Department of Influenza Research, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
Adv Exp Med Biol. 2013;756:271-83. doi: 10.1007/978-94-007-4549-0_34.
This study presents epidemiological and clinical data on non-sentinel patients considered by physicians as suspected to be infected with pandemic A(H1N1)2009 virus, from whom clinical specimens were sent for testing to the National Influenza Center, NIPH-NIH in Warsaw, Poland. Between April 28, 2009 and August 10, 2010, 988 (15.7%) out of the 6,311 specimens were tested by the National Influenza Center, including 798 from non-sentinel sources and 190 from sentinel influenza surveillance network. The non-sentinel specimens were tested by conventional RT-PCR to detect influenza A and in the case of positive specimens - one-step real-time RT-PCR to detect the pandemic virus A(H1N1)2009. In 145 (18.2%) cases, infections with the pandemic virus were confirmed, with the highest number in patients aged 15-25. In 45% of the confirmed cases, a history of travel to other countries was registered. The most common symptoms were fever ≥38°C (72.7%), cough (50%), sore throat, and myalgia (26.1%). In 40.7% of the swabbed patients, clinical and epidemiological criteria for the novel influenza A(H1N1)2009, set by the European Commission, were met. There were, however, specimens from persons without any reasonable indication for testing for the pandemic virus, specimens collected incorrectly, and documentation without basic information. These weaknesses resulted in unnecessary costs and overload of health care units. An improvement should be achieved in the area of communication between different pandemic players in the future. More attention is also needed to ensure that requirements and recommendations are known and used.
本研究介绍了波兰华沙国家流感中心(NIPH-NIH)收到的疑似感染大流行 A(H1N1)2009 病毒的非哨点患者的临床和流行病学数据,这些患者的临床标本是由医生送来检测的。2009 年 4 月 28 日至 2010 年 8 月 10 日,国家流感中心检测了 988 份(占 6311 份的 15.7%)标本,包括 798 份非哨点来源和 190 份哨点流感监测网络的标本。非哨点标本采用常规 RT-PCR 检测流感 A,并对阳性标本进行一步法实时 RT-PCR 检测大流行病毒 A(H1N1)2009。在 145 例(占 18.2%)确诊病例中,发现了感染大流行病毒的病例,其中 15-25 岁患者的感染人数最多。在 45%的确诊病例中,有出国旅行史。最常见的症状是发热≥38°C(72.7%)、咳嗽(50%)、咽痛和肌痛(26.1%)。在 40.7%的拭子采集患者中,符合欧盟委员会设定的新型流感 A(H1N1)2009 的临床和流行病学标准。然而,也有一些标本是来自没有任何理由进行大流行病毒检测的人,采集标本不正确,以及没有基本信息的文件。这些弱点导致了不必要的成本和医疗保健单位的负担过重。未来应该在不同大流行参与者之间的沟通方面取得改进。还需要更加注意确保要求和建议得到了解和使用。