Severe infection with H1N1 requiring intensive care--lessons for preparedness programmes.
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.
Chien
Jaime M F
JM
Department of Infectious Diseases, Singapore General Hospital, Singapore. jaime.chien.m.f@singhealth.com.sg
Tan
Ban Hock
BH
Yang
Kok Soong
KS
Tan
Thuan Tong
TT
Low
Chian Yong
CY
Kurup
Asok
A
Leong
Hoe Nam
HN
Low
Jenny G H
JG
Kang
Mei Ling
ML
Chlebicki
Maciej Piotr
MP
Koh
Yin Ling
YL
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