title: Influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand.
abstract: BACKGROUND
  The first human infections with influenza A(H1N1)pdm09 virus were confirmed in April 2009. We describe the clinical and epidemiological characteristics of influenza A(H1N1)pdm09-associated pneumonia deaths in Thailand from May 2009-January 2010.
  
  
  METHODS
  We identified influenza A(H1N1)pdm09-associated pneumonia deaths from a national influenza surveillance system and performed detailed reviews of a subset.
  
  
  RESULTS
  Of 198 deaths reported, 49% were male and the median age was 37 years; 146 (73%) were 20-60 years. Among 90 deaths with records available for review, 46% had no identified risk factors for severe influenza. Eighty-eight patients (98%) received antiviral treatment, but only 16 (18%) initiated therapy within 48 hours of symptom onset.
  
  
  CONCLUSIONS
  Most influenza A(H1N1)pdm09 pneumonia fatalities in Thailand occurred in adults aged 20-60 years. Nearly half lacked high-risk conditions. Antiviral treatment recommendations may be especially important early in a pandemic before vaccine is available. Treatment should be considered as soon as influenza is suspected.
authors: International Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. charatdaob@th.cdc.gov
authors: Charatdao
authors: C
authors: Bunthi
authors: Somsak
authors: S
authors: Thamthitiwat
authors: Henry C
authors: HC
authors: Baggett
authors: Pasakorn
authors: P
authors: Akarasewi
authors: Ruchira
authors: R
authors: Ruangchira-urai
authors: Susan A
authors: SA
authors: Maloney
authors: Kumnuan
authors: K
authors: Ungchusak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D011024:Pneumonia, Viral / Q000150:complications / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000998:Antiviral Agents
references: MMWR Morb Mortal Wkly Rep. 2009 May 1;58(16):435-7
references: 19407739
references: N Engl J Med. 2009 Jun 18;360(25):2605-15
references: 19423869
references: Arch Bronconeumol. 2010 Mar;46 Suppl 2:13-8
references: 20353854
references: Emerg Infect Dis. 2010 Feb;16(2):343-4
references: 20113578
references: JAMA. 2009 Nov 4;302(17):1896-902
references: 19887665
references: Emerg Infect Dis. 2012 Jul;18(7):1058-64
references: 22709628
references: PLoS One. 2009 Nov 11;4(11):e7776
references: 19936224
references: MMWR Recomm Rep. 2011 Jan 21;60(1):1-24
references: 21248682
references: BMC Infect Dis. 2010 May 31;10:145
references: 20513239
references: PLoS One. 2009 Jun 25;4(6):e6051
references: 19557130
references: Intern Med. 2010;49(5):427-30
references: 20190477
references: Rev Esp Salud Publica. 2010 Sep-Oct;84(5):517-28
references: 21203717
references: MMWR Morb Mortal Wkly Rep. 2009 May 8;58(17):467-70
references: 19444150
references: Emerg Infect Dis. 2011 Aug;17(8):1467-71
references: 21801625
references: Euro Surveill. 2010 Sep 23;15(38):
references: 20929651
references: Emerg Infect Dis. 2011 Aug;17(8):1479-83
references: 21801628
references: Euro Surveill. 2009 Aug 20;14(33):
references: 19712643
references: Jpn J Infect Dis. 2010 Jul;63(4):251-6
references: 20657064
references: Euro Surveill. 2010 May 20;15(20):
references: 20504388
references: Saudi Med J. 2010 Sep;31(9):993-8
references: 20844810
references: Clin Infect Dis. 2011 Jan 1;52 Suppl 1:S69-74
references: 21342902
references: Clin Microbiol Infect. 2011 Feb;17(2):247-50
references: 20518797
references: Clin Infect Dis. 2011 Jan 1;52 Suppl 1:S60-8
references: 21342901
references: N Engl J Med. 2009 Nov 12;361(20):1935-44
references: 19815859
references: JAMA. 2009 Nov 4;302(17):1880-7
references: 19822626
references: BMC Infect Dis. 2010 Jan 07;10:5
references: 20059763
references: MMWR Morb Mortal Wkly Rep. 2009 Apr 24;58(15):400-2
references: 19390508
references: BMJ. 2009 Oct 06;339:b3928
references: 19808768
references: Vaccine. 2011 Nov 28;29(51):9459-66
references: 22024174
references: Emerg Infect Dis. 2011 Apr;17(4):708-10
references: 21470467
references: Thorax. 2010 Jul;65(7):645-51
references: 20627925
references: Rev Esp Salud Publica. 2010 Sep-Oct;84(5):547-67
references: 21203719
references: Euro Surveill. 2009 Aug 06;14(31):
references: 19660247
references: MMWR Morb Mortal Wkly Rep. 2009 May 22;58(19):536-41
references: 19478723