To the Editor: Chang and colleagues suggest that the clinical course and outcomes of patients infected with pandemic (H1N1) 2009 influenza virus are comparable to those with seasonal influenza infection, and that increased hospital and intensive care unit (ICU) admissions with influenza reflected a higher incidence of disease in the community rather than enhanced virulence of the pandemic influenza virus.1 However, this conclusion was based on an analysis of data from a single hospital, which did not examine whether the community incidence of influenza was increased or whether infection with pandemic (H1N1) 2009 influenza increased the risk of admission to a hospital or ICU compared to infection with seasonal influenza.
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- 1. Chang Y-S, van Hal SJ, Spencer PM, et al. Comparison of adult patients hospitalised with pandemic (H1N1) 2009 influenza and seasonal influenza during the “PROTECT” phase of the pandemic response. Med J Aust 2010; 192: 90-93. <MJA full text>
- 2. 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. Euro Surveill 2009; 14 (42). pii: 19365. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19365 (accessed Feb 2010).
- 3. The ANZIC Influenza Investigators. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 2009; 361: 1925-1934.
We acknowledge the work of the eight NSW public hospital laboratories that contributed data, as well as the work of the NSW public health network and the NSW intensive care community.
David Durrheim receives money for direct expenses and travel as a member of the World Health Organization Strategic Advisory Group of Experts (SAGE) on Immunization to the Director General.