Sumber : ScienceDaily

Pelajaran yang didapat dari 13 anak di Johns Hopkins Children’s Center yang menjadi kritis dari virus H1N1 menunjukkan bahwa meskipun semua pasien selamat, komplikasi serius berkembang dengan cepat, tak terduga, dengan variasi yang besar dari pasien ke pasien dan dengan kebutuhan yang serius terhadap pemantauan ketat dan penyesuaian pengobatan yang cepat.

Pelajaran ini dan temuan lainnya diterbitkan dalam jurnal Pediatric Critical Care Medicine versi internet pada 31 Desember 2009. Pelajaran ini diyakini sebagai analisis pertama yang diterbitkan mengenai H1N1 pada anak.

Analisis Johns Hopkins menunjukkan bahwa 12 dari 13 anak yang sangat sakit memiliki kondisi medis yang membuat mereka lebih rentan, termasuk penyakit sel sabit (sickle cell disease), asma dan HIV. Komplikasi bervariasi dari kegagalan ginjal sampai kepada gejala gangguan pernapasan, kadar oksigen rendah dan tekanan darah rendah yang sangat berbahaya.

Temuan penting dari ini adalah juga bahwa delapan dari 13 anak memiliki hasil tes awal yang negatif. Hal ini menekankan untuk kebutuhan tes yang lebih sensitif.

Oleh karena itu, peneliti mengatakan, semua anak dengan gejala menyerupai flu terlepas dari hasil tes ditangani dengan pemberian antivirus. Penelitian sebelumnya telah menunjukkan bahwa antivirus adalah pengobatan yang paling efektif bagi orang dengan flu jika digunakan dalam 12 sampai 48 jam setelah gejala muncul. Saat ini Johns Hopkins mengobati semua pasien rawat inap dengan demam yang tidak bisa dijelaskan dan gejala serupa flu terlepas dari hasil tes.

“Yang paling mengejutkan, dan mungkin temuan yang paling penting, adalah bahwa virus H1N1 berperilaku tak terduga dan bervariasi dari satu pasien ke pasien yang lain dan bahkan di dalam pasien yang sama dari hari ke hari, jadi kita harus siap sedia dan bereaksi cepat dengan menyesuaikan terapi , “kata pemimpin penelitian Lockman Justin, seorang spesialis perawatan kritis anak di Johns Hopkins Children’s.

Peneliti mengingatkan bahwa penelitian lebih banyak dan lebih besar diperlukan untuk memandu masa depan praktik dan rekomendasi untuk pengobatan H1N1 pada anak-anak.

“Analisis kami memang mengungkapkan beberapa pola dan kecenderungan yang menarik, tetapi juga menunjukkan kepada kita berapa banyak lagi kita harus belajar tentang perilaku virus yang baru dan menarik ini,” kata penyelidik senior David Nichols, MD, profesor anestesiologi/ seorang spesialis perawatan kritis anak di Johns Hopkins School of Medicine.

Tim Hopkins menganalisis data dari 140 pasien anak yang didiagnosis dengan H1N1 antara Juni 2009 dan Agustus 2009, dimana 13 terus mengembangkan penyakit kritis dan dirawat di unit perawatan intensif anak (pediatric intensive care unit/PICU) di Hopkins Children’s. Flu yang baru ini, pada mulanya disebut dengan flu babi, muncul untuk pertama kalinya pada bulan April 2009.

Temuan lain yang dilaporkan dalam artikel meliputi:

Asma adalah kondisi kronis yang paling umum yang mendasari (11 dari 13 anak memiliki asma), diikuti oleh penyakit neuromuskular seperti cerebral palsy.

Hampir setengah dari anak-anak menjadi sangat sakit, mereka membutuhkan ventilator untuk membantu mereka bernapas. Namun, tidak ada anak-anak meninggal atau diharuskan untuk menjalani ECMO (extra-corporeal membrane oxygenation), cara terakhir dari perangkat perawatan kritis yang mengambil alih paru-paru dan jantung pasien untuk diberikan oksigen dan mensirkulasikan darah ketika organ tubuh pasien sudah tidak mampu melakukannya lagi.

Satu dari empat anak mengembangkan infeksi bakteri sekunder berbahaya, lebih sering daripada yang diyakini sebelumnya, yang menunjukkan perlunya pemantauan ketat untuk infeksi serupa pada anak-anak dengan H1N1.

