RESUMEN
(See the Editorial Commentary by Martin on pages 368-9.)Using population-based surveillance data, we analyzed antiviral treatment among hospitalized patients with laboratory-confirmed influenza. Treatment increased after the influenza A(H1N1) 2009 pandemic from 72% in 2010-2011 to 89% in 2014-2015 (P < .001). Overall, treatment was higher in adults (86%) than in children (72%); only 56% of cases received antivirals on the day of admission.
Asunto(s)
Antivirales/uso terapéutico , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/tratamiento farmacológico , Gripe Humana/epidemiología , Oseltamivir/uso terapéutico , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Tiempo de Internación , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , Estudios Retrospectivos , Estaciones del Año , Estados Unidos/epidemiología , Adulto JovenRESUMEN
West Nile virus (WNV) activity has fluctuated in the south-central United States since its introduction. Seasonal outbreaks are common, with three in Oklahoma during 2003, 2007, and 2012. Morbidity and mortality rates vary during each outbreak. Long-term neurologic sequelae in association with West Nile virus disease (WNVD) are well-described, but limited information is available about delayed mortality among acute WNV infection survivors. A retrospective cohort analysis of all confirmed and probable WNVD cases reported to the Oklahoma State Department of Health (OSDH) during 2003, 2007, and 2012 was performed. OSDH surveillance data and mortality data from Oklahoma's vital statistics database were used to construct a descriptive epidemiologic analysis of the geography, temporality, severity, and associated mortality for each outbreak season. A Kaplan-Meier survival curve and standardized mortality ratios (SMRs) were calculated to measure survival of the 2003 and 2007 WNVD cohorts. Seventy-nine cases during 2003, 107 cases during 2007, and 180 cases during 2012 met inclusion criteria. Median ages of the 2003, 2007, and 2012 cohorts were 48, 58, and 59 years, respectively; race, sex, and symptom information were not substantially different. Each outbreak season had a different severity, temporality, and geography. Age- and sex-adjusted SMRs for the combined 2003 and 2007 cohorts censored at 5 years was 0.9 (95% confidence interval 0.51-1.75); no substantial difference was observed between the survival curves. Although similar patterns of long-term mortality were evident on the survival curves, SMRs did not demonstrate increased 5-year cumulative risk for death for patients surviving acute WNV infection.
Asunto(s)
Brotes de Enfermedades , Estaciones del Año , Fiebre del Nilo Occidental/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Estudios de Cohortes , Monitoreo Epidemiológico , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Oklahoma/epidemiología , Estudios Retrospectivos , Factores de Tiempo , Fiebre del Nilo Occidental/complicaciones , Fiebre del Nilo Occidental/mortalidad , Fiebre del Nilo Occidental/virología , Virus del Nilo Occidental , Adulto JovenRESUMEN
We challenge the notion that influenza B is milder than influenza A by finding similar clinical characteristics between hospitalized adult influenza-cases. Among patients treated with oseltamivir, length of stay and mortality did not differ by type of virus infection.