. En caso de baja sensibilidad y especificidad, las pruebas deben ajustarse con el fin de mejorar su poder de detección del nuevo agente. Existen múltiples pruebas diagnósticas que presentan cada una sus ventajas y limitaciones y su selección dependerá de las condiciones específicas de cada laboratorio diagnóstico.The diagnosis of infection by influenza viruses relays on direct and indirect virologic techniques. Different diagnostic tests have variable sensitivities and specificities depending to a large extent on the genetic and antigenic features of the circulating virus. When a new viral variant appears, commercially available tests must be validated in order to verify their performance at detecting the new virus. If a low sensitivity or specificity is found, tests must be adjusted in order to improve their detection power for the new agent. There are multiple diagnostic tests, each one with its own advantages and limitations; so the selection of a test will depend on the specific conditions of a particular diagnostic laboratory.

  6. Novel Influenza A (H1N1/09) Virus Infection during Pregnancy in a Kidney Transplant Recipient


    We report the first case of a pregnant renal transplant patient with H1N1/09 infection. The woman showed a mild clinical course after diagnosis of H1N1/09 infection and therapy with oseltamivir (2 × 45 mg per day). After delivery by cesarean section, the neonate exhibited moderate respiratory and circulatory dysregulation, which spontaneously normalised a few days postpartum. In conclusion, rapid diagnosis of H1N1/09 and dose-adapted therapy with oseltamivir resulted in successful delivery of...

  7. Experimental infection with a Thai reassortant swine influenza virus of pandemic H1N1 origin induced disease.

    Charoenvisal, Nataya; Keawcharoen, Juthatip; Sreta, Donruethai; Tantawet, Siriporn; Jittimanee, Suphattra; Arunorat, Jirapat; Amonsin, Alongkorn; Thanawongnuwech, Roongroje


    Following the emergence of the pandemic H1N1 influenza A virus in 2009 in humans, this novel virus spread into the swine population. Pigs represent a potential host for this virus and can serve as a mixing vessel for genetic mutations of the influenza virus. Reassortant viruses eventually emerged from the 2009 pandemic and were reported in swine populations worldwide including Thailand. As a result of the discovery of this emergent disease, pathogenesis studies of this novel virus were conducted in order that future disease protection and control measures in swine and human populations could be enacted. The pandemic H1N1 2009 virus (pH1N1) and its reassortant virus (rH1N1) isolated from pigs in Thailand were inoculated into 2 separate cohorts of 9, 3-week-old pigs. Cohorts were consisted of one group experimentally infected with pH1N1 and one group with rH1N1. A negative control group consisting of 3 pigs was also included. Clinical signs, viral shedding and pathological lesions were investigated and compared. Later, 3 pigs from viral inoculated groups and 1 pig from the control group were necropsied at 2, 4, and 12 days post inoculation (DPI). The results indicated that pigs infected with both viruses demonstrated typical flu-like clinical signs and histopathological lesions of varying severity. Influenza infected-pigs of both groups had mild to moderate pulmonary signs on 1-4 DPI. Interestingly, pigs in both groups demonstrated viral RNA detection in the nasal swabs until the end of the experiment (12 DPI). The present study demonstrated that both the pH1N1 and rH1N1 influenza viruses, isolated from naturally infected pigs, induced acute respiratory disease in experimentally inoculated nursery pigs. Although animals in the rH1N1-infected cohort demonstrated more severe clinical signs, had higher numbers of pigs shedding the virus, were noted to have increased histopathological severity of lung lesions and increased viral antigen in lung tissue, the findings were

  8. 甲型H1N1流感的11个必备常识



  9. 2009年深圳市某街道甲型H1N1流感流行病学分析%Epidemiological characteristics of influenza A (H1N1) in a strict of Shenzhen in 2009

    谢显清; 刘福益; 刘松


    目的 探讨深圳市某街道2009年甲型H1N1流感的流行病学特征.方法 将2009年流感样病例建立数据库进行统计学分析,对死亡病例进行个案分析.结果 2009年甲型H1N1流感实验室确诊65例,其中重症患者10例(死亡1例);病例主要集中在10-11月(333例);学校和托幼机构为高发场所(363例,98.9%);5~14岁青少年为易感人群(293例,79.8%).结论 深圳市某街道2009年甲型H1N1流感发病高峰出现在11月,主要在封闭、人群集中、接触密切的学校和托幼机构暴发.%aObjective To investigate epidemiological characteristics of influenza A(H1N1) in a strict of Shenzhen in 2009. Method Collected the data of influenza A( HI N1) to statistical analysis. Results 65 cases of influenza A(H1N1) in 2009, 10 cases of patient were severe and 1 patient were dead. There were 333 cases of influenza A (H1N1) during October to November. There were 363 cases of influenza A(H1N1) in school and nursery. 293 cases of influenza A(H1N1) 5-14 years. Conclusion The influenza A(H1N1) break out peaking in November. The influenza A(H1N1) outbreak in schools and nurseries was the mainly characterized of influenza A(H1N1) in a strict.

  10. Single dose vaccination of the ASO3-adjuvanted A(H1N1)pdm09 monovalent vaccine in health care workers elicits homologous and cross-reactive cellular and humoral responses to H1N1 strains.

    Lartey, Sarah; Pathirana, Rishi D; Zhou, Fan; Jul-Larsen, Åsne; Montomoli, Emanuele; Wood, John; Cox, Rebecca Jane


    Healthcare workers (HCW) were prioritized for vaccination during the 2009 influenza A(H1N1)pdm09 pandemic. We conducted a clinical trial in October 2009 where 237 HCWs were immunized with a AS03-adjuvanted A(H1N1)pdm09 monovalent vaccine. In the current study, we analyzed the homologous and cross-reactive H1N1 humoral responses using prototype vaccine strains dating back to 1977 by the haemagglutinin inhibition (HI), single radial hemolysis SRH), antibody secreting cell (ASC) and memory B cell (MBC) assays. The cellular responses were assessed by interferon-γ (IFN-γ) ELISPOT and by intracellular staining (ICS) for the Th1 cytokines IFN-γ, interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α). All assays were performed using blood samples obtained prior to (day 0) and 7, 14 and 21 d post-pandemic vaccination, except for ASC (day 7) and ICS (days 0 and 21). Vaccination elicited rapid HI, SRH and ASC responses against A(H1N1)pdm09 which cross reacted with seasonal H1N1 strains. MBC responses were detected against the homologous and seasonal H1N1 strains before vaccination and were boosted 2 weeks post-vaccination. An increase in cellular responses as determined by IFN-γ ELISPOT and ICS were observed 1-3 weeks after vaccination. Collectively, our data show that the AS03-adjuvanted A(H1N1)pdm09 vaccine induced rapid cellular and humoral responses against the vaccine strain and the response cross-reacted against prototype H1N1 strains dating back to 1977.

  11. 清新县甲型H1N1流感流行因素分析%Analysis on factors of H1N1 flu pandemic influenza in Qingxin county

    黄彩琼; 黄德厚; 周志珊; 朱永坚; 邝西金; 李初升; 欧映红; 马励斌


    [Objective]To grasp the dynamic features and popular rule of H1N1 flu outbreak in our county through the system monitoring survey,to analyze the popular factors of influenza H1N1flu,provide the scientific basis for improving the prevention and control measures.[Methods]Six towns were selected as monitoring stations in Qingxin county central,southem and northern region,extracting the general population venous blood,ELISA test was carried out on a H1N1 IgG antibody serologicad survey,at the same time the face to face questionnaire of epidemiological investigation was also conducted.[Results]The serum samples of 1325 persons were tested,influenza H1N1 flu antibody positive for 190 people,positive rate was 14.34%,H1N1 influenza virus infection in patients in our county were mainly light and inapparent,the life of a crowd gathered H1N1 IgG antibody was higher than that in the crowd gathered(P< 0.05),influenza H1N1 flu vaccine for 2.49% rate,the effect of immunity for 57.58%,a cold of visit for 70.66% rate,the case of H1N1 influenza was not found in the survey group.[Conclusions]The main factors influencing our county H1N1 flu pandemic influenza are the vaccine immunization rates among immune effect and medical diagnosis accuracy,the susceptibility of living gathering group,infections status with light and inapparent as main condition,the vaccination for H1N1 flu vaccine crowd influenza and influenza H1N1 flu knowledge training for clinical doctors should be strengthened,the nursery institutions and schools and other clustering area are still important places to be prevented and controlled for H1N1 flu prevention in our county.%[目的]通过系统监测调查,及时掌握我县甲型H1N1流感的疫情动态和流行规律,分析其流行因素,为我县完善甲型H1N1流感的防控工作提供科学依据.[方法]在清新县中部、南部、北部地区选择6个镇作为监测点,抽取普通人群静脉血,用酶联免疫试验检测甲型H1N1 IgG抗

  12. 甲型H1N1流感的Monte Carlo预测模型研究%Research on Monte Carlo Prediction Model for Influenza A H1N1

    李明; 曾志; 武祯; 孙晓北


    According to the statistical data of the eruption of the influenza A H1N1 in a certain city,the prediction model of the spread of the influenza A H1N1 are constructed by Monte Carlo method,through which the eruption of the influenza A H1N1 in this city is simulated.The results show that the simulation results have good accordance with the real data,which infers that the prediction of epidemiology could be solved by Monte Carlo method.%依据某市甲型H1N1流感暴发统计数据,利用Monte Carlo方法建立甲型H1N1流感传播的预测模型,模拟预测该市甲型H1N1流感暴发情况。结果表明模拟结果与实际数据吻合良好,Monte Carlo方法能够解决流行病传染预测问题。

  13. The Primary Exploration of Enrichment Methods for Influenza A (H1N1) Virus%检测甲型H1N1流感病毒富集方法的初步探索

    李华; 柯华昕; 龙润乡; 杨蓉; 何春艳; 白慧珠; 崔萍芳; 谢忠平


    目的 探索甲型H1N1流感病毒的富集方法,提高流感病毒核酸检测的灵敏度.方法 分别用ProteinA/G及H1N1特异性血清处理流感病毒样品,根据国家流感中心设计的H1N1亚型检测通用引物,采用反转录-聚合酶链反应(RT-PCR)方法,扩增产物为527bp,来评价病毒的富集效果.结果 两种富集方法均能提高检测灵敏度,用ProteinA/G富集处理后检测灵敏度可达10-6,用H1N1特异性血清沉淀富集处理后灵敏度为10-5.结论 初步建立的富集甲型H1N1流感病毒方法,有效提高了流感病毒RT-PCR检测的灵敏度,可用于甲型H1N1流感病毒的检测.

  14. Potency of a vaccine prepared from A/swine/Hokkaido/2/1981 (H1N1 against A/Narita/1/2009 (H1N1 pandemic influenza virus strain

    Okamatsu Masatoshi


    Full Text Available Abstract Background The pandemic 2009 (H1N1 influenza virus has spread throughout the world and is now causing seasonal influenza. To prepare for the emergence of pandemic influenza, we have established a library of virus strains isolated from birds, pigs, and humans in global surveillance studies. Methods Inactivated whole virus particle (WV and ether-split (ES vaccines were prepared from an influenza virus strain, A/swine/Hokkaido/2/1981 (H1N1, from the library and from A/Narita/1/2009 (H1N1 pandemic strain. Each of the vaccines was injected subcutaneously into mice and their potencies were evaluated by challenge with A/Narita/1/2009 (H1N1 virus strain in mice. Results A/swine/Hokkaido/2/81 (H1N1, which was isolated from the lung of a diseased piglet, was selected on the basis of their antigenicity and growth capacity in embryonated chicken eggs. Two injections of the WV vaccine induced an immune response in mice, decreasing the impact of disease caused by the challenge with A/Narita/1/2009 (H1N1, as did the vaccine prepared from the homologous strain. Conclusion The WV vaccine prepared from an influenza virus in the library is useful as an emergency vaccine in the early phase of pandemic influenza.

  15. Real-time numerical forecast of global epidemic spreading: case study of 2009 A/H1N1pdm

    Tizzoni Michele


    Full Text Available Abstract Background Mathematical and computational models for infectious diseases are increasingly used to support public-health decisions; however, their reliability is currently under debate. Real-time forecasts of epidemic spread using data-driven models have been hindered by the technical challenges posed by parameter estimation and validation. Data gathered for the 2009 H1N1 influenza crisis represent an unprecedented opportunity to validate real-time model predictions and define the main success criteria for different approaches. Methods We used the Global Epidemic and Mobility Model to generate stochastic simulations of epidemic spread worldwide, yielding (among other measures the incidence and seeding events at a daily resolution for 3,362 subpopulations in 220 countries. Using a Monte Carlo Maximum Likelihood analysis, the model provided an estimate of the seasonal transmission potential during the early phase of the H1N1 pandemic and generated ensemble forecasts for the activity peaks in the northern hemisphere in the fall/winter wave. These results were validated against the real-life surveillance data collected in 48 countries, and their robustness assessed by focusing on 1 the peak timing of the pandemic; 2 the level of spatial resolution allowed by the model; and 3 the clinical attack rate and the effectiveness of the vaccine. In addition, we studied the effect of data incompleteness on the prediction reliability. Results Real-time predictions of the peak timing are found to be in good agreement with the empirical data, showing strong robustness to data that may not be accessible in real time (such as pre-exposure immunity and adherence to vaccination campaigns, but that affect the predictions for the attack rates. The timing and spatial unfolding of the pandemic are critically sensitive to the level of mobility data integrated into the model. Conclusions Our results show that large-scale models can be used to provide valuable real

  16. Characterizing the epidemiology of the 2009 influenza A/H1N1 pandemic in Mexico.

    Gerardo Chowell


    Full Text Available BACKGROUND: Mexico's local and national authorities initiated an intense public health response during the early stages of the 2009 A/H1N1 pandemic. In this study we analyzed the epidemiological patterns of the pandemic during April-December 2009 in Mexico and evaluated the impact of nonmedical interventions, school cycles, and demographic factors on influenza transmission. METHODS AND FINDINGS: We used influenza surveillance data compiled by the Mexican Institute for Social Security, representing 40% of the population, to study patterns in influenza-like illness (ILIs hospitalizations, deaths, and case-fatality rate by pandemic wave and geographical region. We also estimated the reproduction number (R on the basis of the growth rate of daily cases, and used a transmission model to evaluate the effectiveness of mitigation strategies initiated during the spring pandemic wave. A total of 117,626 ILI cases were identified during April-December 2009, of which 30.6% were tested for influenza, and 23.3% were positive for the influenza A/H1N1 pandemic virus. A three-wave pandemic profile was identified, with an initial wave in April-May (Mexico City area, a second wave in June-July (southeastern states, and a geographically widespread third wave in August-December. The median age of laboratory confirmed ILI cases was ∼ 18 years overall and increased to ∼ 31 years during autumn (p<0.0001. The case-fatality ratio among ILI cases was 1.2% overall, and highest (5.5% among people over 60 years. The regional R estimates were 1.8-2.1, 1.6-1.9, and 1.2-1.3 for the spring, summer, and fall waves, respectively. We estimate that the 18-day period of mandatory school closures and other social distancing measures implemented in the greater Mexico City area was associated with a 29%-37% reduction in influenza transmission in spring 2009. In addition, an increase in R was observed in late May and early June in the southeast states, after mandatory school

  17. Epidemiology, clinical characteristics and resource implications of pandemic (H1N1) 2009 in intensive care units in Ireland.

    Nicolay, Nathalie


    To describe the incidence, clinical characteristics and outcomes of critically ill patients in Ireland with pandemic (H1N1) 2009 infection, and to provide a dynamic assessment of the burden of such cases on Irish intensive care units.

  18. Computer-aided assessment of pulmonary disease in novel swine-origin H1N1 influenza on CT

    Yao, Jianhua; Dwyer, Andrew J.; Summers, Ronald M.; Mollura, Daniel J.


    The 2009 pandemic is a global outbreak of novel H1N1 influenza. Radiologic images can be used to assess the presence and severity of pulmonary infection. We develop a computer-aided assessment system to analyze the CT images from Swine-Origin Influenza A virus (S-OIV) novel H1N1 cases. The technique is based on the analysis of lung texture patterns and classification using a support vector machine (SVM). Pixel-wise tissue classification is computed from the SVM value. The method was validated on four H1N1 cases and ten normal cases. We demonstrated that the technique can detect regions of pulmonary abnormality in novel H1N1 patients and differentiate these regions from visually normal lung (area under the ROC curve is 0.993). This technique can also be applied to differentiate regions infected by different pulmonary diseases.

  19. Guidance for Testing and Labeling Claims against Pandemic 2009 H1N1 Influenza A Virus (Formerly called Swine Flu )

    This document provides guidance labeling and testing for antimicrobial pesticides in several forms that are used to treat hard non-porous surfaces in healthcare facilities and other settings against Pandemic 2009 H1N1 influenza A Virus.

  20. Impact of Body Mass Index on Immunogenicity of Pandemic H1N1 Vaccine in Children and Adults

    Callahan, S. Todd; Wolff, Mark; Hill, Heather R.; Edwards, Kathryn M.; Keitel, Wendy; Atmar, Robert; Patel, Shital; Sahly, Hana El; Munoz, Flor; Paul Glezen, W.; Brady, Rebecca; Frenck, Robert; Bernstein, David; Harrison, Christopher; Jackson, Mary Anne; Swanson, Douglas; Newland, Jason; Myers, Angela; Livingston, Robyn A; Walter, Emmanuel; Dolor, Rowena; Schmader, Kenneth; Mulligan, Mark J.; Edupuganti, Srilatha; Rouphael, Nadine; Whitaker, Jennifer; Spearman, Paul; Keyserling, Harry; Shane, Andi; Eckard, Allison Ross; Jackson, Lisa A.; Frey, Sharon E.; Belshe, Robert B.; Graham, Irene; Anderson, Edwin; Englund, Janet A.; Healy, Sara; Winokur, Patricia; Stapleton, Jack; Meier, Jeffrey; Kotloff, Karen; Chen, Wilbur; Hutter, Julia; Stephens, Ina; Wooten, Susan; Wald, Anna; Johnston, Christine; Edwards, Kathryn M.; Buddy Creech, C.; Todd Callahan, S.


    Obesity emerged as a risk factor for morbidity and mortality related to 2009 pandemic influenza A (H1N1) infection. However, few studies examine the immune responses to H1N1 vaccine among children and adults of various body mass indices (BMI). Pooling data from 3 trials of unadjuvanted split-virus H1N1 A/California/07/2009 influenza vaccines, we analyzed serologic responses of participants stratified by BMI grouping. A single vaccine dose produced higher hemagglutination inhibition antibody titers at day 21 in obese compared to nonobese adults, but there were no significant differences in responses to H1N1 vaccine among children or adults of various BMI following 2 doses. PMID:24795475

  1. 对26例甲型H1N1流感患儿的护理体会




  2. An Analysis of 332 Fatalities Infected with Pandemic 2009 Influenza A (H1N1) in Argentina

    Balanzat, Ana M.; Hertlein, Christian; Apezteguia, Carlos; Bonvehi, Pablo; Cámera, Luis; Gentile, Angela; Rizzo, Oscar; Gómez-Carrillo, Manuel; Coronado, Fatima; Azziz-Baumgartner, Eduardo; Chávez, Pollyanna R.; Widdowson, Marc-Alain


    Background The apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities. Methods We identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group. Results Of 332 influenza A H1N1pdm fatalities, 226 (68%) were among persons aged Argentina, though timeliness of antiviral treatment improved during the pandemic. PMID:22506006

  3. Management of severe respiratory failure following influenza A H1N1 pneumonia

    Michela Vivarelli


    Full Text Available The use of non-invasive ventilation (NIV in severe hypoxemic respiratory failure (PaO2/FIO2 ≤250 due to H1H1 virus pneumonia is controversial. In this prospective study, we aimed to assess the efficacy of NIV in avoiding endotracheal intubation and to identify predictors of success or failure. Nineteen patients with H1N1 viral pneumonia had severe respiratory failure (PaO2/FIO2 ratio ≤250. Five patients with PaO2/FIO2 lower than 150 and simplified acute physiology score (SAPS II lower than 34 underwent NIV and were admitted to the Intensive Care Unit and received NIV as first-line therapy. NIV failed in 2 of the 14 patients but had a good outcome in 12. None of the patients treated with NIV died. The duration of NIV was 5.0±1.9 days and the hospital stay was 11.3±1.2 days. The average PaO2/FIO2 ratio after 1 h of NIV was 239.1+38.7. No patient had multi-organ failure. PaO2/FIO2 ratio after 1 h and SAPS II at admission were independent variables correlated with the success of NIV. In our study, NIV was successful in 12 of the 14 patients (85.7% and this is one of the highest success rates in the literature. In our opinion, the reason for these results is the strict selection of patients with severe respiratory failure (PaO2/FIO2 ratio ≥150 and the strict following of predictors of success for NIV such as SAPS II of 34 or lower and PaO2/FIO2 ratio of 175 or lower after 1 h of NIV. Clinicians should be aware of pulmonary complications of influenza A H1N1 and strictly select the patients to undergo NIV. NIV could have an effective and safe role in reducing the high demand for critical care beds, particularly during the pandemic.

  4. Timeliness of contact tracing among flight passengers for influenza A/H1N1 2009

    Swaan Corien M


    Full Text Available Abstract Background During the initial containment phase of influenza A/H1N1 2009, close contacts of cases were traced to provide antiviral prophylaxis within 48 h after exposure and to alert them on signs of disease for early diagnosis and treatment. Passengers seated on the same row, two rows in front or behind a patient infectious for influenza, during a flight of ≥ 4 h were considered close contacts. This study evaluates the timeliness of flight-contact tracing (CT as performed following national and international CT requests addressed to the Center of Infectious Disease Control (CIb/RIVM, and implemented by the Municipal Health Services of Schiphol Airport. Methods Elapsed days between date of flight arrival and the date passenger lists became available (contact details identified - CI was used as proxy for timeliness of CT. In a retrospective study, dates of flight arrival, onset of illness, laboratory diagnosis, CT request and identification of contacts details through passenger lists, following CT requests to the RIVM for flights landed at Schiphol Airport were collected and analyzed. Results 24 requests for CT were identified. Three of these were declined as over 4 days had elapsed since flight arrival. In 17 out of 21 requests, contact details were obtained within 7 days after arrival (81%. The average delay between arrival and CI was 3,9 days (range 2-7, mainly caused by delay in diagnosis of the index patient after arrival (2,6 days. In four flights (19%, contacts were not identified or only after > 7 days. CI involving Dutch airlines was faster than non-Dutch airlines (P Conclusion CT for influenza A/H1N1 2009 among flight passengers was not successful for timely provision of prophylaxis. CT had little additional value for alerting passengers for disease symptoms, as this information already was provided during and after the flight. Public health authorities should take into account patient delays in seeking medical advise and

  5. Prediction of clinical factors associated with pandemic influenza A (H1N1 2009 in Pakistan.

    Nadia Nisar

    Full Text Available BACKGROUND: Influenza is a viral infection that can lead to serious complications and death(s in vulnerable groups if not diagnosed and managed in a timely manner. This study was conducted to improve the accuracy of predicting influenza through various clinical and statistical models. METHODOLOGY: A retrospective cross sectional analysis was done on demographic and epidemiological data collected from March 2009 to March 2010. Patients were classified as ILI or SARI using WHO case definitions. Respiratory specimens were tested by RT-PCR. Clinical symptoms and co-morbid conditions were analyzed using binary logistic regression models. RESULTS: In the first approach, analysis compared children (≤12 and adults (>12. Of 1,243 cases, 262 (21% tested positive for A(H1N1pdm09 and the proportion of children (≤12 and adults (>12 were 27% and 73% respectively. Four symptoms predicted influenza in children: fever (OR 2.849, 95% CI 1.931-8.722, cough (OR 1.99, 95% CI 1.512-3.643, diarrhea (OR 2.100, 95% CI 2.040-3.25 and respiratory disease (OR 3.269, 95% CI 2.128-12.624. In adults, the strongest clinical predictor was fever (OR 2.80, 95% CI 1.025-3.135 followed by cough (OR 1.431, 95% CI 1.032-2.815. In the second instance, patients were separated into two groups: SARI 326 (26% and ILI 917 (74% cases. Male to female ratio was 1.41∶1.12 for SARI and 2∶1.5 for ILI cases. Chi-square test showed that fever, cough and sore throat were significant factors for A(H1N1pdm09 infections (p = 0.008. CONCLUSION: Studies in a primary care setting should be encouraged focused on patients with influenza-like illness to develop sensitive clinical case definition that will help to improve accuracy of detecting influenza infections. Formulation of a standard "one size fits all" case definition that best correlates with influenza infections can help guide decisions for additional diagnostic testing and also discourage unjustified antibiotic prescription and usage

  6. Horizontal transmission of novel H1N1/09 influenza virus in a newborn:Myth or fact?

    Uttam Kumar Sarkar; Utpala Mitra; Mamta Chawla Sarkar; Shanta Dutta; Himanish Roy; Mrinal Kanti Chatterjee; Phalguni Dutta


    Horizontal transmission of H1N1/09 virus infection is very common however; transmission through this route has not been reported in newborns. To our knowledge, this is the first case report of newborn who acquired infection of novel H1N1/09 virus horizontally through asymptomatic family members or hospital staff during epidemic period in Kolkata, India. Baby recovered without antiviral therapy but received antibiotic for bacterial co-infection.

  7. Comorbid presentation of severe novel influenza A (H1N1) and Evans syndrome: a case report

    CHEN Hui; JIA Xin-lei; GAO Heng-miao; QIAN Su-yun


    One 22-month-old boy who was admitted for a fever lasting 6 days as well as a cough and wheezing lasting 2 days was reported. He was diagnosed with influenza A (H1N1, severe type), severe pneumonia, acute respiratory distress syndrome (ARDS), Evans syndrome and multiple organ failure. This is the first case of novel influenza A (H1N1) and Evans syndrome. The pathogenesis is still unknown.

  8. Impact on pregnancies in south Brazil from the influenza A (H1N1 pandemic: cohort study.

    André Anjos da Silva

    Full Text Available INTRODUCTION: The emergence of a new subtype of the influenza virus in 2009 generated interest in the international medical community, the media, and the general population. Pregnant women are considered to be a group at risk of serious complications related to the H1N1 influenza virus. The aim of this study was to evaluate the outcomes and teratogenic effects of pregnancies exposed to the H1N1 virus during the Influenza A epidemic that occurred in the state of Rio Grande do Sul in 2009. METHODS: This is an uncontrolled prospective cohort study of pregnant women with suspected symptoms of Influenza A who were reported in the Information System for Notifiable Diseases-Influenza (SINAN-Influenza during the epidemic of 2009 (database from the state of Rio Grande do Sul, Brazil. There were 589 cases of pregnant women with suspected infection. Among these, 243 were tested by PCR and included in the analysis. The main outcome measures were: maternal deaths, pregnancy outcome, stillbirths, premature births, low birth weight, congenital malformations, and odds ratios for H1N1+ and non-H1N1 pregnant women. RESULTS: There were one hundred and sixty-three (67% confirmed cases of H1N1, 34 cases (14% of seasonal Influenza A and 46 (19% who were negative for Influenza A. There was no difference between the three groups in clinical parameters of the disease. There were 24 maternal deaths--18 of them had H1N1. There were 8 stillbirths--5 were children of H1N1 infected mothers. There were no differences in perinatal outcomes. CONCLUSIONS: The present data do not indicate an increase in teratogenic risk from exposure to the influenza A (H1N1 virus. These results will help to strengthen the data and clarify the health issues that arose after the pandemic.

  9. Corticosteroid treatment ameliorates acute lung injury induced by 2009 swine origin influenza A (H1N1 virus in mice.

    Chenggang Li

    Full Text Available BACKGROUND: The 2009 influenza pandemic affected people in almost all countries in the world, especially in younger age groups. During this time, the debate over whether to use corticosteroid treatment in severe influenza H1N1 infections patients resurfaced and was disputed by clinicians. There is an urgent need for a susceptible animal model of 2009 H1N1 infection that can be used to evaluate the pathogenesis and the therapeutic effect of corticosteroid treatment during infection. METHODOLOGY/PRINCIPAL FINDINGS: We intranasally inoculated two groups of C57BL/6 and BALB/c mice (using 4- or 6-to 8-week-old mice to compare the pathogenesis of several different H1N1 strains in mice of different ages. Based on the results, a very susceptible 4-week-old C57BL/6 mouse model of Beijing 501 strain of 2009 H1N1 virus infection was established, showing significantly elevated lung edema and cytokine levels compared to controls. Using our established animal model, the cytokine production profile and lung histology were assessed at different times post-infection, revealing increased lung lesions in a time-dependent manner. In additional,the mice were also treated with dexamethasone, which significantly improved survival rate and lung lesions in infected mice compared to those in control mice. Our data showed that corticosteroid treatment ameliorated acute lung injury induced by the 2009 A/H1N1 virus in mice and suggested that corticosteroids are valid drugs for treating 2009 A/H1N1 infection. CONCLUSIONS/SIGNIFICANCE: Using the established, very susceptible 2009 Pandemic Influenza A (H1N1 mouse model, our studies indicate that corticosteroids are a potential therapeutic remedy that may address the increasing concerns over future 2009 A/H1N1 pandemics.

  10. Narcolepsy with cataplexy after A/H1N1 vaccination – A case reported from Cuba

    Yaimi Rosales Mesa


    Full Text Available Narcolepsy with cataplexy is a rare sleep disorder with a neurological basis which has been recently linked to H1N1 vaccination either in children or adults. Cases from Europe, United States and Brasil were registered. Authors describe a case report of a 15 years old boy who developed narcolepsy with cataplexy after H1N1 vaccination in Havana. As far as it is concerned this is the first case reported from Cuba.

  11. Determinants of 2009 A/H1N1 influenza vaccination among pregnant women in Hong Kong.

    Tarrant, Marie; Wu, Kendra M; Yuen, Carol Yuet Shueng; Cheung, Ka Lun; Chan, Vincci Hiu Sze


    During the 2009–2010 A/H1N1 influenza pandemic, pregnant women infected with the virus experienced excess morbidity and mortality when compared with other groups. Once a vaccine was available, pregnant women were a priority group for vaccination. Only a few studies have reported on the uptake of 2009 A/H1N1 influenza vaccine among pregnant women during the pandemic and none were from Asia. The purpose of this study was to examine factors associated with 2009 A/H1N1 influenza vaccine uptake among pregnant women in Hong Kong. Using a multi-center, cross-sectional design, we recruited 549 postpartum women from four post-natal wards in Hong Kong over a 4-month period during the second wave of the A/H1N1 influenza pandemic in the winter and spring of 2010. Only 6.2% (n = 34) of participants had received the 2009 A/H1N1 influenza vaccine and 4.9% (n = 27) had received the seasonal influenza vaccine. The most common reasons for not receiving the 2009 A/H1N1 vaccine were fear of causing harm to themselves or their fetus. A high knowledge level (OR = 19.06; 95% CI 5.55, 65.48), more positive attitudes (OR = 3.52; 95% CI 1.37, 9.07), and having a family member who had the 2009 A/H1N1 influenza vaccine (OR = 7.69; 95% CI 2.92, 20.19) were independently and positively associated with vaccination. Study results show an unacceptably low uptake of the pandemic A/H1N1 influenza vaccine among pregnant women in Hong Kong. Interventions to increase influenza vaccine knowledge and uptake among this group should be a priority for future pandemic planning and seasonal vaccination campaigns.

  12. Thoracic computerized tomographic (CT findings in 2009 influenza A (H1N1 virus infection in Isfahan, Iran

    Mojtaba Rostami


    Full Text Available Background: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1 in an appropriate clinical setting. Methods: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23 rd 2009 to February 20 th 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1 virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. Results: Patchy infiltration (34.6%, lobar consolidation (30.8%, and interstitial infiltration (26.9% with airbronchogram (38.5% were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8% showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS. Conclusions: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1 in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific.

  13. Safety of the Pandemic H1N1 Influenza Vaccine among Pregnant U.S. Military Women and Their Newborns


    liveborn neo- nates resulting from these pregnancies were obtained by linking pregnancy episodes to V3x.xx-coded neo- natal hospital discharge records as...Naval Health Research Center Safety of the Pandemic H1N1 Influenza Vaccine among Pregnant Women and Their Newborns Ava M.S. Conlin Anna...Safety of the Pandemic H1N1 Influenza Vaccine Among Pregnant U.S. Military Women and Their Newborns Ava Marie S. Conlin, DO, MPH, Anna T. Bukowinski

  14. Antibodies against avian-like A (H1N1) swine influenza virus among swine farm residents in eastern China.

    Yin, Xiuchen; Yin, Xin; Rao, Baizhong; Xie, Chunfang; Zhang, Pengchao; Qi, Xian; Wei, Ping; Liu, Huili


    In 2007, the avian-like H1N1 virus (A/swine/Zhejiang/1/07) was first isolated in pigs in China. Recently, it was reported that a 3-year-old boy was infected with avian-like A (H1N1) swine influenza virus (SIV) in Jiangsu Province, China. To investigate the prevalence of avian-like A (H1N1) SIV infection among swine farm residents in eastern China, an active influenza surveillance program was conducted on swine farms in this region from May 21, 2010 through April 22, 2012. A total of 1,162 participants were enrolled, including 1,136 persons from 48 pig farms, as well as 26 pig farm veterinarians. A total of 10.7% and 7.8% swine farm residents were positive for antibodies against avian-like A (H1N1) SIV by HI and NT assay, respectively, using 40 as the cut-off antibody titer. Meanwhile, all the serum samples collected from a control of healthy city residents were negative against avian-like A (H1N1) SIV. As the difference in numbers of antibody positive samples between the swine farm residents and health city residents controls was statistically significant (P = 0.002), these data suggest that occupational exposure to pigs may increase swine farm residents' and veterinarians' risk of avian-like A (H1N1) SIV infection in eastern China. This study provides the first data on avian-like A (H1N1) SIV infections in humans in China; the potential for avian-like A (H1N1) SIV entering the human population should also be taken into consideration.

  15. On the roads to H1N1 pandemic era:drive safe and fearless using colour-coded masks

    M Shahid


    ABSTRACT Notwithstanding the end of2009 H1N1 pandemic, the threat for its revisit still persists andWHO has warned to remain vigilant. During that time the situation was more panicky than fatal. In this article, a suggestion to minimize the panic is provided by the usage of colour-coded masks and is proposed hereby as a“population segregation”approach in case of the revisit ofH1N1 or similar threatening respiratory viral infections.

  16. 许昌地区新型甲型H1N1流感合并细菌感染分析%Analyze on Novel A/H1N1 influenza infected by bacteria in Xuchang area

    任丽娟; 艾根伟


    目的 研究新型甲型H1N1流感患者合并细菌感染情况.方法 收集咽拭子标本800份,检测其甲型H1N1流感病毒RNA,同时做咽拭子的细菌培养,根据结果 分析甲型H1N1流感患者合并细菌感染及致病菌的药敏情况.结果 800份样本中423例H1N1 RNA阳性;其中73例合并不同的细菌感染,占甲流患者的17%,多数细菌的耐药性较强.结论 许昌地区2009年的甲流疫情中,甲流患者合并细菌感染的情况值得关注,治疗中要注意细菌培养并合理用药.%Objective To research the patients with Novel A/H1N1 who had infected by bacteria.Methods To collect 800 examples of fauces swabs and incubat the swabs and detect the novel A( H1N1 ) influenza virus RNA,on the basis of the results,we could analyze whether the novel A/H1N1 influenza patients infected by bacteria.Results There were 423 patients who had infected by novel A/H1N1 influenza and 73( 17% ) of them had co-infected by bacteria,most of the bacteria were drug fast.Conclusions During the epidemic disease of novel A/H1N1 influenza in Xuchang area in 2009, the co-infected by bacteria and A/H1N1 should be payed more attention, furthermore, we should gave our attention to germicultue and prescribe medicines in reason.

