Evaluation of clinical, laboratory and prognosis of patients in an influenza epidemic
Yıl 2023,
Cilt: 16 Sayı: 2, 208 - 214, 05.04.2023
Türkan Tüzün
,
Duru Mıstanoğlu Özatağ
,
Şebnem Emine Parsbur
,
Ayşenur Beyazıt Üçgün
Öz
Objective: Influenza is an infectious respiratory disease that causes widespread epidemics and pandemics in the community. It is usually self-limiting but may cause significant morbidity and mortality due to complications. We aimed at evaluating the clinical, laboratory and prognosis of adult patients hospitalised with a pre-diagnosis of seasonal influenza.
Materials and methods: It is a descriptive study based on the data from 50 patients hospitalised with a preliminary diagnosis of seasonal influenza between 1 December 2015 and 31 January 2016.
Results: The average age of the patients was 55.44±17.17 years (20-89) and 64% of them were women. Of the cases, 36% were H1N1 positive, 30% were H3N2 positive and 34% had negative PCR results. The time from the onset of symptoms to hospital admission was 3.72±2.51 days (1-11). Comorbidities were present in 38 (76%) patients. Four patients had mortality.
Conclusion: Influenza can be self-limited according to the characteristics of the host, as well as cause mortality. In this study, it was found to cause severe illness and death in a healthy young adult. Therefore, it is important to avoid contact with infected patients, hand washing and vaccination to reduce influenza and its complications. In addition, if our preliminary diagnosis of influenza continues, further evaluations should be made even if the PCR is negative.
Kaynakça
- Referans1. Gaitonde, David Y et al. “Influenza: Diagnosis and Treatment.” American family physician vol. 100,12 (2019): 751-58.
- Referans2. Su S, Fu X, Li G, Kerlin F, Veit M. Novel Influenza D virus: Epidemiology, pathology, evolution and biological characteristics. Virulence. 2017 Nov 17;8(8):1580-91. doi: 10.1080/21505594.2017.1365216
- Referans3. Krammer F, Smith G, Fouchier R, Peiris M, Kedzierska K, Dohert PC, et al. Influenza. Nat Rev Dis Primers. 2018 Jun 28;4(1):3. doi:10.1038/s41572-018-0002-y
- Referans4. Nesmith N, Williams JV, Johnson M, Zhu Y, Griffin M, Talbot HK. Sensitive Diagnostics Confirm That Influenza C is an Uncommon Cause of Medically Attended Respiratory Illness in Adults. Clin Infect Dis. 2017 Sep 15;65(6):1037-39. doi: 10.1093/cid/cix471
- Referans5. LaRussa P, Pandemic novel 2009 H1N1 influenza: what have we learned? Semin Respir Crit Care Med. 2011 Aug;32(4):393-9. doi: 10.1055/s-0031-1283279
- Referans6. Peiris JS, Tu WW, Yen HL. A novel H1N1 virus causes the first pandemic of the 21st century, Eur J Immunol 2009;39(11):2946-54. doi: 10.1002/eji.200939911
- Referans7. Satpathy HK, Lindsay M, Kawwass JF: Novel H1N1 virus infection and pregnancy, Postgrad Med 2009;121(6):106-12 doi:10.3810/pgm.2009.11.2080
- Referans8. Yahşi A, Grip, Klinik Tıp Pediatri Dergisi,2017, 9(5),1-7.
Referans9. Quach C, Piché-Walker L, Platt R, Moore D. Risk factors associated with severe influenza infections in childhood: implication for vaccine strategy. Pediatrics. 2003;112(3 Pt 1):e197-201. doi:10.1542/peds.112.3.e197
- Referans10. Morgan R, Klein SL. The intersection of sex and gender in the treatment of influenza. Curr Opin Virol. 2019;35:35-41. doi:10.1016/j.coviro.2019.02.009
- Referans11. Wong KC, Luscombe GM, Hawke C. Influenza infections in Australia 2009-2015: is there a combined effect of age and sex on susceptibility to virus subtypes? BMC Infect Dis. 2019 Jan 10;19(1):42. doi: 10.1186/s12879-019-3681-4
- Referans12. Saltoğlu N, Balkan İİ. H1N1: Klinik Görünümler. ANKEM Derg 2010;24 (Ek 2):196-200.
