• 생명과학회지
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• 제30권9호
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• pp.749-762
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• 2020

돼지인플루엔자는 동물에서 사람에게 감염할 수 있는 인수공통전염병이다. 우리는 2019년 한국 돼지농장에서 호흡기 증상을 보이는 돼지에서 3주의 H1N2형 인플루엔자바이러스를 분리하였다. 유전자 분석결과, 이들 바이러스의 8개 유전자 중 PA 및 NP 유전자는 2009 대유행 H1N1 인플루엔자 유래였고, 나머지 유전자는 돼지에 유행하는 H3N2 및 H1N2 인플루엔자 유래 유전자를 가진 재조합 바이러스 이었다. 분리된 H1N2 바이러스를 마우스에 접종한 결과, 마우스는 17% 정도 체중이 감소하였고, 염증 세포들이 침윤한 간질성 폐렴 증상을 보였다.

• Pediatric Infection and Vaccine
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• 제18권2호
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• pp.173-181
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• 2011

목 적 : 신종 인플루엔자 A (H1N1) 바이러스는 2009년 4월 멕시코에서 처음 확인된 후 급속히 전 세계로 확산되어 국내에서도 전국적인 유행을 보였다. 저자들은 2009-2010에 소아에서 유행한 신종 인플루엔자 A (H1N1) 바이러스 감염의 임상적, 역학적 특징을 알아보고자 하였다. 방 법: 2009년 8월부터 2010년 2월까지 대구파티마병원 소아청소년과에서 신종 인플루엔자 A (H1N1) 바이러스 감염으로 확진되었던 2,781명을 대상으로 하였다. 확진은 비인두 가검물을 채취하여 중합효소 연쇄반응 검사에서 양성을 보인 경우로 하였다. 의무기록지를 후향적으로 분석하였다. 결 과: 6,786명이 RT-PCR 검사를 받았으며 그중 2,781이 양성이었다. 158명(5.7%)이 입원치료를 받았으며, 입원군의 평균연령($5.4{\pm}3.3$세)이 비입원군($7.5{\pm}3.9$세)에 비해 의미 있게 낮았다(P<0.001). 입원군 중에서 산소치료, 면역글로불린 및 스테로이드 치료, 인공호흡기 치료가 필요했던 경우는 폐렴 환자에 비해 천명음이 동반한 폐렴 환자에서 의미있게 많았으며(P=0.013), 폐렴군에서도 기관지성 폐렴에 비해 분절성, 대엽성, 간질성 혼합성, 흉수가 동반된 경우에 보다 적극적인 치료가 필요하였다(P=0.007). 확진 환자 중 1세 미만의 영아는 83명이었고 그중 71명에서 oseltamivir 처방이 이루어졌고 항바이러스제 사용으로 인한 특이한 이상 소견은 발견되지 않았다. 결 론: 2009-2010에 대유행한 A형 인플루엔자 바이러스(H1N1)는 어린 연령 군에서 더 입원치료가 더 많이 필요하였다. 천명음이 동반된 폐렴경우 그리고 분절성, 대엽성, 간질성, 혼합성 폐렴이거나 흉수가 동반된 경우는 조기에 적극적인 치료가 필요하다고 생각된다.

• 미생물학회지
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• 제55권1호
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• pp.25-32
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• 2019

Influenza A (H1N1) virus caused a worldwide pandemic in 2009-2010 and still remains in seasonal circulation. Continuous surveillance activities are encouraged in the post pandemic phase to watch over the trend of occurrence every year, this is better to be done by a rapid and sensitive method for its detection. This study was conducted to detect proportions of occurrence of influenza A virus (H1N1) in patients with influenza-like illness. Samples from 500 patients with influenza or influenza-like clinical presentation were tested by real-time reverse transcription polymerase chain reaction (RT-PCR) and virus tissue culture. Among the total 500 participants, 193 (38.6%) were females and 307 (61.4%) males. Seventy-one patients (14.2%) were positive for H1N1 virus infection with real-time RT-PCR while 52 (10.4%) were positive by tissue culture. Non-statistically significant relation was found between age and gender with the positivity of H1N1. Sensitivity and specificity of real-time RT-PCR was 98.08% and 95.54%, respectively, in comparison to virus isolation with accuracy 95.8%. This study showed that H1N1 virus was responsible for a good proportion of influenza during the post-pandemic period. Real-time RT-PCR provides rapidity and sensitivity for the detection of influenza A virus (H1N1) compared with virus isolation and thus it is recommended as a diagnostic tool.