  17. Influenza A (H1N1 2009: Impact on Frankfurt in due consideration of health care and public health

    Groneberg David A


    Full Text Available Abstract Background In April 2009 a novel influenza A H1N1/2009 virus was identified in Mexico and in the United States which quickly spread around the world. Most of the countries established infection surveillance systems in order to track the number of (laboratory-confirmed H1N1 cases, hospitalizations and deaths. Methods The impact of the emergence of the novel pandemic (H1N1 2009 virus on Frankfurt was statistically evaluated by the Health Protection Authority, City of Frankfurt am Main. Vaccination rates of the health care workers (HCWs of the University Hospital Frankfurt were measured by the Occupational Health Service. Results Although the virulence of pandemic (H1N1 2009 seems to be comparable with seasonal influenza, a major patient load and wave of hospital admissions occurred in the summer of 2009. Even though the 2009 vaccination rate of the University Hospital Frankfurt (seasonal influenza [40.5%], swine flu [36.3%] is better than the average annual uptake of influenza vaccine in the German health care system (approximately 22% for seasonal and 15% for swine flu, vaccination levels remain insufficient. However, physicians were significantly (p Conclusions The outbreak of the pandemic (H1N1 2009 in April 2009 provided a major challenge to health services around the world. Nosocomial transmission of H1N1/2009 has been documented. Present experience should be used to improve pandemic preparedness plans and vaccination programs ought to target as many HCWs as possible.

  18. Genetic Characterization and Evolution of H1N1pdm09 after Circulation in a Swine Farm

    Arianna Boni


    Full Text Available Following the emergence of the A(H1N1pdm09 in humans, this novel influenza virus was reverse transmitted from infected people to swine population worldwide. In this study we investigated the molecular evolution of A(H1N1pdm09 virus identified in pigs reared in a single herd. Nasal swabs taken from pigs showing respiratory distress were tested for influenza type A and A(H1N1pdm09 by real-time RT-PCR assays. Virus isolation from positive samples was attempted by inoculation of nasal swabs samples into specific pathogen free embryonated chicken eggs (ECE and complete genome sequencing was performed on virus strains after replication on ECE or from original swab sample. The molecular analysis of hemagglutinin (HA showed, in four of the swine influenza viruses under study, a unique significant amino acid change, represented by a two-amino acid insertion at the HA receptor binding site. Phylogenetic analysis of HA, neuraminidase, and concatenated internal genes revealed a very similar topology, with viruses under study forming a separate cluster, branching outside the A(H1N1pdm09 isolates recognized until 2014. The emergence of this new cluster of A(H1N1pdm09 in swine raises further concerns about whether A(H1N1pdm09 with new molecular characteristics will become established in pigs and potentially transmitted to humans.

  19. H7N9 Influenza Virus Is More Virulent in Ferrets than 2009 Pandemic H1N1 Influenza Virus.

    Yum, Jung; Ku, Keun Bon; Kim, Hyun Soo; Seo, Sang Heui


    The novel H7N9 influenza virus has been infecting humans in China since February 2013 and with a mortality rate of about 40%. This study compared the pathogenicity of the H7N9 and 2009 pandemic H1N1 influenza viruses in a ferret model, which shows similar symptoms to those of humans infected with influenza viruses. The H7N9 influenza virus caused a more severe disease than did the 2009 pandemic H1N1 influenza virus. All of the ferrets infected with the H7N9 influenza virus had died by 6 days after infection, while none of those infected with the 2009 pandemic H1N1 influenza virus died. Ferrets infected with the H7N9 influenza virus had higher viral titers in their lungs than did those infected with the 2009 pandemic H1N1 influenza virus. Histological findings indicated that hemorrhagic pneumonia was caused by infection with the H7N9 influenza virus, but not with the 2009 pandemic H1N1 influenza virus. In addition, the lung tissues of ferrets infected with the H7N9 influenza virus contained higher levels of chemokines than did those of ferrets infected with the 2009 pandemic H1N1 influenza virus. This study suggests that close monitoring is needed to prevent human infection by the lethal H7N9 influenza virus.

  20. 浅析体育运动对预防甲型H1N1的作用




  1. 校园内甲型H1N1流感的护理及预防




  2. Emergence of influenza A (H1N1 PDM09 in the remote Islands of India - A molecular approach

    N Muruganandam


    Full Text Available Background: A disease outbreak of A (H1N1 PDM09 was reported in Andaman and Nicobar islands in 2009 with an attack rate of 33.5% among settler population and 26.3% among the aboriginal Nicobarese tribe. During the ongoing outbreak of A (H1N1 PDM09 disease in different parts of the world, a subject working in Dubai city of Saudi Arabia, came to Port Blair, following which the pandemic triggered for the first time in these Islands. Materials and Methods: During the period August 2009 to January 2011, 30 confirmed cases of Influenza A (H1N1 PDM09 virus infection was detected. To understand the genetic relationship, the NA gene sequences of the viruses were phylogenetically analysed together along with the virus sequence isolated from other parts of the world. Result: Formation of multiple clusters were observed, with the sequences of Andaman Islands, mainland India, Mexico, Saudi Arabia and few other counties clustering together. The sequence analysis data revealed that there was no specific mutation conferring resistance to oseltamivir among the Andaman A (H1N1 PDM09 virus isolates. The result of phylogenetic analysis have also revealed that the A (H1N1 PDM09 virus might have spread in these remote Islands of India via the subject from Saudi Arabia/Dubai. Conclusion: A (H1N1 PDM09 Influenza outbreak have highlighted the need to strengthen the region-specific pandemic preparedness plans and surveillance strategies.

  3. Identification of Suitable Natural Inhibitor against Influenza A (H1N1) Neuraminidase Protein by Molecular Docking

    Sahoo, Maheswata; Jena, Lingaraja; Rath, Surya Narayan


    The influenza A (H1N1) virus, also known as swine flu is a leading cause of morbidity and mortality since 2009. There is a need to explore novel anti-viral drugs for overcoming the epidemics. Traditionally, different plant extracts of garlic, ginger, kalmegh, ajwain, green tea, turmeric, menthe, tulsi, etc. have been used as hopeful source of prevention and treatment of human influenza. The H1N1 virus contains an important glycoprotein, known as neuraminidase (NA) that is mainly responsible for initiation of viral infection and is essential for the life cycle of H1N1. It is responsible for sialic acid cleavage from glycans of the infected cell. We employed amino acid sequence of H1N1 NA to predict the tertiary structure using Phyre2 server and validated using ProCheck, ProSA, ProQ, and ERRAT server. Further, the modelled structure was docked with thirteen natural compounds of plant origin using AutoDock4.2. Most of the natural compounds showed effective inhibitory activity against H1N1 NA in binding condition. This study also highlights interaction of these natural inhibitors with amino residues of NA protein. Furthermore, among 13 natural compounds, theaflavin, found in green tea, was observed to inhibit H1N1 NA proteins strongly supported by lowest docking energy. Hence, it may be of interest to consider theaflavin for further in vitro and in vivo evaluation. PMID:27729839

  4. Pandemic H1N1 2009 virus in Norwegian pigs naïve to influenza A viruses

    Germundsson, A.; Gjerset, B.; Hjulsager, Charlotte Kristiane

    In March-April 2009, a novel pandemic influenza A (H1N1) virus (pH1N1-09v) emerged in the human population. The first case of pH1N1v infection in pigs was reported from Canada in May 2009. In Norway, pH1N1v infection was recorded in a swine herd on the 10th of October of 2009. Here, we report...... showed clinical signs or iii) with a history of close contact with or close proximity to infected herds. In addition, blood samples were collected from nucleus and multiplier breeding herds. Detection of pH1N1-09v was initially performed using a real-time RT-PCR targeted to detect influenza A virus....... Positive samples were tested by a pH1N1-09v specific real-time RT-PCR. Blood samples were tested for presence of antibodies against influenza A virus by ELISA (IDVET) and positive samples in the ELISA were tested by haemagglutinin inhibition test using A/California/07/09 as antigen. From the onset...

  5. 一起寄宿制学校甲型H1N1流感暴发危险因素分析%Risk factors of influenza A(H1N1)outbreak in a boarding school

    陈希; 李铁钢; 柳洋; 狄飚; 袁俊; 王鸣


    目的 探讨一起甲型H1N1流感在寄宿制学校暴发的危险因素,为制定甲型H1N1流感疫情的防控措施提供科学依据.方法 采用RT-PCR方法以及血凝抑制试验,进行甲型H1N1流感病毒核酸及血清抗体检测;同时进行面对问卷调查并查阅校医门诊记录,运用病例对照研究,分析甲型H1N1流感病毒感染的危险因素.结果 一次疫情暴发后,学生甲型H1N1流感感染率为32.69%.X2检验表明,同班同学发热(OR=2.257,95%CI=1.664~3.060)、同宿舍室友发热(OR=2.270,95%CI=1.782~2.891)、宿舍每天开排气扇(OR=0.776,95%CI=0.617~0.976)、宿舍朝向与当时季节风向不一致(OR=1.417,95%CI=1.114~1.801)均与甲型H1N1流感感染有关.结论 加强晨检、及时发现传染源并采取单间隔离或居家隔离是控制甲型H1N1流感暴发疫情的重要手段,加强居室通风是切实可行的预防措施.%Objective To investigate the risk factors of influenza A ( H1N1 ) outbreak in a boarding school, and to provide scientific evidence for the prevention and control. Methods RT - PCR and hemngglutination inhibition test for pandemic influenza A ( H1 N1 ) virus were used to test the nucleic acid and serum antibody. Case-control study design was adopted to analyze the risk factors of influenza A ( H1N1 ) of infection. Results Afteran outhreak of influenza (H1N1), the prevalence of influenza A (H1N1) infection was32.69%. Having classmates who had afever ( OR = 2. 257, 95 % CI = 1. 664 - 3. 060 ), living with a roommate with fever ( OR = 2. 270, 95 % CI = 1. 782 - 2. 891 ), having ventilating fan in the dormitory ( OR = 0. 776, 95% CI = 0.617 - 0. 976 ), and the direction of the dormitory was inconsistent with current seasonal wind direction ( OR =1. 417, 95% CI = 1.114 - 1. 801 ) were all risk factors of influenza A ( H1N1 ). Conclusion Emphasizing morning check, discovering contngium timely and taking isolation or quarantine measures for the influenza

  6. Pandemic H1N1 influenza A directly induces a robust and acute inflammatory gene signature in primary human bronchial epithelial cells downstream of membrane fusion.

    Paquette, Stéphane G; Banner, David; Chi, Le Thi Bao; Leόn, Alberto J; Xu, Luoling; Ran, Longsi; Huang, Stephen S H; Farooqui, Amber; Kelvin, David J; Kelvin, Alyson A


    Pandemic H1N1 influenza A (H1N1pdm) elicits stronger pulmonary inflammation than previously circulating seasonal H1N1 influenza A (sH1N1), yet mechanisms of inflammatory activation in respiratory epithelial cells during H1N1pdm infection are unclear. We investigated host responses to H1N1pdm/sH1N1 infection and virus entry mechanisms in primary human bronchial epithelial cells in vitro. H1N1pdm infection rapidly initiated a robust inflammatory gene signature (3 h post-infection) not elicited by sH1N1 infection. Protein secretion inhibition had no effect on gene induction. Infection with membrane fusion deficient H1N1pdm failed to induce robust inflammatory gene expression which was rescued with restoration of fusion ability, suggesting H1N1pdm directly triggered the inflammatory signature downstream of membrane fusion. Investigation of intra-virion components revealed H1N1pdm viral RNA (vRNA) triggered a stronger inflammatory phenotype than sH1N1 vRNA. Thus, our study is first to report H1N1pdm induces greater inflammatory gene expression than sH1N1 in vitro due to direct virus-epithelial cell interaction.

