Nihon rinsho. Japanese journal of clinical medicine
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Pandemic influenza H1N1 2009 caused more severe diseases in children and young adults than seasonal influenza. The typical manifestation of severe diseases was diffuse viral pneumonia complicated with acute respiratory distress syndrome. Over half of the severe cases had underlying conditions, in which pregnancy and morbid obesity were regarded as major risk factors. ⋯ The level of plasma cytokines was also elevated in the severe cases. Antiviral use was generally recommended for the severe cases and might improve the outcomes. Further studies are needed for better clinical management of the severe cases of the latest pandemic influenza.
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Humans experienced various disease pandemics in the history of the world. Disease can spread over the world more rapidly and in larger scale than in any other time in the past as the world is getting smaller. The World Health Organization established its innovative event-based surveillance system in close collaboration with many partners at global scale for early detection and rapid response to the public health events (PHE) of international importance in 1997. It has been being strengthened to respond effectively to PHEs in harmony with the International Health Regulations which were revised in 2005.
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In Japan, about 20 million people were infected with pandemic (H1N1) 2009 virus between July 2009 and March 2010. About 60% of them were under 15 years, but only 38 pediatric deaths were reported. ⋯ The time from onset to appear dyspnea in patients with lower respiratory complications was very short, and encephalopathy also appears very rapidly. It is very important to observe clinical course closely and to start neuraminidase inhibitor within 48 hours.
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Newborns should be considered to be at high risk of developing complications of novel influenza like pandemic influenza A (H1N1) 2009, because maternal antibodies are not transferred via crossing the placenta. In Japan, some newborns with pandemic influenza A (H1N1) 2009 appeared non-specific symptoms, such as fever, poor activity and sucking, and apnea. ⋯ Orally oseltamivir(3-4 mg/kg/dose twice a day for 5 days) was used for treatments of flu-infected newborns. Contact and droplet precautions were very important measures to prevent transmission of pandemic influenza A (H1N1) 2009 virus to newborns.
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A new pandemic influenza A (H1N1) virus had emerged and rapidly spread throughout the world. The clinical pathological observations associated with severe cases of pandemic (H1N1) 2009 are similar to that of high pathogenic avian influenza (H5N1). In order to find the most effective treatment methods for this pandemic influenza (H1N1), we describe our experiences, investigations and collaboration studies of avian influenza (H5N1) in Vietnam in association of our cooperative study of pandemic (H1N1) 2009 in Mexico. Effective treatment methods for critical illness due to influenza will be discussed from medical, regional and global points of view, which may be applied for the treatment of any type of influenza virus.