Articles: pandemics.
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Obstetrics and gynecology · Feb 2011
Case Reports2009 pandemic influenza A (H1N1) and vaccine failure in pregnancy.
Emerging data suggest that pregnancy conveys high risk for severe complications from the 2009 pandemic influenza A virus (2009 H1N1) infection. ⋯ With the expectation that 2009 H1N1 will continue to cause disease in the immediate future, the virus has been included as a component of the 2010-2011 seasonal influenza vaccine. Vaccination of pregnant women is strongly encouraged. However, regardless of vaccination history, clinicians should remain vigilant for 2009 H1N1 infection when the virus is in circulation, and should not delay antiviral treatment of pregnant women with suspected influenza.
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Pediatr Allergy Immunol · Feb 2011
Characteristics of atopic children with pandemic H1N1 influenza viral infection: pandemic H1N1 influenza reveals 'occult' asthma of childhood.
The number of human cases of pandemic H1N1 influenza viral infection has increased in Japan since April 2009, as it has worldwide. This virus is widespread in the Yamaguchi prefecture in western Japan, where most infected children exhibited respiratory symptoms. Bronchial asthma is thought to be one of the risk factors that exacerbate respiratory symptoms of pandemic H1N1-infected patients, but the pathogenesis remains unclear. ⋯ However, the severity of the attack did not correlate with the severity of the pulmonary complications of pandemic H1N1 influenza viral infection. The pandemic H1N1 influenza virus greatly increases the risk of lower respiratory tract complications such as asthma attack, pneumonia, and atelectasis, when compared to the seasonal influenza virus. Furthermore, our results suggest that pandemic H1N1 influenza viral infection can easily induce a severe asthma attack, pneumonia, and atelectasis in atopic children without any history of either an asthma attack or asthma treatment.
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We describe hospital preparedness, including costs, and clinical characteristics of the 2009 influenza A (H1N1) pandemic in adult patients in a Belgian tertiary care centre. A task force coordinated the overall management, including triage and hospitalisation. Between 1 June and 30 November 2009, 521 patients with influenza-like illness were admitted to the emergency ward. ⋯ The financial impact of the epidemic was estimated at €75,691, and approximately half of these costs were related to the enhanced infection control practices. The Belgian 2009 influenza A (H1N1) pandemic, as described in a cohort of 43 hospitalised patients, was associated with a relatively high ICU admission rate of 26% and a fairly typical mortality rate of 3%. This retrospective study may help us refine the management of future epidemics.
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Our study reviews the spontaneous reports of adverse events following immunisation submitted to the Danish Medicines Agency during the 2009-2010 influenza A/H1N1v season. During the study period (4 November 2009-31 March 2010), 607 reports comprising 1885 adverse events were reported among 339,507 influenza A/H1N1v vaccinated individuals (reporting rate, 179 per 100,000 vaccinated). ⋯ In conclusion, we did not observe any strong signals of any unknown or serious adverse events associated with influenza A/H1N1v vaccination in Denmark. Our experience also demonstrates the well-known limitations of spontaneous reports with respect to evaluation of a casual relationship and highlights the importance for a timely availability of background events rates and the need for new approaches to study late adverse effects following immunisation.
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Med Health Care Philos · Feb 2011
Anti-theory in action? Planning for pandemics, triage and ICU or: how not to bite a bullet.
Anti-theory is a multi-faceted critique of moral theory which, it appears, is undergoing something of reassessment. In a recent paper Hämäläinen discusses the relevance of an anti-theoretical perspective for the activity of applied ethics. This paper explores her view of anti-theory. ⋯ Following Hämäläinen in contrasting reflective equilibrium with her anti-theory inspired suggestion of an instrumental approach to moral theory in practice I demonstrate how this understanding complements the diversity of our intuitive moral judgements. Consequentially I suggest that this anti-theoretical instrumental approach is in greater accord with the conditions under which such policy planning and decision making is, or will be, made. Furthermore, on the grounds of keeping open the ethical dimensions of medical practice in conditions of uncertainty, i.e. during a pandemic, I suggest that the anti-theoretical instrumental perspective is, ethically, the preferable approach to producing such policies and guidelines.