European conference offers findings on H1N1

Apr 13, 2010 (CIDRAP News) – A variety of new findings concerning diagnostic issues and other aspects of pandemic H1N1 influenza were among the hundreds of studies presented at the 20th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), which concluded today in Vienna, Austria. Here is a sampling:

Levels of C-reactive protein (CRP) in the blood, measured at admission, can provide an early indicator that patients may need intensive care. Of 191 H1N1 patients admitted to a Tel Aviv hospital, 17 were admitted to the intensive-care unit, 8 required mechanical ventilation, and 3 died. Serum CRP levels at admission were three times higher in those who later needed ICU care and ventilation than in those who did not. (Zimmerman et al)

Gastrointestinal illness and diarrhea separate patients with H1N1 flu from patients with seasonal flu, according to researchers at Bangkok’s Chulalongkorn Memorial Hospital. Among 167 patients with the 2009 pandemic strain seen last July and August, 16.3% had diarrhea, compared with 5.3% of the 57 patients with seasonal flu seen during the same period. The two groups experienced the same rates of all other flu symptoms: fever, cough, sore throat, aches, and breathing difficulties. (Thiansukhon et al)

Test results from a cohort of patients evaluated for flu in Greece established that fever cannot be considered a diagnostic sign for novel H1N1 flu, as patients with very mild disease and no fever were tested positive by polymerase chain reaction for that flu strain, while patients with more pronounced symptoms proved not to have flu. (Kalpakou et al)

Oseltamivir resistance, marked by the H274Y mutation, emerged in a 2-year-old flu patient in Pavia, Italy, who was already suffering from acute lymphatic leukemia. The mutation was detected after she was treated with antivirals for 17 days yet still remained positive for flu-virus RNA. The child recovered; the finding marks Italy’s first known drug-resistant strain. (Campanini et al)

The microblogging service Twitter.com may provide an early-warning signal for the emergence of novel syndromes, if algorithms can be worked out to filter useful information, location clustering, and social networks, according to a British analysis. Between May and August 2009, Twitter carried more than 1 million 140-character "tweets" mentioning flu, while the phrase "I have swine flu" appeared 2,888 times and "I have flu" appeared 1,530 times. (Kostkova et al)

See also:

Final program for ECCMID
http://www.congrex.ch/eccmid2010/

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