Emergency Department, University Hospital, Basel, Switzerland.
Swiss Med Wkly. 2009 Dec 26;139(51-52):731-7. doi: 10.4414/smw.2009.12952.
To describe the disease burden, clinical pattern and outcome of influenza-related cases presenting to a Swiss Emergency Department (ED), during the first wave of the 2009 pandemic.
Retrospective analysis of prospectively collected data at the University Hospital of Basel, Switzerland. All patients presenting to the ED with influenza-like symptoms from June 1 to October 23, 2009, were studied. Rate of hospitalisation, demographic characteristics, symptoms, microbiological diagnoses and complications of influenza infection were analysed.
One tenth (808 of 8356 patients) of all non-trauma ED presentations, during the study period, were a result of suspected influenza-related illness. Influenza A/H1N1v infection accounted for 5% of these presentations. Patients aged 50 years or less accounted for 87% of these presentations and for 100% of A/H1N1v infection. The highest detection rate of A/H1N1v-infection occurred in July, and the highest rate of clinical presentations occurred in August 2009. Underlying medical disease was observed in 14% of all patients. The presence of fever, cough and myalgia was the prime clinical predictor for the presence of A/H1N1v infection. 16% of patients with this triad suffered from A/H1N1v.
Suspected A/H1N1v infection contributed to a considerable health care burden in Switzerland. However, the rate of true positivity was low (5%), hospitalisations rare (5%), and mortality did not occur. Therefore, the first wave of the A/H1N1v pandemic in Switzerland was rather media "hype" than real threat.
描述在 2009 年大流行的第一波期间，瑞士一家急诊部（ED）因流感相关病例的疾病负担、临床模式和结局。
对瑞士巴塞尔大学医院前瞻性收集的数据进行回顾性分析。研究了 2009 年 6 月 1 日至 10 月 23 日期间因流感样症状就诊于 ED 的所有患者。分析了住院率、人口统计学特征、症状、微生物学诊断和流感感染并发症。
在所研究期间，所有非创伤性 ED 就诊患者的十分之一（8356 例中的 808 例）是疑似流感相关疾病的结果。甲型 H1N1v 感染占这些就诊病例的 5%。年龄在 50 岁或以下的患者占这些就诊病例的 87%，占 H1N1v 感染的 100%。H1N1v 感染的最高检出率出现在 7 月，临床就诊的最高发生率出现在 2009 年 8 月。所有患者中 14%存在基础疾病。发热、咳嗽和肌痛的存在是 H1N1v 感染存在的主要临床预测因素。三组合中有 16%的患者患有 H1N1v。
疑似 H1N1v 感染在瑞士造成了相当大的医疗保健负担。然而，真正的阳性率很低（5%），住院率罕见（5%），死亡率并未发生。因此，瑞士的 H1N1v 大流行第一波更多的是媒体“炒作”，而不是真正的威胁。
