2009年泰国国立法政大学医院儿科患者的甲型H1N1流感大流行情况。

Pandemic influenza (H1N1) 2009 of pediatric patients at Thammasat University Hospital.

作者信息

Bumpenkiatigul Narumon, Tangsathapornpong Auchara, Sritipsukho Paskorn

机构信息

Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

出版信息

J Med Assoc Thai. 2012 Jan;95 Suppl 1:S1-7.

PMID:23964436

Abstract

BACKGROUND

An emerge of pandemic influenza H1N1 2009 has devastated the global community. Pediatric population is among the groups with high attack rate.

OBJECTIVE

To study the clinical presentation of pediatric patients (0-15 years old) infected with influenza H1N1 2009 and to evaluate the sensitivity and specificity of the rapid influenza test.

MATERIAL AND METHOD

Retrospective data was collected from the medical reports of patients presenting with influenza like illness (ILI) whose samples from nasal swab were tested for H1N1 using reverse transcription polymerase chain reaction (RT-PCR) during June-September 2009 at the Thammasat University Hospital.

RESULTS

Of 68 patients, 26 were confirmed to have H1N1 2009 strain. Of these, 61.5% were older than 5 years old; 26.9% had underlying conditions and 38.4% had hospitalization. All 26 patients presented with fever and cough; 73% had coryza; 57.6% had sore throat; and 88.4% had injected throat. Six patients (23%) had pneumonia. Patients younger than 5 years old experienced dyspnea and had abnormal results of a chest radiograph significantly more often than patients older than 5. Patients with H1N1 2009 strain were more likely to have sore throat, myalgia, and injected throat than non H1N1 2009 group. However chest wall retraction and abnormal chest radiograph were found significantly less often in the H1N1 group compared to the non-H1N1. No death case was reported. The rapid influenza test was found to have sensitivity of 80%, specificity of 64%, positive predictive value of 74.5%, and negative predictive value of 84.3% when compared to RT-PCR method.

CONCLUSION

During pandemic period, older children with influenza like illness had novel H1N1 2009 infection more than younger children. The majority of pediatric patients presented with mild symptoms. Patients aged below 5 years more frequently experienced pneumonia. The rapid influenza test showed a high sensitivity but low specificity.

摘要

背景

2009年甲型H1N1流感大流行给全球带来了巨大破坏。儿童群体是发病率较高的群体之一。

目的

研究2009年感染甲型H1N1流感的儿科患者（0至15岁）的临床表现，并评估快速流感检测的敏感性和特异性。

材料与方法

回顾性收集了2009年6月至9月期间在泰国法政大学医院就诊的流感样疾病（ILI）患者的医疗报告数据，这些患者的鼻拭子样本采用逆转录聚合酶链反应（RT-PCR）检测甲型H1N1流感。

结果

68例患者中，26例确诊感染2009年甲型H1N1流感毒株。其中，61.5%的患者年龄大于5岁；26.9%的患者有基础疾病，38.4%的患者住院治疗。26例患者均有发热和咳嗽症状；73%的患者有鼻塞；57.6%的患者有咽痛；88.4%的患者有咽喉充血。6例患者（23%）患有肺炎。5岁以下的患者出现呼吸困难和胸部X光检查结果异常的情况明显多于5岁以上的患者。感染2009年甲型H1N1流感毒株的患者比未感染该毒株的患者更易出现咽痛、肌痛和咽喉充血。然而，与未感染甲型H1N1流感的患者相比，甲型H1N1流感患者出现胸壁凹陷和胸部X光检查异常的情况明显较少。未报告死亡病例。与RT-PCR方法相比，快速流感检测的敏感性为80%，特异性为64%，阳性预测值为74.5%，阴性预测值为84.3%。