scholarly journals Severe ARDS due to Influenza A (H1N1) pdm09 Infection During Pregnancy Followed by Intrauterine Fetal Death at Alka Hospital, Lalitpur

2017 ◽  
Vol 2 (2) ◽  
pp. 227-229
Author(s):  
Gentle Sunder Shrestha ◽  
A Bhuju ◽  
DN Manandhar ◽  
N Sharma
Keyword(s):  
Influenza A ◽  
Fetal Death ◽  
Severe Disease ◽  
Fetal Loss ◽  
Intrauterine Fetal Death ◽  
High Risk Population ◽  
Rapid Progression ◽  
Increased Risk ◽  
Influenza A H1n1 ◽  
Refractory Hypotension

Pandemic due to Influenza A (H1N1) pdm 09 has been a significant cause of morbidity and mortality worldwide. Pregnant women are at risk of severe disease and ARDS, with rapid progression of disease. There is increased risk of fetal loss. Little evidence exists regarding the management of ARDS in pregnancy. Here we report a case of H1N1 virus infection in a pregnant woman in third trimester complicated by severe ARDS and intra-uterine fetal death. Fetus was successfully expelled using vaginal Misoprostol, which was followed by improvement in oxygenation indices. However, the patient died of refractory hypotension. Influenza vaccination in the high risk population may be invaluable. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 227-229

Pandemic 2009 Influenza A (H1N1) Virus among Japanese Healthcare Workers: Seroprevalence and Risk Factors

2012 ◽  
Vol 33 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Yoko Nukui ◽  
Shuji Hatakeyama ◽  
Takatoshi Kitazawa ◽  
Tamami Mahira ◽  
Yoshizumi Shintani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Influenza A ◽  
H1n1 Virus ◽  
Healthcare Personnel ◽  
Care Hospital ◽  
Occupational Risk Factors ◽  
Increased Risk ◽  
Influenza A H1n1 ◽  
2009 H1n1

Objective.To evaluate the seroprevalence and risk factors for 2009 influenza A (H1N1) virus infection among healthcare personnel.Design.Observational cross-sectional study.Patients and Setting.Healthcare workers (HCWs) in an acute care hospital.Methods.Between September 14 and October 4, 2009, before 2009 H1N1 vaccination, we collected serological samples from 461 healthy HCWs. Hemagglutination-inhibition antibody assays were conducted. To evaluate the risk factors of seropositivity for 2009 H1N1 virus, gender, age, profession, work department, usage of personal protective equipment, and seasonal influenza vaccination status data were gathered via questionnaires.Results.Our survey showed that doctors and nurses were at highest risk of seropositivity for the 2009 H1N1 virus (odds ratio [OR], 5.25 [95% confidence interval {CI}, 1.21–22.7]). An increased risk of seropositivity was observed among pediatric, emergency room, and internal medicine staff (adjusted OR, 1.98 [95% CI, 1.07–3.65]). Risk was also higher among HCWs who had high titers of antibodies against the seasonal H1N1 virus (adjusted OR, 1.59 [95% CI, 1.02–2.48]).Conclusions.Seropositivity for the 2009 H1N1 virus was associated with occupational risk factors among HCWs.Infect Control Hosp Epidemiol 2012;33(1):58-62

Impaired Hemostasis Leads To Alveolar Hemorrhages and Increased Mortality In Influenza A Infection

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1095-1095
Author(s):  
Silvio Antoniak ◽  
Kohei Tatsumi ◽  
Justin Milner ◽  
Melinda Beck ◽  
Nigel Mackman
Keyword(s):  
Influenza A ◽  
Viral Infections ◽  
Inflammatory Responses ◽  
Conflicts Of Interest ◽  
Littermate Control ◽  
Virus Challenge ◽  
Protein Levels ◽  
Increased Risk ◽  
Influenza A H1n1 ◽  
Body Weights

