Zusammenfassung
ZIEL DER STUDIE: Untersuchung klinischer und labortechnischer Charakteristika von Patienten, die mit einer Influenza A H1N1 Virusinfektion während der 2009/10 Pandemie aufgenommen waren. METHODEN: Prospektive Beobachtungsstudie, die Labor und klinische Parameter von Patienten mit Influenza ähnlicher Erkrankung (ILI), die entweder positiv oder negativ auf Influenza A H1N1 waren, vergleicht. ERGEBNISSE: Zwischen 21. Oktober 2009 bis 14. Februar 2010 wurden 196 Patienten mit ILI aufgenommen, von denen bei 66 der Test auf Influenza A H1N1 positiv war. Die Patienten mit der H1N1 Infektion waren jünger (43 Jahre vs. 65 Jahre; P < 0,01), waren häufiger schwanger (P < 0,01), und hatten häufiger Allergien (P < 0,05) beziehungsweise Asthma (P < 0,01). Außerdem hatten sie öfter Fieber (91 % vs. 72,9 %; P < 0,01) und eine höhere Prävalenz von Kopfweh (31,8 % vs. 18,5 %; P < 0,05). Bei den H1N1 positiven Patienten waren die C-reaktiven Protein werte (88 pg/dl vs. 126 pg/dl; P < 0,01), die Procalcitoninwerte (0,42 μg/l vs. 3,98 μg/l; P < 0,05) und die die Leukozytenzahl (7,4*109/l vs. 11,7*109/l; P < 0,01) niedriger – die Troponinwerte (0,162 µ/l vs. 0,146 μg/l; P < 0,01) waren vergleichsweise erhöht. Bei den H1N1 negativen Patienten wurden häufiger bakterielle Infektionen beobachtet (68,8 % vs. 89,2 %; P < 0,05). SCHLUSSFOLGERUNGEN: In der vorliegenden Studie unterschieden sich Influenza A H1N1 infizierte Patienten von solchen mit ILI ohne H1N1 Infektion in verschiedenen Laborwerten und klinischen Charakteristika. Dies wurde schon von anderen Untersuchern beobachtet. Unsere Studie legen zusätzlich Symptome, wie zum Beispiel eine höhere Inzidenz von Kopfweh, oder höhere Troponin Werte als für eine Infektion mit Influenza A H1N1 typisch nahe.
Summary
OBJECTIVE: To investigate clinical and laboratory features of patients with Influenza A H1N1 virus infection hospitalized during 2009/2010 pandemic. METHODS: Prospective observational study comparing clinical and laboratory characteristics of Influenza A H1N1 positive and negative patients with influenza-like illness (ILI). RESULTS: From October 21, 2009 to February 14, 2010 196 ILI patients were admitted, of which 66 tested positive for Influenza A H1N1. The patients with H1N1 infection were younger (43 years vs. 65 years; P < 0.01), more patients were pregnant (P < 0.01), had allergies (P < 0.05) or, asthma (P < 0.01). H1N1 positive patients were more often febrile (91% vs. 72.9%; P < 0.01) and had a higher prevalence of headache (31.8% vs. 18.5%; P < 0.05). Lower values of C-reactive protein (88 pg/dl vs. 126 pg/dl; P < 0.01), procalcitonine (0.42 µg/l vs. 3.98 µg/l; P < 0.05), leukocyte count (7.4*109/l vs. 11.7*109/l; P < 0.01) and higher values of troponin (0.162 µ/l vs. 0.146 µg/l; P < 0.01) were found in H1N1 positive patients. More bacterial infections were found in H1N1 negative group (68.8% vs. 89.2%; P < 0.05). CONCLUSIONS: In this study patients infected with Influenza A H1N1 differed from H1N1 negative ILI patients in several clinical and laboratory characteristics. The same was observed also by other investigators. The results of the study suggest some other specific features, such as a higher incidence of headache and higher values of troponin in Influenza A H1N1 infected patients.
