severe human influenza infections in thailand oseltamivir treatment and risk factors for fatal outcome严重的人类流感感染在泰国奥司他韦治疗和致命的危险因素的结果.pdfVIP

Severe Human Influenza Infections in Thailand: Oseltamivir Treatment and Risk Factors for Fatal Outcome 1 2 1 2 Wanna Hanshaoworakul , James Mark Simmerman *, Ubolrat Narueponjirakul , Wiwan Sanasuttipun , 3 2 1 2 1 Vivek Shinde , Suchada Kaewchana , Darin Areechokechai , Jens Levy , Kumnuan Ungchusak 1 Bureau of Epidemiology, Thailand Ministry of Public Health, Nonthaburi, Thailand, 2 International Emerging Infections Program, Thailand MOPH – U. S. CDC Collaboration, Ministry of Public Health, Nonthaburi, Thailand, 3 Influenza Division, U. S. Centers for Disease Control, Atlanta, Georgia, United States of America Abstract Background: Influenza is often not recognized as an important cause of severe or fatal disease in tropical and subtropical 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 opportunity to describe the epidemiology of laboratory-confirmed severe and fatal human influenza infections. Methodology/Principal Findings: During January 2004 through December 2006, 11,641 notifications to the NAIS were investigated in 73 of 76 Thai provinces. Clinical and demographic data and respiratory swab specimens were collected and tested by PCR for influenza. Using the NAIS database, we identified all patients with laboratory confirmed human influenza (A/H3N2, A/H1N1 and Type B) infection. A retrospective medical record review was conducted on all fata