Giving the clinician a basic understanding of epidemiology as an analytical instrument for the selection of methods of diagnosis and treatment, it is maintained, is the way to enhance his capacity for critical evaluation.
Yes In 2009, cases of influenza were reported beginning in February. Case definitions, laboratory diagnostics and procedures for data collection did not change during the time period covered in this report; this eliminates the possibility that findings were related to changes in surveillance methodology as a result of the pandemic, which can be a problem when using historical controls.
Viral coinfection, especially with RSV, has been hypothesized to reduce the T helper cell 1 response, thereby increasing disease severity [28]. There were no deaths of patients with pH1N1 ≥60 years old. Epub 2003 Apr 11. The median number of days from onset of symptoms to presentation at an ambulatory clinic for patients with influenza A was two days and was similar across all influenza subtypes (P = 0.11). No, Is the Subject Area "H1N1" applicable to this article? A description of the surveillance system for hospitalized pneumonia and ambulatory ILI in Guatemala has been presented previously [22]. e15826. We found a higher proportion of patients with diarrhea among those with seasonal H1N1 (14%) than either pH1N1 (7%) or H3N2 (5%), although this difference was not statistically significant (P = 0.24). Patients who did not return by six weeks were followed with a phone call to determine their vital status. As reported previously [22], in this population, the proportion of hospitalized pneumonia patients with influenza A reporting a chronic or underlying medical problem was very low, less than 20%, and there was no significant difference between patients with seasonal H1N1 and pH1N1 (P = 0.93). There were no significant differences in either sex or age distributions between the eligible pneumonia or ILI patients who consented to enrollment and those who did not, or between those enrolled pneumonia or ILI patients who agreed to have a respiratory specimen taken and those who declined (data not shown).
(2010) Concurrent comparison of epidemiology, clinical presentation and outcome between adult patients suffering from the pandemic influenza A (H1N1) 2009 virus and the seasonal influenza A virus infection. There have been three other concurrent comparisons of seasonal influenza and pH1N1 in hospitalized patients that reported on severe outcomes; none found any significant differences in the ICU admission rates or CFP by influenza subtype, but all occurred in well-resourced settings where antivirals would have been available for treatment [13]–[15]. 1993 Nov;28(6):267-74. doi: 10.1007/BF00795906.
Surveillance for ILI in public ambulatory clinics began in Santa Rosa in November 2007 in one health center (staffed by at least one physician) and was then expanded to five additional health posts (staffed by nurses) in June 2009 in response to the pH1N1 pandemic. Quality-adjusted life-years lack quality in pediatric care: a critical review of published cost-utility studies in child health. Although signs of severity (admission to an intensive care unit, mechanical ventilation and death) were higher among cases of pH1N1 than seasonal H1N1, none of the differences was statistically significant. https://doi.org/10.1371/journal.pone.0015826.g003. Clinical signs and symptoms of patients with ILI were similar across influenza A subtypes (Table 3), apart from difficulty breathing and pleuritic chest pain, which were significantly less likely to be reported by ILI patients with pH1N1 than those with seasonal H1N1 or influenza A (H3N2). Of the four deaths associated with pH1N1 among this age group, three (75%) patients were coinfected with RSV. Trained study nurses took nasopharyngeal swabs (NP) from all eligible and consenting patients with pneumonia and ILI, whereas oropharyngeal (OP) swabs were also taken from pneumonia patients; NP and OP swabs were put into one tube with viral transport media and stored at 4°C until they could be processed and sent to the laboratory at the UVG. There was no difference in the proportion of children <5 years old and persons ≥5 years old with respect to having taken any medication, including antipyretics and antivirals, within the 72 hours prior to admission (data not shown). There have been few reports of concurrent comparisons of the epidemiology of seasonal influenza and pH1N1 [13]–[18], and only one from a low-resource setting in the tropics where, until recently, influenza was not recognized as a significant problem [19]–[21]. As a result of the small number of H3N2 in the hospitalized pneumonia patients, we have limited comparison of the characteristics of hospitalized pneumonia patients to those with seasonal H1N1 and pH1N1. 1981;29(1):75-83. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0015826, http://data.worldbank.org/indicator/NY.GNP.PCAP.CD. We looked for differences in treatment seeking behaviors and treatments taken before admission that could explain this finding, but the use of any medication, and antipyretics in particular, did not differ between hospitalized pneumonia patients with seasonal H1N1 and pH1N1. Asthma was the most common condition reported. Both seasonal H1N1 and pH1N1 caused pneumonia primarily in children <1 year old; infants account for approximately 3% of the Guatemalan population, but they made up 37% and 39% of the hospitalized pneumonia patients with pH1N1 and seasonal H1N1, respectively. Patients admitted to two public hospitals in Guatemala in 2008–2009 who met a pneumonia case definition, and ambulatory patients with influenza-like illness (ILI) at 10 ambulatory clinics were invited to participate. No, Is the Subject Area "Pandemics" applicable to this article? The proportion of patients with respiratory distress who required mechanical ventilation was more than three times higher among the hospitalized pneumonia patients with pH1N1 (11%) compared with those with seasonal H1N1 (3%), but the difference was not statistically significant (P = 0.14). Soc Psychiatry Psychiatr Epidemiol. Among the influenza A viruses that could be subtyped, there was no significant difference in the subtype distribution between pneumonia and ILI patients (P = 0.17). In both the hospital and ambulatory clinics, care sought for the current illness episode prior to hospital admission or presentation to the ambulatory clinic was reported by the patient or caregiver, along with any medicines taken prior to admission or presentation.
https://doi.org/10.1371/journal.pone.0015826, Editor: Benjamin J. Cowling, The University of Hong Kong, Hong Kong, Received: September 2, 2010; Accepted: November 29, 2010; Published: December 30, 2010. This limitation has been noted for least one other similar study [29], and should be taken into consideration when evaluating results from our study. [Principles and definitions in epidemiology (author's transl)]. Please enable it to take advantage of the complete set of features! Among ILI patients, there was no statistical difference between the age distribution of pH1N1 and seasonal H1N1 (P = 0.22) or pH1N1 and H3N2 (P = 0.25) (Table 3). Contributed reagents/materials/analysis tools: KAL WA AE SJO AMF. Ano ang pinakamaliit na kontinente sa mundo? Data were collected using preprogrammed, hand-held personal digital assistants. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. For more information about PLOS Subject Areas, click The CDC participated in all aspects of study design, data collection, data analysis and manuscript preparation. It is also for this reason that it is often possible to complete a Master in Public Health (MPH) degree with an epidemiology concentration. The group most affected by ILI due to influenza A was school-age children from five to 14 years old with 108 (44%) cases of influenza A; there was no statistically significant difference in the proportion of pH1N1 cases aged 5 to 14 years old (80/162, 49%) in comparison to seasonal H1N1 (17/51, 33%; P = 0.05) or H3N2 (6/21; 29%; P = 0.10). Relatives of adult patients who were unconscious or unable to provide consent on enrollment were asked to provide written, informed consent for their relative to participate, and this consent was renewed directly with the patient on regaining consciousness. All positive pH1N1 results were reported immediately to the MSPAS, who informed the local public health authorities and patients in each site.
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