Severe Human Influenza Infections in Thailand Oseltamivir Treatment and Risk Factors for Fatal Outcome 英文参考文献.docVIP

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Severe Human Influenza Infections in Thailand Oseltamivir Treatment and Risk Factors for Fatal Outcome 英文参考文献.doc

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Severe Human Influenza Infections in Thailand Oseltamivir Treatment and Risk Factors for Fatal Outcome 英文参考文献

SevereHumanInfluenzaInfectionsinThailand: OseltamivirTreatmentandRiskFactorsforFatal Outcome WannaHanshaoworakul1,JamesMarkSimmerman2*,UbolratNarueponjirakul1,WiwanSanasuttipun2, VivekShinde3,SuchadaKaewchana2,DarinAreechokechai1,JensLevy2,KumnuanUngchusak1 1Bureau of Epidemiology, Thailand Ministry of Public Health, Nonthaburi, Thailand, 2International Emerging Infections Program, Thailand MOPH – U. S. CDC Collaboration,MinistryofPublicHealth,Nonthaburi,Thailand,3InfluenzaDivision,U.S.CentersforDiseaseControl,Atlanta,Georgia,UnitedStatesofAmerica Abstract Background:Influenzaisoftennotrecognizedasanimportantcauseofsevereorfataldiseaseintropicalandsubtropical countries in Southeast Asia. The extent to which Oseltamivir treatment may protect against a fatal outcome in severe influenza infections is not known. Thailand’s National Avian Influenza Surveillance (NAIS) system affords a unique opportunitytodescribetheepidemiologyoflaboratory-confirmedsevereandfatalhumaninfluenzainfections. Methodology/Principal Findings: During January 2004 through December 2006, 11,641 notifications to the NAIS were investigatedin73of76Thaiprovinces.Clinicalanddemographicdataandrespiratoryswabspecimenswerecollectedand testedbyPCRforinfluenza.UsingtheNAISdatabase,weidentifiedallpatientswithlaboratoryconfirmedhumaninfluenza (A/H3N2, A/H1N1 and Type B) infection. A retrospective medical record review was conducted on all fatal cases with laboratoryconfirmedinfluenzaandfromasampleofhospitalizedcasesin28provinces.Theassociationofunderlyingrisk factors, Oseltamivir treatmentand risk ofafatal outcome wereexamined. Humaninfluenza infections wereidentified in 2,075(18%)cases.Twenty-two(1%)deathsoccurredincludingsevendeathsinchildrenlessthantenyearsofage.Thirty-five percent of hospitalized human influenza infections had chest X-ray confirmed pneumonia. Current or former smoking; advancedage,hypertensionandunderlyingcardiovascular,pulmonaryorendocrinediseasewereassociatedwithafatal outcomefromhuma