William Fischer, MD; Trish Perl, MD, M.Sc., dan Alexandra Valsamakis, MD Ph.D.; semua dari Johns Hopkins.

Referensi
Early Lessons from the H1N1 Pandemic: Critical Illness in Children Unpredictable but Survivable

SWINE FLU CLINIC

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“Is the CDC ready for a pandemic?” LaPook asked.

“We’ve been preparing three to four years,” said Toby Crafton, the command center’s operations manager. “We’re as ready as we can be.”

One of the most vexing questions: Why does the virus seem to be more deadly in some than others?

“That is the critical question,” said Dr. Richard Besser, the acting head of the CDC. “We want to understand why are we seeing a different picture in Mexico than we’re seeing in the United States.”

The CDC is hoping analysis of tissue samples from flu victims in Mexico will provide some insight.

As the threat level rises, a key question at this 24-7 operations center: Should efforts go forward to produce a vaccine?

“It’s big decision,” Besser said. “Do we ramp up production for this new infection? Is it something we’ll expect to see in our communities next year?”

Work on a vaccine is progressing at these highly secured labs.

“The vaccine companies want something that will grow quickly so their production can go along pretty fast,” said Michael Shaw, the head of the CDC Virology Lab.

Within a week, the CDC hopes to send samples of the new virus to manufacturers so they can begin developing a vaccine. But there’s no green light yet for actual vaccine production.

“We anticipate that when we decide to manufacture a vaccine, we will have a large quantity of vaccine by the fall,” Besser said.

Officials say making a new vaccine for the virus will not interfere with developing the vaccine this fall for the ordinary flu, which kills 36,000 people a year.

One thing the CDC has learned in the past week: the virus we’ve been calling “swine flu” has never been found in pigs.

Shaw says, “We’re realizing it’s not really accurate. It’s a human flu. What more can we say?”

Like all flu viruses, this one has the ability to change, which is why the CDC is working so hard to unlock its secrets.

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Experts On Modeling Infectious Disease Spread

13 June 2009

Scientists involved in the National Institutes of Health’s Models of Infectious Disease Agent Study (MIDAS) are developing computational tools to study the emergence, spread and containment of contagious outbreaks, including H1N1…
[read article]

UK Tops The List Of 213 Countries At Extreme Risk To The Spread Of Swine Flu

13 June 2009

A Warwick Business School professor and one of the founders of global risks specialist, Maplecroft, has released three new maps and indices revealing the countries most at risk from an influenza pandemic…
[read article]

No Time For Complacency In Pandemic Planning: Aon

13 June 2009

In light of the World Health Organization raising its pandemic flu alert to the top phase of its six-phase scale, Aon Corporation (NYSE: AOC) today issued the following statement by Gisele Norris, DrPH, national director of…
[read article]

Swine Flu News Articles Archive  -   Page 1

13 June 2009

Preparing For Worst-Case Scenarios

12 June 2009

Australia: Face Mask That Kills Swine Flu Readied For Australian Pandemic Fight

‘Virtual World’ Training For Public Health Emergencies Evaluated By UIC

As Flu Pandemic Declared, Leaders Must Focus On Poor Countries To Avert ‘Bleaker Picture’

IDRI Makes Its Adjuvant Available To Increase Global Supply Of Pandemic Vaccines

DoH Confirms First Cases Of NOVEL H1N1 Influenza A On The Island Of Kaua’i, Hawai’i

24 New Swine Flu Cases In Mississippi

H1N1 (Swine) Flu Cases Escalate In Rhode Island, USA

WHO Declares H1N1 Virus Spread A Pandemic

First Anchorage Novel H1N1 confirmed, Alaska

WHO Raises Pandemic Alert To Phase 6, Director General Gives Speech

11 June 2009

Lethality Of H1N1 Influenza Virus Increasing According To Latest Analysis Of Virus Peptide Genomic Data

DxNA Submits Its Rapid Detection Platform Test For H1N1 To FDA

Spike In Australian H1N1 Cases Could Lead WHO To Declare Pandemic

RT-PCR Technology Provides New Accurate Diagnostic Test For Swine H1N1 Influenza

Swine Flu Media Bulletin, Wales

WHO May Declare Pandemic As Swine Flu Surges In Australia

10 June 2009

Swine Flu Daily Media Bulletin Issued At: 11am Sunday 7 June 2009, Wales

Also In Global Health News: HIV Aid For Vietnam; Gates To Meet With WHO; Women’s Health In Philippines; Zambian Health Workers; HIV In Ghana

