Population-based surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009

作者：Reyes Lissette; Arvelo Wences; Estevez Alejandra; Gray Jennifer; Moir Juan C; Gordillo Betty; Frenkel Gal; Ardon Francisco; Moscoso Fabiola; Olsen Sonja J; Fry Alicia M; Lindstrom Steve; Lindblade Kim A^*

来源：Influenza and Other Respiratory Viruses, 2010, 4(3): 129-140.

DOI：10.1111/j.1750-2659.2010.00138.x

• Epidemiology
• Guatemala
• influenza
• pandemic influenza
• population-based

Background
In April 2009, 2009 pandemic influenza A H1N1 (2009 H1N1) was first identified in Mexico but did not cause widespread transmission in neighboring Guatemala until several weeks later.
Methodology and principle findings
Using a population-based surveillance system for hospitalized pneumonia and influenza-like illness ongoing before the 2009 H1N1 pandemic began, we tracked the onset of 2009 H1N1 infection in Guatemala. We identified 239 individuals infected with influenza A (2009 H1N1) between May and December 2009, of whom 76 were hospitalized with pneumonia and 11 died (case fatality proportion: 4 center dot 6%, 95% confidence interval [CI] 2 center dot 3-8 center dot 1%). The median age of patients infected with 2009 H1N1 was 8 center dot 8 years, the median age of those hospitalized with pneumonia was 4 center dot 2 years, and five (45 center dot 5%) deaths occurred in children < 5 years old. Crude rates of hospitalization between May and December 2009 were highest for children < 5 years old. Twenty-one (27 center dot 6%) of the patients hospitalized with 2009 H1N1 were admitted to the intensive care unit and eight (10 center dot 5%) required mechanical ventilation. Underlying chronic conditions were noted in 14 (18 center dot 4%) of patients with pneumonia hospitalized with 2009 H1N1 infection.
Conclusions and significance
Chronic illnesses may be underdiagnosed in Guatemala, making it difficult to identify this risk group for vaccination. Children 6 months to 5 years old should be among priority groups for vaccination to prevent serious consequences because of 2009 H1N1 infection.

• 出版日期2010-5