Department of Surveillance and Epidemiology, Ministry of Health and Population, Cairo, Egypt.
Central Public Health Laboratory, Cairo, Egypt.
JMIR Public Health Surveill. 2021 Apr 28;7(4):e27433. doi: 10.2196/27433.
Sentinel surveillance of influenza-like illness (ILI) in Egypt started in 2000 at 8 sentinel sites geographically distributed all over the country. In response to the COVID-19 pandemic, SARS-CoV-2 was added to the panel of viral testing by polymerase chain reaction for the first 2 patients with ILI seen at one of the sentinel sites. We report the first SARS-CoV-2 and influenza A(H1N1) virus co-infection with mild symptoms detected through routine ILI surveillance in Egypt.
This report aims to describe how the case was identified and the demographic and clinical characteristics and outcomes of the patient.
The case was identified by Central Public Health Laboratory staff, who contacted the ILI sentinel surveillance officer at the Ministry of Health. The case patient was contacted through a telephone call. Detailed information about the patient's clinical picture, course of disease, and outcome was obtained. The contacts of the patient were investigated for acute respiratory symptoms, disease confirmation, and outcomes.
Among 510 specimens collected from patients with ILI symptoms from October 2019 to August 2020, 61 (12.0%) were COVID-19-positive and 29 (5.7%) tested positive for influenza, including 15 (51.7%) A(H1N1), 11 (38.0%) A(H3N2), and 3 (10.3%) influenza B specimens. A 21-year-old woman was confirmed to have SARS-CoV-2 and influenza A(H1N1) virus coinfection. She had a high fever of 40.2 °C and mild respiratory symptoms that resolved within 2 days with symptomatic treatment. All five of her family contacts had mild respiratory symptoms 2-3 days after exposure to the confirmed case, and their symptoms resolved without treatment or investigation.
This case highlights the possible occurrence of SARS-CoV-2/influenza A(H1N1) coinfection in younger and healthy people, who may resolve the infection rapidly. We emphasize the usefulness of the surveillance system for detection of viral causative agents of ILI and recommend broadening of the testing panel, especially if it can guide case management.
埃及于 2000 年在全国 8 个哨点开始进行流感样疾病（ILI）的哨点监测。为应对 COVID-19 大流行，在其中一个哨点首次接诊的 2 例ILI 患者中，聚合酶链反应（PCR）病毒检测中增加了 SARS-CoV-2。我们报告了首例通过埃及常规 ILI 监测发现的 SARS-CoV-2 和甲型流感（H1N1）病毒合并感染的轻症病例。
本报告旨在描述该病例是如何被发现的，以及患者的人口统计学和临床特征及结局。
中央公共卫生实验室工作人员发现了该病例，他们联系了卫生部的 ILI 哨点监测官员。通过电话联系了病例患者。详细获取了患者临床特征、病程和结局的信息。对患者的接触者进行了急性呼吸道症状、疾病确诊和结局的调查。
在 2019 年 10 月至 2020 年 8 月期间，对 510 例ILI 症状患者的标本进行了采集，其中 61 例（12.0%）COVID-19 阳性，29 例（5.7%）流感阳性，包括 15 例（51.7%）甲型 H1N1、11 例（38.0%）甲型 H3N2 和 3 例（10.3%）乙型流感。一名 21 岁女性被确诊为 SARS-CoV-2 和甲型 H1N1 病毒合并感染。她有 40.2°C 的高热和轻微的呼吸道症状，对症治疗 2 天后缓解。与确诊病例接触后 2-3 天，她的 5 名家庭接触者均出现轻度呼吸道症状，未经治疗或调查即自行缓解。
该病例突出了 SARS-CoV-2/甲型 H1N1 合并感染可能发生在年轻和健康人群中，这些患者可能会迅速清除感染。我们强调了监测系统对ILI 病毒病原体的检测作用，并建议扩大检测范围，特别是如果它可以指导病例管理。
