Drozd-Sokołowska Joanna Ewa, Dulny Grażyna, Waszczuk-Gajda Anna, Wiktor-Jędrzejczak Wiesław
Department of Haematology, Oncology and Internal Diseases, Medical University of Warsaw, Poland.
Epidemiological Service, Central Clinical Hospital, Medical University of Warsaw, Poland.
Przegl Epidemiol. 2014;68(4):621-6.
Influenza A H1N1 virus strain was associated with the pandemic outbreak of febrile respiratory infections worldwide in 2009, however in August 2010, the WHO announced that the world had entered the postpandemic period. It offered specific recommendations for this period, including the identification of clusters of severe respiratory disorders and deaths. Here we report the fulminant course of influenza AH1N1 infection in the postpandemic period in a group of patients in a single hematology department. We make an attempt to identify potential risk factors and the mode of spreading, and to provide recommendations for best practice.
We conducted a retrospective analysis of a cluster of patients diagnosed with or suspected of influenza A H1N1 infection in the period from December 2010 to March 2011.
Fourteen patients with hematological disorders unexpectedly developed acute respiratory failure ARDS (Acute Respiratory Distress Syndrome). Of them, nine tested positive for influenza A H1N1 in a screening test and eight in confirmatory polymerase chain reaction. The infection was fatal in nine patients, despite artificial ventilation in eight and oseltamivir administration in 11. Ten were in reverse isolation according to CDC. No similar cases occurred in the whole hospital concurrently, or in the hematology wards at any other time.
The occurrence of A H1N1 epidemics in a hematological ward in the post-pandemic period highlights the importance of awareness of this complication, prompt testing and antiviral treatment. Furthermore, it confirms the importance of vaccinating patients and personnel against influenza as a prophylactic measure.
甲型H1N1流感病毒株与2009年全球发热性呼吸道感染的大流行有关，然而在2010年8月，世界卫生组织宣布世界已进入大流行后时期。该组织针对这一时期提供了具体建议，包括识别严重呼吸道疾病和死亡病例群。在此，我们报告了在大流行后时期，一个血液科的一组患者中甲型H1N1流感感染的暴发性病程。我们试图确定潜在风险因素和传播方式，并提供最佳实践建议。
我们对2010年12月至2011年3月期间诊断为或疑似感染甲型H1N1流感的一组患者进行了回顾性分析。
14例血液系统疾病患者意外发生急性呼吸窘迫综合征（ARDS）。其中，9例在筛查试验中甲型H1N1流感检测呈阳性，8例在聚合酶链反应确诊试验中呈阳性。尽管8例患者接受了人工通气，11例患者服用了奥司他韦，但仍有9例患者感染致死。根据美国疾病控制与预防中心（CDC）的建议，10例患者接受了反向隔离。同期全院及血液科病房在其他任何时间均未发生类似病例。
大流行后时期血液科病房发生甲型H1N1流感疫情凸显了认识这一并发症、及时检测和抗病毒治疗的重要性。此外，这也证实了对患者和医护人员进行流感疫苗接种作为预防措施的重要性。