  7. Ambient air quality monitoring during the H1N1 influence period in Pune (India).

    Pathak, M; Deshpande, A; Mirashe, P K; Sorte, R B; Ojha, A


    Ambient air quality in an urban area is directly linked with activity level in the city including transport, business and industrial activities. Maharashtra Pollution Control Board (MPCB) has established an ambient air quality network in the city including state-of-the-art continuous air quality monitoring stations which indicate short duration air quality variations for criteria and non-criteria pollutants. The influence of H1N1 outbreak in Pune hitting its worst pandemic condition, led the civic authorities to implement stringent isolation measures including closure of schools, colleges, business malls, cinema halls, etc. Additionally, the fear of such a pandemic brought the city to a stand still. It was therefore necessary to assess the impacts of such activity level on ambient air quality in the city. It has been observed that such events have positive impacts on air quality of the city. There was a decrease in PM concentration almost to the tune of 30 to 40% if the impacts of precipitation, i.e. seasonal variations, are taken into account. Similarly, the non criteria pollutants too showed a marked but unusual decrease in their concentrations in this ever growing city. The influence of these in turn led to lowered concentrations of secondary pollutants, i.e. O3. Overall, the ambient air quality of Pune was found to be improved during the study period.

  8. Factores genéticos en casos graves de gripe (H1N1 2009

    Francesc Calafell i Majó


    Full Text Available La pandemia de gripe (H1N1 2009 generó una serie de cuestiones, entre las cuales estuvo que entre un 25 y un 30% de los casos graves de gripe no presentaron ningún factor de riesgo obvio. Hipotetizamos que un elemento que puede contribuir a la respuesta son factores de riesgo gené ticos del huésped involucrados en la mala progresió n de la enfermedad. Varios indicios nos llevaron a esta hipótesis: estudios de agregación familiar en islandeses y mormones de Utah muestran una cierta heredabilidad de la mortalidad por gripe; se conocen casi 300 genes humanos necesarios para la replicació n del virus de la gripe; y los pacientes más graves de gripe (H1N12009 mostraron una desregulació n del sistema inmune adaptativo. Estamos abordando este problema mediante un diseñ o caso-control (casos hospitalizados de gripe (H1N12009 confirmados contra casos ambulatorios, tambié n confirmados para (H1N12009, en el que se genotiparán más de un milló n de polimorfismos de cambios de nucleó tido (SNPs y de variació n de número de copia (CNVs en casos y controles.

  9. Acute Respiratory Distress Syndrome (ARDS) from Endemic Influenza A/H1N1: Prehospital Management.

    Salihefendic, Nizama; Zildzic, Muharem; Ahmetagic, Sead


    Acute respiratory distress syndrome (ARDS) is a form of acute life threatening respiratory failure. In daily practice there is difficulty in diagnostic and therapeutic management of Acute respiratory distress syndrome (ARDS). We observed delay in diagnostic and therapeutic procedures in patients with clinical signs for the presence of severe respiratory disorders. Finding timely evidence of the presence the clinical signs of threatening ARDS and underlying diseases like influenza A/H1N1 during prehospital period in early stage of disease it is possible introduce early adequate treatment: high flow oxygen, fluid replacement and pharmacological and antiviral therapy. This measure can reduce high mortality in patients who develop ARDS. It is important to improve diagnostic criteria for a precise definition of ARDS and transfer it in practice of emergency and family medicine, microbiology, intensive care units, hospital departments of infectious and respiratory diseases. In this article we underlined the key elements of the new definition of ARDS, diagnostic criteria and the importance of early diagnosis in prehospital period following clinical feature and course (a presence of severe dyspnea) by adding chest x-ray and laboratory investigations.

  10. Economic impacts of a hypothetical H1N1 pandemic : a cross-sectional analysis.

    Smith, Braeton J.; Shaneyfelt, Calvin R.


    A NISAC study on the economic effects of a hypothetical H1N1 pandemic was done in order to assess the differential impacts at the state and industry levels given changes in absenteeism, mortality, and consumer spending rates. Part of the analysis was to determine if there were any direct relationships between pandemic impacts and gross domestic product (GDP) losses. Multiple regression analysis was used because it shows very clearly which predictors are significant in their impact on GDP. GDP impact data taken from the REMI PI+ (Regional Economic Models, Inc., Policy Insight +) model was used to serve as the response variable. NISAC economists selected the average absenteeism rate, mortality rate, and consumer spending categories as the predictor variables. Two outliers were found in the data: Nevada and Washington, DC. The analysis was done twice, with the outliers removed for the second analysis. The second set of regressions yielded a cleaner model, but for the purposes of this study, the analysts deemed it not as useful because particular interest was placed on determining the differential impacts to states. Hospitals and accommodation were found to be the most important predictors of percentage change in GDP among the consumer spending variables.

  11. 如何防控二代甲型H1N1流感

    张彦平; 冯录召



  12. Severe Respiratory Sequelae Of H1N1 : Clinical Features, Management And Outcome – A Review

    Ismail A Hamid


    Full Text Available Since the outbreak of the novel influenza H1N1 in April 2009 in Mexico, more then half a million cases have been recorded with more then 6000 deaths.In contrast to seasonal flu, this virus appears to have a predilection for the young, obese and pregnant.It’s most important and almost fatal complication is Acute Respiratory Distress Syndrome (ARDS. Intensive care units (ICU around the world have scrambled to upgrade various treatment modalities including high frequency oscillation ventilation, inotropes, antivirals and antibiotics in an effort to reduce the mortality arising out of this complication. More importantly, this complication appears reversible if adequate and early therapy is instituted. In particular, rescue therapies that allow the lung to rest appear to have brought success in some clinical settings. This article describes the experiences of seven centers that have used various modalities as rescue therapy in patients having Acute Respiratory Distress Syndrome (ARDS. The experiences in 13 patients at the University of Michigan, 58 in Mexico, 168 in Canada, 180 patients at Leicester UK, 194 in Australia and New Zealand and case reports from Hong Kong and Singapore are described.

  13. Influenza A(H1N1)pdm09 vaccination policies and coverage in Europe.

    Mereckiene, J


    In August 2010 the Vaccine European New Integrated Collaboration Effort (VENICE) project conducted a survey to collect information on influenza A(H1N1)pdm09 vaccination policies and vaccination coverage in the European Union (EU), Norway and Iceland. Of 29 responding countries, 26 organised national pandemic influenza vaccination and one country had recommendations for vaccination but did not have a specific programme. Of the 27 countries with vaccine recommendations, all recommended it for healthcare workers and pregnant women. Twelve countries recommended vaccine for all ages. Six and three countries had recommendations for specific age groups in children and in adults, countries for specific adult age groups. Most countries recommended vaccine for those in new risk groups identified early in the pandemic such as morbid obese and people with neurologic diseases. Two thirds of countries started their vaccination campaigns within a four week period after week 40\\/2009. The reported vaccination coverage varied between countries from 0.4% to 59% for the entire population (22 countries); 3% to 68% for healthcare workers (13 countries); 0% to 58% for pregnant women (12 countries); 0.2% to 74% for children (12 countries). Most countries identified similar target groups for pandemic vaccine, but substantial variability in vaccination coverage was seen. The recommendations were in accordance with policy advice from the EU Health Security Committee and the World Health Organization.

  14. H1N1 and TV News in Colombia: Risk Representations and Imaginaries

    Lina Mondragón Pérez


    Full Text Available The media play a significant role in public health issues, particularly when they become the main or one of the main sources of information for citizens. Their role is key in risk perceptions of the population no matters if it’s near or away from the actual risk. This work studied the forms of treatment that three Colombian news made of the topic of H1N1 flu in the early days that the news appeared in the media agenda. The analysis here allowed us to meet relevant elements of the position taken by the national news Noticias RCN, Noticias Caracol and CM& in the coverage of the virus, which was characterized by a tendency towards dramatization of the content shown in overexposure of the subject. We searched some elements to approach the representations given by the media and possible matches, and resonance with the public representations with this issue, related to this event and with more general aspects of health risks, whose importance is growing in Colombian and Latin-American media.

  15. 甲型H1N1流感在世界蔓延



    2009年2开始,墨西哥东部的Veracruz州,离首都墨西哥城5小时车程的La Gloria村,3000名居民中的116患了发热呼吸系统疾病。医务人员对当地30名呼吸疾病患者进行病毒检测。结果仅其中一位名叫Edgar Hemandez的5岁男孩,在4月被确诊为H1N1型猪流感病毒检测阳性,其他患者感染的病毒均是普通流感病毒H2N3。该村子附近共有8家卫生情况很差的养猪场,所以该村被认为是墨西哥猪流感疫情的爆发源。

  16. Issues in pharmacotherapy of 2009 H1N1 influenza infection

    Gupta Y


    Full Text Available The pandemic caused by the 2009 H1N1 influenza A virus has been a cause of great concern for healthcare professionals and the scientific community worldwide. Due to the widespread resistance of the virus to adamantanes, pharmacotherapy is currently limited to neuraminidase inhibitors, oseltamivir and zanamivir. The use of neuraminidase inhibitors in India is primarily associated with issues of patient and physician awareness, variability in disease management guidelines, safety and efficacy in the Indian population, need for active drug safety monitoring, and development of resistance due to possible misuse. In addition, other issues like availability of the drugs in retail and stockpiling by the public health authorities need careful introspection. The development of influenza vaccines in India and its adequate availability to the country′s populace also poses significant challenges in the management of the pandemic. In light of the limited therapeutic options available for the management of the disease, research on novel targets and pharmacological agents would also be beneficial in addressing the challenges of future outbreaks.

  17. Structural Characterization of the 1918 Influenza H1N1 Neuraminidase

    Xu, X.; Zhu, X.; Dwek, R.A.; Stevens, J.; Wilson, I.A.


    Influenza virus neuraminidase (NA) plays a crucial role in facilitating the spread of newly synthesized virus in the host and is an important target for controlling disease progression. The NA crystal structure from the 1918 'Spanish flu' (A/Brevig Mission/1/18 H1N1) and that of its complex with zanamivir (Relenza) at 1.65-{angstrom} and 1.45-{angstrom} resolutions, respectively, corroborated the successful expression of correctly folded NA tetramers in a baculovirus expression system. An additional cavity adjacent to the substrate-binding site is observed in N1, compared to N2 and N9 NAs, including H5N1. This cavity arises from an open conformation of the 150 loop (Gly147 to Asp151) and appears to be conserved among group 1 NAs (N1, N4, N5, and N8). It closes upon zanamivir binding. Three calcium sites were identified, including a novel site that may be conserved in N1 and N4. Thus, these high-resolution structures, combined with our recombinant expression system, provide new opportunities to augment the limited arsenal of therapeutics against influenza.

  18. Supply of neuraminidase inhibitors related to reduced influenza A (H1N1) mortality during the 2009-2010 H1N1 pandemic: summary of an ecological study.

    Miller, Paula E; Rambachan, Aksharananda; Hubbard, Roderick J; Li, Jiabai; Meyer, Alison E; Stephens, Peter; Mounts, Anthony W; Rolfes, Melissa A; Penn, Charles R


    When the influenza A (H1N1) pandemic spread across the globe from April 2009 to August 2010, many WHO Member States used antiviral drugs, specifically neuraminidase inhibitors (NAIs) oseltamivir and zanamivir, to treat influenza patients in critical condition. Antivirals have been found to be effective in reducing severity and duration of influenza illness, and likely reduce morbidity; however, it is unclear whether NAIs used during the pandemic reduced H1N1 mortality. To assess the association between antivirals and influenza mortality, at an ecologic level, country-level data on supply of oseltamivir and zanamivir were compared to laboratory-confirmed H1N1 deaths (per 100 000 people) from July 2009 to August 2010 in 42 WHO Member States. From this analysis, it was found that each 10% increase in kilograms of oseltamivir, per 100 000 people, was associated with a 1·6% reduction in H1N1 mortality over the pandemic period [relative rate (RR) = 0·84 per log increase in oseltamivir supply]. Each 10% increase in kilogram of active zanamivir, per 100 000, was associated with a 0·3% reduction in H1N1 mortality (RR = 0·97 per log increase). While limitations exist in the inference that can be drawn from an ecologic evaluation, this analysis offers evidence of a protective relationship between antiviral drug supply and influenza mortality and supports a role for influenza antiviral use in future pandemics. This article summarises the original study described previously, which can be accessed through the following citation: Miller PE, Rambachan A, Hubbard RJ, Li J, Meyer AE, et al. (2012) Supply of Neuraminidase Inhibitors Related to Reduced Influenza A (H1N1) Mortality during the 2009-2010 H1N1 Pandemic: An Ecological Study. PLoS ONE 7(9): e43491.

