TY - JOUR
T1 - Chest radiography findings in adults with pandemic H1N1 2009 influenza.
AU - McEwan, Ruth
AU - Scriven, James
AU - Green, Christopher
AU - Bailey, Mark
AU - Banerjee, Arpan
PY - 2010/6/1
Y1 - 2010/6/1
N2 - The current pandemic of a novel influenza A (H1N1) virus, commonly referred to as ‘‘swine flu’’, began in Mexico in March 2009 and reached the UK in April 2009. By 21 July 2009, more than 850 suspected cases of influenza had been seen at Birmingham Heartlands Hospital (BHH), including 52 adults with laboratory-confirmed pandemic H1N1 influenza who were admitted. Of seven patients (13%) requiring intensive care, six needed mechanical ventilation, two needed extra-corporeal membrane oxygenation (ECMO) and one died. Of the 52 admitted adults, 42 (81%) had respiratory symptoms or signs and positive PCR tests for novel Influenza A (H1N1) virus. These patients also had chest radiographs (CXR) taken, which were abnormal for 12 patients (29%). Of these, six patients had bilateral consolidation, which was bibasal in three and widespread in three; all six had pleural effusions. A further six patients had unilateral consolidation with predominantly basal changes; one of these patients had a pleural effusion. The odds ratio for requiring intubation and ventilation with H1N1 influenza and an abnormal CXR was 29.0 (95% confidence interval 2.93–287.0). CXR changes were not common in swine flu, but a significant minority of those requiring admission had consolidation on their CXR. Those who required admission and had CXR changes are more likely to require intubation and ventilation than those without abnormalities on CXR.
AB - The current pandemic of a novel influenza A (H1N1) virus, commonly referred to as ‘‘swine flu’’, began in Mexico in March 2009 and reached the UK in April 2009. By 21 July 2009, more than 850 suspected cases of influenza had been seen at Birmingham Heartlands Hospital (BHH), including 52 adults with laboratory-confirmed pandemic H1N1 influenza who were admitted. Of seven patients (13%) requiring intensive care, six needed mechanical ventilation, two needed extra-corporeal membrane oxygenation (ECMO) and one died. Of the 52 admitted adults, 42 (81%) had respiratory symptoms or signs and positive PCR tests for novel Influenza A (H1N1) virus. These patients also had chest radiographs (CXR) taken, which were abnormal for 12 patients (29%). Of these, six patients had bilateral consolidation, which was bibasal in three and widespread in three; all six had pleural effusions. A further six patients had unilateral consolidation with predominantly basal changes; one of these patients had a pleural effusion. The odds ratio for requiring intubation and ventilation with H1N1 influenza and an abnormal CXR was 29.0 (95% confidence interval 2.93–287.0). CXR changes were not common in swine flu, but a significant minority of those requiring admission had consolidation on their CXR. Those who required admission and had CXR changes are more likely to require intubation and ventilation than those without abnormalities on CXR.
U2 - 10.1259/bjr/24252450
DO - 10.1259/bjr/24252450
M3 - Article
C2 - 20505030
VL - 83
SP - 499
EP - 504
JO - British Journal of Radiology
JF - British Journal of Radiology
IS - 990
ER -