Abstract Objective Viral infections lead to activation of coagulation which enhances inflammatory responses. For instance, influenza A is associated with activation of coagulation and the increased risk for thrombotic events, such as myocardial infarction. Protease-activated receptor 4 (PAR-4) is the main functional receptor on mouse platelets. Here, we investigated the role of tissue factor (TF) and platelets in influenza A infection in mice. Methods We used male LowTF mice, which express 1% of normal TF levels, PAR-4 deficient mice and respective control mice. All mice were infected intranasal with influenza A H1N1/PR8. Changes in body weights and survival were analyzed up to 14 days after infection. In addition, bronchoalveolar lavage (BAL) was collected and analyzed 7 days after virus challenge. Results LowTF mice exhibited increased loss of body weights compared to littermate control mice between day 4 and 6 after infection (P<0.05). At day 7, BAL of LowTF had increased levels of free hemoglobin compared to infected control mice (2.60±0.39 g/dL vs. 0.05±0.02 g/dL, P<0.05). In addition, LowTF lungs exhibited increased protein levels in the BAL compared to controls (1.52±0.18 mg/mL vs. 0.70±0.26 mg/mL, P<0.05). Lung histology revealed that LowTF mice had extensive hemorrhages. The impaired hemostasis resulted in increased mortality in LowTF mice compared to control mice (90% vs 30%, P<0.004, N=9-10, Figure). Similarly, mice with defective thrombin signaling in platelets (PAR-4-/-) exhibited visible lung hemorrhages with increased hemoglobin levels in the BAL (P<0.05) at day 7 and increased mortality compared to controls (57% vs 10%, P<0.03, N=9-14, Figure). Conclusions TF mediated activation of coagulation and PAR-4 dependent platelet activation are essential for pulmonary hemostasis during influenza A infection. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Critical care surveillance: insights into the impact of the 2010/11 influenza season relative to the 2009/10 pandemic season in England

2013 ◽  
Vol 18 (23) ◽  
Author(s):  
H K Green ◽  
J Ellis ◽  
M Galiano ◽  
J M Watson ◽  
R G Pebody
Keyword(s):  
Critical Care ◽  
Influenza A ◽  
Influenza Season ◽  
Severe Disease ◽  
Vaccine Uptake ◽  
Cold Weather ◽  
Influenza B ◽  
Influenza A H1n1 ◽  
The Impact ◽  
Age Shift

In 2010/11, the influenza season in England was marked by a relative increase in impact on the population compared to that seen during the 2009/10 pandemic, with the same influenza subtype, A(H1N1)pdm09, circulating. The peaks in critical care bed occupancy in both seasons coincided with peaks in influenza A(H1N1)pdm09 activity, but onset of influenza in 2010/11 additionally coincided with notably cold weather, a comparatively smaller peak in influenza B activity and increased reports of bacterial co-infection. A bigger impact on critical care services was seen across all regions in England in 2010/11, with, compared to 2009/10, a notable age shift in critical care admissions from children to young adults. The peak of respiratory syncytial virus (RSV) activity did not coincide with critical care admissions, and regression analysis suggested only a small proportion of critical care bed days might be attributed to the virus in either season. Differences in antiviral policy and improved overall vaccine uptake in 2010/11 with an influenza A(H1N1)pdm09 strain containing vaccine between seasons are unlikely to explain the change in impact observed between the two seasons. The reasons behind the relative high level of severe disease in the 2010/11 winter are likely to have resulted from a combination of factors, including an age shift in infection, accumulation of susceptible individuals through waning immunity, new susceptible individuals from new births and cold weather. The importance of further development of severe influenza disease surveillance schemes for future seasons is reinforced.

scholarly journals Safety of Influenza A H1N1pdm09 Vaccines: An Overview of Systematic Reviews

2021 ◽  
Vol 12 ◽  
Author(s):  
Lene Kristine Juvet ◽  
Anna Hayman Robertson ◽  
Ida Laake ◽  
Siri Mjaaland ◽  
Lill Trogstad
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Systematic Reviews ◽  
Pregnancy Outcomes ◽  
Influenza A ◽  
Demyelinating Diseases ◽  
Short Term ◽  
Serious Adverse Events ◽  
Increased Risk ◽  
Influenza A H1n1

