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Pandemic A(H1N1) 2009 influenza: review of the Southern Hemisphere experience

  • M. E. FALAGAS (a1) (a2) (a3), P. K. KOLETSI (a1), E. BASKOUTA (a1), P. I. RAFAILIDIS (a1) (a2), G. DIMOPOULOS (a1) (a4) and D. E. KARAGEORGOPOULOS (a1)
  • DOI:
  • Published online: 05 October 2010

We sought to systematically review the published literature describing the epidemiological aspects of the first wave of pandemic A(H1N1) 2009 influenza in the Southern Hemisphere. Fifteen studies were included in this review, originating from South America, Australia or New Zealand, and Africa. Across the different studies, 16·8–45·3% of the laboratory-confirmed cases were admitted to hospital, and 7·5–26·0% of these cases were admitted to intensive care units (ICUs). The fatality rate was 0·5–1·5% for laboratory-confirmed cases in 6/8 studies reporting specific relevant data, and 14·3–22·2% for cases admitted to ICUs in 5/7 studies, respectively. In 4/5 studies the majority of laboratory-confirmed cases were observed in young and middle-aged adults, the percentage of older adults increased the higher the level of healthcare the cases received (e.g. laboratory confirmation, hospitalization or ICU admission) or for fatal cases. Many of the cases had no prior comorbidity, including conditions identified as risk factors for seasonal influenza. Pregnant women represented 7·4–9·1% and 7·1–9·1% of unselected laboratory-confirmed cases and of those admitted to ICUs, respectively. Obesity and morbid obesity were more commonly reported as the level of healthcare increased.

Corresponding author
*Author for correspondence: M. Ε. Falagas, M.D., M.Sc., D.Sc., Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece. (Email:
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G Neumann , T Noda , Y Kawaoka . Emergence and pandemic potential of swine-origin H1N1 influenza virus. Nature 2009; 459: 931939.

New South Wales Public Health Network. Outbreak of swine-origin influenza A (H1N1) virus infection – Mexico, March–April 2009. Morbidity And Mortality Weekly Report 2009; 58: 467470.

ME Falagas , Seasonality of mortality: the September phenomenon in Mediterranean countries. Canadian Medical Association Journal 2009; 181: 484486.

EG Mourtzoukou , ME Falagas . Exposure to cold and respiratory tract infections. International Journal of Tuberculosis and Lung Disease 2007; 11: 938943.

G Caprotta , Influenza A H1N1 respiratory infection in an intensive care unit in Argentina [in Spanish]. Anales de Pediatría (Barcelona, Spain) 2010; 72: 6266.

C Bantar , Severe acute respiratory disease in the setting of an epidemic of swine-origin type A H1N1 influenza at a reference hospital in Entre Rios, Argentina. Clinical Infectious Diseases 2009; 49: 14581460.

D Schout , Epidemiology of human infection with the novel virus influenza A (H1N1) in the Hospital das Clinicas, Sao Paulo, Brazil – June–September 2009. Clinics (São Paulo, Brazil) 2009; 64: 10251030.

CV Munayco , Epidemiological and transmissibility analysis of influenza A(H1N1)v in a southern hemisphere setting: Peru. Eurosurveillance: Bulletin Europeen sur les Maladies Transmissibles 2009; 14: pii=19299.

B Archer , Interim report on pandemic H1N1 influenza virus infections in South Africa, April to October 2009: epidemiology and factors associated with fatal cases. Eurosurveillance: Bulletin Europeen sur les Maladies Transmissibles 2009; 14: pii=19369.

A Davies , Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. Journal of the American Medical Association 2009; 302: 18881895.

New South Wales Public Health Network. Progression and impact of the first winter wave of the 2009 pandemic H1N1 influenza in New South Wales, Australia. Eurosurveillance: Bulletin Europeen sur les Maladies Transmissibles 2009; 14: pii=19365.

WW Thompson , Mortality associated with influenza and respiratory syncytial virus in the United States. Journal of the American Medical Association 2003; 289: 179186.

L Simonsen , Pandemic versus epidemic influenza mortality: a pattern of changing age distribution. Journal of Infectious Diseases 1998; 178: 5360.

K Hancock , Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. New England Journal of Medicine 2009; 361: 19451952.

S Jain , Hospitalized patients with 2009 H1N1 influenza in the United States, April–June 2009. New England Journal of Medicine 2009; 361: 19351944.

WP Glezen , RB Couch . Interpandemic influenza in the Houston area, 1974–76. New England Journal of Medicine 1978; 298: 587592.

L Dodds , Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women. Canadian Medical Association Journal 2007; 176: 463468.

JA Poole , HN Claman . Immunology of pregnancy. Implications for the mother. Clinical Reviews in Allergy & Immunology 2004; 26: 161170.

TV Hartert , Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season. American Journal of Obstetrics and Gynecology 2003; 189: 17051712.

SA Harper , Seasonal influenza in adults and children – diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clinical Infectious Diseases 2009; 48: 10031032.

ME Falagas , Effect of body mass index on the outcome of infections: a systematic review. Obesity Reviews 2009; 10: 280289.

ME Falagas , DE Karageorgopoulos . Adjustment of dosing of antimicrobial agents for bodyweight in adults. Lancet 2010; 375: 248251.

ME Falagas , Treatment options for 2009 H1N1 influenza: evaluation of the published evidence. International Journal of Antimicrobial Agents 2010; 35: 421430.

C Reed , Estimates of the prevalence of pandemic (H1N1) 2009, United States, April–July 2009. Emerging Infectious Diseases 2009; 15: 20042007.

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