Impact of the A (H1N1) pandemic influenza (season 2009-2010) on patients with cystic fibrosis.

Assael BM, Barreto C, Bentur L, Bhatt JM, Repetto T, Chipps B, Colombo C, De Boeck K, Derelle J, Desager KN, Salvatore D, Escribano A, Kerem E, Lebecque P, Lischka A, Lucidi V, Malfroot A, Minicucci L, Munck A, Padoan R, Pardo F, Collura M, Raia V, Lutz N, Van Daele S, Vazquez C. Source Dipartimento di Medicina del Lavoro Clinica del Lavoro L. Devoto, Sezione di Statistica Medica e Biometria G.A.Maccacaro, Università degli Studi di Milano, Italy. Abstract BACKGROUND: Influenza, like other respiratory viral infections, can cause acute deterioration of lung function in patients with cystic fibrosis (CF). Previous studies on a small number of patients reported that most people with CF infected with A (H1N1) influenza experienced a mild course of disease. AIM: To characterise the impact of A (H1N1) infection on CF in a large number of patients from different centres and countries. METHODS: CF centres accessing the web-site of the European Cystic Fibrosis Society (ECFS) were asked to report clinical data on patients with an ascertained diagnosis of influenza caused by the A (H1N1) virus. The study was web-based and data were collected through an electronic data sheet on the ECFS website. RESULTS: Twenty-five centres from 10 countries caring for 4698 patients with CF reported data on 110 patients (2.3%), median age 13 years (range 1-39 years). The prevalence of infection in each centre ranged from 0% to 9.4%. Only 8.8% of the patients had been vaccinated. The main symptoms were fever and respiratory exacerbation requiring IV antibiotics in 53% of the patients; 48% of the patients were hospitalised for an average of 12.9 days (range 2-56) and 31% required oxygen treatment during the time of the infection. Most of the patients recovered and FEV(1) 1 month after the infection was similar to that before the infection. However, 6 patients were admitted to ICU, 5 with mechanical ventilation. Three patients with severe respiratory disease died. CONCLUSIONS: A (H1N1) influenza infection caused transient but significant morbidity in most of the patients with CF. However, in a small number of patients with severe lung disease, A (H1N1) influenza was associated with respiratory deterioration, mechanical ventilation and even death.