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N Engl J Med. 2009 Jun 18;360(25):2605-15. doi: 10.1056/NEJMoa0903810. Epub 2009 May 7.

Emergence of a novel swine-origin influenza A (H1N1) virus in humans.

Collaborators (340)

Massingale S, Pippin T, Davidson S, Butler J, McLaughlin J, Funk E, Anderson SM, Erhart L, Komatsu KK, Lemusu S, Mageo S, Tuliau I, Acosta M, Anderson O, Chavez G, Chen S, Cottam D, Fritz C, Gilliss D, Glaser C, Glover J, Guevara H, Hansen K, Harriman K, Harrison R, Hatch D, Kayman H, Kim J, Kimura A, Kjemtrup A, Kreutzer R, Louie J, Lyman B, Matyas B, Messenger S, Moyer E, Neiman R, Rosen H, Rosenberg J, Rudolph L, Salibay K, Samuels M, Schechter R, Schnurr D, Shaikh-Lesko R, Sheets C, Starling C, Sun B, Talarico J, Vugia D, Wheeler C, Winter K, Wohlfeiler D, Yamada E, Kenfield J, Gershman K, Calonge N, Cartter M, Fontana J, Mshar P, Davies L, Holmes BL, Glymph C, Lum G, Diggs R, Ball L, Hamilton J, Hopkins R, Duguies L, Mathew A, O'Mallan JT, Cole D, Drenzek CL, Parrott T, Elm JL, Nakata M, Park SY, Awosika-Olumo D, Finley C, Hunt K, McMahon K, Kriner P, Lopez K, Rios M, Glazier M, Monroe J, Richards S, Garvey A, Harris M, Quinlisk P, BaƱez Ocfemia MC, Hunt DC, Neises D, Trevino-Garrison IC, Humbaugh KE, Lutterloh EC, Sugg TJ, Guidry J, Martin S, Ratard R, Gensheimer K, Pelletier A, Robinson S, Blythe D, Cocoros NM, Lett SM, Smole S, Collins J, Vagasky S, Wells E, Currier M, Byers P, James R, DeVries A, Lynfield R, Magnan S, Oo K, Patrick S, Turabelidze G, Barnard B, Weber A, Mason J, Faix D, Blair P, Sherman S, Tueller J, Safranek T, Schaeffer J, Williams R, Adamski C, Talbot E, Mcrae-Stern S, Genese C, Malavet M, McHugh L, St George K, Noyes K, Smith PF, Casani J, Engel J, Moore Z, Dwelle D, Feist M, Wiedrich T, O'Quin J, Boyland K, Bradley B, Smith F, Smith K, Winpisinger K, Bradley K, McDermott M, Rayno K, Cieslak P, Hedberg K, Kohn M, Lute J, Moll M, Ostroff S, Green SY, Bandy U, Cooper T, King E, Alsip BJ, Blevins FA, Guerra FA, Sanchez R, Ginsberg M, Johnson J, Maroufi A, Sunega D, Drociuk D, Gibson J, Potter G, Horan V, Jameson B, Kightlinger L, Jones T, Kirschke D, Moore K, Alaniz C, Davis C, Espinoza R, Fonseca VP, Guerra S, Hannemann B, Heseltine G, Jones R, Morgan C, Pascoe N, Penfield S, Rohr-Allegrini C, Shim T, Taylor J, Taylor R, Walea N, Zane D, Sinclair LE, Shim MJ, Lucas PM, Gibbons TF, Garrett T, Herlihy R, Rolfs R, Celotti M, Kelso P, Schoenfeld S, Helentjaris D, Pearson JL, Remley K, Gautom R, Goldoft M, Marfin A, Davis J, Foldy S, Heffernan R, Erickson A, McClinton R, Van Houten C, Armstrong G, Ades A, Balish A, Barnes J, Barzilay E, Berman L, Beato R, Bell M, Biggerstaff M, Blau DM, Braden C, Brammer L, Bresee J, Callahan D, Chen L, Cohen N, Coh A, Conklin L, Cox N, Cortes J, Davis C, Deyde V, Dee D, Desai M, Dharan N, Donis R, Doshi S, Emery S, Epperson S, Erdman D, Esposito DH, Fields B, Fiore A, Fischer G, Fisher M, Fonseca M, Foust A, Fowlkes A, Fry A, Gladden RM, Gould H, Gross D, Guh A, Hall H, Han GS, Harcourt BH, Hillman M, Honein M, Hughes M, Hwang I, Hwang W, Iuliano D, Iwomoto M, Jackson ML, Jaeger JL, Janusz K, Jarquin V, Jernigan D, Jernigan J, Johnson J, Kallen A, Katz J, Katz K, Klimov AA, Kniss K, Kamimoto L, Kent C, Kutty P, Loustalot F, Lynch M, Maccannella T, Massoudi M, McDonald C, McMorrow M, Menon M, Montiel S, Moore M, Morgan OW, Mattson CL, Novak R, Nguyen T, Nowell M, Okomo-Adhiambo M, Olsen S, O'Reilly C, Oyervides O, Patel MK, Parks S, Peebles P, Peters P, Petrowski C, Pilishvili T, Pordell P, Redd S, Reed C, Reynolds M, Schrag SL, Scott C, Serdarevic F, Sessions W, Smith C, Srinivasan A, Staples E, Stuart A, Sugerman D, Suryaprasad A, Swerdlow D, Shu B, Silk BJ, Tate JE, Toews K, Verani JR, Villenueva J, Wang R, Waterman S, Williams A, Weidle P, Weston E, Wu KH, Wu H, Zipprich J.

Erratum in

  • N Engl J Med. 2009 Jul 2;361(1):102.

Abstract

BACKGROUND:

On April 15 and April 17, 2009, novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in specimens obtained from two epidemiologically unlinked patients in the United States. The same strain of the virus was identified in Mexico, Canada, and elsewhere. We describe 642 confirmed cases of human S-OIV infection identified from the rapidly evolving U.S. outbreak.

METHODS:

Enhanced surveillance was implemented in the United States for human infection with influenza A viruses that could not be subtyped. Specimens were sent to the Centers for Disease Control and Prevention for real-time reverse-transcriptase-polymerase-chain-reaction confirmatory testing for S-OIV.

RESULTS:

From April 15 through May 5, a total of 642 confirmed cases of S-OIV infection were identified in 41 states. The ages of patients ranged from 3 months to 81 years; 60% of patients were 18 years of age or younger. Of patients with available data, 18% had recently traveled to Mexico, and 16% were identified from school outbreaks of S-OIV infection. The most common presenting symptoms were fever (94% of patients), cough (92%), and sore throat (66%); 25% of patients had diarrhea, and 25% had vomiting. Of the 399 patients for whom hospitalization status was known, 36 (9%) required hospitalization. Of 22 hospitalized patients with available data, 12 had characteristics that conferred an increased risk of severe seasonal influenza, 11 had pneumonia, 8 required admission to an intensive care unit, 4 had respiratory failure, and 2 died. The S-OIV was determined to have a unique genome composition that had not been identified previously.

CONCLUSIONS:

A novel swine-origin influenza A virus was identified as the cause of outbreaks of febrile respiratory infection ranging from self-limited to severe illness. It is likely that the number of confirmed cases underestimates the number of cases that have occurred.

2009 Massachusetts Medical Society

Comment in

PMID:
19423869
[PubMed - indexed for MEDLINE]
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