A comparison of clinical and epidemiological characteristics of fatal human infections with H5N1 and human influenza viruses in Thailand, 2004-2006

The National Avian Influenza Surveillance (NAIS) system detected human H5N1 cases in Thailand from 2004-2006. Using NAIS data, we identified risk factors for death among H5N1 cases and described differences between H5N1 and human (seasonal) influenza cases. NAIS identified 11,641 suspect H5N1 cases...

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Published in:PloS one 2011-04, Vol.6 (4), p.e14809-e14809
Main Authors: Shinde, Vivek, Hanshaoworakul, Wanna, Simmerman, James M, Narueponjirakul, Ubolrat, Sanasuttipun, Wiwan, Kaewchana, Suchada, Areechokechai, Darin, Ungchusak, Kumnuan, Fry, Alicia M
Format: Article
Language:English
Subjects:
Algorithms
Animals
Antiviral agents
Avian flu
Avian influenza
Avian influenza viruses
Birds
Blood
Cohort Studies
Communicable Disease Control
Diagnostic systems
Epidemics
Epidemiology
Exposure
Fatalities
Fever
Geography
Health aspects
Humans
Identification methods
Infectious Diseases
Infectious Diseases/Epidemiology and Control of Infectious Diseases
Infectious Diseases/Respiratory Infections
Infectious Diseases/Viral Infections
Influenza
Influenza A
Influenza A Virus, H5N1 Subtype - metabolism
Influenza in Birds - epidemiology
Influenza in Birds - mortality
Influenza in Birds - virology
Influenza, Human - epidemiology
Influenza, Human - mortality
Influenza, Human - virology
Laboratories
Leukocytes
Liver
Medical records
Oseltamivir
Polymerase Chain Reaction
Public Health and Epidemiology/Global Health
Public Health and Epidemiology/Infectious Diseases
Respiratory failure
Retrospective Studies
Risk analysis
Risk Factors
Seasons
Thailand
Viruses
Vomiting
White blood cell count
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creator Shinde, Vivek
Hanshaoworakul, Wanna
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Sanasuttipun, Wiwan
Kaewchana, Suchada
Areechokechai, Darin
Ungchusak, Kumnuan
Fry, Alicia M
description The National Avian Influenza Surveillance (NAIS) system detected human H5N1 cases in Thailand from 2004-2006. Using NAIS data, we identified risk factors for death among H5N1 cases and described differences between H5N1 and human (seasonal) influenza cases. NAIS identified 11,641 suspect H5N1 cases (e.g. persons with fever and respiratory symptoms or pneumonia, and exposure to sick or dead poultry). All suspect H5N1 cases were tested with polymerase chain reaction (PCR) assays for influenza A(H5N1) and human influenza viruses. NAIS detected 25 H5N1 and 2074 human influenza cases; 17 (68%) and 22 (1%) were fatal, respectively. We collected detailed information from medical records on all H5N1 cases, all fatal human influenza cases, and a sampled subset of 230 hospitalized non-fatal human influenza cases drawn from provinces with ≥1 H5N1 case or human influenza fatality. Fatal versus non-fatal H5N1 cases were more likely to present with low white blood cell (p = 0.05), lymphocyte (p
doi_str_mv 10.1371/journal.pone.0014809
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Using NAIS data, we identified risk factors for death among H5N1 cases and described differences between H5N1 and human (seasonal) influenza cases. NAIS identified 11,641 suspect H5N1 cases (e.g. persons with fever and respiratory symptoms or pneumonia, and exposure to sick or dead poultry). All suspect H5N1 cases were tested with polymerase chain reaction (PCR) assays for influenza A(H5N1) and human influenza viruses. NAIS detected 25 H5N1 and 2074 human influenza cases; 17 (68%) and 22 (1%) were fatal, respectively. We collected detailed information from medical records on all H5N1 cases, all fatal human influenza cases, and a sampled subset of 230 hospitalized non-fatal human influenza cases drawn from provinces with ≥1 H5N1 case or human influenza fatality. Fatal versus non-fatal H5N1 cases were more likely to present with low white blood cell (p = 0.05), lymphocyte (p<0.02), and platelet counts (p<0.01); have elevated liver enzymes (p = 0.05); and progress to circulatory (p<0.001) and respiratory failure (p<0.001). There were no differences in age, medical conditions, or antiviral treatment between fatal and non-fatal H5N1 cases. Compared to a sample of human influenza cases, all H5N1 cases had direct exposure to sick or dead birds (60% vs. 100%, p<0.05). Fatal H5N1 and fatal human influenza cases were similar clinically except that fatal H5N1 cases more commonly: had fever (p<0.001), vomiting (p<0.01), low white blood cell counts (p<0.01), received oseltamivir (71% vs. 23%, p<.001), but less often had ≥1 chronic medical conditions (p<0.001). In the absence of diagnostic testing during an influenza A(H5N1) epizootic, a few epidemiologic, clinical, and laboratory findings might provide clues to help target H5N1 control efforts. 