Respiratory Disease in Adults during Pandemic (H1N1) 2009 Outbreak, Argentina

DOI: 10.3201/eid1512.091062
Suggested citation for this article: Zala C, Gonzalez R. Respiratory disease in adults during pandemic (H1N1) 2009 outbreak, Argentina [letter]. Emerg Infect Dis. 2009 Dec; [Epub ahead of print]

Respiratory Disease in Adults during Pandemic (H1N1) 2009 Outbreak, Argentina

To the Editor: We report a mild to moderate respiratory disease in patients seeking treatment for influenza-like illness (ILI) within the first 8 weeks of an outbreak of influenza A pandemic (H1N1) 2009 virus (pandemic [H1N1] 2009) infection in the Province of Buenos Aires. The first cases of pandemic (H1N1) 2009 in Argentina were reported in early May 2009 in travelers returning from Mexico and the United States.
In mid-June, a sharp increase was reported in the number of patients with acute respiratory symptoms who were seeking treatment in emergency rooms. By July 9th, the Argentinean Ministry of Health had confirmed 2,677 cases and 82 deaths; most of those infected were residents of Buenos Aires and the surrounding area (1). When the World Health Organization raised the pandemic level to 6, >80% of circulating influenza A virus in Argentina was subtype H1N1 (2). At the Hospital Central de San Isidro, a tertiary hospital of 160 beds in the Province of Buenos Aires, initial clinical evaluation of patients with ILI symptoms included physical examination and, eventually, chest radiograph and pulse oximetry. Because diagnostic resources were limited, patients with ILI were eligible to receive oseltamivir with no prior sampling for respiratory pathogens. A standardized form was used for prescription and data collection, including demographic data, history of influenza vaccination, date symptoms began, and coexisting illnesses. From June 16 to July 5, a total of 2,135 patients with ILI were evaluated. The age of patients ranged from 14 to 82 years of age (median, 35 years); 854 patients (40 %) were male. Because of lower respiratory disease, a total of 166 (8%) of 2,135 patients were admitted to the internal medicine ward (n = 139) or to the intensive care unit (n = 27). At admission, patients had >1 of the following: diffuse pulmonary infiltrates, room air oxygen saturation <95%, crackles on auscultation. Other clinical...

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