Effects of Early Oseltamivir Therapy on Viral Shedding in 2009 Pandemic Influenza A (H1N1) Virus Infection

L, Li; Chow, Angela; Lye, David C.; Tan, Alvin Wai Kit; Krishnan, Prabha; Cui, Lin; Win, Nwe Nwe N; Chan, Mónica; Lim, Poh Lian; Lee, Cheng Cheng C; Leo, Yee Sin

doi:10.1086/651083

Cited by 147 publications

(136 citation statements)

References 16 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…These results agree with those of previous studies 13, 18. A recent Italian study19 has reported that the duration of viral shedding is significantly reduced when therapy is initiated within 2 days of symptom onset.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Ryoo

Kim

Sohn

et al. 2012

Influenza Resp Viruses

View full text Add to dashboard Cite

BackgroundThe duration of viral shedding is an important determinant of infectivity and transmissibility and provides vital information for effective infection prevention and control. However, few studies have evaluated viral shedding in patients admitted to hospital with 2009 H1N1 influenza and treated with oseltamivir.ObjectiveTo determine the incidence of prolonged 2009 H1N1 influenza viral shedding in patients treated for 5 days with oseltamivir and to identify factors that promote prolonged viral shedding.MethodsThis was a prospective, observational cohort study of 173 patients infected with 2009 H1N1 influenza (confirmed by RT‐PCR) who were admitted to isolation rooms in the emergency department of our hospital between August 25, 2009 and December 31, 2009. All of the patients were treated according to institutional protocols and received routine follow‐up RT‐PCR testing after 5 days of oseltamivir therapy. Prolonged viral shedding was defined as a positive follow‐up RT‐PCR result.ResultOf the 173 patients in our cohort, 88 (50·8%) showed persistent viral shedding after oseltamivir treatment. Viral shedding was significantly prolonged if antiviral therapy was started ≥2 days after symptom onset (OR 2·74, 95% CI 1·29–5·82), if there were major comorbidities (OR 3·07, 95% CI 1·29–7·32), and/or if respiratory symptoms were still present on the day 5 of antiviral treatment (OR 4·13, 95% CI 2·10–8·11).ConclusionsThe presence of major comorbidities, a delay in initiating antiviral treatment, and continuing respiratory symptoms after 5 days of antiviral treatment are associated with prolonged shedding of the 2009 H1N1 influenza virus.

show abstract

Section: Discussionsupporting

confidence: 93%

“…With regard to 2009 H1N1 influenza, Ling et al 18. have reported that younger immunocompetent adults show prolonged shedding, while Cao et al 13.…”

Section: Discussionmentioning

confidence: 99%

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Ryoo

Kim

Sohn

et al. 2012

Influenza Resp Viruses

View full text Add to dashboard Cite

show abstract

“…Of note, delayed oseltamivir therapy was significantly found in patients with lung involvement. In consistent with previous reports, 35 , 40 , 41 our data recommended an early treatment with oseltamivir for patients whenever 2009 pandemic influenza A (H1N1) is diagnosed or epidemiologically suspected, regardless of age, and this may be particularly important for those with pulmonary involvement.…”

Section: Discussionsupporting

confidence: 91%

2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Lee

Liu

Wang

et al. 2012

Influenza Resp Viruses

View full text Add to dashboard Cite

Please cite this paper as: Lee and Liu et al. (2012) 2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement. Influenza and Other Respiratory Viruses 6(601), e152–e161. Background To better understand clinical and laboratory characteristics in children, adults, and patients with lung involvement suffering 2009 pandemic influenza A (H1N1). Methods A total of 442 patients with 2009 pandemic influenza A (H1N1) were retrospectively analyzed. Results Comparing to their adult counterpart (n = 55), pediatric patients (n = 387) had significantly higher frequencies of fever, rhinorrhea, cough, sore throat, nausea/vomiting, and longer length of fever; lower frequencies of chest pain and dyspnea; higher incidence of lymphopenia; and lower incidence of elevated serum C‐reactive protein. Among the 227 patients with radiographs available, lung involvement was found in 19 (8·4%) (52·6% consolidation and 47·4% interstitial infiltrations), including 18 children and one adult. One child with lung consolidation died of multiorgan failure. Significant findings in patients with lung involvement included predominant young age (≤10 years), prolonged fever, and delayed oseltamivir therapy (≥48 hours after onset of illness); higher frequencies of dyspnea, nausea/vomiting, and altered consciousness; and higher incidences of leukopenia, elevated serum creative kinase, and lactic dehydrogenase. Conclusions Among patients with 2009 pandemic influenza A (H1N1), we found significant difference in clinical manifestations between children and adults, and significant differences in clinical and laboratory manifestations between patients with lung involvement and those without. On the basis of data from this study and the existing literature, early treatment with oseltamivir is recommended for patients with 2009 pandemic influenza A (H1N1), regardless of age.

show abstract

“…Studies have shown that prolonged clearance of nasopharyngeal influenza viral RNA load is associated with the severity of the disease, and a rapid decrease in viral load was noted as of the first day of oseltamivir initiation (6,14). It was reported in the study conducted by Jain et al (15) that antiviral treatment was not initiated in any one of the patients who died of influenza in the first 48 h after the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Severe Pneumonia and Convulsion Caused by Influenza H1N1 Virus in an Asthma Patient: Case Report

Özdemir¹,

Kurt²

2017

Istanbul Med J

View full text Add to dashboard Cite

Pandemic influenza A (H1N1) virus, unlike seasonal influenza, has a high attack rate and contagiousness (1). While the pandemic influenza virus shows symptoms like many seasonal influenza viruses in many people, unlike seasonal influenza, it may cause severe infections in healthy and young adults. These clinical differences between seasonal and pandemic influenza are shown in Table 1. It can cause more serious infections and deaths in those with underlying chronic illnesses, such as asthma, in infants, children aged under 5 years, and the elderly (1, 2).In this case report, we present a 12-year-old patient who had asthma as an underlying chronic disease, who applied to our clinic with the complaint of attacks and had bacterial pneumonia and convulsions secondary to pandemic influenza. Case ReportA 12-year-old girl who complained of a 1-month-long cough and newly started shortness of breath was hospitalized with the diagnosis of asthma by the polyclinic that followed up the patient. The weight of the patient was 30 kg, height was 157 cm, fever at the time of admission was 36.5°C, respiratory rate was 42/min, arterial tension was 105/54 mmHg, pulse was 154/min, and saturation was 96%. While the patient was receiving asthma attack treatment and recovering in the clinic, she began to develop fever, malaise, loss of appetite, and widespread muscle pain on the third day of hospitalization. On the following day, diarrhea and vomiting occurred two to three times. Then, leukopenia, anemia, and thrombocytopenia developed. In the laboratory examination of the patient at this time, leukocyte was 3,470/mm 3 , hemoglobin was 10.7 g/dL, platelet was 137,000/mm 3 , C-reactive protein (CRP) was 81mg/ L (normal: <5), sedimentation was 89/h, aspartate aminotransferase (AST) was 430 U/L, alanine transaminase (ALT) was 320 U/L, and lactate dehydrogenase (LDH) was 1524 U/L. Posterioanterior (PA) chest X-ray showed consolidation (pneumonic infiltration) in the bilateral basal segments (Figure 1). Meropenem treatment was initiated in the patient. The patient did not have any previous history of convulsion and experienced a tonic-clonSevere Pneumonia and Convulsion Caused by Influenza H1N1 Virus in an Asthma Patient: Case Report Pandemic influenza virus (H1N1) has a higher attack rate than seasonal influenza virus and is more contagious than seasonal influenza infection. H1N1 infection might cause more severe disease leading to death, if patients have a debilitating chronic disease such as asthma or are pregnant, elderly, and younger than 5 years. The case of a 12-year-old asthmatic patient with pneumonia and convulsion secondary to H1N1 infection during her asthma attack is presented. The 12-year-old asthmatic patient presented with one-month history of coughing and dyspnea. When she was admitted, her fever was 36.5°C, respiratory rate was 42/minute, blood pressure was 105/54 mmHg, pulse was 154/minute, and oxygen saturation was 96%. Her physical examination revealed rhonchi and crackles on her lung. When her asthma attack improved at ...

show abstract

Effects of Early Oseltamivir Therapy on Viral Shedding in 2009 Pandemic Influenza A (H1N1) Virus Infection

Abstract: Prolonged viral shedding was noted in young immunocompetent adults with mild pandemic influenza (H1N1) 2009 despite receipt of oseltamivir. When prescribed during the first 3 days of illness, oseltamivir shortened the duration of viral shedding.

Cited by 147 publications

References 16 publications

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Severe Pneumonia and Convulsion Caused by Influenza H1N1 Virus in an Asthma Patient: Case Report

Contact Info

Product

Resources

About