  19. 甲型 H1N1流感患者心理健康状况调查%Surveys of mental health status of H1N1 patients



    Objective To explore the mental health status of H1N1 patients in order to provide basis for clinical mental intervention .Methods Assessments were conducted with the Symptom Checklist-90 (SCL-90) in 71 H1N1 patients .Results T he total ,interpersonal relation ,anxiety and phobia score of the patients compared with national adult norm (P0 .05) .Conclusion Influenza A (H1N1) patients have such mental problems as interpersonal relation ,anxiety ,phobia and so on ,routine medication plus purposeful mental intervention has great significance for promoting patients’ early rehabilitation .%目的:探讨甲型 H1N1流感患者的心理健康状况,为临床心理干预提供依据。方法对71例甲型H1N1流感患者采用症状自评量表进行测评分析。结果甲型 H1N1流感患者症状自评量表总均分、人际关系敏感、焦虑及恐怖因子分显著高于国内成人常模( P<0.05或0.01),其他项目评分比较差异无显著性( P>0.05)。结论甲型 H1N1流感患者存在人际关系敏感、焦虑、恐怖等心理问题,在常规药物治疗的基础上联合有针对性的心理干预,对促进患者的早日康复具有重要意义。

  20. Co-infection of classic swine H1N1 influenza virus in pigs persistently infected with porcine rubulavirus.

    Rivera-Benitez, José Francisco; De la Luz-Armendáriz, Jazmín; Saavedra-Montañez, Manuel; Jasso-Escutia, Miguel Ángel; Sánchez-Betancourt, Ivan; Pérez-Torres, Armando; Reyes-Leyva, Julio; Hernández, Jesús; Martínez-Lara, Atalo; Ramírez-Mendoza, Humberto


    Porcine rubulavirus (PorPV) and swine influenza virus infection causes respiratory disease in pigs. PorPV persistent infection could facilitate the establishment of secondary infections. The aim of this study was to analyse the pathogenicity of classic swine H1N1 influenza virus (swH1N1) in growing pigs persistently infected with porcine rubulavirus. Conventional six-week-old pigs were intranasally inoculated with PorPV, swH1N1, or PorPV/swH1N1. A mock-infected group was included. The co-infection with swH1N1 was at 44 days post-infection (DPI), right after clinical signs of PorPV infection had stopped. The pigs of the co-infection group presented an increase of clinical signs compared to the simple infection groups. In all infected groups, the most recurrent lung lesion was hyperplasia of the bronchiolar-associated lymphoid tissue and interstitial pneumonia. By means of immunohistochemical evaluation it was possible to demonstrate the presence of the two viral agents infecting simultaneously the bronchiolar epithelium. Viral excretion of PorPV in nasal and oral fluid was recorded at 28 and 52 DPI, respectively. PorPV persisted in several samples from respiratory tissues (RT), secondary lymphoid organs (SLO), and bronchoalveolar lavage fluid (BALF). For swH1N1, the viral excretion in nasal fluids was significantly higher in single-infected swH1N1 pigs than in the co-infected group. However, the co-infection group exhibited an increase in the presence of swH1N1 in RT, SLO, and BALF at two days after co-infection. In conclusion, the results obtained confirm an increase in the clinical signs of infection, and PorPV was observed to impact the spread of swH1N1 in analysed tissues in the early stage of co-infection, although viral shedding was not enhanced. In the present study, the interaction of swH1N1 infection is demonstrated in pigs persistently infected with PorPV.

  1. Investigation of school H1N1 flu outbreak in Qinnan District of Qinzhou City%钦州市钦南区学校甲型H1N1流感暴发疫情调查

    沈平; 裴俊; 莫德凯; 廖开周; 滕辉


    目的 分析钦州市钦南区学校甲型H1N1流感暴发疫情情况,为控制学校甲型H1N1流感暴发疫情提供参考.方法 采用面对面个案调查和现场调查方法,对钦南区7起中小学校甲型H1N1流感暴发疫情的病例进行调查,分析病例的流行病学特征.结果 7起暴发疫情共报告急性流感样病例139例,采集其中22例病例的咽拭子经实验室检测,18例为甲型H1N1流感确诊病例;病例症状比较轻,以咳嗽(94.96%)、头痛(70.50%)、咽痛(48.92%)、头晕(38.85%)、乏力或酸痛(占42.45%)、流涕或鼻塞(占17.99%)为主,无死亡病例;病例全部为学生;男女生发病差异无统计学意义(P>0.05);住宿生与非住宿生患病率差异无统计学意义(P>0.05);未接种甲型H1N1流感疫苗的学生的罹患率高于接种的学生(P<0.01).结论 及早对可疑发热病例进行实验检测,早诊断、早隔离、早治疗病例,加强密切接触者的隔离与管理,可以有效控制甲型H1N1流感在学校的流行;甲型H1N1流感疫苗具有很好的免疫保护作用.%Objective To analyze school H1N1 flu outbreak in Qinnan District of Qinzhou and to provide evidence for prevention school influenza H1N1 outbreak. Methods By using face-to-face case investigation and field investigation method, the 7 cases of influenza A( H1N1 ) were investigated by descriptive epidemiological methods for epidemiological characteristics. Results A total of 139 patients were reported acute influenzalike cases, 18 of 22 cases' throat swabs were tested by laboratory testing for influenza H1N1 flu confirmed cases. All the cases were mild, which were mainly cough (94.96% ) , headache (70.50% ) , pharynx pain (48.92% ), dizziness (38.85% ), exhaustion or ache (42.45% ), runny or rhinostegnosis( 17.99% ) , there were no deaths. Cases were all for students. The pathogenic difference between men and women without statistically significant meaning( P >0.05 ). The prevalence had no




    [目的]通过对青海省2009年甲型H1N1流感进行疫情资料的分析,为制定防治对策提供科学依据.[方法]运用描述流行病学方法描述甲型H1N1流感的流行病学特征,采用Excel软件进行统计分析.[结果]青海省2009年共报告甲型H1N1流感2109例,死亡7例,发病率为38.05/10万,死亡率为0.13/10万,病死率为0.33%:发病率居甲、乙类传染病第3位.病例主要集中在人口比较集中的西宁市和海东地区;发病高峰期在9~10月份,占全年甲型H1N1流感发病数的86.11%;发病年龄以8~24岁组青少年为主,占总病例数的80.56%;男性发病率显著高于女性,男、女性别发病数之比为1.68∶1.[结论]2009年甲型H1N1流感发病率较高,发病以8~24岁青少年为主,职业主要以学生为主,防治的重点应放在人口比较密集的场所,学生为甲型H1N1流感发病的高危人群.接种甲型H1N1流感疫苗是预防和控制甲型H1N1流感的重要措施之一.%[Objective] To analyze the epidemic data of A (H1N1) influenza in 2009 in Qinghai province, and provide evidence for the implementation of control strategies. [Methods] The epidemiological characteristics of A (H1N1) influenza were analyzed by descriptive epidemiological method, and data was analyzed by Excel 2003, [Results] It was shown that 2109 influenza A (H1N1) cases were reported in 2009 in Qinghai province, the incidence rate was 38.05/100 000. A total of 7 death cases reported, and the mortality rate was 0.13/100 000 and the fatality rate was 0.33%. The incidence rate of A (HIM) influenza ranked the third of infectious diseases A and B, The cases mainly concentrated in Xining City and Haidong District with relatively dense population. The season peak appeared from September to October, which accounted for 86.11% of the total cases. The person aged 8 to 24 years old were affected easily, which accounted for 80.56% of the total cases. The incidence rate in males was

  3. Analyzing on variation of influenza A(H1N1)in Minhang district in Shanghai%上海市闵行区甲型H1N1流感病毒株变异分析

    杨丽华; 王小光; 丁克颖; 骆邻飞; 吴菊英


    Objective:To investigate the genetic and antigenic variation of influenza A (H1N1 ) in Minhang area, and provide evidence for the prevention and control of the disease. Methods: Nasopharyngeal swabs from influenza - like - illness were collected in Sentinel hospitals in minhang from August 2009 - March 2011, and detected by real - time RT - PCR. Viruses were isolated with MDCK cells and identified with haemagglutination inhibition test (HI). HA and PB2 genes of partial influenza A ( H1N1 ) virus were sequenced, to analysis the variation on genes and amino acid sites. Results: The first outbreaks of influenze A ( H1N1 ) occurred in August 2009 - March 2010, 232 cases of influenza A ( H1N1 ) were reported, the proportion of influenze A (H1N1) cases among all patients was 54.33%. The second outbreaks of influenze A (H1N1) occurred in december 2010 -March 2011, 71 cases of influenza A ( H1N1 ) were reported, the proportion of influenze A ( H1N1 ) cases among all patients was 62.83%. The HA phylogenetic tree of influenza A (H1N1 ) showed that ,the viruses isolated from first outbreaks of influenze A (H1N1 ) was not in the same trunk with the second, Variation of HA occurs to some extent. The analysis of amino acid sites on HA showed that, the antigenic site of some strains were changed during the second epidemic process. Analysis on the amino acid of PB2 protein showed the residues at the positions 627 and 701 were Glutamic acid and Aspartic acid respectively ,which were the amino acid site of avian flu PB2 protein, but the mutation of residues were E677G. Conclusion: Variation occurs in Minhang district between the viruses strains isolated from causative influenze H1N1 in the spring season of 2011 from the pandemic influenza in North America, and antigenic drift strains and adaptive evolution appeared.%目的:了解上海市闵行区人群中甲型H1N1流感病毒株基因特性及抗原变异情况,为甲型H1N1流感防控提供科学依据.方法:采集2009年8

  4. The Prevention and Control of Type A H1N1 Influenza for Hospital Outpatient%医院门诊甲型H1N1流感的预防控制



    Type A H1N1 influenza as acute respiratory infections,the pathogen is a new type of type A H1N1 viruses,the flu season is winter and spring,out-patients as the hospital’s first pass through preflight triage,vaccination and other measures to reduce cross infection in hospitals or reducing influenza morbidity.%  甲型H1N1流感为急性呼吸道传染病,其病原体是一种新型的甲型H1N1流感病毒,冬春季为流感多发季节,门诊作为患者进入医院的第一道关口,通过采取预检分诊、预防接种等措施减少医院内交叉感染或减少甲型H1N1流感发病率。

  5. 2009-2011年珠海市甲型H1N1流感流行特征分析%Analysis of prevalent features of influenza A ( H1N1 ) in Zhuhai City,2009-2011