• IMMUNE NETWORK
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• 제16권5호
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• pp.311-315
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• 2016

A pandemic influenza A (H1N1) virus strain was isolated from a pig farm in Korea in December 2009. The strain was propagated in and isolated from both the Madin-Darby canine kidney cell line and embryonated eggs. The partial and complete sequences of the strain were identical to those of A/California/04/2009, with >99% sequence similarity in the HA, NA, M, NS, NP, PA, PB1, and PB2 genes. The isolated strain was inactivated and used to prepare a swine influenza vaccine. This trial vaccine, containing the new isolate that has high sequence similarity with the pandemic influenza A (H1N1) virus, resulted in seroconversion in Guinea pigs and piglets. This strain could therefore be a potential vaccine candidate for swine influenza control in commercial farms.

• Clinical and Experimental Pediatrics
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• 제53권10호
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• pp.886-891
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• 2010

Purpose: This study aims to investigate the clinical characteristics of children diagnosed with the novel influenza A (H1N1) in the winter of 2009 at a single medical institution. Methods: Out of 545 confirmed cases of influenza A (H1N1) in children, using the real time RT-PCR method at Kosin University Gospel Hospital from September to December of 2009, 149 patients and their medical records were reviewed in terms of symptoms, laboratory findings, complications and transmission within a family. Results: Median age of subjects was 7 years (range: 2 months-18 years). New cases increased rapidly from September to reach a peak in November, then declined rapidly. Most frequently observed symptoms were fever (96.7%), cough (73.2%), rhinorrhea (36.9%) and sore throat (31.5%). Average body temperatures on the 1st, 2nd and 3rd hospital day were $38.75{\pm}0.65^{\circ}C$, $38.08{\pm}0.87^{\circ}C$ and $37.51{\pm}0.76^{\circ}C$, respectively. Complete blood counts and biochemical tests performed on the first admission day showed within the reference values in most cases. Of the 82 patients with simple chest radiography, 18 (22%) had pneumonic lesions; multi-focal bronchopneumonia in eleven, single or multi-segmental lobar pneumonia in five, and diffuse interstitial pneumonia in two patients. All of the 149 patients improved from their symptoms and discharged within 9 days of admission without any late complication. Conclusion: Children with 2009 pandemic influenza A (H1N1) at our single institution displayed nonspecific symptoms and laboratory findings, resembling those of common viral respiratory illnesses, and did not appear to develop more severe disease.

• 대한한방내과학회지
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• 제30권3호
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• pp.558-570
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• 2009

Background : Since March 2009, when the first patient of novel influenza A (H1N1) was reported, many deaths have occurred in North and Central America. The start of the 2009 influenza pandemic was declared by WHO Director-General Dr. Margaret Chan on 11 June 2009, and the level of influenza pandemic alert raised from phase 5 to phase 6. There was no vaccine yet developed, and many experts worried that the novel H1N1 virus could kill as many or more as did the influenza pandemic in 1918-1919. Objective : To evaluate the possibility of treatment for 2009 novel influenza A (H1N1) using herbal remedies and other non-conventional therapies. Methods : We researched the clinical studies for novel H1N1 influenza virus-related herbal medicine or non-conventional medicine treatment using internet search engines including PubMed and CNKI. In addition, we reviewed many reports and clinical practice guidelines (CPG) for influenza A (H1N1). Results : Two case series were selected after reviewing 701 papers, and two CPG published by the Chinese government and Jilin province identified. They reported that the clinical symptoms were no more significant than seasonal influenza, and the condition of patients more than 45 years old was milder than those less than 45 years old. There are no patients with gastric problems, and oseltamivir has been used at the same time in all patients. Conclusion : The efficacy and effectiveness of herbal medicine and other non-conventional treatments for the novel influenza A (H1N1) is questionable, and more studies are needed to draw a firm conclusion. However, in the severe acute respiratory syndrome (SARS) experience in 2002/2003, it was demonstrated that herbal medicine can relieve all symptoms of SARS patients, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other medicines, and reduce case fatality rate. In light of the current situation that there is no vaccine or conventional treatment yet available, the study of herbal medicine and other non-conventional therapies are also necessary for appropriate evaluation.

• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.109-116
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• 2010

Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

• 한국임상약학회지
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• 제21권4호
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• pp.353-363
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• 2011

The World Health Organization (WHO) declared the outbreak of H1N1 pandemic in 2009. South Korea also had outbreaks of H1N1 virus and used oseltamivir in large volume with increased reports of adverse drug reaction(ADR). The present study was aimed to investigate the ADR frequency, the factors related to ADR, and characteristics of oseltamivir's ADR. Participants for the study were patients randomly drawn from those who were prescribed oseltamivir for treatment from CHA Bundang Medical Center during October 1 and October 30. The information examined as factors related to ADR were collected by a subsequent cross-sectional telephone survey. The factors are the following; a) age; b) gender; c) patient medical history; d) diagnosis of H1N1 virus; e) adherence; f) whether taking other medication with oseltamivir or not; and g) the number of combined medications. We also asked ADR after taking oseltamivir. Total subjects were 86 patients. The average age is $22.6{\pm}18.48$ years old. The gender was 45.3% women and 54.7% men. Half (50%) of all respondents showed one or more ADR, 67.4% were positively diagnosed for H1N1 virus, and 54.7% were completed the full course of oseltamivir (i.e. twice daily x 5days). The most frequently reported ADR symptoms were: dizziness (15.1%), nausea (11.6%), lethargy (10.4%), diarrhea (10.4%), abdominal pain (8.1%), headache and vomiting (6.9%). ADR classifications by categories are gastro intestinal (44.2%), neuropsychiatric events (22.1%), systemic symptom (20.9%), skin events (5.8%), eye events (4.7%), and other cases (2.3%). The onset of ADR 'after taking 1~3 doses' was 69.7%. No increase in neuropsychiatric events was detected in children and adolescents. No factors examined for the study do have significant influence on the presence of ADR. This study showed that ADR of oseltamivir have occurred in half of the patients. The use of oseltamivir is essential for treatment and prophylaxis of influenza A(H1N1). But mass treatment should be properly monitored for ADR.

• Journal of Yeungnam Medical Science
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• 제27권1호
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• pp.18-26
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• 2010

The clinical picture in severe cases of pandemic (H1N1) 2009 influenza is markedly different from the disease pattern seen during the epidemics of seasonal influenza as many of those affected were previously healthy young people. Current predictions estimate that during a pandemic wave, 12~30% of the population will develop clinical influenza (compared with 5~15% for seasonal influenza) with 4% of those patients requiring hospital admissions and one in five requiring critical care. Until July 6, 94,512 people have been infected in 122 countries, of whom 429 have died with an overall case-fatality rate of <0.5%. Most of the confirmed cases of S-OIV (Swine-Origin Influenza A Virus) infection have been characterized by a self-limited, uncomplicated febrile respiratory illness and 38% of the cases have also included vomiting or diarrhea. Efforts to control these outbreaks are based on our understanding of novel S-OIV (Swine-Origin Influenza A Virus) and the previous influenza pandemics. So, this review covers the experience with S-OIV (Swine-Origin Influenza A Virus) for the admission and background data and the clinical presentation, diagnosis and treatment of H1N1 in pediatric patient with S-OIV (Swine-Origin Influenza A Virus) at YUMC, 2009.

• Journal of Microbiology and Biotechnology
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• 제20권10호
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• pp.1450-1456
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• 2010

Accurate and rapid diagnosis of Pandemic Influenza A/H1N1 2009 virus (H1N1 2009) infection is important for the prevention and control of influenza epidemics and the timely initiation of antiviral treatment. This study was conducted to evaluate the performance of several diagnostic tools for the detection of H1N1 2009. Flocked nasopharyngeal swabs were collected from 254 outpatients of suspected H1N1 2009 during October 2009. This study analyzed the performances of the RealTime Ready Inf A/H1N1 Detection Set (Roche), Influenza A (H1N1) Real-Time Detection Kit (Bionote), Seeplex Influenza A/B OneStep Typing Set [Seeplex Reverse Transcriptase PCR (RT-PCR)], BinaxNow Influenza A & B Test Kit [Binax Rapid Antigen Test (RAT)], and SD BIOLINE Influenza Ag kit (SD RAT). Roche and Bionote real-time RT-PCR showed identical results for the H1N1 2009 hemagglutinin gene. Compared with real-time RT-PCR, the sensitivities and specificities were 83.7% and 100% for Seeplex RT-PCR, 64.5% and 94.7% for Binax RAT, and 69.5% and 100% for SD RAT. The sensitivities of Seeplex RT-PCR, Binax RAT, and SD RAT in patients aged over 21 years were 73.7%, 47.4%, and 57.9%, respectively. The sensitivities of Seeplex RT-PCR, Binax RAT, and SD RAT on the day of initial symptoms were mostly lower (68.8%, 56.3%, and 31.3%, respectively). In conclusion, multiplex RT-PCR and RAT for the detection of H1N1 2009 were significantly less sensitive than real-time RT-PCR. Moreover, a negative RAT may require more sensitive confirmatory assays, because it cannot be ruled out from influenza infection.