Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team
Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team
复制标题
DOI：
10.1056/nejmoa0903810
复制
发表时间：
2009-06-18
影响因子：
158.5
通讯作者：
Uyeki, Timothy M.
中科院分区：
文献类型：
--
作者：
Dawood, Fatimah S.;Jain, Seema;Uyeki, Timothy M.
背景2009年4月15日和4月17日，在美国从两名流行病学上无关联的患者中获得的标本中鉴定出新型猪源甲型H1N1流感病毒（S-OIV）。在墨西哥、加拿大和其他地方也发现了相同的病毒株。我们描述了642例确诊的人S-OIV感染病例，这些病例是从快速发展的美国流感中发现的。S.方法：在美国对人类感染不能分型的甲型流感病毒实施了加强监测。样本被送往疾病控制和预防中心进行实时逆转录酶-聚合酶链反应确证性检测。从4月15日到5月5日，在41个州共确定了642例S-OIV感染确诊病例。患者的年龄范围为3个月至81岁; 60%的患者为18岁或以下。在有数据的患者中，18%最近去过墨西哥，16%是从学校爆发的S-OIV感染中确定的。最常见的症状是发热（94%的患者）、咳嗽（92%）和咽喉痛（66%）; 25%的患者有腹泻，25%的患者有呕吐。在已知住院状态的399例患者中，36例（9%）需要住院。在22例有可用数据的住院患者中，12例具有增加严重季节性流感风险的特征，11例患有肺炎，8例需要入住重症监护室，4例呼吸衰竭，2例死亡。S-OIV被确定为具有独特的基因组组成，尚未被确定previous.CONCLUSIONSA新的猪源性流感A病毒被确定为范围从自限性到严重疾病的发热性呼吸道感染暴发的原因。确诊病例的数量可能低估了已发生病例的数量。
BACKGROUNDOn April 15 and April 17, 2009, novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in specimens obtained from two epidemiologically unlinked patients in the United States. The same strain of the virus was identified in Mexico, Canada, and elsewhere. We describe 642 confirmed cases of human S-OIV infection identified from the rapidly evolving U. S. outbreak.METHODSEnhanced surveillance was implemented in the United States for human infection with influenza A viruses that could not be subtyped. Specimens were sent to the Centers for Disease Control and Prevention for real-time reverse-transcriptase-polymerasechain-reaction confirmatory testing for S-OIV.RESULTSFrom April 15 through May 5, a total of 642 confirmed cases of S-OIV infection were identified in 41 states. The ages of patients ranged from 3 months to 81 years; 60% of patients were 18 years of age or younger. Of patients with available data, 18% had recently traveled to Mexico, and 16% were identified from school outbreaks of S-OIV infection. The most common presenting symptoms were fever (94% of patients), cough (92%), and sore throat (66%); 25% of patients had diarrhea, and 25% had vomiting. Of the 399 patients for whom hospitalization status was known, 36 (9%) required hospitalization. Of 22 hospitalized patients with available data, 12 had characteristics that conferred an increased risk of severe seasonal influenza, 11 had pneumonia, 8 required admission to an intensive care unit, 4 had respiratory failure, and 2 died. The S-OIV was determined to have a unique genome composition that had not been identified previously.CONCLUSIONSA novel swine-origin influenza A virus was identified as the cause of outbreaks of febrile respiratory infection ranging from self-limited to severe illness. It is likely that the number of confirmed cases underestimates the number of cases that have occurred.