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Characteristics of pandemic influenza A (H1N1) infection in patients presenting to a university hospital in Riyadh, Saudi Arabia
BinSaeed Abdulaziz
Annals of Saudi Medicine , 2010,
Abstract: Background and Objectives : A national plan of management for flu-like illnesses was developed by the Saudi Ministry of Health after the first outbreak in Saudi Arabia in June. We describe the clinical presentation of the H1N1 cases attending King Khalid University Hospital (KKUH) between July through September 2009 and identify the high-risk age groups. Methods : All patients presenting with influenza-like illnesses (ILI) in the H1N1 clinics during the specified period were clinically examined and tested using reverse transcription polymerase chain reaction (RT-PCR). Those who were clinically diagnosed and confirmed positive for novel influenza A (H1N1) were included in the study. Results : Over a 6-week period, 117 cases of laboratory-confirmed cases were reported in KKUH with a mean (SD) age of 19.6 (16.7) years, of whom 72 (62.1%) were males. Most reported cases were Saudis (n=99, 85.3%); 94 (81%) had no travel history outside the country; 100 (86.2%) had had no contact with an H1N1-identified patient; 33% were aged 5-14 years and 28.4% were aged 15-29 years. The most commonly reported symptoms were fever in 99 (85.3%), cough in 9 (81%), runny nose (33.6%) and sore throat (21.3%). All 117 cases were confirmed positive using real time RT-PCR testing. Thirty-one cases (26%) were admitted and 22 of those (71%) recovered after receiving oseltamivir. Two deaths were attributed to the 2009 pandemic. One patient died of chronic pulmonary disease. The other cause of death was unknown. Conclusion : These findings indicate indigenous influenza A (H1N1) transmission, and confirm the urgent need for prevention strategies which specifically target children and young adults, who appear to have a higher risk of infection and hospitalization. Such measures include immunization, improved personal hygiene, and increased ventilation in habitations.
Adnan Agha,Abdul Qader Alrawi,Abdelhaleem Bella,Mohammed S. AlAyed
Mediterranean Journal of Hematology and Infectious Diseases , 2012, DOI: 10.4084/mjhid.2012.
Abstract: Background Pandemic influenza A (H1N1) virus emerged and spread globally in the spring of 2009. We describe the clinical features of the patients who were hospitalized with 2009 H1N1 influenza July 2009 to June 2010 in a tertiary care hospital in Khamis Mushyt, Saudi Arabia. We analyzed the clinical and laboratory variables in order to determine predictors of poor outcome Methods We performed a prospective study in all patients who were hospitalized for at least 48 hours and with a positive test for 2009 H1N1 virus through RT-PCR(real time polymerase chain reaction). Their epidemiological, clinical, biochemical characteristics were collected and the hospital course of the patients with eventual outcome (discharge or death) was observed. We applied a logistic regression analysis to determine the best predictor of death.
A novel influenza A (H1N1) outbreak experience among residents of a long term-care facility in Saudi Arabia during 2010 seasonal flu circulation  [cached]
Raouf M. Afifi,Sherif Omar,Ahmed El Raggal
Infectious Disease Reports , 2012, DOI: 10.4081/idr.2012.e23
Abstract: The aim of this work was to describe and analyze an outbreak of novel 2009 influenza A (H1N1) among residents of a long-term care facility (LTCF) in Prince Mansour Military Hospital (PMMH), Taif, Saudi Arabia. These patients had been admitted to the LTCF months or years before the outbreak for several reasons, e.g. cerebral palsy, neurological deficits due to road traffic accidents with resultant handicap, chronic diseases associated with old age. An observational study was carried out to demonstrate and analyze the epidemiological characteristics (demographic factors, risk factors, and outcomes) associated with the outbreak in order to clarify which prevention and control measures had been taken and which recommendations were followed. During the period October 28 to November 11 2010, 21 LTCF residents were suspected to be clinically involved: fever ≥38oC with influenza-like illness (ILI). Age ranged from 9-91 years (mean 46±24.13); 62% were males. Among them, 12 (57%) were influenza A (H1N1) positive by reverse transcription polymerase chain reaction (RTPCR). Mortality involved 2 (17%) of the A (H1N1) laboratory confirmed individuals. Implementation of the recommended infection control measures mitigated the transmission of infection to new individuals. The fulfillment of strict infection control measures could limit H1N1 infection among LTCFPMMH patients. Routine influenza, including specific H1N1 immunization of all LTCF residents together with their healthcare staff, should be mandatory in those settings serving immunocompromised patients.
