Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico
Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico
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DOI：
10.1056/nejmoa0904252
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发表时间：
2009-08-13
影响因子：
158.5
通讯作者：
Cordova-Villalobos, Jose Angel
中科院分区：
文献类型：
--
作者：
Perez-Padilla, Rogelio;de la Rosa-Zamboni, Daniela;Cordova-Villalobos, Jose Angel
背景2009年3月下旬，墨西哥爆发了一场呼吸道疾病，后来被证明是由新型猪源甲型H1N1流感病毒（S-OIV）引起的。我们描述的临床和流行病学特征的人住院的肺炎在国家三级医院呼吸系统疾病在墨西哥城谁有实验室确诊的S-OIV感染，也被称为猪流感。MethodsWe采用回顾性医疗图表审查收集数据的住院患者。使用实时逆转录聚合酶链反应assay.ResultsFrom 2009年3月24日至4月24日，共有18例肺炎和确诊的S-OIV感染的标本中确认为急性呼吸道疾病住院的98例患者在墨西哥城的国家呼吸系统疾病研究所。18例患者中一半以上的年龄在13岁至47岁之间，只有8例有既往病史。18名患者中有16名患者是首次因病住院;另外2名患者是从其他医院转来的。所有患者均有发热、咳嗽、呼吸困难或呼吸窘迫、血清乳酸脱氢酶水平升高和双侧斑片状肺炎。其他常见的发现是肌酸激酶水平升高（62%的患者）和淋巴细胞减少症（61%）。12名患者需要机械通气，7人死亡。在7天内与最初的病例患者接触后，轻度或中度流感样疾病的22名卫生保健工作者，他们与奥司他韦治疗，没有人住院。ConclusionsS-OIV感染可能会导致严重的疾病，急性呼吸窘迫综合征，并在以前健康的人谁是年轻到中年死亡。在卫生保健工作者中没有严重的继发感染。
BackgroundIn late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu.MethodsWe used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay.ResultsFrom March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level ( in 62% of patients) and lymphopenia ( in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized.ConclusionsS-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe.