Postpandemic influenza A/H1N1pdm09 is still causing severe perinatal complications
Main Article Content
Keywords
Critical Care, Influenza A Virus, H1N1 Subtype, Infection, Pandemics, Pregnancy
Abstract
Although influenza A/H1N1pdm09 is not causing a pandemic anymore, we recently observed two critically ill pregnant women infected by this virus. We present these cases to illustrate the possible severe complications of an – at that moment – seasonal influenza in pregnancy. We discuss the epidemiological differences between the pandemic and postpandemic phase and try to explain the high virulence of H1N1-infections in pregnancy by discussing insights in immunology during pregnancy. We conclude that although the influenza A/H1N1pdm09 is in the postpandemic phase, infection by this influenza virus still needs to be considered in pregnant women with progressive respiratory dysfunction.
Downloads
Abstract 1094
PDF Downloads 780
HTML Downloads 1948
Cover letter Downloads 0
References
[2] Shiley KT, Nadolski G, Mickus T, Fishman NO, Lautenbach E. Differences in the epidemiological characteristics and clinical outcomes of pandemic (H1N1) 2009 influenza, compared with seasonal influenza. Infect Control Hosp Epidemiol 2010;31: 676-82.
[3] Mosby LG, Rasmussen SA, Jamieson DJ. 2009 pandemic influenza A (H1N1) in pregnancy: a systematic review of the literature. Am J Obstet Gynecol 2011;205: 10-8.
[4] Maravi-Poma E, Martin-Loeches I, Regidor E, Laplaza C, Cambra K, Aldunate S, Guerrero JE, Loza-Vazquez A, Arnau E, Almirall J, Lorente L, Arenzana A, Magret M, Reig Valero R, Marquez E, Gonzalez N, Bermejo-Martin JF, Rello J, Grupo Espanol de Trabajo de Gripe Grave A. Severe 2009 A/H1N1v influenza in pregnant women in Spain. Crit Care Med 2011;39: 945-51.
[5] Ellington SR, Hartman LK, Acosta M, Martinez-Romo M, Rubinson L, Jamieson DJ, Louie J. Pandemic 2009 influenza A (H1N1) in 71 critically ill pregnant women in California. Am J Obstet Gynecol 2011;204: S21-30.
[6] Pierce M, Kurinczuk JJ, Spark P, Brocklehurst P, Knight M, on behalf of U. Perinatal outcomes after maternal 2009/H1N1 infection: national cohort study. BMJ 2011;342: d3214.
[7] Esteban-Vasallo MD, Dominguez-Berjon MF, Aerny-Perreten N, Astray-Mochales J, Martin-Martinez F, Genova-Maleras R. Pandemic influenza A (H1N1) 2009 in Madrid, Spain: incidence and characteristics in immigrant and native population. Eur J Public Health 2011.
[8] Chan KH, Zhang AJ, To KK, Chan CC, Poon VK, Guo K, Ng F, Zhang QW, Leung VH, Cheung AN, Lau CC, Woo PC, Tse H, Wu W, Chen H, Zheng BJ, Yuen KY. Wild type and mutant 2009 pandemic influenza A (H1N1) viruses cause more severe disease and higher mortality in pregnant BALB/c mice. PLoS One 2010;5: e13757.
[9] Marcelin G, Aldridge JR, Duan S, Ghoneim HE, Rehg J, Marjuki H, Boon AC, McCullers JA, Webby RJ. Fatal outcome of pandemic H1N1 2009 influenza virus infection is associated with immunopathology and impaired lung repair, not enhanced viral burden, in pregnant mice. J Virol 2011;85: 11208-19.
[10] Poole JA, Claman HN. Immunology of pregnancy. Implications for the mother. Clin Rev Allergy Immunol 2004;26: 161-70.
[11] Couch RB, Englund JA, Whimbey E. Respiratory viral infections in immunocompetent and immunocompromised persons. Am J Med 1997;102: 2-9; discussion 25-6.
[12] Bolotin S, Pebody R, White PJ, McMenamin J, Perera L, Nguyen-Van-Tam JS, Barlow T, Watson JM, for the UKSISSSG. A New Sentinel Surveillance System for Severe Influenza in England Shows a Shift in Age Distribution of Hospitalised Cases in the Post-Pandemic Period. PLoS One 2012;7: e30279.
[13] Martin-Loeches I, Diaz E, Vidaur L, Torres A, Laborda C, Granada R, Bonastre J, Martin M, Insausti J, Arenzana A, Guerrero JE, Navarrete I, Bermejo-Martin J, Suarez D, Rodriguez A, the HNSRCWg. Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients. Crit Care 2011;15: R286.
[14] Viasus D, Cordero E, Rodriguez-Bano J, Oteo JA, Fernandez-Navarro A, Ortega L, Gracia-Ahufinger I, Farinas MC, Garcia-Almodovar E, Payeras A, Pano-Pardo JR, Munez-Rubio E, Carratala J, Novel Influenza ASGotSNfRiID. Changes in epidemiology, clinical features and severity of influenza A (H1N1) 2009 pneumonia in the first post-pandemic influenza season. Clin Microbiol Infect 2012;18: E55-62.
[15] Lehners N, Geis S, Eisenbach C, Neben K, Schnitzler P. Changes in severity of influenza A(H1N1)pdm09 infection from pandemic to first postpandemic season, Germany. Emerg Infect Dis 2013;19: 748-55.