原创力文档H1N1流感与ICUPPT
降低H1N1病死率-ICU 席修明 2009.9.16 流感对人类的威胁 1918 流感的世界大流行导致5000万人死亡，美国估计675,000人 1957 的流感导致全球1-200万人死亡，美国至少70,000人 成为今天是否做好公共卫生准备的试金石 When it came to treating influenza patients, doctors, nurses and druggists were at a loss. 判断流行病的严重程度 ? Pandemic Severity Index 流行病的死亡率是评价流行严重程度的重要指标 The severity index 可以很好预测流行 为流感今后的流行提供决策 Pre-Pandemic Planning:? Pandemic Severity Index The Persistent Legacy of the 1918 Influenza Virus n engl j med 361;3 nejm.org july 16, 2009 Map: International Co-circulation of 2009 H1N1 and Seasonal Influenza (As of September 4, 2009; posted September 11, 2009, 6:00 PM ET) Centers for Disease Control and Prevention ? Map: International Co-circulation of 2009 H1N1 and Seasonal Influenza (As of October 2, 2009; posted October 2, 2009, 11:00 AM ET) Centers for Disease Control and Prevention ? 2008-2009 Influenza Season Week 38 ending September 26, 2009 Weekly Laboratory-Confirmed and Syndromic-Based Influenza-AssociatedHospitalizations and Deaths, National Summary, 2008-09 From August 30 - September 26, 2009, 16,174 hospitalizations and 1,379 deaths associated with influenza virus infection or based on syndromic surveillance for influenza and pneumonia, were reported to CDC Pneumonia and Influenza (PI) Mortality Surveillance: During week 38, 6.1% of all deaths reported through the 122-Cities Mortality Reporting System were due to PI. This percentage was below the epidemic threshold of 6.4% for week 38 Centers for Disease Control and Prevention ? Epidemiology of Fatal Cases associated with Pandemic H1N1 Influenaza 2009 EUROSURVEI L LANCE Vol . 14 · Issue 33 · 20 August 2009 Percentage Distribution of Deaths from Severe Pneumonia during the 2009 Study Period, as Compared with Influenza Seasons from 2006 through 2008, in Mexico N Engl J Med 2009;361:674-9. Bacterial Coinfections in Lung Tissue Specimens from Fatal Cases of 2009 Pandemic Influenza A (H1N1) United States 7例22 (29%) of the 77 patients, including 10 caused by Streptococcus pneumo- 10
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