The WHO has revised their guidelines on the current management of patients with H1N1 (guideline)
In a CDC press release, cautionary enthusiasm was heralded, as the first declines in influenza activity were reported last week. Given the upcoming travel season, however, there is no way to predict what activity will occur in the weeks to months ahead. As Dr. Anne Schuchat (director of the national center for immunization and respiratory diseases) espoused, "Nothing is typical about this year's influenza" (CDC site)
The CDC has released a health advisory, reminding physician to vaccinate all patients >age 65, and all patients age 2-64 with high risk conditions, with the pneumococcal polysaccharide vaccine. Vaccination rates in the latter group are low, and these patients may be at high risk for pneumococcal superinfection following an influenza illness (CDC site)
This CDC summary provides a bulleted summary of tips for anti-viral treatment of patients with influenza. The highlights for hospitalized patients include: All hospitalized patients should be treated, treatment of patients even after > 48 hours of symptoms is reasonable, and treatment should not be delayed pending lab confirmation (CDC sheet)
In this characterization of 1088 cases of H1N1 that were either hospitalized or died between April-August 2009 in California, researchers found that 2/3 of the patients had abnormal chest xrays, 1/3 had false negative antigen testing, 2/3 had risk factors for complications, and 1/3 were admitted to the ICU. Median age was 27, overall mortality was 11%, and the highest risk of death (once hospitalized) was in those > age 50. Secondary bacterial infection was rare (4%) (abstract).