Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico
Abstract
BACKGROUND: In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu. METHODS: We used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay. RESULTS: From March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level (in 62% of patients) and lymphopenia (in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized. CONCLUSIONS: S-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe.
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Six studies reported use of antibiotics prior to specimen collection in subjects with bacterial co-infection in 21-22% of those tested.
“Six studies reported use of antibiotics prior to specimen collection in subjects with bacterial co-infection in 21–22% of those tested [23, 24].”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [23]
The mPCR assay did not test for S. pneumoniae in one study and the authors could not report the presence of this organism.
“However, the mPCR assay did not test for S. pneumoniae in one study and the authors could not report the presence of this organism [23].”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [23]
The study conducted in Mexico early in the pandemic isolated ventilator-associated bacteria in 4 (22%) cases, with Acinetobacter baumannii, Achromobacter xylosoxidans, methicillin-resistant Staphylococcus aureus, and Escherichia coli identified.
“The study conducted in Mexico early in the pandemic [23] isolated ventilator-associated bacteria in 4 (22%) cases, with Acinetobacter baumannii, Achromobacter xylosoxidans, methicillin-resistant Staphylococcus aureus, and Escherichia coli identified.”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [23]
Of the 11 studies of hospitalised cases with confirmed pneumonia, 2 reported no evidence of bacterial co-infection in their cohort.
“Of the 11 studies, 2 reported no evidence of bacterial co-infection in their cohort of patients [4, 23], however, neither reported the proportion of patients tested.”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [23]
A case series of the first 18 H1N1pdm-infected patients hospitalized in Mexico City reported no evidence of coinfection with other common respiratory viruses.
“A case series of the first 18 H1N1pdm-infected patients hospitalized in Mexico City reported no evidence of coinfection with other common respiratory viruses [5].”
From Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza (2009) · cites this paper as [5]
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Pandemic (H1N1) 2009 influenza
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SARS-CoV-2 in immunocompromised individuals
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Fatalities Associated with the 2009 H1N1 Influenza A Virus in New York City
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Pathogenesis and transmission of swine origin A(H3N2)v influenza viruses in ferrets
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Incidence, Etiology, and Outcomes of Community-Acquired Pneumonia: A Population-Based Study
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Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment
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- Authors
- Perez-Padilla, R., de la Rosa-Zamboni, D., Ponce de Leon, S., Hernandez, M., Quiñones-Falconi, F., Bautista, E., Ramirez-Venegas, A., Rojas-Serrano, J., Ormsby, C. E., Corrales, A., Higuera, A., Mondragon, E., & Cordova-Villalobos, J. A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2009-08-13
- Volume
- 361
- Issue
- 7
- Pages
- 680-689
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2162080474
- Semantic Scholar
- 89e69bd797eb37d8cd32ad46052d7add62ead232
- Cited by
- 1,325
- References
- 32
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 11 · 2023: 15 · 2022: 21 · 2021: 29 · 2020: 49 · 2019: 22 · 2018: 22 · 2017: 19 · 2016: 40 · 2015: 45 · 2014: 53 · 2013: 106 · 2012: 164
- FWCI
- 195.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- pneumonia, respiratory failure, acute respiratory distress syndrome, hospitalized patients, young and middle-aged adults, healthcare workers, nosocomial transmission, mechanical ventilation, mortality, lymphopenia, creatine kinase, oseltamivir
- MeSH terms
- Adolescent, Adult, Antiviral Agents, Child, Child, Preschool, Female, Hospitalization, Humans, Infant, Influenza, Human, Lung, Male, Mexico, Middle Aged, Pneumonia, Viral, Radiography, Respiratory Distress Syndrome, Respiratory Insufficiency, Retrospective Studies, Age Distribution, Infectious Disease Transmission, Patient-to-Professional, APACHE, Influenza A Virus, H1N1 Subtype, Oseltamivir, Young Adult
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