Characteristics | N | % |
Type of medical facility† | ||
Secondary level | 52 | 53 |
Tertiary level | 47 | 47 |
Main symptoms | ||
Fever | 84 | 84 |
Cough | 85 | 85 |
Dyspnoea | 75 | 75 |
Myalgias | 30 | 30 |
Headache | 22 | 22 |
Treatment schedules | ||
Steroids | 59 | 59 |
Adrenaline | 13 | 13 |
Norepinephrine | 25 | 25 |
Dopamine | 22 | 22 |
Antiviral therapy (oseltamivir or zanamivir) | 56 | 56 |
Antimicrobial agents‡ | 94 | 94 |
Mechanical ventilation | 84 | 84 |
Radiological description (n=82) | ||
Multiple foci pneumonia§ | 77 | 93.9 |
Pleural effusion | 5 | 6.1 |
Positive bacterial cultures (n=2) | ||
Staphylococcus epidermidis | 1 | 1 |
Staphylococcus ominis | 1 | 1 |
Cause of death certificate | ||
Pneumonia¶ | 68 | 68 |
Pneumonia associated with other diagnoses** | 26 | 26 |
Other diagnoses†† | 6 | 6 |
Number of days from admission to death* | Range 0–58, median 4.0, mean 6.9 | |
Number of days from initial symptoms to death | Range 2–71, median 10.5, mean 13.1 |
↵* One case was excluded because that individual was never hospitalised.
↵† The medical facility where patients were admitted for treatment for H1N1 and where they died was the same in all cases.
↵‡ Antimicrobial agents included cephalosporins (cefuroxime, cefotaxime, ceftriaxone, ceftazidime and cefepime), quinolones (ciprofloxacin, ofloxacin, norfloxacin, levofloxacin and gatifloxacin) and macrolides (erythromycin and clarithromycin).
↵§ Multiple foci pneumonia: diagnosis was made when we noted two or more consolidation zones in the lungs, outside the base of the lung.
↵¶ Death due to H1N1 was defined as having more than three of the following clinical symptoms: cough, fever, coughing, malaise, myalgia, homeostasis, runny nose, cyanosis, headache, chest pain, sore throat and conjunctival hyperemia. All deaths had confirmed A(H1N1) influenza by PCR studies.
↵** A patient was defined as being infected with H1N1 when he or she had more than three clinical symptoms. Other conditions included refractory metabolic acidosis, hydroelectric imbalance, viral encephalitis, septic shock, bilateral bacterial pneumonia, type 2 diabetes mellitus, epilepsy, acute respiratory failure, hypertension, chronic obstructive pulmonary disease and lupus erythematosus.
↵†† Uraemic syndrome, acute lung oedema, acute respiratory failure, lower respiratory tract infection, sudden death, ventricular fibrillation, massive pleural effusion, probable influenza, probable whooping cough syndrome. They also had confirmed A(H1N1) influenza by PCR studies.