Provincial Laboratory for Public Health, Edmonton;
Can J Infect Dis Med Microbiol. 2010 Winter;21(4):e151-7. doi: 10.1155/2010/293098.
In March 2009, global surveillance started detecting cases of influenza-like illness in Mexico. By mid-April 2009, two pediatric patients were identified in the United States who were confirmed to be infected by a novel influenza A (H1N1) strain. The present article describes the first identified severe respiratory infection and the first death associated with pandemic H1N1 (pH1N1) in Canada.
Enhanced public health and laboratory surveillance for pH1N1 was implemented throughout Alberta on April 24, 2009. Respiratory specimens from all patients with a respiratory illness and travel history or those presenting with a severe respiratory infection requiring hospitalization underwent screening for respiratory viruses using molecular methods. For the first severe case identified and the first death due to pH1N1, histocompatibility leukocyte antigens were compared by molecular methods.
The first death (a 39-year-old woman) occurred on April 28, 2009, and on May 1, 2009, a 10-year-old child presented with severe respiratory distress due to pH1N1. Both patients had no travel or contact with anyone who had travelled to Mexico; the cases were not linked. Histocompatibility antigen comparison of both patients did not identify any notable similarity. pH1N1 strains identified in Alberta did not differ from the Mexican strain.
Rapid transmission of pH1N1 continued to occur in Alberta following the first death and the first severe respiratory infection in Canada, which were identified without any apparent connection to Mexico or the United States. Contact tracing follow-up suggested that oseltamivir may have prevented ongoing transmission of pH1N1.
2009 年 3 月，全球监测系统开始在墨西哥发现类流感病例。到 2009 年 4 月中旬，美国发现了两例经确认感染新型甲型 H1N1 流感病毒的儿科患者。本文描述了加拿大首例确诊的严重呼吸道感染和首例与大流行 H1N1（pH1N1）相关的死亡病例。
2009 年 4 月 24 日，艾伯塔省在整个省内加强了 pH1N1 的公共卫生和实验室监测。对所有有呼吸道疾病和旅行史的呼吸道疾病患者，或有严重呼吸道感染需要住院的患者的呼吸道标本，采用分子方法进行呼吸道病毒筛查。对首例严重病例和首例因 pH1N1 死亡的病例，采用分子方法比较人类白细胞抗原。
首例死亡（一名 39 岁妇女）发生在 2009 年 4 月 28 日，2009 年 5 月 1 日，一名 10 岁儿童因 pH1N1 出现严重呼吸窘迫。两名患者均无旅行史，也未与任何去过墨西哥的人接触，两例病例没有关联。对两名患者的人类白细胞抗原比较未发现任何显著相似性。在艾伯塔省发现的 pH1N1 株与墨西哥株没有区别。
在加拿大首例死亡和首例严重呼吸道感染发生后，pH1N1 在艾伯塔省继续快速传播，且与墨西哥或美国没有明显联系。接触者追踪随访表明，奥司他韦可能防止了 pH1N1 的持续传播。
