|
INFLUENZA PANDEMIC (H1N1) 2009: VIET NAM, PATIENT DATA
*******************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Wed 8 Jul 2009
From: Rogier van Doorn
<hrogier@gmail.com>
In the Hospital for Tropical Diseases in Ho Chi Minh City, Viet Nam,
patients with flu symptoms and a positive RT-PCR [real time polymerase
chain reaction]
result for pandemic (H1N1) 2009 virus infection with the CDC assay
(specific A(H1N1)v primers/probe) are hospitalized and treated with
oseltamivir (75mg bd) until RT-PCR results are negative.
We collected clinical data, haematology and biochemistry, and daily
virological data (nose and throat swabs) from the 1st 44 pandemic
(H1N1) 2009 RT-PCR positive patients in Viet Nam hospitalized between
29 May and 26 June 2009. The average age of the patients was 28.6
years (3-62), 19 female and 25 male. 5 patients contracted flu while
in Viet Nam but with a clear epidemiological link to someone with
"imported" pandemic (H1N1) 2009, 39 cases were thought to be directly
imported (14 US, 18 Australia, 2 Canada, 2 Thailand, 1 Japan, 1 China,
and 1 Singapore).
Fever was present in 91 percent (n=40), cough in 55 percent (n=24),
runny nose in 20 percent (n=9), sore throat in 27 percent (n=12), and
diarrhea in 2 percent (n=1). Average duration of fever on presentation
was 2 days. After 24 hours 75 percent (n=33) of patients had a normal
temperature. All patients had a mild illness course.
Viral PCR was positive on day 0 for all patients with an average Ct
value of 30.3. The number of PCR positive patients dropped to 25 after
1 day (average Ct 30.3). On day 2, 21 patients were positive (average
Ct 35.8) and on day 3 and 4, 8 patients were still PCR positive
(average Ct 37.0 and 37.2). No patients were positive on day 5, 6 and 7.
These data suggest that patients treated with oseltamivir have a
favourable clinical and virological response and are not shedding
viral RNA after 5 days of treatment. In comparison, Whitley et al
[Pediatr Infect Dis J 2001 20:127] found 55 percent (n=51/93) culture
positive patients in oseltamivir treated children with non-severe
influenza on day 4.
There have been a few anecdotal reports from Viet Nam of patients that
remained symptomatic and PCR positive for a prolonged period, and one
patient in our hospital (not included in this report) had a positive
PCR after 18 doses of oseltamivir. Investigations into the presence of
the NA H274Y mutation in [virus isolated from] these patients are
ongoing but have so far been negative.
[Byline: Tran Tinh Hien
Nguyen Thanh Truong
Nguyen van Vinh Chau
Tran Thuy Ngan
Jeremy Farrar
Rogier van Doorn
Hospital for Tropical Diseases
Ho Chi Minh City
Viet Nam]
--
Rogier van Doorn
Hospital for Tropical Diseases
Wellcome Trust Major Overseas Programme
Oxford University Clinical Research Unit
190 Ben Ham Tu
District 5
Ho Chi Minh City
Viet Nam
<rvandoorn@oucru.org>
[ProMED-mail welcomes the opportunity to make these data available to
the general healthcare community. - Mod.CP]
[see also:
Influenza A (H1N1) - worldwide (86): official nomenclature 20090706.2430
Influenza A (H1N1) - worldwide (83): antiviral resistance 20090705.2417
Influenza A (H1N1) - worldwide (82): transmission 20090704.2402
Influenza A (H1N1) - worldwide (81): epidemic analysis 20090703.2391
Influenza A (H1N1) - worldwide (80): Argentina, human to pig 20090701.2376
Influenza A (H1N1) - worldwide (79): case count 20090701.2372
Influenza A (H1N1) - worldwide (78): Tamiflu resistance, DK 20090630.2359
Influenza A (H1N1) - worldwide (76): comments on 1918 virus (03)
20090625.2309
Influenza A (H1N1) - worldwide (74): susp. origin 20090624.2303
Influenza A (H1N1) - worldwide (73): case count, epidemiology 20090622.2288
Influenza A (H1N1) - worldwide (72): case count, epidemiology 20090619.2261
Influenza A (H1N1) - worldwide (70): risk factors 20090619.2260
Influenza A (H1N1) - worldwide (69): other viral infections 20090618.2254
Influenza A (H1N1) - worldwide (68): southern hemisphere 20090618.2253
Influenza A (H1N1) - worldwide (65): antivirals in pregnancy 20090616.2224
Influenza A (H1N1) - worldwide (64): case count, pandemic 20090616.2221
Influenza A (H1N1) - worldwide (62): Egypt, Lebanon 20090611.2150
Influenza A (H1N1) - worldwide (62): Egypt, Lebanon 20090611.2150
Influenza A (H1N1) - worldwide (60): Egypt (Cairo) 20090608.2117
Influenza A (H1N1) - worldwide (59): Worldwide 20060608.2117
Influenza A (H1N1) - worldwide (58): USA, Africa 20090607.2109
Influenza A (H1N1) - worldwide (57): Brazil, USA 20090605.2090
Influenza A (H1N1) - worldwide (55) 20090603.2056
Influenza A (H1N1) - worldwide (47): China, epidemiology 20090526.1962
Influenza A (H1N1) - worldwide (45) 20090525.1951
Influenza A (H1N1) - worldwide (42) 20090523.1929
Influenza A (H1N1) - worldwide (39) 20090521.1903
Influenza A (H1N1) - worldwide (37) 20090520.1893
Influenza A (H1N1) - worldwide (34) 20090518.1863
Influenza A (H1N1) - worldwide (31) 20090516.1835
Influenza A (H1N1) - worldwide (29) 20090515.1824
Influenza A (H1N1) - worldwide (26) 20090514.1798
Influenza A (H1N1) - worldwide (23) 20090511.1764
Influenza A (H1N1) - worldwide (21) 20090510.1749
Influenza A (H1N1) - worldwide (19) 20090509.1733
Influenza A (H1N1) - worldwide (17) 20090508.1722
Influenza A (H1N1) - worldwide (15) 20090507.1709
Influenza A (H1N1) - worldwide (13) 20090506.1695
Influenza A (H1N1) - worldwide (11): coincident H3N2 variation 20090505.1679
Influenza A (H1N1) - worldwide 20090430.1636
Influenza A (H1N1) "swine flu": worldwide (07), update, pandemic 5
20090429.1622
Influenza A (H1N1) "swine flu": Worldwide 20090427.1583
Influenza A (H1N1) virus, human: worldwide 20090426.1577
Influenza A (H1N1) virus, human - New Zealand, susp 20090426.1574
Influenza A (H1N1) virus, human - N America (04) 20090426.1569
Influenza A (H1N1) virus, human - N America 20090425.1552
Acute respiratory disease - Mexico, swine virus susp 20090424.1546
Influenza A (H1N1) virus, swine, human - USA (02): (CA, TX) 20090424.1541
Influenza A (H1N1) virus, swine, human - USA: (CA) 20090422.1516
Influenza A (H1N1) virus, swine, human - Spain 20090220.0715]
.....................cp/ejp/jw
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
<http://www.isid.org/ProMEDMail_Premium.shtml>
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################
|