Articles: pandemics.
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MMWR Morb. Mortal. Wkly. Rep. · Sep 2011
Severe illness from 2009 pandemic influenza A (H1N1)--Utah, 2009-10 influenza season.
Influenza-associated hospitalizations have been a reportable condition in Utah since 2005, and surveillance for influenza hospitalizations has been a valuable tool for identifying and tracking the population impact of serious influenza illness. During the 2009 influenza A (H1N1) pandemic, Utah public health officials used comparisons with hospitalization data from three previous influenza seasons to rapidly assess the impact of 2009 H1N1 and enable public health authorities to target persons at greatest risk for severe illness. ⋯ During the 4-month "spring wave" of the H1N1 pandemic, a greater percentage of hospitalizations (30.9%) resulted in severe illness than during the 9-month "fall wave" (23.0%). Surveillance for influenza hospitalizations can provide essential data to public health authorities that will help them identify those populations at greatest risk for severe illness.
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Despite the fact that the 2009 H1N1 pandemic influenza strain was less severe than had been feared, both seasonal epidemics of influenza-like-illness and future influenza pandemics have the potential to place a serious burden on health services. The closure of schools has been postulated as a means of reducing transmission between children and hence reducing the number of cases at the peak of an epidemic; this is supported by the marked reduction in cases during school holidays observed across the world during the 2009 pandemic. However, a national policy of long-duration school closures could have severe economic costs. ⋯ These results support the UK decision not to use localized school closures as a control mechanism, but have far wider international public-health implications. The spatial heterogeneities in both population density and hospital capacity that give rise to our results exist in many developed countries, while our model assumptions are sufficiently general to cover a wide range of pathogens. This leads us to believe that when a pandemic has severe implications for ICU capacity, only widespread school closures (with their associated costs and organizational challenges) are sufficient to mitigate the burden on the worst-affected hospitals.
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Intensive care medicine · Sep 2011
The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks.
In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet. ⋯ A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.
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Pediatric emergency care · Sep 2011
Multicenter Study Comparative StudyH1N1 hemagglutinin-inhibition seroprevalence in Emergency Department Health Care workers after the first wave of the 2009 influenza pandemic.
The 2009 H1N1 pandemic (H1N1pdm) virus has been associated with high rates of asymptomatic infections. Existing influenza infection control policies do not address potential transmission through exposure to asymptomatic infected individuals in health care settings. We conducted a seroprevalence study of H1N1pdm infection to determine whether health care workers (HCWs) in the emergency department showed increased evidence of infection during the first wave of the pandemic than that previously reported in adults in the community. ⋯ The higher serodetection rates in adults observed in the current study suggest potentially significantly more frequent infections in HCWs than in the general population. Further investigations are needed to ascertain the relative incidence of influenza infections in HCWs and non-HCWs, to study influenza transmission by asymptomatic infected subjects and ascertain the burden of such transmission in health care settings.