| Pandemia H1N1 en niños que requirieron terapia intensive en Australia y Nueva Zelanda duranter el invierno 2009 |
Pandemic H1N1 in children requiring intensive care in Australia and New Zealand during winter 2009.
Yung M, Slater A, Festa M, Williams G, Erickson S, Pettila V, Alexander J, Howe BD, Shekerdemian LS; Australia and New Zealand Intensive Care Influenza Investigators and the Paediatric Study Group and the Clinical Trials Group of the Australia New Zealand Intensive Care Society.
Intensive Care Unit, Women's and Children's Hospital, Adelaide, Australia.
Pediatrics. 2011 Jan;127(1):e156-63. Epub 2010 Dec 20.
Abstract
OBJECTIVE: To describe in detail the pediatric intensive care experience of influenza A, particularly pandemic H1N1-09, in Australia and New Zealand during the 2009 Southern Hemisphere winter and to compare the pediatric experience with that of adults. METHOD: This was an inception-cohort study of all children who were admitted to intensive care with confirmed influenza A during winter 2009 at all general ICUs and PICUs in Australia and New Zealand. RESULTS: From June 1 through August 31, 2009, 107 children (20.0 per million [95% confidence interval: 16.1-23.8]) with influenza A, including 83 (15.5 per million [95% confidence interval: 12.1-18.9]) with H1N1-09 were admitted to ICUs. Fifty-two percent (39 of 75) of children with H1N1-09 had 1 or more comorbidity, most commonly neurologic (20%). Most (48 of 83 [58%]) presented with pneumonia. Thirteen of 83 (16%) had neurologic presentations. Eighty percent of the children with H1N1-09 required ventilation. Mortality was lower than in adults: 6 of 83 (7%) vs 114 of 668 (17%) (P = .02). The median length of stay for children with H1N1-09 was 5 days. Children with H1N1-09 occupied 773 bed-days (147 per million children) and 5.8% of specialist PICU beds. Presentation with septic shock or after cardiac arrest and the presence of 1 or more comorbidities were risk factors for severe disease. CONCLUSIONS: H1N1-09 caused a substantial burden on pediatric intensive care services in Australia and New Zealand. Compared with adults, children more commonly had nonrespiratory presentations and required ventilation more often but had a lower mortality rate.
http://pediatrics.aappublications.org/content/127/1/e156.full.pdf
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| Pandemia 2009 con el virus H1N1 en niños y adultos: un studio de cohorts en un solo hospital durante la epidemia |
Pandemic 2009 H1N1 virus infection in children and adults: A cohort study at a single hospital throughout the epidemic.
Rhim JW, Go EJ, Lee KY, Youn YS, Kim MS, Park SH, Kim JC, Kang JH.
Int Arch Med. 2012 Mar 26;5(1):13. [Epub ahead of print]
Abstract
BACKGROUND: In 2009, there was an influenza pandemic in South Korea. The aim of this study was to evaluate the epidemiological, clinical and laboratory characteristics of this infection in children and adults. METHODS: We evaluated the epidemiologic characteristics of patients infected with the 2009 H1N1 influenza A virus (4,463 patients, age range from 2 mo to 86 y), and the clinical and laboratory findings of 373 inpatients (80/217 children, [less than or equal to]15 y, had pneumonia and 36/156 adults, >16 y, had pneumonia) in a single hospital during the epidemic. RESULTS: The majority of infected patients (94%) were less than 40 y, and greater than 90% of cases occurred during a two-month period. The rates of admission and pneumonia were 8.4% (373/4,463) and 2.5% (116/4,463), respectively. The rates of admission and pneumonia, total duration of fever, the frequency of underlying diseases, and the values of C-reactive protein and erythrocyte sedimentation rate tended to increase as age increased; highest rates were found in the [greater than or equal to]65 y group. Pneumonia was founded more boys than girls in children, but more female than male in adults. The adult patients with pneumonia had higher leukocyte counts with lower lymphocyte differentials than the group without pneumonia, as shown in children group. CONCLUSION: Our results suggest that the immunologic reaction to viral insults may be associated with age, sex and underlying diseases, and that unknown herd immunity may affect populations. The patients with underlying diseases, especially in older patients may have immunologic insufficiency that is associated with immunologic consumption by the underlying diseases.
http://www.intarchmed.com/content/pdf/1755-7682-5-13.pdf
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| Epidemia de influenza del año 2009 en un hospital pediátrico y costos médicos directos en menoresde 5 años comparados con el período 2006-2008 |
Giglio ND, Castellano VE, Rüttimann RW, Vidal GI, Gentile A.
Servicio de Promoción y Protección de la Salud, Área Epidemiología, Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina. norbergiglio@gmail.com
Arch Argent Pediatr. 2012 Jan-Feb;110(1):19-26.
RESUMEN
Introducción. Anualmente se producen brotes epidémicos de variada intensidad atribuibles a Influenza y las instituciones de salud multiplican su capacidad de respuesta en términos de recursos médicos. Este cuadro genera un incremento en los costos institucionales durante la
circulación del virus y, con la aparición del nuevo virus pandémico Influenza A (pH1N1), los costos podrían haber aumentado en relación a los años anteriores. Objetivo. Valorar los costos directos en salud atribuibles a influenza durante el año 2009 y compararlo con años previos en el Hospital de Niños Ricardo Gutiérrez (HNRG) de la Ciudad de Buenos Aires, Argentina. Material y métodos. Con datos de las consultas ambulatorias e internaciones por Infección Respiratoria Aguda atribuibles a Influenza de los años 2006 a 2009 se realizó un estudio epidemiológico de corte transversal, con control retrospectivo, para valorar costos en niños menores de 5 años. Con los costos obtenidos para cada año, se realizó el cálculo del costo incremental del período de estudio 2009 en relación al costo promedio de los períodos 2006-2008. Resultados. El costo incremental total (hospitalizaciones y consultas ambulatorias por influenza) del período de estudio 2009 en relación al costo promedio del período 2006-2007-2008 fue US$ 91 512. Para las hospitalizaciones, el costo incremental del período de estudio 2009 en relación al costo promedio del período 2006-2007-2008 fue de US$ 147 560 y de la consulta ambulatoria de US$ -56 048. Conclusiones. El período de estudio 2009 generó un costo mayor en relación al promedio de los años 2006-2007-2008, asociado al número de hospitalizaciones atribuibles a Influenza A (pH1N1).
Palabras clave: subtipo H1N1 del virus de la Influenza A, costos de la atención en salud.
http://www.scielo.org.ar/pdf/aap/v110n1/v110n1a06.pdf |
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