Pandemik grip

Year 2012, Volume: 29 Issue: 3s, 193 - 200, 06.02.2013

İlker Balkan

https://doi.org/10.5835/jecm.omu.29.s3.016

Abstract

Mart 2009’da Meksika’nın kuzeyinde ve Kaliforniya’da kümelenme gösteren grip benzeri olguların iki domuz, bir kuş ve bir insan orijinli influenza virüsü ile ortak genom segmentleri içeren dörtlü reassortant (çeşitlenmiş) yapıda “yeni” bir virüs ile ilişkili olduğu saptanmıştır. İlerleyen haftalarda virüsün en az iki kıtada insandan insana bulaş yoluyla yayıldığının tesbit edilmesi üzerine 11 Haziran 2009’da Dünya Sağlık Örgütü (DSÖ) tarafından pandemi alarmı en yüksek düzey olan faz 6’ya yükseltilmiştir. Pandemi dünya genelinde 212’den fazla ülkede milyonlarca grip olgusuna ve en az 16 bin (resmi rakam 15921) teyid edilmiş ölüme yol açmıştır. DSÖ tarafından yapılan 10 Ağustos 2010 tarihli açıklama ile pandeminin sona erdiği ve dünya genelinde “post-pandemik dönem”e girildiği duyurulmuştur. Ülkemizde ilk yerli pandemik grip olgusu 16 Mayıs 2009’da teyid edilmiştir. Kasım 2009’da salgın hızı zirveye ulaşmış ve Sağlık Bakanlığı verilerine göre Türkiye genelinde yaklaşık 6,5 milyon kişinin enfekte olduğu salgında 13,111 olgu hastanelere yatırılmış, 2721 olgu yoğun bakım birimlerinde izlenmiş, 1161 olgu ventilatöre bağlanmış, 656 olgu hayatını kaybetmiştir. Kaybedilen olguların %59,1’ini kronik hastalığı bulunan olgular, %6,1’ini gebe veya lohusa olgular oluşturmuştur. Başlangıçta duyulan kaygıların aksine pandeminin hafif bir şekilde atlatıldığı söylenebilir. Virüs mutasyon geçirip ölümcül bir forma dönüşmemiş, oseltamivir direnci yaygınlaşmamış, üretilen aşı sirküle eden virüs kökenleri ile örtüşerek etkili olmuş ve son derece iyi bir güvenlik profili göstermiştir. 90 yıl önce yaşanan trajik H1N1 pandemisine dair ortak hafızanın ürettiği korku ve kaygılar yüksek iletişim teknolojisi ve yaygın sağlık altyapısının katkıları ile aşılmış ve 2009 pandemisi bir buçuk yıl içinde bilinen mevsimsel grip seyrine geri dönerek insanlık tecrübesine büyük ölçüde bir başarı öyküsü olarak kaydedilmiştir. 

Keywords

Pandemi, İnfluenza A, H1N1, Pnömoni, Grip aşısı, Post-pandemik dönem

References

• Agarwal, P.P, Cinti, S., Kazerooni, E.A., 2009. Chest radiographic and CT findings in novel swine-origin influenza A (H1N1) virus (S-OIV) infection. A.J.R. 193, 1488.
• Armstrong, G.L., Brammer, L., Finelli, L., 2011. Timely assessment of the severity of the 2009 H1N1 influenza pandemic. Clin. Infect. Dis. 52, 83.
• Ayala, E., Kagawa, F.T., Wehner, J.H., Tam, J., Upadhyay, D., 2009. Rhabdomyolysis associated with 2009 influenza A(H1N1). JAMA. 302, 1863.
• Bautista, E., Chotpitayasunondh, T., Gao, Z., Harper, S.A., Shaw, M., Uyeki, T.M., Zaki, S.R., Hayden, F.G., Hui, D.S., Kettner, J.D., Kumar, A., Lim, M., Shindo, N., Penn, C., Nicholson, K.G.. Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza, 2010. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. New Engl. J. Med. 362, 1708.
• Beutel, G., Wiesner, O., Eder, M., Hafer, C., Schneider, A.S., Kielstein, J.T., Kühn, C., Heim, A., Ganzenmüller, T., Kreipe, H.H., Haverich, A., Tecklenburg, A., Ganser, A., Welte, T, Hoeper MM., 2011. Virus-associated hemophagocytic syndrome as a major contributor to death in patients with 2009 influenza A (H1N1) infection. Crit. Care. 15, 80.
• Boloñati, N., Dalamon, R., Sanchez Mercol, V.I., Espinoza, M., Peuchot, J.C., Karolinski, A., Bruno, M., Borsa, A., Ferrero, F., Bonina, A., Ra- monet, M., Albano, L.C., Luedicke, N., Alterman, E., Savy, V., Baumeister, E., Chappell, J.D., Edwards, K.M., Melendi, G.A., Polack, F.P., 2010. Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. New Engl. J. Med. 362, 45.
• Cao, B., Li, X.W., Mao, Y., Wang, J., Lu, H.Z., Chen, Y.S., Liang, Z.A., Liang, L., Zhang, S.J., Zhang, B., Gu, L., Lu, L.H., Wang, D.Y., Wang, C., National Influenza A Pandemic (H1N1) 2009 Clinical Investigation Group of China. 2009. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in China, New Engl. J. Med. 361, 2507.
• Cowling, B.J., Chan, K.H., Fang, V.J., Lau, L.L., So, H.C., Fung, R.O., Ma, E.S., Kwong, A.S., Chan, C.W., Tsui, W.W., Ngai, H.Y., Chu, D.W., Lee, P.W., Chiu, M.C., Leung, G.M., Peiris, J.S., 2010. Comparative epidemiology of pandemic and seasonal influenza A in households. New Engl. J. Med. 362, 2175.
• Creanga, A.A, Johnson, T.F., Graitcer, S.B., Hartman, L.K., Al-Samarrai, T., Schwarz, A.G., Chu, S.Y., Sackoff, J.E., Jamieson, D.J., Fine, A.D., Shapiro-Mendoza, C.K., Jones, L.E., Uyeki, T.M., Balter, S., Bish, C.L., Finelli, L., Honein, M.A., 2010. Severity of 2009 pandemic influ- enza A (H1N1) virus infection in pregnant women. Obstet. Gynecol. 115, 717.
• Crum-Cianflone, N.F., Blair, P.J., Faix, D., Arnold, J., Echols, S., Sherman, S.S., Tueller, J.E., Warkentien, T., Sanguineti, G., Bavaro, M., Hale, B.R., 2009. Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries. Clin. Infect. Dis. 49, 1801.
• Dawood, F.S., Jain, S., Finelli, L., Shaw, M.W., Lindstrom, S., Garten, R.J., Gubareva, L.V., Xu, X., Bridges, C.B., Uyeki, T.M., Novel Swine- Origin Influenza A (H1N1) Virus Investigation Team, 2009. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. New Engl. J. Med. 360, 2605.
• Dede, F., Celen, S., Bilgin, S., Ure, G., Ozcan, A., Buzgan, T., Kose, R., 2011. Maternal deaths associated with H1N1 influenza virus infection in Turkey: A whole-of-population report. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03002.x.
• De la Rosa-Zamboni, D., Ponce de Leon, S., Hernandez, M., Quiñones-Falconi, F., Bautista, E., Ramirez-Venegas, A., Rojas-Serrano, J., Orms- by, C.E., Corrales, A., Higuera, A., Mondragon, E., Cordova-Villalobos, J.A., INER Working Group on Influenza, 2009. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. New Engl. J. Med. 361, 680.
• De la Tabla, V.O., Masiá, M., Antequera, P., Martin, C., Gazquez, G., Buñuel, F., Gutiérrez, F. J., 2010. Comparison of combined nose-throat swabs with nasopharyngeal aspirates for detection of pandemic influenza A/H1N1 2009 virus by real-time reverse transcriptase PCR. Clin. Microbiol. 48, 3492.
• Domínguez-Cherit, G., Lapinsky, S.E., Macias, A.E., Pinto, R., Espinosa-Perez, L., de la Torre, A., Poblano-Morales, M., Baltazar-Torres, J.A., Bautista, E., Martinez, A., Martinez, M.A., Rivero, E., Valdez, R., Ruiz-Palacios, G., Hernández, M., Stewart, T.E., Fowler, R.A., 2009. Criti- cally Ill patients with 2009 influenza A(H1N1) in Mexico. JAMA. 302, 1880.
• Ergönül, Ö., Alan, S., Ak, Ö., Sargın, F., Kantürk, A., Gündüz, A., Ergin, D., Öncül, O., Balkan, İ.İ., Ceylan, B., Benzonana, N., Yazıcı, S., Şimşek, F., Uzun, N., İnan, A., Eren, G., Ciblak, M., Midilli, K., Badur, S., Gencer, S., Nazlıcan, Ö., Özer, S., Özgüneş, N., Yıldırmak, T., Aslan, T., Göktaş, P, Saltoğlu, N., Fincancı, M., Eraksoy, H., Dokucu, A.İ., 2011. Pandemic influenza A (H1N1) Virus Infection Among the Hospitalized Adult Patients in Istanbul KLİMİK 2011 kongresinde poster olarak sunulmuştur.
• Fraser, C., Donnelly, C.A., Cauchemez, S., Hanage, W.P., Van Kerkhove, M.D., Hollingsworth, T.D., Griffin, J., Baggaley, R.F., Jenkins, H.E., Lyons, E.J., Jombart, T., Hinsley, W.R., Grassly, N.C., Balloux, F., Ghani, A.C., Ferguson, N.M., Rambaut, A., Pybus, O.G., Lopez-Gatell, H., Alpuche-Aranda, C.M., Chapela, I.B., Zavala, E.P., Guevara, D.M., Checchi, F., Garcia, E., Hugonnet, S., Roth, C., WHO Rapid Pan- demic Assessment Collaboration, 2009. Pandemic potential of a strain of influenza A (H1N1): Early findings. Science. 324,1557.
• Graitcer, S.B., Gubareva, L., Kamimoto, L., Doshi, S., Vandermeer, M., Louie, J., Waters, C., Moore, Z., Sleeman, K., Okomo-Adhiambo, M, Marshall, S.A., St George, K., Pan, C.Y., LaPlante, J.M., Klimov, A., Fry, A.M., 2011. Characteristics of patients with oseltamivir-resistant pandemic (H1N1) 2009, United States. Emerg. Infect. Dis. 17, 255.
• Haiatullah, A., Balkan, İ.İ., Saltoğlu, N., Tabak, F., Can, G., Aygün, G., Erol, S., Tayran, N., Samastı, M., Altındaş, F., Öztürk, R., 2010. Sağlık çalışanlarında H1N1 aşısı ile H1N1 ve mevsimsel grip aşılarının yan etkilerinin irdelenmesi. Toraks 2010 Kongresinde poster olarak sunulmuştur.
• Jain, S., Kamimoto, L., Bramley, A.M., Schmitz, A.M., Benoit, S.R., Louie, J., Sugerman, D.E., Druckenmiller, J.K., Ritger, K.A., Chugh, R., Jasuja, S., Deutscher, M., Chen, S., Walker, J.D., Duchin, J.S., Lett, S., Soliva, S., Wells, E.V., Swerdlow, D., Uyeki, T.M., Fiore, A.E., Olsen, S.J., Fry, A.M., Bridges, C.B., Finelli, L., 2009 Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team, 2009. Hospitalized patients with 2009 H1N1 influenza in the United States,. New Engl. J. Med. 361, 1935.
• Jean, C., Louie, J.K., Glaser, C.A., Harriman, K., Hacker, J.K., Aranki, F., Bancroft, E., Farley, S., Ginsberg, M., Hernandez, L.B., Sallenave, C.S., Radner, A.B., 2010. Invasive group A streptococcal infection concurrent with 2009 H1N1 influenza. Clin. Infect. Dis. 50, e59.
• Karadeli, E., Koc, Z., Ulusan, S., Erbay, G., Demiroglu, Y.Z., Sen, N., 2011. Chest radiography and CT findings in patients with the 2009 pan- demic (H1N1) influenza. Diagn. Interv. Radiol. 17, 216-222.
• Kumar, A., Zarychanski, R., Pinto, R., Cook, D.J., Marshall, J., Lacroix, J., Stelfox, T., Bagshaw, S., Choong, K., Lamontagne, F., Turgeon, A.F., Lapinsky, S., Ahern, S.P., Smith, O., Siddiqui, F., Jouvet, P., Khwaja, K., McIntyre, L., Menon, K., Hutchison, J., Hornstein, D., Joffe, A., Lauzier, F., Singh, J., Karachi, T., Wiebe, K., Olafson, K., Ramsey, C., Sharma, S., Dodek, P., Meade, M., Hall, R., Fowler, R.A. Canadian Critical Care Trials Group H1N1 Collaborative, 2009. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. J.A.M.A. 302, 1872.
• Kumar, K., Guirgis, M., Zieroth, S., Lo, E., Menkis, A.H., Arora, R.C., Freed, D.H., 2011. Influenza myocarditis and myositis: Case presentation and review of the literature. Can. J. Cardiol. 27, 514-522.
• Lee, E.H., Wu, C., Lee, E.U., Stoute, A., Hanson, H., Cook, H.A., Nivin, B., Fine, A.D., Kerker, B.D., Harper, S.A., Layton, M.C., Balter, S., 2010. Fatalities associated with the 2009 H1N1 influenza A virus in New York city. Clin. Infect. Dis. 50, 1498.
• Lessler, J., Reich, N.G., Cummings, D.A., Nair, H.P., Jordan, H.T., Thompson, N., New York City Department of Health and Mental Hygiene Swine Influenza Investigation Team, 2009. Outbreak of 2009 pandemic influenza A (H1N1) at a New York City school. New Engl. J. Med. 361, 2628.
• Louie, J.K., Acosta, M., Winter, K., Jean, C., Gavali, S., Schechter, R., Vugia, D., Harriman, K., Matyas, B., Glaser, C.A., Samuel, M.C., Rosen- berg, J., Talarico, J., Hatch, D., California Pandemic (H1N1) Working Group, 2009. Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California. J.A.M.A. 302, 1896.
• Mamelund, S.E., 2008. Influenza, Historical. In: Heggenhougen K, Quah S, eds. International Encyclopedia of Public Health. Oxford: Elsevier. 3, 596-608.
• Martin-Loeches, I., Papiol, E., Rodríguez, A., Diaz, E., Zaragoza, R., Granada, R.M., Socias, L., Bonastre, J., Valverdş, M., Pozo, J.C., Luque, P., Juliá-Narvaéz, J.A., Cordero, L., Albaya, A., Serón, D., Rello, J., the H1N1 SEMICYUC Working Group, 2011a. Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection. Crit. Care. 15, 66.
• Martín-Loeches, I., Sanchez-Corral, A., Diaz, E., Granada, R.M., Zaragoza, R., Villavicencio, C., Albaya, A., Cerdá, E., Catalán, R.M., Luque, P., Paredes, A., Navarrete, I., Rello, J., Rodríguez, A., H1N1 SEMICYUC Working Group, 2011b. Community-acquired respiratory coinfec- tion in critically ill patients with pandemic 2009 influenza A(H1N1) virus. Chest. 139, 555.
• Murray, R.J., Robinson, J.O., White, J.N., Hughes, F., Coombs, G.W., Pearson, J.C., Tan, H.L., Chidlow, G., Williams, S., Christiansen, K.J., Smith, D.W., 2010. Community-acquired pneumonia due to pandemic A(H1N1)2009 influenzavirus and methicillin resistant Staphylococ- cus aureus co-infection. PLoS One. 5, 8705.
• Örnek, T., Yalçın, F.D., Ekin, S., Yalçın, S., Yemişen, M., 2011. Pneumonia in patients with novel influenza A (H1N1) virus in Southeastern Turkey. Wien. Klin. Wochenschr.123, 106-111.
• Özdemir, N., Celkan, T., Midilli, K., Aygün, G., Sinekbasan, S., Kılıç, O., Apak, H., Camcıoğlu, Y., Yıldız, I., 2011. Novel influenza a (H1N1) infection in a pediatric hematology oncology clinic during the 2009-2010 pandemia. Pediatr. Hematol. Oncol. 28, 288-293.
• Özkan, M., Tuygun, N., Erkek, N., Aksoy, A., Yildiz, Y.T., 2011. Neurologic manifestations of novel influenza A (H1N1) virus infection in child- hood. Pediatr. Neurol. 45, 72-76.
• Palacios, G., Hornig, M., Cisterna, D., Savji, N., Bussetti, A.V., Kapoor, V., Hui, J., Tokarz, R., Briese, T., Baumeister, E., Lipkin, W.I., 2009. Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1). MMWR 58, 1-4.
• Perez-Padilla, R., de la Rosa-Zamboni, D., Ponce de Leon, S., Hernandez, M., Quiñones-Falconi, F., Bautista, E., Ramirez-Venegas, A., Rojas- Serrano, J., Ormsby, C.E., Corrales, A., Higuera, A., Mondragon, E., Cordova-Villalobos, J.A., 2009. INER Working Group on Influenza. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N. Engl. J. Med. Aug. 361, 680-689.
• Saltoğlu, N., Balkan, İ.İ., 2010. Pandemik Influenza klinik görünümleri (derleme). ANKEM Derg. 24, 196-200.
• Santucho, F., Cabral, G., Gregorio, G.L., Moreno, R., Lutz, M.I., Panigasi, A.L., Saligari, L., Caballero, M.T., Egües Almeida, R.M., Gutierrez Meyer, M.E., Neder, M.D., Davenport, M.C., Del Valle, M.P., Santidrian, V.S., Mosca, G., Garcia Domínguez, M., Alvarez, L., Landa, P., Pota, A., Ling, L.M., Chow, A.L., Lye, D.C., Tan, A.S., Krishnan, P., Cui, L., Win, N.N., Chan, M., Lim, P.L., Lee, C.C., Leo, Y.S., 2010. Effects of early oseltamivir therapy on viral shedding in 2009 pandemic influenza A (H1N1) virus infection. Clin. Infect. Dis. 50, 963.
• Siston, A.M., Rasmussen, S.A., Honein, M.A., Fry, A.M., Seib, K., Callaghan, W.M., Louie, J., Doyle, T.J., Crockett, M., Lynfield, R., Moore, Z., Wiedeman, C., Anand, M., Tabony, L., Nielsen, C.F., Waller, K., Page, S., Thompson, J.M., Avery, C., Springs, C.B., Jones, T., Williams, J.L., Newsome, K., Finelli, L., Jamieson, D.J., Pandemic H1N1 Influenza in Pregnancy Working Group, 2010. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA. 303, 1517.
• Tan, K., Prerna, A., Leo, Y.S., 2010. Surveillance of H1N1-related neurological complications. Lancet Neurol. 9, 142.
• Tang, J.W., Shetty, N., Lam, T., 2010. Features of the new pandemic influenza A/N1N1/2009 virus: Virology, epidemiology, clinical and public health aspects. Curr. Opin. Pulm. Med. 16, 235-241.
• T.C. Sağlık Bakanlığı, www.grip.saglik.gov.tr. Erişim: 30.09.2011.
• Thorner, A.R., 2011. Clinical manifestations and diagnosis of pandemic H1N1 influenza in: Last updated 13th June 2011.
• To, K.K., Hung, I.F., Li, I.W., Lee, K.L., Koo, C.K., Yan, W.W., Liu, R., Ho, K.Y., Chu, K.H., Watt, C.L., Luk, W.K., Lai, K.Y., Chow, F.L., Mok, T., Buckley, T., Chan, J.F., Wong, S.S., Zheng, B., Chen, H., Lau, C.C., Tse, H., Cheng, V.C., Chan, K.H., Yuen, K.Y., 2010. Delayed clearance of viral load and marked cytokine activation in severe cases of pandemic H1N1 2009 influenza virus infection. Clin. Infect. Dis. 50, 850.
• Treanor, J., 2011. Influenza viruses, including avian influenza and swine influenza in: Principles and practice of ınfectious diseases. Mandell, Bennett, Dolin(eds). 7th edition, 2265-2288.
• Tütüncü, E.E., Ozturk, B., Gurbuz, Y., Haykir, A., Sencan, I., Kuşçu, F., Dede, G., Kilic, A.U., Senturk, G.C., 2010. Clinical characteristics of 74 pandemic H1N1 influenza patients from Turkey. Risk factors for fatality Saudi Med. J. 31, 993-998.
• United States Centers for Disease Control and Prevention (CDC), 2009a. H1N1 early outbreak and disease characteristics. http://www.cdc.gov/ h1n1flu/surveillanceqa.htm. Erişim: Eylül 2011.
• United States Centers for Disease Control and Prevention (CDC), 2009b. Interim guidance for clinicians on identifying and caring for patients with swine-origin influenza A (H1N1) virus infection. http://www.cdc.gov/swineflu/identifyingpatients.htm. Erişim: Eylül 2011.
• United States Centers for Disease Control and Prevention (CDC), 2009c. Interim guidance on case definitions to be used for investigations of novel influenza A (H1N1) cases. http://www.cdc.gov/h1n1flu/casedef.htm. Erişim: Eylül 2011.
• United States Centers for Disease Control and Prevention (CDC), 2009d. Interim Recommendations for Clinical Use of Influenza Diagnostic Tests During the 2009-10 Influenza Season. http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm. Erişim: 28 Eylül 2011.
• United States Centers for Disease Control and Prevention (CDC), 2009e. Introduction and transmission of 2009 pandemic influenza A (H1N1) Virus--Kenya, June-July 2009. MMWR Morb Mortal Wkly Rep. 58, 1143.
• United States Centers for Disease Control and Prevention (CDC), 2009f. Recommendations for use of antiviral medications for the manage- ment of influenza in children and adolescents for the 2009-2010 season - pediatric supplement for healthcare providers. http://www.cdc.gov/ h1n1flu/recommendations_pediatric_supplement.htm. Erişim: Eylül 2011.
• United States Centers for Disease Control and Prevention (CDC), 2009g. Updated interim recommendations for obstetric health care providers related to use of antiviral medications in the treatment and prevention of influenza for the 2009-2010 season. http://www.cdc.gov/H1N1flu/ pregnancy/antiviral_messages.htm. Erişim: Eylül 2011.
• United States Centers for Disease Control and Prevention (CDC), 2010. Pandemic influenza A (H1N1) in pregnant women requiring intensive care - New York City, 2009. MMWR Morb Mortal Wkly Rep. 59, 321.
• Wise, M.E., De Perio, M., Halpin, J., Jhung, M., Magill, S., Black, S.R., Gerber, S.I., Harriman, K., Rosenberg, J., Borlaug, G., Finelli, L., Olsen, S.J., Swerdlow, D.L., Kallen, A.J., 2011. Transmission of pandemic (H1N1) 2009 influenza to healthcare personnel in the United States. Clin. Infect. Dis. 1, 198.
• World Health Organization (WHO), 2009a. Human infection with new influenza A (H1N1) virus: Clinical observations from Mexico and other affected countries, May 2009. Weekly epidemiological record 84,185. http://www.who.int/wer/2009/wer8421. pdf. Erişim: Eylül 2011.
• World Health Organization (WHO), 2009b. Outbreak of swine origin influenza A (H1N1) virus infection-Mexico, March-April 2009. http//www. who.int, MMWR Morb Mortal Wkly Rep. 58, 467. Erişim: Eylül 2011.
• World Health Organization (WHO), 2009c. World now at the start of 2009 influenza pandemic. http//www.who.int/mediacentre/news/ statements/2009/h1n1_pandemic_phase6_20090611 /en/ index.html. Erişim: Eylül 2011.
• World Health Organization (WHO), 2010. In focus: H1N1 now in the post-pandemic period. August 10, 2010. http://www.who.int/csr/disease/ swineflu/en/index.html. Erişim: Eylül 2011.
• Yang, Y., Sugimoto, J.D., Halloran, M.E., Basta, N.E., Chao, D.L., Matrajt, L., Potter, G., Kenah, E., Longini, I.M. Jr., 2009. The transmissibility and control of pandemic influenza A (H1N1) virus. Science. 326, 729.
• Yoo, S.J., Moon, S.J., Kuak, E.Y., Yoo, H.M., Kim, C.K., Chey, M.J., Shin, B.M., 2010. Frequent detection of pandemic (H1N1) 2009 virus in stools of hospitalized patients. J. Clin. Microbiol. 48, 2314.