Graham James, Shirm Steven, Storm Elizabeth, Lyle Kristen, Linam W Matthew, Romero José
Department of Pediatrics, University of Arkansas College of Medicine and Arkansas Children's Hospital, Little Rock, Arkansas, USA.
Am J Disaster Med. 2011 Jul-Aug;6(4):211-8. doi: 10.5055/ajdm.2011.0060.
The purpose of this study was to describe the impact of the 2009 H1N1 influenza pandemic on a pediatric emergency department (ED) at a freestanding children's hospital in the summer and fall of 2009.
In July 2009, active prospective surveillance for influenza-like illness (ILI) was performed on a daily basis of patients presenting to the ED of Arkansas Children's Hospital. The Centers for Disease Control and Prevention definition of ILI was used. Records of daily ILI volume were kept. A retrospective review of admissions from the ED to the inpatient service was done for patients with ILI and non-ILI. In addition, comparisons of monthly patient census for the months involved were compared with historical census data.
When public schools started in mid-August 2009, there was a rapid and dramatic increase in the number of patients with ILI seen in the pediatric ED. Within 3 weeks, as many as 120 patients with ILI per day were being seen in the ED. The month of September 2009 was the highest census month ever recorded in this ED. The admission rate of the patients with ILI was lower than patients with non-ILI between September and November 2009 (10.8 percent vs 14.8 percent).
The 2009 H1N1 influenza pandemic resulted in unprecedented patient volumes in this pediatric ED; however, patient acuity (based on admission rate) for patients with ILI was lower than patients with non-ILI. Pandemic influenza can overwhelm emergency care resources, even when the overall severity of illness is relatively low.
本研究旨在描述2009年甲型H1N1流感大流行对一家独立儿童医院儿科急诊科在2009年夏秋季节的影响。
2009年7月，对阿肯色儿童医院急诊科就诊的患者进行了每日流感样疾病（ILI）主动前瞻性监测。采用疾病控制与预防中心对ILI的定义。记录每日ILI病例数。对ILI患者和非ILI患者从急诊科到住院部的收治情况进行回顾性分析。此外，将所涉月份的每月患者普查数据与历史普查数据进行比较。
2009年8月中旬公立学校开学后，儿科急诊科ILI患者数量迅速大幅增加。在3周内，急诊科每天接诊多达120例ILI患者。2009年9月是该急诊科有记录以来普查人数最多的月份。2009年9月至11月期间，ILI患者的收治率低于非ILI患者（10.8%对14.8%）。
2009年甲型H1N1流感大流行导致该儿科急诊科患者数量空前；然而，ILI患者的病情严重程度（基于收治率）低于非ILI患者。即使疾病总体严重程度相对较低，大流行性流感也可能使急诊护理资源不堪重负。
