• Charatdao Bunthi, Somsak Thamthitiwat, Henry C Baggett, Pasakorn Akarasewi, Ruchira Ruangchira-urai, Susan A Maloney, and Kumnuan Ungchusak.
• International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. charatdaob@th.cdc.gov
• Plos One. 2013 Jan 1; 8 (2): e54946.

BackgroundThe first human infections with influenza A(H1N1)pdm09 virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010.MethodsWe identified influenza A(H1N1)pdm09-associated pneumonia deaths from a national influenza surveillance system and performed detailed reviews of a subset.ResultsOf 198 deaths reported, 49% were male and the median age was 37 years; 146 (73%) were 20-60 years. Among 90 deaths with records available for review, 46% had no identified risk factors for severe influenza. Eighty-eight patients (98%) received antiviral treatment, but only 16 (18%) initiated therapy within 48 hours of symptom onset.ConclusionsMost influenza A(H1N1)pdm09 pneumonia fatalities in Thailand occurred in adults aged 20-60 years. Nearly half lacked high-risk conditions. Antiviral treatment recommendations may be especially important early in a pandemic before vaccine is available. Treatment should be considered as soon as influenza is suspected.

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