Initial H1N1 Patient Information Helped Guide Outbreak Response in NYC
Emma Hitt, PhD
Authors and Disclosures
January 7, 2010 — A medical record review of the first 99 patients with 2009 pandemic influenza A (H1N1) hospitalized in New York City (NYC) has helped guide subsequent efforts against the pandemic, according to a study conducted by the NYC Department of Health and Mental Hygiene (DOHMH).
The study is published in the January 8 issue of the Morbidity and Mortality Weekly Report.
The authors, led by Meredith E. Slopen, MSW, with the NYC DOHMH, concluded from the findings that public education campaigns should "encourage patients at high risk of severe illness to be vaccinated, and should emphasize to medical providers the importance of early antiviral therapy for children aged <2 years and patients with underlying risk conditions."
The analysis assessed disease and patient characteristics of the first patients with H1N1 influenza. Medical record information was collected within about 2 weeks and included patient demographics, disease severity, and use of antiviral medications.
Among the 99 patients, about 60% were younger than 18 years and 91% were younger than 50 years.
The most frequently reported underlying condition was asthma, observed in about half of the patients. Other patients (17%) had multiple underlying conditions (asthma, chronic metabolic disorder, and/or renal disease plus immunosuppressive conditions).
Patients receiving oseltamivir within 2 days of the onset of symptoms had shorter hospitalizations than patients who received treatment on day 3 or later (P = .03). According to the report, this finding "generally supported DOHMH's public health messages that persons with underlying conditions should seek care as early as possible."
Among obese adults, 92% had an underlying condition that could increase the risk for severe influenza or complications. Of the 4 deaths observed, 3 occurred in obese individuals.
"Whether obesity itself contributes to the risk of acquiring H1N1 influenza or to the risk of severe disease or death remains unclear but has been a focus of investigation during the H1N1 pandemic," the study authors point out in the editorial note. They suggest that height and weight should be documented in the records of all hospitalized patients with H1N1 influenza.
Morb Mortal Wkly Rep. 2010;58:1436-1440.