Epidemiology of Human Infection with the Novel Virus Influenza A (H1H1) in the Hospital das Clínicas, São Paulo, Brazil – June–September 2009

Abstract

The pandemic novel influenza A (H1N1) infection was considered widespread in Brazil on July 16, 2009. Since then, 46,810 cases of acute respiratory syndrome have been reported in Brazil, most of them concentrated in São Paulo. Through September 16, we have confirmed 9,249 cases of novel influenza A H1N1in Brazil, including 699 deaths. The mortality rate observed in Brazil is 0.47/100,000 inhabitants and varies according to region. In this period, São Paulo registered 3733 cases (40.3% of the total) of novel influenza A (H1N1) infection and 327 deaths, reflecting a mortality rate of 0.79/100,000 inhabitants.The Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC) is a reference center for H1N1 cases in São Paulo. During the winter of 2009, 472 patients in this hospital were diagnosed with H1N1 infection; of these, 210 were admitted, and 16 died. To control this pandemic and to provide adequate care for these patients, the Hospital das Clínicas implemented “bundles” including prevention strategies, an epidemiologic surveillance service, availability of fast diagnosis, antiviral treatment and training of staff.The purpose of this manuscript is to describe the epidemiologic features of novel human influenza A (H1N1) infection in the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo during the winter period of the 2009 pandemic.

Respiratory virus infections among hospitalized patients with suspected influenza A H1N1 2009 virus during the first pandemic wave in Brazil

“…15 H1N1 2009 virus infected children were older (5 years) than H1N1 negative children (median age 1 year old), in accordance with other studies. 2,14,18 Pandemic influenza occurred in young adults (25 years old), as previously described. 2,14,18 These data will contribute to the growing body of knowledge regarding influenza clinical management and immunization programs.…”

Relacionamento entre bases de dados para vigilância da pandemia de influenza A(H1N1)pdm09, Brasil, 2009-2010

“…Como foi publicado ainda na fase de contenção, fez uma projeção dos cenários da pandemia em um futuro próximo e a necessidade de estruturação dos serviços de saúde para responder a uma emergência em saúde pública 12 . O terceiro artigo relatou a experiência de um hospital público terciário, referência para atendimento dos casos de influenza pandêmica 26 . O perfil apresentado assemelhou-se ao relatado em artigo anterior 12 , sendo mulheres e pessoas com idade entre 0 e 29 anos as mais acometidas.…”

“…O perfil apresentado assemelhou-se ao relatado em artigo anterior 12 , sendo mulheres e pessoas com idade entre 0 e 29 anos as mais acometidas. Os pacientes diferenciaram-se dos atendidos fora desse serviço por apresentarem pelo menos uma comorbidade, como imunossupressão, doença respiratória crônica e doença cardiovascular 26 . Mais um artigo descreveu os antecedentes históricos da pandemia de influenza por novo subtipo viral e sintetizou as informações sobre medidas a serem tomadas a respeito dos casos e contactantes, bem como dos sinais, sintomas e tratamento 27 30 , o objetivo do presente estudo foi descrever, com base no relacionamento entre os sistemas de informação, o perfil epidemiológi-co dos casos notificados por influenza por novo subtipo viral durante a pandemia da infecção.…”

Apresentação clínica e evolução de pacientes com infecção por Influenza A (H1N1) que necessitaram de terapia intensiva durante a pandemia de 2009

“…Large number of quickly disseminating cases was recorded, involving mainly young patients, as suggested by many published cohorts. (3,10,11,(13)(14)(15)(16)(17)(18)(19) Given the large number of cases, although the disease's mortality was apparently low, (3,10,(15)(16)(17)(18) many patients were admitted to ICUs, leading to several studies reporting these cases clinical features and outcomes. (5)(6)(7)(8)(9)(10)12,(19)(20)(21) In this study we revised data from 22 patients admitted to two private hospitals' intensive care units in São Paulo, Brazil.…”

“…(22) This was reproduced in influenza A (H1N1)/2009 infection patients, where 2 to 12% of the cases were pregnant women. (6,7,14,15) Pregnancy was shown to be an isolated admission risk factor. (25) The severe infection risk was 7 times higher than for non-pregnant women, and when the gestational age was greater than 20 weeks, this risk raised to 13 times.…”