- Referans13. Kebabci N, Akalın H, Bölük G, Oğuz- Ayarcı A, Kazak E, Topal U, et al. Pandemik Influenza A (H1N1) 2009 Deneyimi. Klimik Dergisi 25.3 (2012): 117.
- Referans14. Mertz D, Kim TH, Johnstone J, Lam PP, Science M, Kuster SP, et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ. 2013 Aug 23;347: f5061. doi: 10.1136/bmj.f5061
- Referans15. Rello J, Rodríguez A, Ibañez P, Socias L, Cebrian J, Marques A, et al. Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain. Crit Care. 2009;13(5): R148. doi:10.1186/cc8044
- Referans16. Chow EJ, Doyle JD, Uyeki TM. Influenza virus-related critical illness: prevention, diagnosis, treatment. Crit Care. 2019 Jun 12;23(1):214. doi:10.1186/s13054-019-2491-9
- Referans17. Yaşar K, Pehlivanoğlu F, Çiçek G, Şengöz G. 21. Yüzyılın İlk Pandemisi H1N1: Kesin Tanılı Hastaneye Yatırılan Olguların Değerlendirilmesi. Fırat Tıp Dergisi. 2011; 16(3): 132-6.
- Referans18. Basaranoglu ST, Aykaç K, Gözmen O, Tanyıldız M, Tekşam Ö, Kara A. Mevsimsel İnfluenza Döneminde Laboratuvarda Viral Analiz Süresinin Önemi. J Pediatr Inf 2017; 11(4): 161-5. doi: 10.5578/ced.64053
- Referans19. Pando R, Drori Y, Friedman N, Glatman-Freedman A, Sefty H, Shohat T, et al. Influenza A(H1N1) pdm 2009 and influenza B virus co-infection in hospitalized and non-hospitalized patients during the 2015-2016 epidemic season in Israel. J Clin Virol. 2017 Mar;88:12-16. doi: 10.1016/j.jcv.2017.01.002
- Referans20. CDC, Morbidity and Mortality Weekly Report, Influenza Activity United States, 2015-2016 Season and Composition of the 2016-17 Influenza Vaccine. (Date of access: 18.06.2021). Available from: https://www.cdc.gov/mmwr/volumes/65/wr/mm6522a3.htm?s_cid=mm6522a3_w
- Referans21. Havlickova M, Druelles S, Jirincova H, Limberkova R, Nagy A, Rasuli A, et al. Circulation of influenza A and B in the Czech Republic from 2000-2001 to 2015-2016. BMC Infect Dis. 2019 Feb 14;19(1):160. doi: 10.1186/s12879-019-3783-z
- Referans22. Singanayagam A, Singanayagam A, Wood V, Chalmers JD. Factors associated with severe illness in pandemic 2009 influenza a (H1N1) infection: implications for triage in primary and secondary care. J Infect. 2011 Oct;63(4):243-51. doi: 10.1016/j.jinf.2011.07.014
- Referans23. J.M. Hughes, M.E. Wilson, E.H. Lee, C. Wu, E.U. Lee, A. Stoute, et al. Fatalities associated with the 2009 H1N1 influenza A virus in New York City Clinical Infectious Diseases, 2010;50(11):1498-1504. doi:10.1086/652446
- Referans24. Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza, Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM,et al. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. The New England journal of medicine,2010 May 6;362(18):1708-19. doi.org/10.1056/NEJMra1000449
- Referans25. Hancock K, Veguilla V, Lu X, Zhong W, Butler E N, Sun H, et al. Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med. 2009;361(20):1945-52. doi:10.1056/NEJMoa0906453
Bir influenza epidemisinde hastaların klinik, laboratuvar ve prognozlarının değerlendirilmesi
Yıl 2023,
Cilt: 16 Sayı: 2, 208 - 214, 05.04.2023
Türkan Tüzün
,
Duru Mıstanoğlu Özatağ
,
Şebnem Emine Parsbur
,
Ayşenur Beyazıt Üçgün
Öz
Amaç: İnfluenza, toplumda yaygın olarak görülen epidemi ve pandemilere yol açan bulaşıcı bir solunum yolu hastalığıdır. Genellikle kendi kendini sınırlayabilirken komplikasyonlar nedeniyle önemli morbidite ve mortaliteye neden olabilir. Mevsimsel grip ön tanısıyla yatırılarak takip edilen erişkin hastaların klinik, laboratuvar ve prognozlarının değerlendirilmesi amaçlandı.
