Influenza A(H1N1)pdm09: beyond the pandemic

Viasus, Diego; Antón, Andrés; Pumarola, Tomás; Carratalà, Jordi

doi:10.1016/S0213-005X(12)70106-4

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Abstract

On August 2010, the World Health Organization declared the end to the 2009 A(H1N1) pandemic. However, influenza A(H1N1)pdm09 continues to circulate as a seasonal virus. Different viruses have predominated in different parts of the world. To date, influenza A(H1N1)pdm09 has demonstrated little antigenic drift, and its oseltamivir resistance has remained low. In some countries, a higher number of severe cases of influenza A(H1N1)pdm09 infection were documented during the 2010–2011 season than during the pandemic period. In addition, delays in oseltamivir administration, higher ages and comorbidities and low vaccination rates in patients with influenza A(H1N1)pdm09 infection were found during the first postpandemic season. Therefore, physicians should carefully consider the pandemic virus as a possible causative agent in patients with influenza-like illnesses admitted to emergency departments. In addition, surveillance systems and vaccination campaigns should continue after the pandemic period.

Keywords:

Influenza A(H1N1)pdm09

Post-pandemic period

Oseltamivir

Clinical features

Prognosis

Resumen

En agosto de 2010, la Organización Mundial de la Salud declaró el fin de la pandemia de la gripe H1N1. Sin embargo, el virus de la gripe A(H1N1)pdm09 continúa circulando como un virus estacional. Significativamente, diferentes virus han predominado en diferentes partes del mundo en el período pospandémico. Hasta la fecha, el virus de la gripe A(H1N1)pdm09 ha demostrado pocos cambios antigénicos, y la resistencia a oseltamivir se ha mantenido baja. En algunos países se ha documentado un mayor número de casos graves debidos al virus de la gripe A (H1N1)pdm09 durante la temporada de gripe 2010–2011. Además, también se ha reportado durante el primer período de gripe pospandémico: retraso en la administración de tratamiento antiviral, aumento en la edad y la frecuencia de comorbilidades, y tasas bajas de vacunación en los pacientes con infección por gripe A(H1N1)pdm09. Por lo tanto, se debe considerar el virus pandémico como un posible agente causal en pacientes con enfermedad gripal que asisten a los departamentos de emergencia. Además, los sistemas de vigilancia y campañas de vacunación deben continuar después del período pandémico.

Palabras clave:

Virus de la gripe A(H1N1)pdm09

Período pospandémico

Oseltamivir

Características clínicas

Pronóstico

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