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Influenza Other Respir Viruses. 2010 May 1;4(3):129-40. doi: 10.1111/j.1750-2659.2010.00138.x.

Population-based surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009.

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  • 1Ministerio de Salud Pública y Asistencia Social, Guatemala City, Guatemala.



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.


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.


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.

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