    徐郁; 周伴群; 周勇; 焦亮; 李德云; 谭爱军


    Objective To analyze the epidemiological characteristics of pandemic influenza A (H1N1 ) in Zhuhai City, and provide a scientific basis for prevention and control. Methods We established 28 influenza-like illness (ILI) sentinels, 14 influenza pathogen surveillance sites and 8 pneumonia inpatients sentinels in Zhuhai City to collect data of ILI outpatients and was inpatients with pneumonia. The specimens were detected for influenza A ( H1N1 ) pathogen by reverse transcriptase polymerase chain reaction method. We used descriptive epidemiological methods to analyze the epidemiological characteristics of the influenza A (H1N1). Results A total of 173 451 ILI cases were reported and 3 598 cases was detected, and 531 influenza A ( H1N1 ) cases (302 male, 229 female) were confirmed, accounting for 14. 76%. 41 cases and 1 death were infected with A (H1N1) among 1 006 inpatients of pneumonia. The children aged below 10 years were accounted for 77. 21% (410/531 ) of the out-patient number of confirmed cases, 11-20 year-old group accounted for 17.51% (93/531). The prevalence of H1N1 influenza virus infection in 11 -20 and 21-30 age groups was the highest, accounted for 37. 35% (93/249 ) and 16.67% (17/102). On the occupational distribution the positive rate followed by students 30. 65% (213/695), kindergarten children 15.04% (186/1 237). The isolation rates of influenza A ( H1 N1) were 29.32% (78/266), 31.37% (48/153), 60.70% (139/229), and 40.63% (45/160) from September to December 2009, respectively. The number of cases of influenza A ( H1N1 ) and ILI were linear positively correlated, and the multiple correlation coefficient was 0. 51 (P < 0.05 ). The average interval between the onset and seeking medical treatment for influenza A ( H1N1) was 0. 11 day. Respiratory symptoms as the main symptoms of the clinical manifestations were fever ( 100. 00% , 531/531 ), cough (60. 83% , 323/531) , sore throat (56.31% , 299/531) , and other respiratory symptoms. Pneumonia was

  6. Influenza A(H1N1) Oseltamivir Resistant Viruses in the Netherlands During the Winter 2007/2008

    Dijkstra, Frederika; Jonges, Marcel; van Beek, Ruud; Donker, Gé A; Schellevis, François G; Koopmans, Marion; van der Sande, Marianne A.B; Osterhaus, Albert D.M.E; Boucher, Charles A.B; Rimmelzwaan, Guus F; Meijer, Adam


    Background: Antiviral susceptibility surveillance in the Netherlands was intensified after the first reports about the emergence of influenza A(H1N1) oseltamivir resistant viruses in Norway in January, 2008. Methods: Within the existing influenza surveillance an additional questionnaire study was performed to retrospectively assess possible risk factors and establish clinical outcome of all patients with influenza virus A(H1N1) positive specimens. To discriminate resistant and sensitive viruses, fifty percent inhibitory concentrations for the neuramidase inhibitors oseltamivir and zanamivir were determined in a neuraminidase inhibition assay. Mutations previously associated with resistance to neuramidase inhibitors and M2 blockers (amantadine and rimantadine) were searched for by nucleotide sequencing of neuraminidase and M2 genes respectively. Results: Among 171 patients infected with A(H1N1) viruses an overall prevalence of oseltamivir resistance of 27% (95% CI: 20-34%) was found. None of influenza A(H1N1) oseltamivir resistant viruses tested was resistant against amantadine or zanamivir. Patient characteristics, underlying conditions, influenza vaccination, symptoms, complications, and exposure to oseltamivir and other antivirals did not differ significantly between patients infected with resistant and sensitive A(H1N1) viruses. Conclusion: In 2007/2008 a large proportion of influenza A(H1N1) viruses resistant to oseltamivir was detected. There were no clinical differences between patients infected with resistant and sensitive A(H1N1) viruses. Continuous monitoring of the antiviral drug sensitivity profile of influenza viruses is justified, preferably using the existing sentinel surveillance, however, complemented with data from the more severe end of the clinical spectrum. In order to act timely on emergencies of public health importance we suggest setting up a surveillance system that can guarantee rapid access to the latter. PMID:22253652

  7. [Colorimetric detection of human influenza A H1N1 virus by reverse transcription loop mediated isothermal amplification].

    Nie, Kai; Wang, Da-Yan; Qin, Meng; Gao, Rong-Bao; Wang, Miao; Zou, Shu-Mei; Han, Feng; Zhao, Xiang; Li, Xi-Yan; Shu, Yue-Long; Ma, Xue-Jun


    A simple, rapid and sensitive colorimetric Reverse Transcription Loop Mediated Isothermal Amplification (RT-LAMP) method was established to detect human influenza A H1N1 virus. The method employed a set of six specially designed primers that recognized eight distinct sequences of the HA gene for amplification of nucleic acid under isothermal conditions at 65 degrees C for one and half hour. The amplification process of RT-LAMP was monitored by the addition of HNB (Hydroxy naphthol blue) dye prior to amplification. A positive reaction was indicated by a color change from violet to sky blue and confirmed by agarose electrophoresis. The specificity of the RT-LAMP assay was validated by cross-reaction with different swine and human influenza virus including human seasonal influenza A /H1N1 A /H3N2, influenza B and swine A /H1N1. The sensitivity of this assay was evaluated by serial dilutions of RNA molecules from in vitro transcription of human influenza A H1N1 HA gene. The assay was further evaluated with 30 clinical specimens with suspected pandemic influenza A H1N1 virus infection in parallel with RT-PCR detection and 26 clinical specimens with seasonal influenza virus infection. Our results showed that the RT-LAMP was able to achieve a sensitivity of 60 RNA copies with high specificity, and detection rate was comparable to that of the RT-PCR with the clinical samples of pandemic influenza A H1N1 infection. The RT-LAMP reaction with HNB could also be measured at 650nm in a microplate reader for quantitative analysis. Thus, we concluded that this colorimetric RT-LAMP assay had potential for the rapid screening of the human influenza A H1N1 virus infection in National influenza monitoring network laboratories and sentinel hospitals of provincial and municipal region in China.

  8. Cytokine responses in patients with mild or severe influenza A(H1N1)pdm09.

    Bradley-Stewart, A; Jolly, L; Adamson, W; Gunson, R; Frew-Gillespie, C; Templeton, K; Aitken, C; Carman, W; Cameron, S; McSharry, C


    Influenza virus affects millions of people worldwide each year. More severe infection occurs in the elderly, very young and immunocompromised. In 2009, a new variant of swine origin (influenza A(H1N1)pdm09 virus) emerged that produced severe disease in young healthy adults. The aim of this study was to determine whether cytokine concentrations are associated with clinical outcome in patients infected influenza A(H1N1)pdm09 virus. Plasma concentration of 32 cytokines and growth factors were measured using a multiplex bead immunoassay and conventional ELISA in four patient groups. Patients with severe and mild influenza A(H1N1)pdm09 virus infection, rhinovirus infection and healthy volunteers were investigated. In addition, serial samples of respiratory secretions from five patients with severe influenza A(H1N1)pdm09 virus infection were examined. The majority of cytokines measured were elevated in patients with viral respiratory infections compared to the healthy controls. Concentrations of IL-6, IL-10, IL-15, IP-10, IL-2R, HGF, ST2 and MIG were significantly higher (p<0.05) and EGF significantly lower (p=0.0001) in patients with severe influenza A(H1N1)pdm09 virus infection compared to those with mild influenza A(H1N1)pdm09 virus and rhinovirus infection. A number of cytokines were found to be substantially elevated in patients with severe influenza A(H1N1)pdm09 virus infection. This supports and extends other published work suggesting a role for proinflammatory cytokines in influenza-induced lung pathology. Interestingly, EGF was significantly lower in patients with severe infection suggesting it is actively suppressed. As EGF has a role in role in cell proliferation and tissue repair, it may protect the lung from host or virus mediated damage. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Attitudes toward vaccination and the H1N1 vaccine: poor people's unfounded fears or legitimate concerns of the elite?

    Peretti-Watel, Patrick; Raude, Jocelyn; Sagaon-Teyssier, Luis; Constant, Aymery; Verger, Pierre; Beck, François


    In 2009-2010, the H1N1 episode occurred in a general context of decreasing public confidence in vaccination. We assumed opposition to vaccination in general to be an 'unfounded fear', reflecting ignorance and perceived vulnerability among low-socioeconomic status (SES) people, and opposition to the H1N1 vaccine a 'legitimate concern' reflecting the elite's commitment to 'risk culture' in a 'risk society'. We indirectly tested these assumptions by investigating the socioeconomic profiles associated with opposition to vaccination in general and opposition to the H1N1 vaccine specifically. Our second aim was to determine whether or not opposition to the H1N1 vaccine fuelled opposition to vaccination in general. We used data from a telephone survey conducted in 2009-2010 among a random sample of French people aged 15-79 (N = 9480). Attitudes toward vaccination in general and toward the H1N1 vaccine specifically varied significantly between October 2009 and June 2010 with strong correlation being observed between these attitudes throughout the whole period. In multivariable analysis attitudes toward vaccination in general remained a significant predictor of attitudes to the H1N1 vaccine and vice versa, for distinct profiles as follows: males, older people, low-SES people for opposition to vaccination in general, versus females, people aged 35-49 and those with an intermediate SES for opposition to the H1N1 vaccine. Results also differed regarding indicators of social vulnerability, proximity to preventive medicine and vaccination history. The first profile supported the "unfounded fears expressed by low-SES people" hypothesis, while the second echoed previous work related to middle-classes' "healthism". Opposition to vaccination should not be reduced to irrational reactions reflecting ignorance or misinformation and further research is needed to acquire a greater understanding of the motives of opponents.

  10. Melissa offiinalis effiacy against human inflenza virus (New H1N1 in comparison with oseltamivir

    Parvane Jalali


    Full Text Available Objective: To evaluate the antiviral activity of Melissa officinalis (MO extract against the influenza virus H1N1 in vitro. Methods: The cytotoxicity of MO extract was identified on Madin-Darby canine kidney (MDCK cell culture by MTT assay. The virus was inoculated to the cells (multiplicity of infection = 0.1 in two protocols. In protocol 1, the MO extracts at concentrations of 0.005, 0.050, 0.010, 0.100 and 0.500 mg/mL were incubated with the virus for one hour preinoculation. In protocol 2, the mentioned concentrations of MO extracts were added to the cells one-hour post infection. Furthermore, the antiviral effect of oseltamivir with different concentrations was tested as the positive controls. The 50% tissue culture infective dose, neutralizing index and hemagglutination titer were determined. Results: The medicine oseltamivir and MO extracts were not toxic for MDCK at concentrations less than 1 mg/mL. All utilized concentrations of MO extracts were vigorously efficient to decrease the viral yield in both experiments. The 50% tissue culture infective dose of the groups containing up to 0.100 mg/mL of MO extracts in the first experiment in compare with 0.050 mg/mL in the second experiment reduced to 0. Although hemagglutination tests showed little titers, the viral quantity significantly decreased in both experiments. By the way, the medicine oseltamivir could completely suppress viral replication in MDCK. Conclusions: The present study suggests that MO extracts have a potent anti-influenza effect in cell culture.

  11. The challenges of global case reporting during pandemic A(H1N1) 2009.

    Williams, Stephanie; Fitzner, Julia; Merianos, Angela; Mounts, Anthony


    During the 2009 A(H1N1) influenza pandemic, the World Health Organization (WHO) asked all Member States to provide case-based data on at least the first 100 laboratory-confirmed influenza cases to generate an early understanding of the pandemic and provide appropriate guidance to affected countries. In reviewing the pandemic surveillance strategy, we evaluated the utility of case-based data collection and the challenges in interpreting these data at the global level. To do this, we assessed compliance with the surveillance recommendation and data completeness of submitted case records and described the epidemiological characteristics of up to the first 110 reported cases from each country, aggregated into regions. From April 2009 to August 2011, WHO received over 18 000 case records from 84 countries. Data reached WHO at different time intervals, in different formats and without information on collection methods. Just over half of the 18 000 records gave the date of symptom onset, which made it difficult to assess whether the cases were among the earliest to be confirmed. Descriptive epidemiological analyses were limited to summarizing age, sex and hospitalization ratios. Centralized analysis of case-based data had little value in describing key features of the pandemic. Results were difficult to interpret and would have been misleading if viewed in isolation. A better approach would be to identify critical questions, standardize data elements and methods of investigation, and create efficient channels for communication between countries and the international public health community. Regular exchange of routine surveillance data will help to consolidate these essential channels of communication.