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Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shinde, Vivek</au><au>Hanshaoworakul, Wanna</au><au>Simmerman, James M</au><au>Narueponjirakul, Ubolrat</au><au>Sanasuttipun, Wiwan</au><au>Kaewchana, Suchada</au><au>Areechokechai, Darin</au><au>Ungchusak, Kumnuan</au><au>Fry, Alicia M</au><au>Aguilar, Patricia V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of clinical and epidemiological characteristics of fatal human infections with H5N1 and human influenza viruses in Thailand, 2004-2006</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2011-04-29</date><risdate>2011</risdate><volume>6</volume><issue>4</issue><spage>e14809</spage><epage>e14809</epage><pages>e14809-e14809</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract><![CDATA[The National Avian Influenza Surveillance (NAIS) system detected human H5N1 cases in Thailand from 2004-2006. Using NAIS data, we identified risk factors for death among H5N1 cases and described differences between H5N1 and human (seasonal) influenza cases. NAIS identified 11,641 suspect H5N1 cases (e.g. persons with fever and respiratory symptoms or pneumonia, and exposure to sick or dead poultry). All suspect H5N1 cases were tested with polymerase chain reaction (PCR) assays for influenza A(H5N1) and human influenza viruses. NAIS detected 25 H5N1 and 2074 human influenza cases; 17 (68%) and 22 (1%) were fatal, respectively. We collected detailed information from medical records on all H5N1 cases, all fatal human influenza cases, and a sampled subset of 230 hospitalized non-fatal human influenza cases drawn from provinces with ≥1 H5N1 case or human influenza fatality. Fatal versus non-fatal H5N1 cases were more likely to present with low white blood cell (p = 0.05), lymphocyte (p<0.02), and platelet counts (p<0.01); have elevated liver enzymes (p = 0.05); and progress to circulatory (p<0.001) and respiratory failure (p<0.001). There were no differences in age, medical conditions, or antiviral treatment between fatal and non-fatal H5N1 cases. Compared to a sample of human influenza cases, all H5N1 cases had direct exposure to sick or dead birds (60% vs. 100%, p<0.05). Fatal H5N1 and fatal human influenza cases were similar clinically except that fatal H5N1 cases more commonly: had fever (p<0.001), vomiting (p<0.01), low white blood cell counts (p<0.01), received oseltamivir (71% vs. 23%, p<.001), but less often had ≥1 chronic medical conditions (p<0.001). In the absence of diagnostic testing during an influenza A(H5N1) epizootic, a few epidemiologic, clinical, and laboratory findings might provide clues to help target H5N1 control efforts. Severe human influenza and H5N1 cases were clinically similar, and both would benefit from early antiviral treatment.]]></abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21559080</pmid><doi>10.1371/journal.pone.0014809</doi><tpages>e14809</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_1296873916
source PubMed Central Free; Publicly Available Content Database
subjects Algorithms
Animals
Antiviral agents
Avian flu
Avian influenza
Avian influenza viruses
Birds
Blood
Cohort Studies
Communicable Disease Control
Diagnostic systems
Epidemics
Epidemiology
Exposure
Fatalities
Fever
Geography
Health aspects
Humans
Identification methods
Infectious Diseases
Infectious Diseases/Epidemiology and Control of Infectious Diseases
Infectious Diseases/Respiratory Infections
Infectious Diseases/Viral Infections
Influenza
Influenza A
Influenza A Virus, H5N1 Subtype - metabolism
Influenza in Birds - epidemiology
Influenza in Birds - mortality
Influenza in Birds - virology
Influenza, Human - epidemiology
Influenza, Human - mortality
Influenza, Human - virology
Laboratories
Leukocytes
Liver
Medical records
Oseltamivir
Polymerase Chain Reaction
Public Health and Epidemiology/Global Health
Public Health and Epidemiology/Infectious Diseases
Respiratory failure
Retrospective Studies
Risk analysis
Risk Factors
Seasons
Thailand
Viruses
Vomiting
White blood cell count
title A comparison of clinical and epidemiological characteristics of fatal human infections with H5N1 and human influenza viruses in Thailand, 2004-2006
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