Navarro-Reynoso FP, Abdo-Francis M, Ibarra-Pérez C

Language: Spanish
References: 6
Page: 63-67
PDF size: 423.27 Kb.

ABSTRACT

Introduction: We report our experience at the General Hospital of Mexico in México City with the recent Influenza type A (H1N1) epidemic during the period of April 17 to June 9, 2009. Material and methods: Six thousand seven hundred and eighty adults and children with acute respiratory infections were studied at the Emergency and Outpatient Departments during that period. One hundred and twenty seven had a clinical picture suspicious for influenza, 67 of them tested positive for the preliminary serological test, later confirmed by rRT-PCR in 22 of them, including eight members of the health personnel that had been taking care of patients; their average age was 38 years. Results: Fifty five of the 127 suspected cases of influenza A (H1N1) were admitted to the hospital; the 127 received 75 mg q.12 hours of oseltamivir during five days. Forty nine were discharged; six succumbed from a few minutes to 4 days, average 1.5 days, after admission to the Emergency Department or the ICU, due to severe bilateral pneumonia, respiratory insufficiency and multisystemic failure. Forty seven had leucopenia, 8 had leukocytosis. Chest images included consolidations in all, extensive bilateral in 40, predominantly segmental in 9 and lobar in 6. Eighteen required tracheal intubation and ventilatory support; 7 had pleural effusions that did not require chest tube drainage. During the same time frame there were nine more deaths due to atypical pneumonia, unrelated to influenza A (H1N1). None of the patients had been vaccinated against the seasonal influenza. Conclusions: Oseltamivir was given in the presence of suspicious clinical manifestations, even if the preliminary serological test was negative. The six deceased arrived to the Emergency Department in very critical conditions and had to be immediately intubated and artificially ventilated. Members of the health personnel are not exempt from being infected by the influenza A (H1N1) virus.

REFERENCES

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6. Novel influenza A (H1N1) virus infections among health personnel. United States, April-May 2009. MMWR June 19, 2009.