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Population-based surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009
Lissette Reyes1, Wences Arvelo, Alejandra Estevez
1Ministerio de Salud Pública y Asistencia Social, Guatemala City, Guatemala.
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.
Insights
The 2009 H1N1 influenza pandemic disproportionately affected young children in Guatemala, with the highest hospitalization rates in those under five. Prioritizing vaccination for children aged six months to five years is crucial to prevent severe outcomes from this pandemic influenza.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- The 2009 pandemic influenza A H1N1 (2009 H1N1) virus emerged in Mexico in April 2009.
- Widespread transmission in Guatemala began several weeks after its initial identification.
Purpose of the Study:
- To track the onset and impact of 2009 H1N1 infection in Guatemala.
- To identify demographic groups most affected by the pandemic influenza.
Main Methods:
- Utilized a pre-existing population-based surveillance system for pneumonia and influenza-like illness.
- Monitored 2009 H1N1 infections from May to December 2009.
Main Results:
- Identified 239 cases of 2009 H1N1 infection, with 76 hospitalizations for pneumonia and 11 deaths (case fatality proportion: 4.6%).
- Young children, particularly those under five years old, experienced the highest hospitalization rates.
- Five deaths occurred in children under five years old; 27.6% of hospitalized patients required intensive care, and 10.5% needed mechanical ventilation.
Conclusions:
- Chronic illnesses may be underdiagnosed in Guatemala, complicating risk group identification for vaccination.
- Children aged six months to five years should be prioritized for vaccination against 2009 H1N1 to mitigate severe illness and mortality.
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