New York Times Examines Varying Definitions Of ‘Pandemic’

Tool For Fast Pandemic Detection To Fight Swine Flu

Welsh Assembly Government Written Statement – Swine Influenza, Wales

CEL-SCI Expands Testing Of Its Vaccine To Determine Efficacy Against More Virulent Strain Of H1N1 Swine And Other Influenza Viruses

09 June 2009

Map Of H1N1 Swine Flu Outbreaks To-Date

Pinal County Public Health & State Confirm H1N1-related Death

Swine Flu Reinforces Role Of Community Pharmacists

WHO To Incorporate Disease Severity Into Pandemic Alert Scale

08 June 2009

China Quarantines New Orleans Mayor And Wife Over Swine Flu

Strategies To Assist Parents Manage Children’s Worries Over The H1N1 Flu (Swine Flu)

Swine Flu Update, UK

Officials Worry About Swine Flu Preparedness Amid Budget Cuts

With Shrinking Budgets, States Cutting Health Services

Funding For Research On The H1N1 Flu Virus Announced By Government Of Canada

07 June 2009

First Novel H1N1 Influenza Case Confirmed In Autauga County

06 June 2009

Global Confirmed Swine Flu Cases Exceed 21,000, Including 125 Deaths

CEL SCI Collaborators Demonstrate Novel L.E.A.P.S. Vaccines Immunize Mice Against Tuberculosis Antigens And Suggest Potential To Treat Swine Flu

05 June 2009

WHO Antivirals Arrive In Nigeria

White House Seeks More Money For Swine Flu

Congress Unlikely To Approve Obama’s Request For Additional Flu Money, Majority Leader Says

New Report Finds 10 Early Lessons Learned From The H1N1 Outbreak

Animal Production And Health To Be Addressed At FAO/IAEA Symposium

Novavax And The NIH Agree To Evaluate A Virus-like Particle (VLP) Vaccine Candidate Against The Novel Influenza A (H1N1) Virus

Teaching Tots The Importance Of Personal Cleanliness

04 June 2009

WHO Closer To Declaring Swine Flu Outbreak A Pandemic

First Confirmed Case Of 2009 H1N1 Flu In Navajo County

Chicago Woman Dies Of Swine Flu After Giving Birth

Swine Flu Media Bulletin, Wales

Sunwin International Increases Availability Of Two Veterinary Medicines To Combat Swine Flu Virus In China

03 June 2009

Efforts To Quickly Develop Swine Flu Vaccine Reported In GEN

Meeting To Examine Human Behavior And The Threat Of Disease

First Pig Stem Cells Made In China

First Probable Case Of Swine Flu In Wales

02 June 2009

Swine Flu Media Bulletin Spread And Extent Of The Outbreak (Information As At 5pm On 27 May), Wales

Second Pediatric Death From H1N1 Virus Was Ten Year Old Girl

01 June 2009

First Novel H1N1 Influenza Cases Confirmed In Baldwin, Colbert And Dale Counties

Flu Pandemic Likely To Strike UK In The Autumn Says Expert

31 May 2009

Bird Flu Virus Remains Infectious Up To 600 Days In Municipal Landfills

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Students with influenza symptoms should stay at home for a week, rather than having schools close, the CDC recommends in the face of more information on the severity of swine-origin influenza A (H1N1). READ MORE…

H1N1 Update for April 27: U.S. Declares Public Health Emergency as Swine Flu Continues to Spread

Federal officials declared a public health emergency on Sunday as more human cases of swine influenza A (H1N1) were confirmed in the U.S., bringing the current total to 20, they said.  READ MORE…

H1N1 Update for May 1: CDC Offers Info for Patients, NYC Cluster Details — and a Name Change

For patients with questions about swine flu, the CDC is offering an online resource called “Swine Flu and You.” READ MORE…

The Sudden Birth of H1N1 “Swine” Flu: What Does the Future Hold?

