Clinical characteristics of paediatric H1N1 admissions in Birmingham, UK

Hackett, Scott; Hill, Leonard; Patel, Jaimin; Ratnaraja, Natasha; Ifeyinwa, Amamilo; Farooqi, Marium; Nusgen, U; Debenham, P; Gandhi, D K; Makwana, Nick; Smit, Erasmus; Welch, S

doi:10.1016/s0140-6736(09)61511-7

Cited by 122 publications

(139 citation statements)

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“…Fever and cough (typical ILI symptoms) are the most common presentations that are occasionally accompanied by a sore throat and rhinorrhea (9,14,(19)(20)(21). The most common symptom in the present study was fever (97.7z), the prevalence being comparable with that in other studies (95z) (22,23).…”

Section: Discussionsupporting

confidence: 86%

Comparisons of Clinical Characteristics between Adult Patients with 2009 H1N1 Influenza and Those with Seasonal Influenza during the 2009 Epidemic in Thailand

et al. 2014

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SUMMARY:Clinical presentations of patients with 2009 H1N1 influenza are generally similar to those of patients with seasonal influenza. A cross-sectional study was conducted among adults at an outpatient clinic in a university hospital setting during the 2009 epidemic. Infections in all patients were confirmed by real-time reverse transcription-polymerase chain reaction. There were 269 patients with 2009 H1N1 influenza and 128 patients with seasonal influenza. Compared with patients with seasonal influenza, patients with 2009 H1N1 influenza were more likely to be aged º20 years (25.7z vs. 8.6z, P º 0.001) and to be students (38.7z vs. 22.0z, P ＝ 0.001), or healthcare workers (20.1z vs. 10.9z, P ＝ 0.022); however, they were less likely to have an underlying disease (25.6z vs. 39.8z, P ＝ 0.004) and influenza vaccination (4.2z vs. 12.2z, P ＝ 0.021). There were no differences in the illness duration, vital signs, and symptoms between groups. Patients with seasonal influenza were more likely to be admitted to the intensive care unit (2.4z vs. 0z, P ＝ 0.033) and exhibited a higher mortality rate (2.4 z vs. 0z, P ＝ 0.093). A history of contact with a confirmed 2009 H1N1 influenza case (odds ratio [OR] ＝ 12.91, P º 0.001) and age (OR ＝ 1.05 per 10 years younger, P ＝ 0.015) were associated with 2009 H1N1 influenza infections. In conclusion, these results showed differences in characteristics between the patients with 2009 H1N1 influenza and those with seasonal influenza.

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Section: Discussionsupporting

confidence: 86%

Comparisons of Clinical Characteristics between Adult Patients with 2009 H1N1 Influenza and Those with Seasonal Influenza during the 2009 Epidemic in Thailand

et al. 2014

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“…Multiple authors have published their clinical experience in the diagnosis and management of influenza A (H1N1) infection [1,[5][6][7], but less attention has been focused on the imaging findings [12].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors and clinical manifestations associated with H1N1 have been previously reported [4][5][6][7][8][9]. Significantly less attention has been given to the imaging findings of H1N1 that may serve as early indicators of the presence and impending severity of disease.…”

mentioning

confidence: 99%

Pulmonary imaging of pandemic influenza H1N1 infection: relationship between clinical presentation and disease burden on chest radiography and CT

