Influenza A/pandemic 2009/H1N1 in the setting of allogeneic hematopoietic cell transplantation: a potentially catastrophic problem in a vulnerable population
- First Online:
- 125 Downloads
We describe Influenza A/pandemic 2009/H1N1 in two allogeneic hematopoietic cell transplantation recipients. The main presentation in both cases consisted of flu-like symptoms manifesting as, fever, arthralgias and myalgias. The virus was isolated in one case from a throat swab and in another case following a bronchoalveolar lavage. Both patients received oseltamivir at a dose of 75 mg orally twice day. The dose of oseltamivir was increased to 150 mg twice per day due to the lack of improvement or progression of symptoms. In one case, clinical symptoms resolved without sequelae. In the second case, pulmonary symptomatology continued to deteriorate, despite aggressive polymicrobial treatment, requiring mechanical ventilation and ultimately the patient died from respiratory failure. These cases highlight the potentially serious effect of the ongoing Influenza A/pandemic 2009/H1N1 pandemic in this very vulnerable population and the urgent need to establish emergency preparedness strategies by oncology and bone marrow transplantation staff to face this serious healthcare challenge.
KeywordsInfluenza A/pandemic 2009/H1N1 Allogeneic hematopoietic cell transplantation
- 1.Update: novel Influenza A (H1N1) virus infection—Mexico, March–May 2009. MMWR Morb Mortal Wkly Rep 2009;58:467–470.Google Scholar
- 2.World Health Organization. World now at the start of 2009 influenza pandemic. Statement to the press by WHO Director-General Dr Margaret Chan, 11 June 2009. http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/print.html). Accessed 17 Sept 2009.
- 3.United States Centers for Disease Control and Prevention. Novel H1N1 flu situation update: 4 Sept 2009. http://www.cdc.gov/h1n1flu/update.htm).
- 4.Vaillant L, La Ruche G, Tarantola A, Barboza P. Epidemic intelligence team at InVS. Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveill. 2009;14:19309.Google Scholar
- 5.Oseltamivir-resistant novel Influenza A (H1N1) virus infection in two immunosuppressed patients—Seattle, WA, 2009. MMWR Morb Mortal Wkly Rep. 2009;58 (Dispatch, August 14);1–4.Google Scholar
- 7.World Health Organization. Influenza-like illness in the United States and Mexico, 24 April 2009. (Available at http://www.who.int/csr/don/2009_04_24/en/index.html).
- 18.Wingard JR. Influenza: preparedness for an inevitable “Emergency” for oncology and BMT units. Natl Compr Canc Netw. 2008;6:215–22.Google Scholar