  12. The effect of risk perception on the 2009 H1N1 pandemic influenza dynamics.

    Piero Poletti

    Full Text Available BACKGROUND: The 2009 H1N1 pandemic influenza dynamics in Italy was characterized by a notable pattern: as it emerged from the analysis of influenza-like illness data, after an initial period (September-mid-October 2009 characterized by a slow exponential increase in the weekly incidence, a sudden and sharp increase of the growth rate was observed by mid-October. The aim here is to understand whether spontaneous behavioral changes in the population could be responsible for such a pattern of epidemic spread. METHODOLOGY/PRINCIPAL FINDINGS: In order to face this issue, a mathematical model of influenza transmission, accounting for spontaneous behavioral changes driven by cost/benefit considerations on the perceived risk of infection, is proposed and validated against empirical epidemiological data. The performed investigation revealed that an initial overestimation of the risk of infection in the general population, possibly induced by the high concern for the emergence of a new influenza pandemic, results in a pattern of spread compliant with the observed one. This finding is also supported by the analysis of antiviral drugs purchase over the epidemic period. Moreover, by assuming a generation time of 2.5 days, the initially diffuse misperception of the risk of infection led to a relatively low value of the reproductive number , which increased to in the subsequent phase of the pandemic. CONCLUSIONS/SIGNIFICANCE: This study highlights that spontaneous behavioral changes in the population, not accounted by the large majority of influenza transmission models, can not be neglected to correctly inform public health decisions. In fact, individual choices can drastically affect the epidemic spread, by altering timing, dynamics and overall number of cases.

  13. Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe.

    Matsuishi, Kunitaka; Kawazoe, Ayako; Imai, Hissei; Ito, Atsushi; Mouri, Kentaro; Kitamura, Noboru; Miyake, Keiko; Mino, Koichi; Isobe, Masanori; Takamiya, Shizuo; Hitokoto, Hidefumi; Mita, Tatsuo


    In order for hospitals to work efficiently in a pandemic, it is important to know how a pandemic affects the hospital staff. The aim of the present study was to investigate the psychological impact of the pandemic (H1N1) 2009 on hospital workers and how it was affected by the characteristics of the hospital, gender, age, job and work environment. In late June 2009, soon after the pandemic had ended in Kobe city, Japan, a questionnaire was distributed consisting of questions on sociodemographic characteristics, 19 stress-related questions and the Impact of Event Scale (IES) to all 3635 employees at three core general hospitals in Kobe. Exploratory factor analysis was applied to the 19 stress-related questions, and this produced four factors for evaluation (anxiety about infection, exhaustion, workload, and feeling of being protected). Multiple regression models were used to evaluate the association of personal characteristics with each score of the four factors and the IES. Valid answers were received from 1625 employees. Workers at a hospital with intense liaison psychiatric services felt less psychological impact. Workers at a hospital that provided staff with information about the pandemic less frequently, felt unprotected. Workers in work environments that had a high risk of infection felt more anxious and more exhausted. The total IES score was higher in workers in high-risk work environments. It is important for hospitals to protect hospital workers during a pandemic and to rapidly share information about the pandemic. Liaison psychiatric services can help to reduce the impact of the pandemic on hospital workers. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.


    杨慧宁; 王鲜平; 吕晓丽; 高敏; 曹力; 张娜


    Objective To study control measures for H1N1 influenza nosocomial infections in a large general hospital.Methods The key management and integrated intervention measures, such as protective isolation and strict disinfection measures, were implemented according to the epidemiologie survey.Results lsolation and protective measures for patients and medical staff respectively and strict disinfection measures were taken.386 cases (including 29 cases that diagnosed in hospital) were accepted as H1N1 influenza in 2009 in the hospital.There was no horizontal propagation among patients and no nosocomial infections among hospital staff.Conclusion Zero target of H1N1 influenza nosocomial infections is achieved through integrated management measures.%目的 研究大型综合医院甲型H1N1流感院内感染控制措施.方法 根据流行病学调查资料,有针对性地采取重点管理和消毒隔离综合措施.结果 通过对病人和医护人员分别隔离保护措施以及严格执行消毒隔离措施,本院2009年度共接诊甲型 H1N1 流感确诊病例386例(含住院确诊29例),未发生病人间横向传播,亦没有医院内工作人员感染.结论 通过实施感染综合管理措施,实现了大量接诊甲型H1N1流感病人的医院内零感染目标.

  15. 63例甲型H1N1流感重症患者的护理体会%Nursing experience of 63 critical ill patients with influenza A H1N1

    顾平; 王美兰; 陆玉梅; 韩建平


    Objective To investigate the nursing methods for critically ill patients with influenza A H1N1. Methods 63 critically ill patient's clinical data with influenza A H1N1 were reviewed, and the clinical features were studied. To apply mental nursing according to individual character, monitor patient's condition closely, implement oxygen therapy, reinforce the management of airway and fluid infusion, recruitment maneuver nursing and enforce standard precautions.Results All patients were cured. No one developed nursing complication and hospital infection.Conclusion Rational therapy together with careful nursing ensured the remedy success of critically ill patients with influenza A H1N1.%目的 探讨甲型H1N1流感重症患者的护理方法.方法 回顾63例甲型H1N1流感重症患者临床资料,根据所有重症病例的临床特点,针对患者的个性化特点提供心理护理,严密监测病情,落实氧疗,加强气道管理,注重液体管理,做好肺复张的护理,实施标准预防.结果 所有病例均获得痊愈出院,未发生护理并发症及院内感染.结论 合理的临床治疗加上周密细致的护理是甲型H1N1流感重症患者救治成功的保证.

  16. Mathematical modeling of the effectiveness of facemasks in reducing the spread of novel influenza A (H1N1.

    Samantha M Tracht

    Full Text Available On June 11, 2009, the World Health Organization declared the outbreak of novel influenza A (H1N1 a pandemic. With limited supplies of antivirals and vaccines, countries and individuals are looking at other ways to reduce the spread of pandemic (H1N1 2009, particularly options that are cost effective and relatively easy to implement. Recent experiences with the 2003 SARS and 2009 H1N1 epidemics have shown that people are willing to wear facemasks to protect themselves against infection; however, little research has been done to quantify the impact of using facemasks in reducing the spread of disease. We construct and analyze a mathematical model for a population in which some people wear facemasks during the pandemic and quantify impact of these masks on the spread of influenza. To estimate the parameter values used for the effectiveness of facemasks, we used available data from studies on N95 respirators and surgical facemasks. The results show that if N95 respirators are only 20% effective in reducing susceptibility and infectivity, only 10% of the population would have to wear them to reduce the number of influenza A (H1N1 cases by 20%. We can conclude from our model that, if worn properly, facemasks are an effective intervention strategy in reducing the spread of pandemic (H1N1 2009.

  17. Effect of short-term school closures on the H1N1 pandemic in Japan: a comparative case study.

    Uchida, M; Tsukahara, T; Kaneko, M; Washizuka, S; Kawa, S


    The 2009 worldwide influenza A/H1N1 pandemic particularly affected younger people, including schoolchildren. We assessed the effects of class/school closure during the pandemic on the spread of H1N1 infection in Japan. We prospectively monitored 2,141 schoolchildren in 57 classes at two elementary schools and two junior high schools in Japan, and evaluated the effects of class/school closures on the spread of H1N1 using descriptive epidemiological methods. The cumulative rate of H1N1 infection among these children was 40.9% (876 children). There was a total of 53 closures of 40 classes, including school closures, during the pandemic. Time-course changes in the epidemic curve showed that school closure reduced the following epidemic peak more than class closure. A Poisson regression model showed that a longer duration of closure was significantly related to decreased H1N1 occurrence after the resumption of classes. School closure more effectively inhibits subsequent epidemic outbreaks than class closure. Longer school closures are effective in reducing the spread of infection, and school closure should be implemented as early as possible.

  18. Haemagglutinin and nucleoprotein replicon particle vaccination of swine protects against the pandemic H1N1 2009 virus.

    Vander Veen, R L; Mogler, M A; Russell, B J; Loynachan, A T; Harris, D L H; Kamrud, K I


    The recent emergence of the pandemic H1N1 (pH1N1) and H3N2 variant influenza A viruses (IAV) in 2009 and 2011-2012, respectively, highlight the zoonotic potential of influenza viruses and the need for vaccines capable of eliciting heterosubtypic protection. In these studies, single-cycle, propagation-defective replicon particle (RP) vaccines expressing IAV haemagglutinin (HA) and nucleoprotein (NP) genes were constructed and efficacy was evaluated in homologous and heterologous pig challenge studies with the pH1N1 2009 influenza virus (A/California/04/2009). Homologous HA RP vaccination eliminated virus shedding and decreased pulmonary pathology in pigs following pH1N1 2009 challenge. An RP vaccine expressing an H3N2-derived NP gene was able to decrease nasal shedding and viral load following heterosubtypic pH1N1 2009 challenge in pigs. These studies indicate that although homologous vaccination of swine remains the most effective means of preventing IAV infection, other vaccine alternatives do offer a level of heterosubtypic protection, and should continue to be evaluated for their ability to provide broader protection.

  19. PLC-γ1 is involved in the inflammatory response induced by influenza A virus H1N1 infection.

    Zhu, Liqian; Yuan, Chen; Ding, Xiuyan; Xu, Shuai; Yang, Jiayun; Liang, Yuying; Zhu, Qiyun


    We have previously reported that phosphoinositide-specific phospholipase γ1 (PLC-γ1) signaling is activated by influenza virus H1N1 infection and mediates efficient viral entry in human epithelial cells. In this study, we show that H1N1 also activates PLCγ-1 signaling in human promonocytic cell line -derived macrophages. Surprisingly, the activated PLCγ-1 signaling is not important for viral replication in macrophages, but is involved in the virus-induced inflammatory responses. PLC-γ1-specific inhibitor U73122 strongly inhibits the H1N1 virus-induced NF-κB signaling, blocking the up-regulation of TNF-α, IL-6, MIP-1α, and reactive oxidative species. In a positive feedback loop, IL-1β and TNF-α activate the PLCγ-1 signaling in both epithelial and macrophage cell lines. In summary, we have shown for the first time that the PLCγ-1 signaling plays an important role in the H1N1-induced inflammatory responses. Our study suggests that targeting the PLCγ-1 signaling is a potential antiviral therapy against H1N1 by inhibiting both viral replication and excessive inflammation.

  20. Differentiation of human influenza A viruses including the pandemic subtype H1N1/2009 by conventional multiplex PCR.

    Furuse, Yuki; Odagiri, Takashi; Okada, Takashi; Khandaker, Irona; Shimabukuro, Kozue; Sawayama, Rumi; Suzuki, Akira; Oshitani, Hitoshi


    April 2009 witnessed the emergence of a novel H1N1 influenza A virus infecting the human population. Currently, pandemic and seasonal influenza viruses are co-circulating in human populations. Understanding the course of the emerging pandemic virus is important. It is still unknown how the novel virus co-circulates with or outcompetes seasonal viruses. Sustainable and detailed influenza surveillance is required throughout the world including developing countries. In the present study, a multiplex PCR using four primers was developed, which was designed to differentiate the pandemic H1N1 virus from the seasonal H1N1 and H3N2 viruses, to obtain amplicons of different sizes. Multiplex PCR analysis could clearly differentiate the three subtypes of human influenza A virus. This assay was performed using 206 clinical samples collected in 2009 in Japan. Between February and April, four samples were subtyped as seasonal H1N1 and four as seasonal H3N2. All samples collected after July were subtyped as pandemic H1N1. Currently, pandemic viruses seem to have replaced seasonal viruses almost completely in Japan. This is a highly sensitive method and its cost is low. Influenza surveillance using this assay would provide significant information on the epidemiology of both pandemic and seasonal influenza.

  1. High-resolution Computed Tomography Findings of H1N1 Influenza-Associated Pneumonia in Korea

    Lee, Byung Chan; Choi, Song; Kim, Jin Woong; Lim, Hyo Soon [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Kwangju (Korea, Republic of); Seon, Hyung Joo; Shin, Sang Soo [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Kwangju (Korea, Republic of); Kim, Yun Hyeon; Park, Kyung Hwa [Dept. of Internal Medicine, Chonnam National University Hospital, Chonnam National University School of Medicine, Kwangju (Korea, Republic of)


    To evaluate and compare the high-resolution computed tomography (HRCT) findings of patients with H1N1 influenza-associated pneumonia compared usual community acquired pneumonia (CAP), to determi