Department of Pediatrics, Center of Infection Control, Tao-Yuan General Hospital, Tao-Yuan, Taiwan, ROC.
Pediatr Neonatol. 2012 Aug;53(4):257-63. doi: 10.1016/j.pedneo.2012.06.005. Epub 2012 Jul 28.
In April 2009, confirmed cases of influenza A (H1N1) infections were reported worldwide, spreading from Mexico and southern California. In order to determine the clinical features of patients infected with this virus before vaccine implementation and evaluate the response of antiviral treatment in Taiwan, we reviewed medical charts and collected clinical data from outpatients and inpatients at the Tao-Yuan General Hospital.
From May 19, 2009, to October 31, 2009, clinical data from patients confirmed by the rapid antigen-screening test for influenza A virus and/or reverse transcriptase-polymerase chain reaction analysis at the Tao-Yuan General Hospital were reviewed retrospectively.
A total of 1158 patients (94.6%) received outpatient management, 66 patients (5.4%) were hospitalized, and no patients died. More than two-thirds of patients were younger than 16 years old. The most common symptoms were fever (99.8%), cough (91.4%), sore throat (63.7%), and rhinorrhea (53.8%). Ninety patients (13.3%) had complications, including lower respiratory tract infections (11.1%). Among the 677 patients receiving follow-ups, none needed mechanical ventilation due to lower respiratory tract infection. Most of the patients (87.2%) began antiviral therapy within 2 days after the onset of symptoms. Ninety percent of patients became afebrile within 2 days after the initiation of antiviral therapy. The number of screening specimens and the positivity rate of the rapid influenza A antigen test were dramatically decreased 4 weeks later, after universal implementation of the pandemic influenza A (H1N1) 2009 vaccine to infants and school-age children.
The clinical spectrum of pandemic influenza A (H1N1) 2009 infection was broad and the severity of disease was mild. Early antiviral treatment was effective in decreasing mortality and morbidity. Early and universal implementation of a novel influenza A vaccine is an effective approach for preventing pandemic community influenza outbreaks, particularly among infants and school-age children.
2009 年 4 月，世界范围内报告了确诊的甲型 H1N1 流感感染病例，这些病例从墨西哥和南加州开始传播。为了确定在实施疫苗之前感染这种病毒的患者的临床特征，并评估台湾地区抗病毒治疗的反应，我们回顾了桃园总医院门诊和住院患者的病历，并收集了临床数据。
从 2009 年 5 月 19 日至 10 月 31 日，我们回顾性分析了在桃园总医院通过甲型流感病毒快速抗原筛查试验和/或逆转录酶聚合酶链反应分析确诊的患者的临床数据。
共有 1158 例患者（94.6%）接受了门诊治疗，66 例患者（5.4%）住院治疗，没有患者死亡。超过三分之二的患者年龄小于 16 岁。最常见的症状是发热（99.8%）、咳嗽（91.4%）、咽痛（63.7%）和流涕（53.8%）。90 例（13.3%）患者出现并发症，包括下呼吸道感染（11.1%）。在接受随访的 677 例患者中，由于下呼吸道感染而需要机械通气的患者为零。大多数患者（87.2%）在症状出现后 2 天内开始接受抗病毒治疗。在开始抗病毒治疗后 2 天内，90%的患者退热。4 周后，在向婴幼儿和学龄儿童普遍接种大流行流感 A（H1N1）2009 疫苗后，甲型流感抗原快速检测的检测标本数量和阳性率显著下降。
大流行流感 A（H1N1）2009 感染的临床谱广泛，疾病严重程度较轻。早期抗病毒治疗可降低死亡率和发病率。早期和普遍实施新型流感 A 疫苗是预防大流行社区流感暴发的有效方法，特别是在婴幼儿和学龄儿童中。
