Clinical Features of the Initial Cases of 2009 Pandemic Influenza A (H1N1) Virus Infection in China
Clinical Features of the Initial Cases of 2009 Pandemic Influenza A (H1N1) Virus Infection in China
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DOI：
10.1056/nejmoa0906612
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发表时间：
2009-12-24
影响因子：
158.5
通讯作者：
Wang, Chen
中科院分区：
文献类型：
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作者：
Cao, Bin;Li, Xing-Wang;Wang, Chen
2009年5月10日，中国记录了首例甲型H1N1流感病毒感染病例。随后，对疑似感染病例的人员和疑似感染者的接触者进行了检测。确诊感染的人住院治疗和隔离，其中一些人被密切观察，以调查的性质和疾病的持续时间。METHODS在2009年5月和6月，我们观察了426人感染2009年甲型H1N1流感病毒被隔离在20个省的61家医院。实时逆转录聚合酶链反应（RT-PCR）检测用于确认感染，密切监测疾病的临床特征，254例患者在发病后48小时内接受奥司他韦治疗。在入境口岸（32.9%的患者）、隔离期间（20.2%）和医院（46.9%）进行了诊断。病毒的中位潜伏期为2天（范围1至7天）。最常见的症状是发热（67.4%）和咳嗽（69.5%）。腹泻发生率为2.8%，恶心呕吐发生率为1.9%。淋巴细胞减少症常见于成人（68.1%）和儿童（92.3%），通常发生在第2天（范围，1 - 3），并在第7天（范围，6 - 9）消退。25.4%的患者出现低钾血症。发热持续时间通常为3天（范围，1至11天）。患者获得阳性实时RT-PCR检测结果的中位时间长度为6天（范围，1至17天）。长期实时RT-PCR阳性的独立风险因素包括年龄小于14岁、男性以及从出现症状到奥司他韦治疗的延迟超过48小时。结论2009年H1N1病毒监测显示，大多数感染者病情较轻。使用实时RT-PCR检测病毒的典型时间段为6天（无论是否存在发热）。如果使用奥司他韦，感染的持续时间可能会缩短。
BACKGROUNDThe first case of 2009 pandemic influenza A (H1N1) virus infection in China was documented on May 10. Subsequently, persons with suspected cases of infection and contacts of those with suspected infection were tested. Persons in whom infection was confirmed were hospitalized and quarantined, and some of them were closely observed for the purpose of investigating the nature and duration of the disease.METHODSDuring May and June 2009, we observed 426 persons infected with the 2009 pandemic influenza A (H1N1) virus who were quarantined in 61 hospitals in 20 provinces. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection, the clinical features of the disease were closely monitored, and 254 patients were treated with oseltamivir within 48 hours after the onset of disease.RESULTSThe mean age of the 426 patients was 23.4 years, and 53.8% were male. The diagnosis was made at ports of entry (in 32.9% of the patients), during quarantine (20.2%), and in the hospital (46.9%). The median incubation period of the virus was 2 days (range, 1 to 7). The most common symptoms were fever (in 67.4% of the patients) and cough (69.5%). The incidence of diarrhea was 2.8%, and the incidence of nausea and vomiting was 1.9%. Lymphopenia, which was common in both adults (68.1%) and children (92.3%), typically occurred on day 2 (range, 1 to 3) and resolved by day 7 (range, 6 to 9). Hypokalemia was observed in 25.4% of the patients. Duration of fever was typically 3 days (range, 1 to 11). The median length of time during which patients had positive real-time RT-PCR test results was 6 days (range, 1 to 17). Independent risk factors for prolonged real-time RT-PCR positivity included an age of less than 14 years, male sex, and a delay from the onset of symptoms to treatment with oseltamivir of more than 48 hours.CONCLUSIONSSurveillance of the 2009 H1N1 virus in China shows that the majority of those infected have a mild illness. The typical period during which the virus can be detected with the use of real-time RT-PCR is 6 days (whether or not fever is present). The duration of infection may be shortened if oseltamivir is administered.