Fatal 2009 pandemic influenza A (H1N1) in a bone marrow transplant recipient

Abstract

Conditions characterized by immunosuppression have been recently reported as risk factors for severe novel swine-origin influenza A (H1N1) virus (S-OIV) infection during the current 2009 pandemic. We report clinical and virological findings, antiviral therapy, and postmortem study of S-OIV in an adult bone marrow transplant recipient. The viral genome was amplified by real time reverse transcriptase polymerase chain reaction (RT-PCR) from a nasopharyngeal swab specimen. The patient developed acute respiratory distress syndrome, septic shock, and eventually succumbed with a severe pulmonary haemorrhage. To the best of our knowledge, the entire clinical/therapy management and pathological examination in a transplant recipient infected with the S-OIV has not been previously documented. The fatal ending in this bone marrow transplant recipient supports recommendations that call for education measures, S-OIV vaccination, early diagnosis and aggressive treatment in the transplant population.

Heterogeneous virulence of pandemic 2009 influenza H1N1 virus in mice

“…Clinically, 2009 influenza pandemic caused self recovering mild disease in the vast majority of patients while only a small group of patients developed serious respiratory complications [21,22]. No explanation has yet been offered for why the clinical profile varies from one patient to another.…”