Swine Origin H1N1 2009课件.ppt

* * * * * * Case Definitions for H1N1 Influenza(CDC. Interim guidance for clinicians on identifying and caring for patients with swine-origin influenza A (H1N1) virus infection. June 2009. Available at: /h1n1flu/identifyingpatients.htm Accessed September 16, 2009.)?Confirmed case: Patient with ILI plus laboratory evidence confirmed by real-time RT-PCR or viral culture;?Probable case: ILI plus laboratory test positive for influenza A and negative for human H1 and H3 by RT-PCR; and?Optional: ILI without negative H1N1 test and (1) previously healthy person 65 years hospitalized for ILI; (2) epidemiologic link to confirmed or probable case in past 7 days; or (3) ILI plus travel to a state or country with confirmed or probable cases. * * * Complications of H1N1 Influenza?Exacerbation of underlying chronic disease;?Complications related to the upper airways, including sinusitis or otitis;?Pulmonary complications, including bronchitis, asthma (sometimes with status asthmaticus), and acute exacerbations of chronic bronchitis; and?Miscellaneous conditions, including cardiac (myocarditis and pericarditis), myositis, rhabdomyolysis, central nervous system complications (encephalopathy, encephalitis, seizures), toxic shock syndrome, and secondary bacterial pneumonia. * evere complications of H1N1 Influenza.?In June 2009, the University of Michigan reported severe pulmonary complications of 2009 H1N1 influenza infection in 10 patients with a median age of 49 years. All 10 patients were referred for severe hypoxemia, ARDS, and inability to oxygenate with conventional ventilation methods. All had severe multilobar pneumonia on x-ray, none had evidence of bacterial pneumonia, and 4 had CT scan-confirmed pulmonary embolism. Lab findings included leukocytosis in 5 (median WBC 9500/mm3), elevated AST levels (41-109 IU/L) in all 10, and elevated CPK levels (51-6572 IU/L) in 6; none had evidence of disseminated intravascular coagulation. The major risk factor was obesity in 9 and morbi