Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Tovilo, K.
PCR confirmed Influenza A H1N1 in South East Austria, season 2009/2010: Epidemiology,
laboratory characteristics and outcome
[ Diplomarbeit ] Medical University of Graz; 2011. pp. 80
[OPEN ACCESS]
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hönigl Martin
- Krause Robert
- Altmetrics:
- Abstract:
- Summary Aim During spring 2009 novel pandemic influenza A (H1N1) virus emerged in Mexico and spread rapidly globally for almost one year till the announced end of the pandemic resulting in millions of laboratory confirmed cases and over 18000 deaths worldwide. Compared to previous non-pandemic influenza seasons, epidemiology of the H1N1 pandemic in 2009-2010 differed significantly. As sensitivity of currently available rapid antigen tests has shown to be low, PCR is the recommended test for diagnosis and confirmation of infection. We retrospectively analyzed cases of PCR confirmed H1N1 influenza in South East Austria, and describe epidemiologic characteristics, laboratory values and outcome of hospitalized patients. Methods This is a retrospective survey of patients with PCR-proven influenza H1N1 infection in South East Austria. Participating hospitals were the University Hospital Graz, and the State Hospitals of Graz-West, Leoben, Bruck, Judenburg, Hörgas-Enzenbach, Feldbach, Deutschlandsberg, Rottenmann, Wagna, and Bad Aussee. PCR testing for the whole region of South-East Austria was done at the Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz and at the Institute for Hospital Hygiene and Microbiology, University Hospital of Graz. 624 cases of H1N1 influenza were detected during the surveillance period from October, 1, 2009 to January, 19, 2010. Complete data sets were available from 197/624 (32%) of patients who were hospitalized or presented to outpatient clinic only at one of the participating hospitals. Data from 402/624 (64%) of patients could not been surveyed as they were, in the vast majority of cases, not submitted to hospital and presented to their family doctor only and therefore no data was available in MEDOCS, the electronic data base. 2.3Results Out of 197 cases (117 male, 80 female, mean age 25 years) 17 (9%) required intensified medical care, 132 (67%) care at normal wards, and 48 (24%) presented to outpatient clinic only. 1% (2/197) had a history of vaccination against H1N1 influenza while 99% had not. Rapid antigen test (BinaxNow, Inverness Medical, Maine, U.S.) was negative in the vast majority of cases (89%). The most consistent laboratory characteristics in our study were total leukocyte count within normal limits, lymphocytopenia, increased lactate dehydrogenase levels, increased creatinine and CRP levels and elevated AST, ALT and GGT counts. 65/197 (33%) of cases received oseltamivir treatment and in a majority of these patients (44/65, 68%) oseltamivir was administered within 48 hours. Antibacterial therapy was administered in 88/197 (45%) of cases. Complications occurred in 51/197 (26%) of cases. 33/197 (17%) of patients developed pneumonia, 8/33 of patients had bacterial pneumonia and 25/33 viral pneumonia due to H1N1. 4/51 of patients showed neurological disorders, 13/51 cases developed respiratory insufficiency and 4/51 cases developed bacteraemia/fungaemia. 5/197 cases (2.5%) had a fatal outcome, 97% survived. Mean age of patients with a fatal outcome was 39.4 years (ranging from 15 to 69 years of age); 2 out of 5 patients with fatal outcome had a history of mild chronic obstructive pulmonary disease. 2.4Conclusion During the surveillance period influenza A (H1N1) virus caused a high number of hospitalizations. In accordance with previously published data median age of PCR confirmed cases in South East Austria was comparably low and a high rate of lower respiratory disease associated with influenza H1N1 infection was observed. Labora ...