Gereç ve yöntem: 1 Aralık 2015-31 Ocak 2016 tarihleri arasında mevsimsel influenza ön tanısı ile yatırılan 50 hastanın bilgilerine dayanan tanımlayıcı bir araştırmadır.
Bulgular: Hastaların ortalama yaşı 55,44±17,17 (20-89) ve %64’ü kadın cinsiyette idi. Olguların %36’sı H1N1 pozitif, %30’u H3N2 pozitif ve %34’ünün PCR sonucu ise negatif idi. Semptomların başlamasından itibaren hastaneye başvurana dek geçen süre 3,72±2,51 gündü (1-11). 38 (%76) hastanın komorbiditesi bulunmaktaydı. Dört hastada mortalite ile sonuçlandı.
Sonuç: İnfluenza, konağın özelliğine göre kendi kendi sınırlayabildiği gibi mortaliteye de neden olmaktadır. Bu çalışmada sağlıklı, genç bir erişkinde şiddetli hastalık ve ölüme neden olduğu görüldü. Bu nedenle influenzayı ve komplikasyonlarını azaltmak için enfekte hastalar ile temastan kaçınmak, el yıkama ve aşılama önemlidir. Ayrıca influenza ön tanımız devam ediyorsa PCR negatif olsa bile ileri değerlendirmeler yapılmalıdır.
Kaynakça
- Referans1. Gaitonde, David Y et al. “Influenza: Diagnosis and Treatment.” American family physician vol. 100,12 (2019): 751-58.
- Referans2. Su S, Fu X, Li G, Kerlin F, Veit M. Novel Influenza D virus: Epidemiology, pathology, evolution and biological characteristics. Virulence. 2017 Nov 17;8(8):1580-91. doi: 10.1080/21505594.2017.1365216
- Referans3. Krammer F, Smith G, Fouchier R, Peiris M, Kedzierska K, Dohert PC, et al. Influenza. Nat Rev Dis Primers. 2018 Jun 28;4(1):3. doi:10.1038/s41572-018-0002-y
- Referans4. Nesmith N, Williams JV, Johnson M, Zhu Y, Griffin M, Talbot HK. Sensitive Diagnostics Confirm That Influenza C is an Uncommon Cause of Medically Attended Respiratory Illness in Adults. Clin Infect Dis. 2017 Sep 15;65(6):1037-39. doi: 10.1093/cid/cix471
- Referans5. LaRussa P, Pandemic novel 2009 H1N1 influenza: what have we learned? Semin Respir Crit Care Med. 2011 Aug;32(4):393-9. doi: 10.1055/s-0031-1283279
- Referans6. Peiris JS, Tu WW, Yen HL. A novel H1N1 virus causes the first pandemic of the 21st century, Eur J Immunol 2009;39(11):2946-54. doi: 10.1002/eji.200939911
- Referans7. Satpathy HK, Lindsay M, Kawwass JF: Novel H1N1 virus infection and pregnancy, Postgrad Med 2009;121(6):106-12 doi:10.3810/pgm.2009.11.2080
- Referans8. Yahşi A, Grip, Klinik Tıp Pediatri Dergisi,2017, 9(5),1-7.
Referans9. Quach C, Piché-Walker L, Platt R, Moore D. Risk factors associated with severe influenza infections in childhood: implication for vaccine strategy. Pediatrics. 2003;112(3 Pt 1):e197-201. doi:10.1542/peds.112.3.e197
- Referans10. Morgan R, Klein SL. The intersection of sex and gender in the treatment of influenza. Curr Opin Virol. 2019;35:35-41. doi:10.1016/j.coviro.2019.02.009
- Referans11. Wong KC, Luscombe GM, Hawke C. Influenza infections in Australia 2009-2015: is there a combined effect of age and sex on susceptibility to virus subtypes? BMC Infect Dis. 2019 Jan 10;19(1):42. doi: 10.1186/s12879-019-3681-4
- Referans12. Saltoğlu N, Balkan İİ. H1N1: Klinik Görünümler. ANKEM Derg 2010;24 (Ek 2):196-200.
- Referans13. Kebabci N, Akalın H, Bölük G, Oğuz- Ayarcı A, Kazak E, Topal U, et al. Pandemik Influenza A (H1N1) 2009 Deneyimi. Klimik Dergisi 25.3 (2012): 117.
- Referans14. Mertz D, Kim TH, Johnstone J, Lam PP, Science M, Kuster SP, et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ. 2013 Aug 23;347: f5061. doi: 10.1136/bmj.f5061
- Referans15. Rello J, Rodríguez A, Ibañez P, Socias L, Cebrian J, Marques A, et al. Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain. Crit Care. 2009;13(5): R148. doi:10.1186/cc8044
- Referans16. Chow EJ, Doyle JD, Uyeki TM. Influenza virus-related critical illness: prevention, diagnosis, treatment. Crit Care. 2019 Jun 12;23(1):214. doi:10.1186/s13054-019-2491-9
- Referans17. Yaşar K, Pehlivanoğlu F, Çiçek G, Şengöz G. 21. Yüzyılın İlk Pandemisi H1N1: Kesin Tanılı Hastaneye Yatırılan Olguların Değerlendirilmesi. Fırat Tıp Dergisi. 2011; 16(3): 132-6.
- Referans18. Basaranoglu ST, Aykaç K, Gözmen O, Tanyıldız M, Tekşam Ö, Kara A. Mevsimsel İnfluenza Döneminde Laboratuvarda Viral Analiz Süresinin Önemi. J Pediatr Inf 2017; 11(4): 161-5. doi: 10.5578/ced.64053
- Referans19. Pando R, Drori Y, Friedman N, Glatman-Freedman A, Sefty H, Shohat T, et al. Influenza A(H1N1) pdm 2009 and influenza B virus co-infection in hospitalized and non-hospitalized patients during the 2015-2016 epidemic season in Israel. J Clin Virol. 2017 Mar;88:12-16. doi: 10.1016/j.jcv.2017.01.002
- Referans20. CDC, Morbidity and Mortality Weekly Report, Influenza Activity United States, 2015-2016 Season and Composition of the 2016-17 Influenza Vaccine. (Date of access: 18.06.2021). Available from: https://www.cdc.gov/mmwr/volumes/65/wr/mm6522a3.htm?s_cid=mm6522a3_w
- Referans21. Havlickova M, Druelles S, Jirincova H, Limberkova R, Nagy A, Rasuli A, et al. Circulation of influenza A and B in the Czech Republic from 2000-2001 to 2015-2016. BMC Infect Dis. 2019 Feb 14;19(1):160. doi: 10.1186/s12879-019-3783-z
- Referans22. Singanayagam A, Singanayagam A, Wood V, Chalmers JD. Factors associated with severe illness in pandemic 2009 influenza a (H1N1) infection: implications for triage in primary and secondary care. J Infect. 2011 Oct;63(4):243-51. doi: 10.1016/j.jinf.2011.07.014
- Referans23. J.M. Hughes, M.E. Wilson, E.H. Lee, C. Wu, E.U. Lee, A. Stoute, et al. Fatalities associated with the 2009 H1N1 influenza A virus in New York City Clinical Infectious Diseases, 2010;50(11):1498-1504. doi:10.1086/652446
- Referans24. Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza, Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM,et al. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. The New England journal of medicine,2010 May 6;362(18):1708-19. doi.org/10.1056/NEJMra1000449
- Referans25. Hancock K, Veguilla V, Lu X, Zhong W, Butler E N, Sun H, et al. Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med. 2009;361(20):1945-52. doi:10.1056/NEJMoa0906453