OBJECTIVE: There were many cases of pandemic influenza A (H1N1) 2009 (H1N1/09) in Japan during the 2009-2010 epidemic. They accounted for 16% of the total population (20.7 million/128 million), and 59% of the patients were children 15 years of age and under (12.2 million/20.7million). However, there were only 38 paediatric deaths. We analyzed the clinical manifestations and treatment of children hospitalized because of H1N1/09 infection in order to clarify the association between treatment with neuraminidase inhibitors and the low mortality rate. METHODS: A retrospective chart review was performed on a total of 1000 paediatric inpatients. RESULTS: The causes of the hospitalizations were respiratory complications in 651 cases (65.1%), neurological complications in 255 cases (25.5%) and other complications in 94 cases. Neuraminidase inhibitors, primarily oseltamivir, had been used to treat 984 (98.4%) of the 1000 patients, and in 88.9% of the patients, treatment with neuraminidase inhibitors was initiated within 48 h after the onset of illness. Only 12 (1.2%) of the 1000 patients underwent mechanical ventilation, and one patient died of H1N1/09 infection. CONCLUSIONS: Although a high proportion of the patients in this study had severe respiratory complications, the case fatality rate was only 0.1%. The low mortality rate of children due to the H1N1/09 epidemic in Japan was probably attributable to the universal implementation of early treatment with neuraminidase inhibitors.
OBJECTIVE: There were many cases of pandemic influenza A (H1N1) 2009 (H1N1/09) in Japan during the 2009-2010 epidemic. They accounted for 16% of the total population (20.7 million/128 million), and 59% of the patients were children 15 years of age and under (12.2 million/20.7million). However, there were only 38 paediatric deaths. We analyzed the clinical manifestations and treatment of children hospitalized because of H1N1/09 infection in order to clarify the association between treatment with neuraminidase inhibitors and the low mortality rate. METHODS: A retrospective chart review was performed on a total of 1000 paediatric inpatients. RESULTS: The causes of the hospitalizations were respiratory complications in 651 cases (65.1%), neurological complications in 255 cases (25.5%) and other complications in 94 cases. Neuraminidase inhibitors, primarily oseltamivir, had been used to treat 984 (98.4%) of the 1000 patients, and in 88.9% of the patients, treatment with neuraminidase inhibitors was initiated within 48 h after the onset of illness. Only 12 (1.2%) of the 1000 patients underwent mechanical ventilation, and one patient died of H1N1/09 infection. CONCLUSIONS: Although a high proportion of the patients in this study had severe respiratory complications, the case fatality rate was only 0.1%. The low mortality rate of children due to the H1N1/09 epidemic in Japan was probably attributable to the universal implementation of early treatment with neuraminidase inhibitors.
Authors: Fiona Havers; Swathi Thaker; Jessie R Clippard; Michael Jackson; Huong Q McLean; Manjusha Gaglani; Arnold S Monto; Richard K Zimmerman; Lisa Jackson; Josh G Petrie; Mary Patricia Nowalk; Krissy K Moehling; Brendan Flannery; Mark G Thompson; Alicia M Fry Journal: Clin Infect Dis Date: 2014-07-16 Impact factor: 9.079
Authors: Stella G Muthuri; Sudhir Venkatesan; Puja R Myles; Jo Leonardi-Bee; Tarig S A Al Khuwaitir; Adbullah Al Mamun; Ashish P Anovadiya; Eduardo Azziz-Baumgartner; Clarisa Báez; Matteo Bassetti; Bojana Beovic; Barbara Bertisch; Isabelle Bonmarin; Robert Booy; Victor H Borja-Aburto; Heinz Burgmann; Bin Cao; Jordi Carratala; Justin T Denholm; Samuel R Dominguez; Pericles A D Duarte; Gal Dubnov-Raz; Marcela Echavarria; Sergio Fanella; Zhancheng Gao; Patrick Gérardin; Maddalena Giannella; Sophie Gubbels; Jethro Herberg; Anjarath L Higuera Iglesias; Peter H Hoger; Xiaoyun Hu; Quazi T Islam; Mirela F Jiménez; Amr Kandeel; Gerben Keijzers; Hossein Khalili; Marian Knight; Koichiro Kudo; Gabriela Kusznierz; Ilija Kuzman; Arthur M C Kwan; Idriss Lahlou Amine; Eduard Langenegger; Kamran B Lankarani; Yee-Sin Leo; Rita Linko; Pei Liu; Faris Madanat; Elga Mayo-Montero; Allison McGeer; Ziad Memish; Gokhan Metan; Auksė Mickiene; Dragan Mikić; Kristin G I Mohn; Ahmadreza Moradi; Pagbajabyn Nymadawa; Maria E Oliva; Mehpare Ozkan; Dhruv Parekh; Mical Paul; Fernando P Polack; Barbara A Rath; Alejandro H Rodríguez; Elena B Sarrouf; Anna C Seale; Bunyamin Sertogullarindan; Marilda M Siqueira; Joanna Skręt-Magierło; Frank Stephan; Ewa Talarek; Julian W Tang; Kelvin K W To; Antoni Torres; Selda H Törün; Dat Tran; Timothy M Uyeki; Annelies Van Zwol; Wendy Vaudry; Tjasa Vidmar; Renata T C Yokota; Paul Zarogoulidis; Jonathan S Nguyen-Van-Tam Journal: Lancet Respir Med Date: 2014-03-19 Impact factor: 30.700
Authors: Paula E Miller; Aksharananda Rambachan; Roderick J Hubbard; Jiabai Li; Alison E Meyer; Peter Stephens; Anthony W Mounts; Melissa A Rolfes; Charles R Penn Journal: PLoS One Date: 2012-09-11 Impact factor: 3.240