Influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand

PLoS One. 2013;8(2):e54946. doi: 10.1371/journal.pone.0054946. Epub 2013 Feb 4.

Abstract

Background: The first human infections with influenza A(H1N1)pdm09 virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010.

Methods: We identified influenza A(H1N1)pdm09-associated pneumonia deaths from a national influenza surveillance system and performed detailed reviews of a subset.

Results: Of 198 deaths reported, 49% were male and the median age was 37 years; 146 (73%) were 20-60 years. Among 90 deaths with records available for review, 46% had no identified risk factors for severe influenza. Eighty-eight patients (98%) received antiviral treatment, but only 16 (18%) initiated therapy within 48 hours of symptom onset.

Conclusions: Most influenza A(H1N1)pdm09 pneumonia fatalities in Thailand occurred in adults aged 20-60 years. Nearly half lacked high-risk conditions. Antiviral treatment recommendations may be especially important early in a pandemic before vaccine is available. Treatment should be considered as soon as influenza is suspected.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Influenza A Virus, H1N1 Subtype / pathogenicity*
  • Influenza, Human / complications
  • Influenza, Human / drug therapy
  • Influenza, Human / mortality*
  • Influenza, Human / pathology
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / pathology
  • Risk Factors
  • Thailand / epidemiology
  • Time Factors

Substances

  • Antiviral Agents

Grants and funding

This work was funded primarily by the Thailand Ministry Of Public Health with additional support from the U.S. Centers for Disease Control and Prevention (CDC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.