Duque V, Cordeiro E, Mota V, Vaz J, Morais C, Rodrigues F, Coelho F, da Cunha J Saraiva, Meliço-Silvestre A
Serviço de Doenças Infecciosas dos Hospitais da Universidade de Coimbra, EPE, Laboratório de Virologia dos Hospitais da Universidade de Coimbra, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal.
Rev Port Pneumol. 2010 Nov-Dec;16(6):870-9.
The first case of pandemic (H1N1) 2009 virus infection was diagnosed in the central region of Portugal on June 16, 2009, in a woman infected in Canada.
The aim of our study was, first to characterize the clinical and epidemiologic aspects of all the patients with clinical manifestations included in the definition of case for investigation with samples submitted to diagnosis of the pandemic (H1N1) 2009 virus infection, in the central region of Portugal; second to assess the precision of the case definition of case for investigation considered in the study according to the presence or the absence of fever at the moment of clinical observation. We reviewed the medical records of all the patients presenting with Influenza like-illness classified as case for investigation and the first cases of patients infected with the new pandemic (H1N1) 2009 virus, diagnosed in the central region of Portugal during the pandemic period between June and August, 2009, were analyzed. Real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) testing was used to confirm the pandemic (H1N1) 2009 virus infection. Data collection was performed on a standardized paper format in agreement with the General Health Directorate.
Pandemic (H1N1) 2009 virus infection was confirmed in 255 patients. Overall, median age was 23 years and 42.7 % were included in the category of 20 to 29 years. Confirmed infection in patients with less than 2 years or greater than 50 years was a rare event. The first cases were imported from Europe, namely France, Spain and England. On a second phase, pandemic (H1N1) 2009 virus infection was acquired in the south of Portugal (Algarve), before de diagnosis of the first domestic case. The incidence rate for pandemic (H1N1) 2009 virus infection was 10.7 per 100,000 persons and was different according to the district. It was higher in the district of Coimbra and Guarda were the main roads connecting to Europe are. The median calculated incubation period for the for pandemic (H1N1) 2009 virus infection was 2 days. The length of the clinical manifestations until the patients look for medical observation had a median time of 2 days. All the cases were of mild to moderate severity. No deaths were observed.
The early days of pandemic (H1N1) 2009 virus infection was mild in our region. Most affected patients were young adults, with the extreme categories ages of life being spared. Early detection and diagnosis, combined with stringent isolation and treatment procedures could have slowed the spread of the infection in our region.
2009年6月16日，在葡萄牙中部地区确诊了首例甲型H1N1流感大流行病毒感染病例，患者为一名在加拿大感染的女性。
我们研究的目的，一是描述葡萄牙中部地区所有有临床表现且样本送检以诊断2009年甲型H1N1流感大流行病毒感染的调查病例定义中的患者的临床和流行病学特征；二是根据临床观察时是否发热评估本研究中考虑的调查病例定义的准确性。我们查阅了所有被分类为调查病例的流感样疾病患者的病历，并分析了2009年6月至8月大流行期间在葡萄牙中部地区确诊的首例2009年甲型H1N1流感大流行病毒感染患者。采用实时逆转录聚合酶链反应（RT-PCR）检测来确认2009年甲型H1N1流感大流行病毒感染。数据收集采用与卫生总局一致的标准化纸质格式。
255例患者确诊感染2009年甲型H1N1流感大流行病毒。总体而言，中位年龄为23岁，42.7%的患者年龄在20至29岁之间。2岁以下或50岁以上患者确诊感染的情况较为罕见。首例病例从欧洲输入，即法国、西班牙和英国。在第二阶段，在葡萄牙南部（阿尔加维）出现了2009年甲型H1N1流感大流行病毒感染，之后才确诊首例本土病例。2009年甲型H1N1流感大流行病毒感染的发病率为每10万人10.7例，且因地区而异。在科英布拉区和瓜尔达区发病率较高，这两个地区是连接欧洲的主要道路所在地区。计算得出的2009年甲型H1N1流感大流行病毒感染的中位潜伏期为2天。患者寻求医疗观察前的临床表现持续时间的中位时间为2天。所有病例病情均为轻度至中度。未观察到死亡病例。
在我们地区，2009年甲型H1N1流感大流行病毒感染初期症状较轻。大多数受影响患者为年轻人，生命两端的年龄段未受影响。早期检测和诊断，结合严格的隔离和治疗程序，可能减缓了该感染在我们地区的传播。
