1. Hospitalized cases of influenza A(H1N1)pdm09 in the French territories of the Americas, July 2009-March 2010
- Author
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Séverine Matheus, Sylvie Cassadou, Marie Barrau, J. Renner, J. L. Chappert, Coralie Gasc, Philippe Quénel, Fatiha Najioullah, Sophie Larrieu, Philippe Dussart, Martine Ledrans, Cellule de l'Institut de Veille Sanitaire en régions Antilles Guyane, Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Service de virologie-immunologie, Centre hospitalier Universitaire, Réseau International des Instituts Pasteur (RIIP), and The authors are grateful to all of the sentinel network practitioners, the clinicians, the Centre National de Référence des Arbovirus (Guyane, France), and the Service de virologie-immunologie of the Centre Hospitalier Universitaire (Martinique, France) for their participation in providing clinical data for this surveillance system. We also thank Vanessa Ardillon, Alain Blateau, Claude Flamand, and Jacques Rosine, epidemiologists at CIRE (Antilles Guyane), for their contribution to the surveillance system.
- Subjects
Male ,epidemiologic methods ,MESH: Comorbidity ,Comorbidity ,medicine.disease_cause ,MESH: Influenza, Human/epidemiology ,0302 clinical medicine ,Influenza A Virus, H1N1 Subtype ,MESH: Pregnancy ,MESH: Aged, 80 and over ,Pregnancy ,MESH: Child ,Pandemic ,virus diseases ,Influenza A virus ,030212 general & internal medicine ,Hospital Mortality ,Pregnancy Complications, Infectious ,Child ,Guadeloupe ,MESH: Guadeloupe/epidemiology ,Aged, 80 and over ,MESH: Aged ,MESH: Middle Aged ,MESH: Pneumonia, Viral/epidemiology ,epidemiological surveillance ,MESH: Infant, Newborn ,Middle Aged ,MESH: Infant ,3. Good health ,French Guiana ,Hospitalization ,MESH: Young Adult ,Child, Preschool ,Population Surveillance ,MESH: Influenza, Human/virology ,Female ,Martinique ,Adult ,medicine.medical_specialty ,Adolescent ,MESH: French Guiana/epidemiology ,Multiple Organ Failure ,West Indies ,030231 tropical medicine ,Pneumonia, Viral ,sentinel surveillance ,MESH: Multiple Organ Failure/epidemiology ,MESH: Martinique/epidemiology ,MESH: Population Surveillance ,03 medical and health sciences ,Young Adult ,MESH: Multiple Organ Failure/virology ,Internal medicine ,Diabetes mellitus ,Intensive care ,Influenza, Human ,medicine ,MESH: Influenza A Virus, H1N1 Subtype ,MESH: Pregnancy Complications, Infectious/epidemiology ,Humans ,MESH: Pneumonia, Viral/virology ,MESH: Hospital Mortality ,Aged ,MESH: Adolescent ,MESH: Humans ,business.industry ,MESH: Child, Preschool ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Outbreak ,Infant ,Influenza a ,MESH: Adult ,medicine.disease ,MESH: Male ,Surgery ,H1N1 subtype ,Observational study ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,MESH: West Indies/epidemiology ,MESH: Female ,MESH: Hospitalization/statistics & numerical data - Abstract
International audience; OBJECTIVE: To describe the methodology used for implementing a surveillance system specifically for influenza A(H1N1)pdm09 in the French West Indies and French Guiana during an outbreak of this new virus in 2009-2010, and to report its main results. METHODS: This was an observational descriptive study of confirmed and probable cases of influenza A(H1N1)pdm09 hospitalized for at least 24 hours in 23 July 2009-3 March 2010. Reverse transcription polymerase chain reaction was performed on nasopharyngeal swab samples according to the Centers for Disease Control and Prevention protocol. A probable case was defined as fever > 38ºC or aches or asthenia with respiratory symptoms (cough or dyspnea). All confirmed and probable hospitalized cases were reported, along with patient's age, sex, clinical condition at admission, place and length of hospitalization, antiviral treatment, underlying conditions, complications, and clinical evolution. A case was classified as severe if respiratory assistance or intensive care was required or if death resulted. RESULTS: A total of 331 confirmed and 16 probable cases were hospitalized, with a hospitalization rate ranging from 4.3 per 1 000 clinical cases in Saint Martin to 10.3 in French Guiana. Of these, 36 were severe, and subsequently, 10 were fatal. The median length of stay was 4 days for non-severe cases and 9 days for severe (P < 0.05). The mean patient age was 21 years, and severe cases were significantly older than non-severe (mean: 38 years versus 19 years, P < 0.05). Underlying conditions associated with a higher risk of severity were 65 years of age or more (RR = 7.5, 95%CI = 4.2-13.3), diabetes (RR = 3.7, 95%CI = 1.5-9.4), cardiac insufficiency (RR = 8.4, 95%CI = 5.2-13.6), and morbid obesity (RR = 4.4, 95%CI = 1.8-10.4). Patients who received antiviral treatment within 2 days of symptom onset had shorter hospital stays (mean: 4 days versus 6.5 days, P < 0.05), and the illness tended to become less severe (11.1% versus 19.0%, P = 0.13). CONCLUSIONS: Active research of hospitalized cases enabled almost exhaustive surveillance. The pandemic's hospitalization rates and lethality were more moderate than expected. Some previously known underlying conditions of severity were confirmed during this outbreak. Furthermore, these results show the validity of early antiviral treatment.
- Published
- 2012
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