RESUMEN
An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus , Pulmón/diagnóstico por imagen , Neumonía Viral , Adulto , Betacoronavirus/aislamiento & purificación , Análisis Químico de la Sangre , COVID-19 , Prueba de COVID-19 , China , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Progresión de la Enfermedad , Genoma Viral , Humanos , Pulmón/patología , Masculino , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Neumonía Viral/transmisión , Radiografía Torácica , SARS-CoV-2 , Análisis de Secuencia de ADN , Viaje , Estados UnidosRESUMEN
Phylogenetic analyses of 169 influenza A(H5N1) virus genomes were conducted for samples collected through active surveillance and outbreak responses in Vietnam between September 2010 and September 2012. While clade 1.1 viruses persisted in southern regions, three genetically distinct subgroups of clade 2.3.2.1 were found in northern and central Vietnam. The identification of each subgroup corresponded with detection of novel reassortants, likely due to their overlapping circulation throughout the country. While the previously identified clade 1.1 and A/Hubei/1/2010-like 2.3.2.1 genotypes remained the predominant viruses detected, four viruses were found to be reassortants between A/Hubei/1/2010-like (HA, NA, PB2, PB1, PA, NP) and A/duck/Vietnam/NCVD-885/2010-like (M, NS) viruses and one virus was identified as having A/duck/Vietnam/NCVD-885/2010-like HA, NA, PB1, and NP with A/Hubei/1/2010-like PB2 and PA genes. Additionally, clade 2.3.2.1 A/Hong Kong/6841/2010-like viruses, first detected in mid-2012, were identified as reassortants comprised of A/Hubei/1/2010-like PB2 and PA and A/duck/Vietnam/NCVD-885/2010-like PB1, NP, NA, M, NS genes.
Asunto(s)
Subtipo H5N1 del Virus de la Influenza A/clasificación , Subtipo H5N1 del Virus de la Influenza A/genética , Gripe Aviar/virología , Filogeografía , ARN Viral/genética , Virus Reordenados/clasificación , Virus Reordenados/genética , Animales , Análisis por Conglomerados , Genotipo , Subtipo H5N1 del Virus de la Influenza A/aislamiento & purificación , Datos de Secuencia Molecular , Aves de Corral , Reacción en Cadena en Tiempo Real de la Polimerasa , Virus Reordenados/aislamiento & purificación , Análisis de Secuencia de ADN , VietnamRESUMEN
BACKGROUND: In April 2009, 2009 pandemic influenza A H1N1 (2009 H1N1) was first identified in Mexico but did not cause widespread transmission in neighboring Guatemala until several weeks later. METHODOLOGY AND PRINCIPLE FINDINGS: Using a population-based surveillance system for hospitalized pneumonia and influenza-like illness ongoing before the 2009 H1N1 pandemic began, we tracked the onset of 2009 H1N1 infection in Guatemala. We identified 239 individuals infected with influenza A (2009 H1N1) between May and December 2009, of whom 76 were hospitalized with pneumonia and 11 died (case fatality proportion: 4.6%, 95% confidence interval [CI] 2.3-8.1%). The median age of patients infected with 2009 H1N1 was 8.8 years, the median age of those hospitalized with pneumonia was 4.2 years, and five (45.5%) deaths occurred in children <5 years old. Crude rates of hospitalization between May and December 2009 were highest for children <5 years old. Twenty-one (27.6%) of the patients hospitalized with 2009 H1N1 were admitted to the intensive care unit and eight (10.5%) required mechanical ventilation. Underlying chronic conditions were noted in 14 (18.4%) of patients with pneumonia hospitalized with 2009 H1N1 infection. CONCLUSIONS AND SIGNIFICANCE: Chronic illnesses may be underdiagnosed in Guatemala, making it difficult to identify this risk group for vaccination. Children 6 months to 5 years old should be among priority groups for vaccination to prevent serious consequences because of 2009 H1N1 infection.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , Gripe Humana/virología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Guatemala/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Risk factor information for severe complications of interpandemic influenza is needed to inform vaccine policy in Thailand. We identified patients with lab-confirmed influenza who were hospitalized with pneumonia during September 2003 to August 2004. Among the 80 case-patients identified through a population-based pneumonia surveillance system in eastern Thailand, cases were 6.2 and 11.1 times more likely to be among persons<1 year old and >75 years old, respectively, compared with the overall population. Cases were also 7.6 times more likely to have chronic respiratory disease. In Thailand, the young, elderly, and those with chronic disease were at high risk for hospitalized pneumonia from influenza.