title: Population-based surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009.
abstract: 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.
  
  
  RESULTS
  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: 4.6%, 95% confidence interval [CI] 2.3-8.1%). The median age of patients infected with 2009 H1N1 was 8.8 years, the median age of those hospitalized with pneumonia was 4.2 years, and five (45.5%) 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 (27.6%) of the patients hospitalized with 2009 H1N1 were admitted to the intensive care unit and eight (10.5%) required mechanical ventilation. Underlying chronic conditions were noted in 14 (18.4%) of patients with pneumonia hospitalized with 2009 H1N1 infection.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ministerio de Salud Pública y Asistencia Social, Guatemala City, Guatemala.
authors.forename: Lissette
authors.initials: L
authors.lastname: Reyes
authors.forename: Wences
authors.initials: W
authors.lastname: Arvelo
authors.forename: Alejandra
authors.initials: A
authors.lastname: Estevez
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gray
authors.forename: Juan C
authors.initials: JC
authors.lastname: Moir
authors.forename: Betty
authors.initials: B
authors.lastname: Gordillo
authors.forename: Gal
authors.initials: G
authors.lastname: Frenkel
authors.forename: Francisco
authors.initials: F
authors.lastname: Ardón
authors.forename: Fabiola
authors.initials: F
authors.lastname: Moscoso
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Olsen
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Steve
authors.initials: S
authors.lastname: Lindstrom
authors.forename: Kim A
authors.initials: KA
authors.lastname: Lindblade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
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