14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 28.020 Session: Influenza Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Investigation of pandemic influenza A (H1N1) 2009 virus: Isolation and genetic analysis of brazilian strains T. Paiva Instituto Adolfo Lutz, São Paulo, Brazil Background: Since April 2009, human cases of respiratory infections originated by novel swineorigin influenza A virus, designated pandemic A(H1N1)v, have been detected worldwide, causing immediate international concern. In Brazil, as of 06 October 2009, there have been 14.229 confirmed cases of infection and 1.167 deaths. Mortality rates of 0.61/100.000 inhabitantes were observed. Methods: The virus samples were obtained from clinical specimens from patients who came from the states of São Paulo, Mato Grosso and Distrito Federal. Virus isolation was performed in MDCK cell cultures. Viral RNA was extracted from the infected cells and submitted to reverse transcription-amplification reactions with primers set designed to cover the complete segments of the HA, NA and MP genes. The amplified products were directed sequenced. The complete genes of hemagglutin (HA), neuraminidase (NA) and matrix (MP) were sequenced. Results: Comparative sequence analysis indicated the presence of point mutations in the HA gene of the Brazilian strains when compared to the reference strain A/California/04/H1N1 (2009). These alterations do not change the all five of the known antigenic sites of the HA protein. The canonical sites for N-linked glycosylation at NxS/T motifs were preserved among strains. Data of the MP sequence analysis revealed that the strains of this study carried the S31N mutation that confers cross-resistence to the adamantine class of anti-influenza drugs. Sequencing of the NA gene showed that the neuraminidase relative drug binding pocket represented by H275 was not altered, yielding the strains sensitive to oseltamivir. Conclusion: These results emphasize the contribution of molecular surveillance, in addition to antigenic characterization to monitor the evolutionary pattern of the pandemic A(H1N1)v, in order to vaccine development, and evaluation of antiviral drugs susceptibility.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 28.021 Session: Influenza Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation An analysis of critically ill patients with the novel influenza A (H1N1) virus in Japan K. Wada 1 , H. Nishiura 2 , A. Kawana 3 1 Kitasato University School of Medicine, Sagamihara, Japan, 2 PRESTO, Japan Science and Technology Agency, Saitama, Japan, 3 National Defense Medical College, Saitama, Japan Background: Japan identified its first case of novel influenza A (H1N1) on 9 May 2009, and its incidence has increased steadily. As of 26 October, 34 deaths have been reported. The aim of this study was to summarize the clinical findings of critically ill patients in Japan. Methods: Critically ill patients are defined as confirmed or probable cases who meet one of the following conditions: a case who (1) was diagnosed with influenza-associated encephalopathy, (2) was admitted to an intensive care unit (ICU), (3) was intubated or (4) died. We analyzed a total of 120 cases, including 23 deaths, who developed the disease by 6 October 2009. Results: Of the 120 cases, those aged < 20 years accounted for 71.7%. All 11 cases aged 65 and older resulted in death, while the proportion of deaths among cases aged < 20 years and adults aged < 65 years was smaller (5.2% and 34.8%, respectively). The mean (SD) and median times from onset to hospitalization were 62.8 (40.2) and 48.0 hours, respectively. The mean (SD) and median times from onset to death for the 23 fatal cases were 160.4 (116.5) and 120.0 hours, respectively. The timing of antiviral administration did not appear to significantly affect the clinical course among critically ill patients. Of the 120 cases, 57 (47.5%) had at least one underlying medical condition. Of the 86 cases aged < 20 years, 27 (31.4%) had one or more comorbidity, with asthma being the most common (22.9%). Similarly, of the 34 adult cases, 30 (88.2%) had comorbidities and chronic respiratory disease (23.5%) was the most common. Conclusion: First, age below 20 were more frequently reported as critically ill than adults. As the epidemic progresses further, the age-composition of severe cases may change. Second, the clinical courses appeared to have been rapid after onset. The time from onset to death in Japan was shorter than those reported elsewhere. Third, approximately half of the cases were accompanied by at least one underlying condition, and this proportion was particularly high among adults.
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