BackgroundIn 2009, a new influenza A H1N1 virus emerged causing a global pandemic. A range of monovalent influenza A H1N1pdm09 vaccines with or without adjuvants were developed. After the mass vaccination campaigns safety concerns related to H1N1pdm09 vaccines were reported. More than a decade later, reported AEFIs are still under scrutiny. We performed a systematic review aiming to synthesize the evidence on the safety of the H1N1pdm09 vaccines on reported outcomes from existing systematic reviews.MethodsFour electronic databases, PubMed, EMBASE, Epistimonikos and the Cochrane Database of Systematic Reviews were searched for articles on H1N1pdm09 vaccination published from 2009 to January 2021. Systematic reviews assessing short- or long-term adverse events after H1N1pdm09 vaccination were considered for inclusion. Data was extracted from all selected reviews. Outcomes were grouped and results from each included review were presented narratively and in tables.Results16 systematic reviews met the inclusion criteria. Reported outcomes were short-term events (3 reviews), fetal/pregnancy outcomes (8 reviews), Guillain-Barré syndrome (GBS) (4 reviews), narcolepsy (2 reviews) demyelinating diseases (1 review based on one study only) and inflammatory bowel disease (IBD) (1 review). Short-term serious adverse events were rare, 3 cases amongst 16725 subjects in 18 randomized controlled trials (0.018%). No deaths were reported. The risks of local events were generally higher for adjuvanted vaccines as compared to unadjuvanted vaccines. Maternal H1N1pdm09 vaccination in any trimester was not associated with an increase in preterm birth, small for gestational age, congenital malformations or fetal death. For GBS, results were conflicting. The main systematic review on narcolepsy found a 5-14-fold increased risk in children, and a 2-7- fold increased risk in adults after vaccination with Pandemrix. The attributable risk of narcolepsy one year after vaccination was 1 case per 18 400 vaccine doses in children/adolescents, and 1 case per 181 000 vaccine doses in adults.ConclusionAdjuvanted vaccines had more local but not serious adverse events compared to unadjuvanted vaccines. Vaccination with Pandemrix was strongly associated with narcolepsy, particularly in children. No increased risks of pregnancy outcomes were seen after pandemic vaccination. The findings on GBS were inconclusive.

scholarly journals Case Report: Heparin-induced thrombocytopenia during COVID-19 outbreak: the importance of scoring system in differentiating with sepsis-induced coagulopathy

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 469
Author(s):  
Louisa Fadjri Kusuma Wardhani ◽  
Ivana Purnama Dewi ◽  
Denny Suwanto ◽  
Ade Meidian Ambari ◽  
Meity Ardiana
Keyword(s):  
Scoring System ◽  
Severe Disease ◽  
Scoring Systems ◽  
Pulmonary Infiltrate ◽  
Nasopharyngeal Swab ◽  
Rapid Progression ◽  
Hypoxemic Respiratory Failure ◽  
Heparin Induced Thrombocytopenia ◽  
Heparin Administration ◽  
Increased Risk

Background: COVID-19 disease is accompanied by derangement of coagulation with a risk of fatal thromboembolic formation. COVID-19 patients are among those indicative for heparin treatment. Increased heparin administration among COVID-19 patients increased heparin induced-thrombocytopenia's risk with/without thrombocytopenia. Case presentation: We present a 71-year-old male patient who came to the emergency room (ER) with a COVID-19 clinical manifestation followed by positive PCR nasopharyngeal swab result. He was assessed to have acute respiratory distress syndrome (ARDS), as shown by rapid progression of hypoxemic respiratory failure and bilateral pulmonary infiltrate. He was then treated with moxifloxacin, remdesivir, dexamethasone, unfractionated heparin (UFH) pump, and multivitamins. During admission, his respiratory symptoms got worse, so he transferred to the ICU for NIV support. On the ninth day of admission, he had gross hematuria followed by a rapid fall of platelet count. We used two different scoring systems (4Ts and HEP scoring system) to confirm the diagnosis of heparin-induced thrombocytopenia (HIT). Following the discontinuation of UFH injection, the thrombocyte continued to rise, and hematuria disappeared. Conclusion: Heparin-induced thrombocytopenia is associated with an increased risk of severe disease and mortality among COVID-19 patients. The differential diagnosis of HIT could be difficult as thrombocytopenia can also be caused by the progression of infection. We use two scoring systems (4Ts and HEP scoring) in order to help us managing the patient. These could improve the outcomes, thus avoiding morbidity and mortality.

scholarly journals 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S256-S257
Author(s):  
Ali Sawani ◽  
Detchvijitr Suwanpakdee ◽  
Veerachai Watanaveeradej ◽  
Alden Weg ◽  
Damon Ellison ◽  
...  
Keyword(s):  
Influenza A ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Clinical Care ◽  
Influenza B ◽  
Rt Pcr ◽  
Early Presentation ◽  
Fever Onset ◽  
Increased Risk ◽  
Influenza A H1n1

