Articles: pandemics.
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Historically, Pacific island countries and territories (PICTs) have been more severely affected by influenza pandemics than any other part of the world. We herein describe the emergence and epidemiologic characteristics of pandemic influenza H1N1 in PICTs from 2009 to 2010. ⋯ Pandemic influenza spread rapidly throughout the Pacific despite enormous distances and relative isolation. Tokelau and Pitcairn may be the only jurisdictions to have remained pandemic-free. Despite being well-prepared, Pacific island countries and territories experienced significant morbidity and mortality, consistent with other indigenous and low-resource settings.For the first time, regional influenza-like-illness surveillance was conducted in the Pacific, allowing health authorities to monitor the pandemic's spread and severity in real-time.Future regional outbreak responses will likely benefit from the lessons learned during this outbreak.
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J Public Health Manag Pract · Jan 2013
Public health emergency preparedness: lessons learned about monitoring of interventions from the National Association of County and City Health Official's survey of nonpharmaceutical interventions for pandemic H1N1.
We assessed local health departments' (LHDs') ability to provide data on nonpharmaceutical interventions (NPIs) for the mitigation of 2009 H1N1 influenza during the pandemic response. ⋯ Many LHDs were unable to monitor implementation of NPI (recommended by LHD or not) within their community during the 2009 H1N1 influenza pandemic. This gap makes it difficult to adjust recommendations or messaging during a public health emergency response. Public health preparedness could be improved by strengthening NPI monitoring capacity.
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There is conflicting data as to whether obesity is an independent risk factor for mortality in severe pandemic (H1N1) 2009 influenza (A(H1N1)pdm09). It is postulated that excess inflammation and cytokine production in obese patients following severe influenza infection leads to viral pneumonitis and/or acute respiratory distress syndrome. ⋯ Among patients admitted to ICU during the first wave of A(H1N1)pdm09, obese and morbidly obese patients with severe infection were more likely to develop pneumonitis compared to non-obese patients, but mortality rates were not increased. CRP is not an accurate marker of pneumonitis.
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Multicenter Study
Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study.
To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. ⋯ These independent risk factors may alert clinicians to children at risk of severe outcomes when presenting with influenza-like illness during future pandemics.