Details:

Alternative Title:
BMC Public Health
Publisher's site:
http://dx.doi.org/10.1186/s12889-015-2064-z
Personal Author:
Chacon, Rafael ; Mirza, Sara ; Rodriguez, David ; Paredes, Antonio ; Guzman, Giselle ; ... More +
Chacon, Rafael ; Mirza, Sara ; Rodriguez, David ; Paredes, Antonio ; Guzman, Giselle ; Moreno, Lourdes ; Then, Cecilia J. ; Jara, Jorge ; Blanco, Natalia ; Bonilla, Luis ; Clara, Wilfrido A. ; Minaya, Percy ; Palekar, Rakhee ; Azziz-Baumgartner, Eduardo Less -
Description:
Background

The demographic characteristics of pandemic influenza decedents among middle and low-income tropical countries are poorly understood. We explored the demographics of persons who died with influenza A (H1N1)pdm09 infection during 2009–2010, in seven countries in the American tropics.

Methods

We used hospital-based surveillance to identify laboratory-confirmed influenza deaths in Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama and Dominican Republic. An influenza death was defined as a person who died within two weeks of a severe acute respiratory infection (SARI) defined as sudden onset of fever >38 °C, cough or sore-throat, and shortness of breath, or difficulty breathing requiring hospitalization, and who tested positive for influenza A (H1N1)pdm09 virus by real time polymerase chain reaction. We abstracted the demographic and clinical characteristics of the deceased from their medical records.

Results

During May 2009-June 2010, we identified 183 influenza deaths. Their median age was 32 years (IQR 18–46 years). One-hundred and one (55 %) were female of which 20 (20 %) were pregnant and 7 (7 %) were in postpartum. One-hundred and twelve decedents (61 %) had pre-existing medical conditions, (15 % had obesity, 13 % diabetes, 11 % asthma, 8 % metabolic disorders, 5 % chronic obstructive pulmonary disease, and 10 % neurological disorders). 65 % received oseltamivir but only 5 % received it within 48 h of symptoms onset.

Conclusions

The pandemic killed young adults, pregnant women and those with pre-existing medical conditions. Most sought care too late to fully benefit from oseltamivir. We recommend countries review antiviral treatment policies for people at high risk of developing complications.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2064-z) contains supplementary material, which is available to authorized users.


Subject:
[+]
Adolescent
Adult
Antiviral Agents
Asthma
Comorbidity
Disease Outbreaks
Female
Fever
Humans
Influenza, Human
Influenza A Virus, H1N1 Subtype
Male
Middle Aged
Oseltamivir
Pregnancy
Pulmonary Disease, Chronic Obstructive
Young Adult

Source:
BMC Public Health. 15.
Pubmed ID:
26227404
Pubmed Central ID:
PMC4521479
Document Type:
Journal Article
Place as Subject:
Central America ; Costa Rica ; Dominican Republic ; El Salvador ; Guatemala ; ... More +
Central America ; Costa Rica ; Dominican Republic ; El Salvador ; Guatemala ; Honduras ; Nicaragua Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:3f0e34e8f2d98a2d30b82bb10316f034a957b3e3702db6da1ce20b6b855df1d2
File Type:

Supporting Files

• 	12889_2015_2064_Fig1_HTML.gif	gif
  	12889_2015_2064_Fig1_HTML.jpg	jpeg
  	12889_2015_2064_MOESM1_ESM.doc	doc
  	12889_2015_Article_2064.nxml	txt
  	license.txt	txt

More +