title: [Severe cases of A(H1N1)v2009 infection in Réunion Island in 2009 and 2010].
abstract: In the Southern hemisphere, Réunion Island acts as a sentinel for infections preferentially occurring during the austral winter that are likely to reach the Northern hemisphere a few months later. We relate the main features concerning patients that were admitted during years 2009 and 2010 in our intensive care unit with an A(H1N1)v2009 infection, mainly for acute respiratory distress. Demographic, clinical, and biological data as well as given medications and outcome were prospectively collected among all PCR-confirmed influenza-infected patients. In 2009 and 2010, 25 patients met the criteria. Patients' median age was 40.4 (±17.4) years. Most of them (22/25) had comorbidities such as: chronic diseases, overweight, obesity, pregnancy, and Down syndrome. Maximum bed-occupation rate was 10 days per million inhabitants. Main diagnosis for ICU admission was virus-related pneumonia. Twenty-two out of 25 patients needed mechanical ventilation, some required rescue therapies such as extracorporeal membranous oxygenation (ECMO) or hi-frequency oscillation ventilation (HFOV), both only available in few French hospitals. Within the study period, 12 patients died (48%) mainly of multi-organ failure. Through 2009 and 2010 autumn and winter periods, for several weeks, the A(H1N1)v2009 virus infection resulted in a significant increase of workload in Réunion Island ICUs. In 2010, the failure of the mass immunization campaign, particularly among the at-risk groups, led to severe cases of A(H1N1)v2009 infections, particularly among patients with comorbidities. Our data may contribute toward better management of influenza virus pandemics in the future.
authors.affiliation: Service De Réanimation Polyvalente, Centre Hospitalier Félix-guyon, Chr Réunion, F-97405, Saint-Denis, France. bernard.gauzere@chr-reunion.fr
authors.forename: B-A
authors.initials: BA
authors.lastname: Gaüzère
authors.forename: F
authors.initials: F
authors.lastname: Bussienne
authors.forename: B
authors.initials: B
authors.lastname: Bouchet
authors.forename: J
authors.initials: J
authors.lastname: Jabot
authors.forename: A
authors.initials: A
authors.lastname: Roussiaux
authors.forename: D
authors.initials: D
authors.lastname: Drouet
authors.forename: S
authors.initials: S
authors.lastname: Djourhi
authors.forename: B
authors.initials: B
authors.lastname: Leauté
authors.forename: D
authors.initials: D
authors.lastname: Belcour
authors.forename: G
authors.initials: G
authors.lastname: Bossard
authors.forename: S
authors.initials: S
authors.lastname: Champion
authors.forename: M-C
authors.initials: MC
authors.lastname: Jaffar-Bandjee
authors.forename: O
authors.initials: O
authors.lastname: Belmonte
authors.forename: P
authors.initials: P
authors.lastname: Vilain
authors.forename: E
authors.initials: E
authors.lastname: Brottet
authors.forename: L
authors.initials: L
authors.lastname: Hoang
authors.forename: D
authors.initials: D
authors.lastname: Vandroux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D004198:Disease Susceptibility; D058872:Epidemics; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000628:therapy / Q000821:virology; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D010343:Patient Admission / Q000706:statistics & numerical data; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology; D011446:Prospective Studies; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology; D017508:Reunion / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents