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BMJ: Sterblichkeit an pandemischer H1N1 Influenza in England.

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  • BMJ: Sterblichkeit an pandemischer H1N1 Influenza in England.

    Im British Medical Journal (BMJ) ist eine Studie unter Analyse von Pflicht-Meldedaten des britischen Gesundheitsdienstes zur H1N1 Influenzapandemie (Datenbasis bis zum 8. November 2009) publiziert worden.

    Ergebnisse (Auszug):

    Die durchschnittliche gesch?tzte Sterblichkeit (estimated case fatality rate) ?ber alle Altersgruppen lag bei 26 Todesf?llen pro 100.000. Die Sterblichkeit war mit 11 pro 100.000 am niedrigsten in der Altersgruppe der Kinder zwischen 5 und 14 Jahren und mit 980 pro 100.000 am h?chsten in der Altersgruppe der ?ber 64 j?hrigen.

    Bei den Todesf?llen, bei denen die pandemische H1N1 Influenza als Todesursache best?tigt wurde, lag der Altersmedian bei 39 Jahren. 36 % dieser Todesf?lle hatten keine oder nur leichte Vorerkrankungen. Die meisten dieser Patienten hatten zwar antivirale Medikamente bekommen, jedoch in 82 % nicht innerhalb der ersten 48 Stunden nach Erkrankungsbeginn.

    In der Schlussfolgerung wird unter Ber?cksichtigung des bedeutsamen Anteils von Todesf?llen ohne relevante Vorerkrankungen eine Ausweitung von Impfprogrammen bef?rwortet sowie die m?glichst fr?he und umfassende Verf?gbarkeit einer antiviralen Behandlung.





    Danke an ironorehopper
    http://www.flutrackers.com/forum/sho...d.php?t=139525
    BMJ. Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study.

    http://www.ncbi.nlm.nih.gov/pubmed/2...?dopt=Abstract
    BMJ.;339:b5213.
    Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study.

    Donaldson LJ, Rutter PD, Ellis BM, Greaves FE, Mytton OT, Pebody RG, Yardley IE.

    Department of Health, Richmond House, London SW1A 2NS. liam.donaldson@dh.gsi.gov.uk

    OBJECTIVE: To establish mortality from pandemic A/H1N1 2009 influenza up to 8 November 2009.

    DESIGN: Investigation of all reported deaths related to pandemic A/H1N1 in England.

    SETTING: Mandatory reporting systems established in acute hospitals and primary care.

    PARTICIPANTS: Physicians responsible for the patient.

    MAIN OUTCOME MEASURES: Numbers of deaths from influenza combined with mid-range estimates of numbers of cases of influenza to calculate age specific case fatality rates. Underlying conditions, time course of illness, and antiviral treatment.

    RESULTS:
    With the official mid-range estimate for incidence of pandemic A/H1N1, the overall estimated case fatality rate was 26 (range 11-66) per 100 000. It was lowest for children aged 5-14 (11 (range 3-36) per 100 000) and highest for those aged >or=65 (980 (range 300-3200) per 100 000).
    In the 138 people in whom the confirmed cause of death was pandemic A/H1N1, the median age was 39 (interquartile range 17-57). Two thirds of patients who died (92, 67%) would now be eligible for the first phase of vaccination in England. Fifty (36%) had no, or only mild, pre-existing illness. Most patients (108, 78%) had been prescribed antiviral drugs, but of these, 82 (76%) did not receive them within the first 48 hours of illness.

    CONCLUSIONS:
    Viewed statistically, mortality in this pandemic compares favourably with 20th century influenza pandemics. A lower population impact than previous pandemics, however, is not a justification for public health inaction. Our data support the priority vaccination of high risk groups. We observed delayed antiviral use in most fatal cases, which suggests an opportunity to reduce deaths by making timely antiviral treatment available, although the lack of a control group limits the ability to extrapolate from this observation. Given that a substantial minority of deaths occur in previously healthy people, there is a case for extending the vaccination programme and for continuing to make early antiviral treatment widely available.
    PMID: 20007665 [PubMed - indexed for MEDLINE]
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