tetano
Editor, Senior Moderator
Impact of antiviral treatment and hospital admission delay on risk of death associated with 2009 A/H1N1 pandemic influenza in Mexico
Gerardo Chowell, C?cile Viboud, Lone Simonsen, Mark A Miller, Santiago Echevarr?a-Zuno, Margot Gonz?lez-Le?n and V?ctor H Borja Aburto
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BMC Infectious Diseases 2012, 12:97 doi:10.1186/1471-2334-12-97
Published: 20 April 2012
Abstract (provisional)
Background
Increasing our understanding of the severity of the 2009 A/H1N1 influenza pandemic could guide prevention efforts in future influenza pandemics.
Methods
We analyzed a large series of laboratory-confirmed pandemic A/H1N1 influenza cases from a prospective surveillance system maintained by the Mexican Social Security system, April- December 2009. We considered a spectrum of disease severity encompassing outpatient visits, hospitalizations, and deaths, and recorded demographic and geographic information on individual patients. We assessed the impact of neuraminidase inhibitor treatment and hospital admission delay ([less than or equal to] > 2 days after disease onset) on the risk of death by multivariate logistic regression.
Results
Approximately 50% of all A/H1N1-positive patients received antiviral medication during the Spring and Summer 2009 pandemic waves in Mexico while only 9% of A/H1N1 cases received antiviral medications during the fall wave (P < 0.0001). After adjustment for age, gender, and geography, antiviral treatment significantly reduced the risk of death (OR = 0.52 (95% CI: 0.30, 0.90)) while longer hospital admission delays increased the risk of death by 2.8-fold (95% CI: 2.25, 3.41).
Conclusions
Our findings underscore the potential impact of decreasing admission delays and increasing antiviral use to mitigate the mortality burden of future influenza pandemics.
http://www.biomedcentral.com/content/pdf/1471-2334-12-97.pdf
Gerardo Chowell, C?cile Viboud, Lone Simonsen, Mark A Miller, Santiago Echevarr?a-Zuno, Margot Gonz?lez-Le?n and V?ctor H Borja Aburto
For all author emails, please log on.
BMC Infectious Diseases 2012, 12:97 doi:10.1186/1471-2334-12-97
Published: 20 April 2012
Abstract (provisional)
Background
Increasing our understanding of the severity of the 2009 A/H1N1 influenza pandemic could guide prevention efforts in future influenza pandemics.
Methods
We analyzed a large series of laboratory-confirmed pandemic A/H1N1 influenza cases from a prospective surveillance system maintained by the Mexican Social Security system, April- December 2009. We considered a spectrum of disease severity encompassing outpatient visits, hospitalizations, and deaths, and recorded demographic and geographic information on individual patients. We assessed the impact of neuraminidase inhibitor treatment and hospital admission delay ([less than or equal to] > 2 days after disease onset) on the risk of death by multivariate logistic regression.
Results
Approximately 50% of all A/H1N1-positive patients received antiviral medication during the Spring and Summer 2009 pandemic waves in Mexico while only 9% of A/H1N1 cases received antiviral medications during the fall wave (P < 0.0001). After adjustment for age, gender, and geography, antiviral treatment significantly reduced the risk of death (OR = 0.52 (95% CI: 0.30, 0.90)) while longer hospital admission delays increased the risk of death by 2.8-fold (95% CI: 2.25, 3.41).
Conclusions
Our findings underscore the potential impact of decreasing admission delays and increasing antiviral use to mitigate the mortality burden of future influenza pandemics.
http://www.biomedcentral.com/content/pdf/1471-2334-12-97.pdf