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References
Prvi primer okužbe z virusom nove gripe v Sloveniji. IVZ. [Internet]. 2009 [cited 2010 Jun 6]. Available from: http://www.ivz.si/Mp.aspx?ni=78&pi=6&_6_id=428&_6_PageIndex=1&_6_groupId=–2&_6_newsCategory=IVZ+kategorija&_6_action=ShowNewsFull&pl=78-6.0
Announced number of new and cumulative confirmed fatal 2009 pandemic influenza A (H1N1) cases in EU and EFTA countries, as of Week 17 - 2010. ECDC. [Internet]. 2010 [cited 2010 Jun 6]. Available from: http://ecdc.europa.eu/en/healthtopics/H1N1/Pages/Reported_number_of_new_and_cumulative_confirmed_fatal_cases.aspx
FluNet. WHO. [Internet]. [cited 2010 Jun 13]. Available from: http://gamapserver.who.int/GlobalAtlas/DataQuery/viewData.asp
Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM, Zaki SR, Hayden FG, Hui DS, Kettner JD, Kumar A, Lim M, Shindo N, Penn C, Nicholson KG. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N Engl J Med 2010;362(18):1708–19
Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360(25):2605–15
Crum-Cianflone NF, Blair PJ, Faix D, Arnold J, Echols S, Sherman SS, Tueller JE, Warkentien T, Sanguineti G, Bavaro M, Hale BR. Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries. Clin Infect Dis. 2009;49(12):1801–10
Poggensee G, Gilsdorf A, Buda S, Eckmanns T, Claus H, Altmann D, Krause G, Haas W. The first wave of pandemic influenza (H1N1) 2009 in Germany: From initiation to acceleration. BMC Infectious diseases. 2010;10:155
Pandemic (H1N1) 2009 - update 86. WHO. [Internet]. 2010 [cited 2010 Jun 13]. Available from: http://www.who.int/csr/don/2010_02_5/en/index.html
FluNet. WHO. [Internet]. [cited 2010 Jun 16]. Available from: http://gamapserver.who.int/GlobalAtlas/DataQuery/viewData.asp
Dee S, Jayathissa S. Clinical and epidemiological characteristics of the hospitalised patients due to pandemic H1N1 2009 viral infection: experience at Hutt Hospital, New Zealand. N Z Med J 2010;123(1312):45–53
Scriven J, Mcewen R, Mistry S, Green C, Osman H, Bailey M, Ellis C. Swine flu: Birmingham experience. Med J Aust. 2010;192(2):84–6
Miller E, Hoschler K, Hardelid P, Stanford E, Andrews N, Zambon M. Incidence of 2009 pandemic influenza A H1N1 infection in England: a cross-sectional serological study. Lancet 2010;375(9720):1100–8
Babek A, Akhtar R, Fadaei Nobari R. Epidemiological and clinical characteristics of Influenza A (H1N1) V infection in Isfahan, Iran, July-October 2009. 20th European congress of clinical microbiology and infectious diseases Vienna, Austria, 2010 Apr 10-13. Clinical microbiology and infection. 2010; Vol. 16, Supp 2, page S711
Ataman Hatipoglu C, Mutlu AG, Bulut C, Altun S, Erdinc FS, Tuncer Ertem G, Kinikli S, Oral B, Tulek N, Demiroz AP. Evaluation of epidemiological, clinical and laboratory characteristics of pandemic influenza A (H1N1) case in a tertiary hospital in turkey. 20th European congress of clinical microbiology and infectious diseases Vienna, Austria, 2010 Apr 10-13. Clinical microbiology and infection. 2010; Vol. 16, Supp 2, page S675
Cao B, Li XW, Mao Y, Wang J, Lu HZ, Chen YS, Liang ZA, Liang L, Zhang SJ, Zhang B, Gu L, Lu LH, Wang DY, Wang C. Clinical features of the initial cases of 2009 pandemic Influenza A (H1N1) virus infection in China. N Engl J Med 2009;361(26):2507–17
Echevarría-Zuno S, Mejía-Aranguré JM, Mar-Obeso AJ, Grajales-Muñiz C, Robles-Pérez E, González-León M, Ortega-Alvarez MC, Gonzalez-Bonilla C, Rascón-Pacheco RA, Borja-Aburto VH. Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis. Lancet 2009;374(9707):2072–9
Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, Louie J, Doyle TJ, Crockett M, Lynfield R, Moore Z, Wiedeman C, Anand M, Tabony L, Nielsen CF, Waller K, Page S, Thompson JM, Avery C, Springs CB, Jones T, Williams JL, Newsome K, Finelli L, Jamieson DJ. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. J Am Med Assoc 2010;303(15):1517–25
Toal M, Agyeman-Duah K, Schwenk A, Yoong W. Swine flu and pregnancy. J Obstet Gynaecol 2010;30(2):97–100
Ison MG, Campbell V, Rembold C, Dent J, Hayden FG. Cardiac findings during uncomplicated acute influenza in ambulatory adults. Clin Infect Dis 2005;40(3):415–2
Greaves K, Oxford JS, Price CP, Clarke GH, Crake T. The prevalence of myocarditis and skeletal muscle injury during acute viral infection in adults: measurement of cardiac troponins I and T in 152 patients with acute influenza infection. Arch Intern Med 2003;163(2):165–8
Situation update in the European Region: overview of influenza surveillance. WHO. [Internet]. [Cited 2010 Jun 16]. Available from: http://www.euro.who.int/Document/CSR/EuroFlu_Situation_update_40-09.pdf
Writing Committee of the WHO. Clinical Aspects of Pandemic 2009 Influenza. N Engl J Med 2010;362:1708–19
Akinci E, Kayaaslan BU, Yetkin MA, Yilmaz S, Aliravci D, Yildiz S, Ulgen F, Eren SS, But A, Yilmaz GR, Bodur H. Evaluation of H1N1 pandemic influenza cases in an infectious diseases clinic. 20th European congress of clinical microbiology and infectious diseases Vienna, Austria, 2010 Apr 10-13. Clinical microbiology and infection 2010;16(Supp. 2):S711
Kalpakou G, Stravopodis P, Aggelopoulou V, Litrokapis M, Verikou M, Gouga D, Koutroubi A, Bourinaris T, Sidirokastriti O, Spinou M. Clinical features of patients with confirmed infection form A/H1N1 virus. 20th European congress of clinical microbiology and infectious diseases Vienna, Austria, 2010 Apr 10-13. Clinical microbiology and infection 2010;16(Supp. 2):S675
Rodriguez C, Cordova E, oviedo G, Cornistein W, Noel A, Vazquez L. Clinical and epidemiological characteristics of outpatients with influenza-like ilness during influenza A H1N1 pandemic in Buenos Aires, Argentina. 20th European congress of clinical microbiology and infectious diseases Vienna, Austria, 2010 Apr 10-13. Clinical microbiology and infection 2010;16(Supp. 2):S305
Trifonov V, Khiabanian H, Rabadan R. Geographic dependence, surveillance, and origins of the 2009 influenza A (H1N1) virus. N Engl J Med 2009;361(2):115–9
Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team, Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360(25):2605–15
Louie JK, Acosta M, Jamieson DJ, Honein MA; California Pandemic (H1N1) Working Group. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N Engl J Med 2010;362(1):27–35
Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, Louie J, Doyle TJ, Crockett M, Lynfield R, Moore Z, Wiedeman C, Anand M, Tabony L, Nielsen CF, Waller K, Page S, Thompson JM, Avery C, Springs CB, Jones T, Williams JL, Newsome K, Finelli L. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA 2010; 303(15):1517–25
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B. Pečavar, K. Nadrah and B. Beović authors contributed equally to this work.
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Pečavar, B., Nadrah, K., Papst, L. et al. Clinical characteristics of adult patients with influenza-like illness hospitalized in general ward during Influenza A H1N1 pandemic 2009/2010. Wien Klin Wochenschr 123, 662–667 (2011). https://doi.org/10.1007/s00508-011-0054-4
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DOI: https://doi.org/10.1007/s00508-011-0054-4