Abbo

Quartin

Morris

et al. 2010

BJR

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ABSTRACT. The potential for pulmonary involvement among patients presenting with novel swine-origin influenza A (H1N1) is high. To investigate the utility of chest imaging in this setting, we correlated clinical presentation with chest radiographic and CT findings in patients with proven H1N1 cases. Subjects included all patients presenting with laboratory-confirmed H1N1 between 1 May and 10 September 2009 to one of three urban hospitals. Clinical information was gathered retrospectively, including symptoms, possible risk factors, treatment and hospital survival. Imaging studies were re-read for study purposes, and CXR findings compared with CT scans when available. During the study period, 157 patients presented with subsequently proven H1N1 infection. Hospital admission was necessary for 94 (60%) patients, 16 (10%) were admitted to intensive care and 6 (4%) died. An initial CXR, carried out for 123 (78%) patients, was abnormal in only 40 (33%) cases. Factors associated with increased likelihood for radiographic lung abnormalities were dyspnoea (p,0.001), hypoxaemia (p,0.001) and diabetes mellitus (p50.023). Chest CT was performed in 21 patients, and 19 (90%) showed consolidation, ground-glass opacity, nodules or a combination of these findings. 4 of 21 patients had negative CXR and positive CT. Compared with CT, plain CXR was less sensitive in detecting H1N1 pulmonary disease among immunocompromised hosts than in other patients (p50.0072). A normal CXR is common among patients presenting to the hospital for H1N1-related symptoms without evidence of respiratory difficulties. The CXR may significantly underestimate lung involvement in the setting of immunosuppression.

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“…It is notable that 29 out of 71 children admitted to hospital in Birmingham did not fulfil the HPA criteria. 25 As Birmingham and London were early hotspots it may be that the populations of Manchester and Sheffield were more aware of the availability of antiviral agents and therefore sought treatment earlier and mitigated the severity of their infection. There may also be confounding factors in terms of local viral evolution and pre-existing local population health that will be explored by other national projects, such as Flu-CIN (Influenza Clinical Information Network).…”

Section: Chaptermentioning

confidence: 99%

“…33 A significant minority of both paediatric and adult patients eventually diagnosed with H1N1 did not fulfil HPA screening criteria, notably for pyrexia. 25,34 Little literature exists on risk assessment of undifferentiated emergency patients, and what there is concentrates on mortality risk. [35][36][37] It appears from the international experience that obesity, 17 pre-existing comorbidity 19 and pregnancy 17,38 convey a worse prognosis during pandemic influenza infection.…”

Section: Chaptermentioning

confidence: 99%

Evaluation of triage methods used to select patients with suspected pandemic influenza for hospital admission: cohort study

Goodacre

Challen²,

Wilson³

et al. 2010

Health Technol Assess

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*Corresponding authorthree survivors who required respiratory support. The five patients with poor outcomes had CURB-65 scores of zero, one (three cases) and two, and PMEWS scores of one, five, six, seven and eight. The swine flu hospital pathway was positive in three out of five cases. The C-statistic for each method was CURB-65 0.78 [95% confidence interval (CI) 0.58 to 0.99], PMEWS 0.77 (95% CI 0.55 to 0.99) and the swine flu hospital pathway 0.70 (95% CI 0.45 to 0.96). Patients with a higher CURB-65 score were more likely to be admitted (p < 0.001): 25 out of 101 (25%) with a score of zero, 11 out of 24 (46%) with a score of one, 7 out of 8 (88%) with a score of two, and the patient with a score of three were admitted. Admitted patients had a higher mean PMEWS score (4.6 vs 2.0, p < 0.001). The C-statistics for CURB-65, PMEWS and the swine flu hospital pathway in adults in terms of discriminating between those admitted and discharged were 0.65 (95% CI 0.54 to 0.76), 0.76 (95% CI 0.66 to 0.86) and 0.62 (95% CI 0.51 to 0.72) respectively. Limitations: The 2009 H1N1 pandemic was much smaller and less severe than predicted and resulted in a lack of sufficient data.

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Clinical characteristics of paediatric H1N1 admissions in Birmingham, UK

Cited by 122 publications

References 0 publications

Comparisons of Clinical Characteristics between Adult Patients with 2009 H1N1 Influenza and Those with Seasonal Influenza during the 2009 Epidemic in Thailand

Comparisons of Clinical Characteristics between Adult Patients with 2009 H1N1 Influenza and Those with Seasonal Influenza during the 2009 Epidemic in Thailand

Pulmonary imaging of pandemic influenza H1N1 infection: relationship between clinical presentation and disease burden on chest radiography and CT

Evaluation of triage methods used to select patients with suspected pandemic influenza for hospital admission: cohort study

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