The past and future flu virus …

In recent weeks, an international outbreak of illness has occurred; it is caused by a new strain of influenza virus (2009 A/H1N1) that contains a combination of swine, avian, and human influenza virus genes. In this post, Anthony L. Komaroff, MD, provides some additional background information. (more…)

• H1N1 Update for April 30: CDC Offers Clinical Guidance, WHO Raises Alert Level Again
• H1N1 Update for April 29: Announcements and Data from Several Government Agencies
• H1N1 Update for April 28: FDA Issues Emergency Authorizations for Flu Drugs; WHO Raises Alert Level

• H1N1 Update for April 24: Additional Swine Flu Cases Found, CDC Says
• Human Infection with Swine Influenza Virus
• First H1N1 News on April 22: Swine Influenza Reported in Two Children in Southern California

• H1N1 Update for May 5: H1N1 Flu’s Course Showing ‘Encouraging Signs’
• CDC Updates on Swine-Origin Influenza A (H1N1)
• H1N1 Update for May 4: Cautious Optimism on Swine Flu

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Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

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Journal Watch AIDS Clinical Care comments on guidance from the CDC regarding HIV-infected patients potentially exposed to H1N1 virus. READ MORE…

• Swine Influenza Updates from the CDC and the FDA

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Pregnant women “in close contact” with those who have confirmed, probable, or suspected swine-origin influenza A (H1N1) infection should receive a 10-day course of zanamivir or oseltamivir, according to an MMWR Dispatch report on three pregnant women with H1N1, one of whom died. READ MORE…

• Flu Cases — But Not Severity — Increase with Wider Testing; Journals Weigh In
• The CDC’s Report on the New Swine-Origin Influenza A (H1N1) Virus
• Triple-Reassortant Swine Influenza A Viruses in the U.S.

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

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• ORIGINAL ARTICLES
  Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans
  Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team
  Full Text | PDF | Supplementary Material
• Triple-Reassortant Swine Influenza A (H1) in Humans in the United States, 2005–2009
  V. Shinde and Others
  Full Text | PDF | Supplementary Material
• H1N1 Influenza A Disease — Information for Health Professionals
  L.R. Baden and Others
  Full Text | PDF | Video
• Implications of the Emergence of a Novel H1 Influenza Virus
  R.B. Belshe Full Text | PDF
• PERSPECTIVE Digital Disease Detection — Harnessing the Web for Public Health Surveillance J.S. Brownstein, C.C. Freifeld, and L.C. Madoff Full Text | PDF
• Influenza A (H1N1) Virus, 2009 — Online Monitoring
  J.S. Brownstein, C.C. Freifeld, and L.C. Madoff
  Full Text | PDF | Interactive Map
• The Signature Features of Influenza Pandemics — Implications for Policy M.A. Miller and Others Full Text | PDF
• From the Archive These articles from our archive include descriptions of avian influenza A, the 1976 swine flu epidemic, the 1918-1919 influenza epidemic, and even the influenza epidemic of 1837. Also included are review articles on the management of seasonal influenza.
  (more…)
• Novel Influenza A (H1N1) Infections Reported in Pregnant Women  The CDC recommends that pregnant women with confirmed, probable, or suspected novel influenza A (H1N1) infection receive antiviral therapy with oseltamivir (Tamiflu).  Anna Wald, MD, MPH, summarizes and comments on an MMWR dispatch. READ MORE…
• H1N1 Update for May 18: New York City Schools and California Hospitals  An MMWR dispatch details the 30 hospitalizations among the roughly 500 suspected or confirmed H1N1 infections in California.
• The New York Times reports on the death from H1N1 of a Queens assistant principal and on the closing of several more schools in the borough.

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email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Supported  by
CLINIC FOR CHILDREN

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phone : 62(021) 70081995 – 5703646

http://childrenclinic.wordpress.com/

Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

Based on performance in the WHO external quality assessment project (EQAP), National Influenza Centres (NICs) of the WHO Global Influenza Surveillance Network (GISN) and national influenza reference laboratories (NIRLs) in countries without NICs, which fulfil the following criteria, have been identified as having PCR capacity, with the necessary laboratory facility and consumables, to detect the influenza A (H1N1) virus, which has recently emerged.

• Scoring 100% in the last WHO external quality assurance programme panel (EQAP) received by the laboratory. In most cases this refers to panel 5, but for those countries that did not receive panel 5, the results for panel 4 are accepted.
• OR A history of consistent correct results for earlier panels.

WHO has been facilitating the distribution of real-time PCR kits with primers and probes specific for the influenza A (H1N1) virus to NICs of GISN and NIRLs.

NICs and NIRLs are listed hereafter, ordered by country, area or territory where they are located. The list will be updated along with the ongoing influenza laboratory capacity building.

1. List of Countries able to perform PCR to diagnose influenza A (H1N1) virus infection in humans [pdf 92kb]
2. WHO External Quality Assessment Project for the Detection of Subtype Influenza A Viruses by PCR (EQAP)

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

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