Abstract Background Influenza infection in children can be severe, resulting in complications such as pneumonia, but may be mitigated by early recognition and administration of antivirals. In this study, we identified risk factors for hospitalization and pneumonia in a pediatric population presenting with influenza-like illness (ILI) in Thailand. Methods Our study included pediatric patients (age &lt; 18 years) presenting with ILI to inpatient and outpatient departments at a public hospital in Bangkok, Thailand, from 2009 to 2016. ILI was defined as fever plus cough or sore-throat, and pneumonia was defined as either lung radiographic or pulmonary examination abnormalities. Demographic and clinical data, as well as nasal and throat swabs, were collected during a one-time interview with patients presenting with ILI. Influenza infections were confirmed via RT-PCR testing of respiratory specimens. Retrospective chart review was used to collect data on individuals with influenza admitted for inpatient care. Results 5,968 children (33.6%) were enrolled with ILI, of whom 1,530 (25.6%) were confirmed to be influenza by RT-PCR, of which 25.5% were influenza A(H1N1)pdm09, 31.5% influenza A(H3N2), and 43.0% influenza B. 124 (8.1%) patients were admitted, and 41 of these children (33.1%) developed pneumonia. Predictors of hospitalization included younger age (4.1 yrs for inpatients vs. 5.6 yrs) and higher presenting temperature (38.6C for inpatient vs. 38.0C) (both P &lt; 0.05). Among children hospitalized with influenza, influenza subtype was not associated with pneumonia risk. Co-detection of Klebsiella pneumoniae was associated with an increased risk of pneumonia (P &lt; 0.05. Patients with pneumonia were younger (4.1 yrs with vs. 6.4 yrs, P = NS), had a longer interval from fever onset to presentation at the hospital, and required longer hospital stays. Risk of pneumonia was decreased in patients who received oseltamivir within 48 hours of fever onset (odds ratio 0.36, 95% confidence interval 0.16–0.91). Conclusion Post viral pneumonia is a potentially serious complication of influenza, requiring longer hospitalization stay and affecting more than one-third of hospitalized pediatric patients with influenza. The risk of pneumonia can be reduced with early presentation for clinical care and prompt administration of oseltamivir following fever onset. Disclosures All authors: No reported disclosures.

Disentanglement of Discordant Monochorionic-Monoamniotic Twins in a Triplet Pregnancy: An Innovative Approach Utilizing Fetoscopic Laser Coagulation with Micro-Laparoscopic Scissor Dissection

2015 ◽  
Vol 40 (4) ◽  
pp. 303-305
Author(s):  
Nadia B. Kunzier ◽  
Baraa Allaf ◽  
Martin R. Chavez ◽  
Diana Abenanti-Richmond ◽  
Anthony M. Vintzileos
Keyword(s):  
Umbilical Cord ◽  
Fetal Death ◽  
Neurological Injury ◽  
Intrauterine Fetal Death ◽  
Laser Coagulation ◽  
Perinatal Morbidity ◽  
Multiple Pregnancies ◽  
Triplet Pregnancy ◽  
Increased Risk ◽  
Fetoscopic Laser Coagulation

Triplet gestations are associated with high perinatal morbidity. Dichorionic-diamniotic triplet pregnancies with growth discordance, polyhydramnios and structural anomalies carry a significantly increased risk of fetal morbidity and mortality from the baseline risks of high-order multiple pregnancies. Intrauterine fetal death of one fetus of a monochorionic pregnancy may cause neurological injury to the surviving fetus. We present a case where an innovative technique was created combining use of the fetoscopic laser and miniature laparoscopic instruments to selectively reduce and disentangle the umbilical cord of the acranial growth-restricted fetus from the structurally normal fetus's umbilical cord in a dichorionic-diamniotic triplet pregnancy.

An increased risk for non allo-immunization related intrauterine fetal death in RhD-negative patients

2008 ◽  
Vol 21 (4) ◽  
pp. 255-259 ◽  
Author(s):  
Gila Ben-David ◽  
Eyal Sheiner ◽  
Amalia Levy ◽  
Offer Erez ◽  
Moshe Mazor
Keyword(s):  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
Increased Risk
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