title: Severe infection with H1N1 requiring intensive care--lessons for preparedness programmes.
abstract: BACKGROUND
  The influenza pandemic has generated much interest in the press and the medical world. We report our experience with 15 cases of severe novel influenza A H1N1 (2009) infections requiring intensive care. The aim of this review is to improve our preparedness for epidemics and pandemics by studying the most severely affected patients.
  
  
  METHODS
  During the epidemic, hospitals were required to provide data on all confirmed H1N1 cases admitted to an intensive care unit (ICU) to the Ministry of Health. We abstracted information from this dataset for this report. To highlight learning points, we reviewed the case notes of, and report, the fi ve most instructive cases.
  
  
  METHODS
  There were 15 cases admitted to an ICU from July 4, 2009 to August 30, 2009. Two patients died.
  
  
  CONCLUSIONS
  The lessons we wish to share include the following: preparedness should include having intermediate-care facilities that also provide single room isolation and skilled nursing abilities, stringent visitor screening should be implemented and influenza may trigger an acute myocardial infarction in persons with risk factors.
authors.affiliation: Department of Infectious Diseases, Singapore General Hospital, Singapore. jaime.chien.m.f@singhealth.com.sg
authors.forename: Jaime M F
authors.initials: JM
authors.lastname: Chien
authors.forename: Ban Hock
authors.initials: BH
authors.lastname: Tan
authors.forename: Kok Soong
authors.initials: KS
authors.lastname: Yang
authors.forename: Thuan Tong
authors.initials: TT
authors.lastname: Tan
authors.forename: Chian Yong
authors.initials: CY
authors.lastname: Low
authors.forename: Asok
authors.initials: A
authors.lastname: Kurup
authors.forename: Hoe Nam
authors.initials: HN
authors.lastname: Leong
authors.forename: Jenny G H
authors.initials: JG
authors.lastname: Low
authors.forename: Mei Ling
authors.initials: ML
authors.lastname: Kang
authors.forename: Maciej Piotr
authors.initials: MP
authors.lastname: Chlebicki
authors.forename: Yin Ling
authors.initials: YL
authors.lastname: Koh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006769:Hospitals, General; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000503:physiopathology*; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D019982:Organizational Case Studies; D012720:Severity of Illness Index; D012846:Singapore