Department of Allergy, Immunology & Respiratory Medicine, Alfred Hospital, Commercial Rd, Melbourne, Victoria, Australia, 3004.
Am J Respir Crit Care Med. 2010 Feb 15;181(4):300-6. doi: 10.1164/rccm.200912-1878CP.
Influenza A/H1N1_09 emerged in Mexico at the end of the Northern Hemisphere winter. Within weeks, the focus shifted to the Southern Hemisphere as the introduction of the novel virus coincided with the beginning of the influenza season. Intensive public health and health services planning had occurred in Australia and New Zealand as preparation for an influenza pandemic before 2009. However, this first pandemic wave was quite different to what had been expected. Key elements of the pandemic and response are outlined from the perspective of clinicians working at the frontline of patient care. In particular, they examine why past influenza pandemics and recent history are poor predictors of the current pandemic, the discordance between potential for transmission and disease severity, the broad clinical spectrum of H1N1_09 infection, clinical and health service management issues, and the relationship between health care and government policy. Finally, they address the need for the respiratory community to show leadership in times of crisis. Lessons learned in Australia and New Zealand during 2009 have important messages for similarly resourced countries in the Northern Hemisphere in the coming months as they face their own influenza season.
甲型 H1N1 流感 09 年在北半球冬季末期出现在墨西哥。几周内，随着新型病毒的引入恰逢流感季节的开始，重点转移到了南半球。澳大利亚和新西兰在 2009 年之前已经进行了密集的公共卫生和卫生服务规划，以准备应对流感大流行。然而，这第一波大流行与预期的完全不同。从处于患者护理第一线的临床医生的角度，概述了大流行和应对措施的关键要素。特别是，他们探讨了为什么过去的流感大流行和近期历史对当前大流行的预测作用较差，传播潜力与疾病严重程度之间的差异，H1N1_09 感染的广泛临床谱，临床和卫生服务管理问题，以及医疗保健与政府政策之间的关系。最后，他们提出了呼吸道疾病社区在危机时刻需要发挥领导作用的问题。澳大利亚和新西兰在 2009 年期间吸取的经验教训，对于北半球资源类似的国家在未来几个月中应对自身的流感季节具有重要意义。
