H1N1 - what have we learned?

Todd Fraser on 26-05-2010

As the Southern Hemisphere influenza season rolls around again, it is appropriate to take stock of what we know and what we do not know about Pandemic 2009 H1N1 Influenza. Swine flu has now claimed in the order of 18 000 lives since it first appeared on the radar in Mexico in early 2009. While most cases are self limiting and mild, occasional infections cause severe respiratory disease, some requiring extracorporeal membrane oxygenation to survive. Certain risk groups have been clearly identified including pregnancy, chronic illness, diabetes, obesity and some indigenous populations. Many units in the Southern Hemisphere were stretched well beyond capacity during the worst of the pandemic - nonetheless, I think most of us sighed with relief that it was not as bad as it could have been. A number of questions remain unclear or unanswered : - what is the best way to diagnose H1N1 influenza? - do steroids improve outcomes? - what dose of oseltamivir is appropriate? - what personal protective equipment is required, particularly in relation to face masks? - what is the best ventilatory strategy, particularly regarding recruitment and PEEP? I'm sure there are many more.

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Todd Fraser wrote 11-01-2010 03:27:16 pm
An interesting report released from The World Health Organisation last month has suggested there may be a mutation to the H1N1 pandemic influenza virus. The new strain is yet to show signs of increased virulence, but has been noted in Australia, Singapore and New Zealand...

Todd Fraser wrote 06-07-2010 12:00:11 pm
Interestingly, the Emergency Committee of the WHO this month has decided to continue to classify the H1N1 pandemic as active (Level 6). This is apparently to be reviewed again in July.

Todd Fraser wrote 08-29-2011 02:01:20 pm
I recorded an interesting podcast with Brent Richards on how Queensland prepared for the epidemic. Lots of interesting issues raised, but the one I found most challenging was that of triage, and how we were going to decide who came into ICU and who did not.

Fortunately, it never got to that point. But how far away is the next pandemic...?

Todd Fraser wrote 01-09-2011 05:07:32 pm
Interesting reports coming out of the UK suggest that the H1N1 epidemic (is that the right word?) is far from over. Pregnant women and young children still appear to be overly represented in patients dying from Hog Wog. Are we going to get another round of it next year?

Todd Fraser wrote 07-11-2010 10:22:12 pm
Check out John Bartlett's top 10 learning points from the pandemic - http://www.medscape.com/viewarticle/723394?src=mp&spon=45&uac=65794FK