Pandemic Influenza: Perception of Medical Students Medical College. Taibah University. Medina, Saudi Arabia 2009
Manal Ibrahim Mahmoud, Khaled El-Harbi
Alexandria Journal of Medicine , 2010,
Abstract: Background: Healthcare workers (HCWs) play a key role in any response to pandemic influenza, and will be in the frontline of exposure to infection. Recent guidance suggests that up to 50% of the workforce may be absent from work at the peak of the pandemic because of caring responsibilities. Objectives: To identify the knowledge of the final year medical students about Pandemic Influenza; and to verify their attitude towards working during pandemic and getting the vaccine of H1N1. Methods: A cross sectional survey was conducted during November 2009. The study population included all final year medical students (69students) of both genders at the medical college, Taibah University, Medina, KSA. A precoded self-reported questionnaire was reported by the students. Quantitative data were presented as mean ± SD. For the comparison of the male and female groups' means, independent samples student t- test and chi-square test and linear regression were used. All tests were two tailed and considered significant when p<0.05. Results: The mean percent score for student's knowledge about H1N1 pandemic was low (59.9%±17.4), 72.5% refused vaccination against H1N1and 31.9% refused joining voluntary work during H1N1 pandemic. Gender, age, marital status and family number were predictors r voluntary work. Conclusion: Defective knowledge and the role of the family are the main factors predispose to further attitude of medical students regarding voluntary work and vaccination.
Estimating the Disease Burden of 2009 Pandemic Influenza A(H1N1) from Surveillance and Household Surveys in Greece  [PDF]
Vana Sypsa,Stefanos Bonovas,Sotirios Tsiodras,Agoritsa Baka,Panos Efstathiou,Meni Malliori,Takis Panagiotopoulos,Ilias Nikolakopoulos,Angelos Hatzakis
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0020593
Abstract: The aim of this study was to assess the disease burden of the 2009 pandemic influenza A(H1N1) in Greece.
The investigation of Risk factors of influenza pandemic H1N1  [PDF]
koorosh Holakooyi Naeini,Reza Chaman,Abbas Rahimi,Masoomeh Javaheri
Knowledge & Health Journal , 2010,
Abstract: 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.
Absence of 2009 Pandemic H1N1 Influenza A Virus in Fresh Pork  [PDF]
Amy L. Vincent,Kelly M. Lager,Michelle Harland,Alessio Lorusso,Eraldo Zanella,Janice R. Ciacci-Zanella,Marcus E. Kehrli Jr.,Alexander Klimov
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0008367
Abstract: The emergence of the pandemic 2009 H1N1 influenza A virus in humans and subsequent discovery that it was of swine influenza virus lineages raised concern over the safety of pork. Pigs experimentally infected with pandemic 2009 H1N1 influenza A virus developed respiratory disease; however, there was no evidence for systemic disease to suggest that pork from pigs infected with H1N1 influenza would contain infectious virus. These findings support the WHO recommendation that pork harvested from pandemic influenza A H1N1 infected swine is safe to consume when following standard meat hygiene practices.
Diagnostic Accuracy of a Rapid Influenza Test for Pandemic Influenza A H1N1  [PDF]
Aubree Gordon,Elsa Videa,Saira Saborío,Roger López,Guillermina Kuan,Angel Balmaseda,Eva Harris
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0010364
Abstract: With the current influenza A H1N1 pandemic (H1N1pdm), it is extremely important that clinicians can quickly and accurately identify influenza cases.
Age Distribution of Cases of 2009 (H1N1) Pandemic Influenza in Comparison with Seasonal Influenza  [PDF]
Drosos E. Karageorgopoulos,Evridiki K. Vouloumanou,Ioanna P. Korbila,Anastasios Kapaskelis,Matthew E. Falagas
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0021690
Abstract: Several aspects of the epidemiology of 2009 (H1N1) pandemic influenza have not been accurately determined. We sought to study whether the age distribution of cases differs in comparison with seasonal influenza.
Pandemic H1N1 influenza infections in 2009  [cached]
Mustafa Hac?mustafao?lu
Turk Pediatri Ar?ivi , 2010,
Abstract: In early spring 2009 an outbreak of H1N1 influenza A virus infection was detected in Mexico, spreaded quickly, and on June 11 2009, World Health Organization raised its pandemic level to phase 6. This novel H1N1 pandemic influenza A virus represented a quadruple reassortment of swine, human and avian influenza virus strains. This pandemic 2009 H1N1 influenza A viruses in different regions of the world were found to be antigenically homogenous. Transmission features, incubation period and clinical findings wee similar with the seasonal influenza viruses, although the gastrointestinal manifestations were more common. Young children (<5years) and some special risk groups are at increased risk for infection complications and mortality. The recommended test for diagnosis is real-time PCR. Pandemic 2009 H1N1 influenza A strains are sensitive to neuraminidase inhibitors (oseltamivir, zanamivir) and resistant to amantadine and rimantadine. Oseltamivir and zanamivir are used for prophlaxis and therapy of infection. However, vaccination against pandemic 2009 H1N1 influenza A should be the main target for individual and population based prevention. Monovalent pandemic 2009 H1N1 influenza A vaccines are available in this (recent) influenza season. According to CDC, the next (2010-2011) influenza season trivalent vaccines will coverage the pandemic 2009 H1N1 influenza A vaccine. (Turk Arch Ped 2010; 45: 80th Year: 31-6)
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