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. 2010 Jun;83(990):499-504.
doi: 10.1259/bjr/24252450.

Chest radiography findings in adults with pandemic H1N1 2009 influenza

R E McEwen  1 , J E Scriven, C A Green, M S Bailey, A K Banerjee
Affiliations

Chest radiography findings in adults with pandemic H1N1 2009 influenza

R E McEwen et al. Br J Radiol. 2010 Jun.

Abstract

The current pandemic of a novel influenza A (H1N1) virus, commonly referred to as "swine flu", began in Mexico in March 2009 and reached the UK in April 2009. By 21 July 2009, more than 850 suspected cases of influenza had been seen at Birmingham Heartlands Hospital (BHH), including 52 adults with laboratory-confirmed pandemic H1N1 influenza who were admitted. Of seven patients (13%) requiring intensive care, six needed mechanical ventilation, two needed extra-corporeal membrane oxygenation (ECMO) and one died. Of the 52 admitted adults, 42 (81%) had respiratory symptoms or signs and positive PCR tests for novel Influenza A (H1N1) virus. These patients also had chest radiographs (CXR) taken, which were abnormal for 12 patients (29%). Of these, six patients had bilateral consolidation, which was bibasal in three and widespread in three; all six had pleural effusions. A further six patients had unilateral consolidation with predominantly basal changes; one of these patients had a pleural effusion. The odds ratio for requiring intubation and ventilation with H1N1 influenza and an abnormal CXR was 29.0 (95% confidence interval 2.93-287.0). CXR changes were not common in swine flu, but a significant minority of those requiring admission had consolidation on their CXR. Those who required admission and had CXR changes are more likely to require intubation and ventilation than those without abnormalities on CXR.

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Figures

Figure 1
Figure 1
CXR of a previously healthy pandemic influenza patient on admission showing consolidation in the right upper lobe.
Figure 2
Figure 2
CXR of a previously healthy pandemic influenza patient on the day after admission showing progression of right upper lobe consolidation and new left upper lobe shadowing. The patient has been intubated.
Figure 3
Figure 3
CXR of a pregnant pandemic influenza patient on admission showing consolidation in the right and left lungs.
Figure 4
Figure 4
CXR of a pregnant pandemic influenza patient on the day after admission showing progression of the consolidation and bilateral effusions.
Figure 5
Figure 5
Chest CT scan showing bilateral basal effusions and bilateral patchy consolidation.
See this image and copyright information in PMC

References

    1. World HealthOrganization Pandemic (H1N1) update 58. 2009 [updated 6 July 2009; cited 24 July 2009]. Available from: http:\\www.who.int\csr\don\2009_07_06\en\index.html.
    1. European CentreforDiseasePreventionandControl ECDC surveillance report. Pandemic (H1N1) report 2009: analysis of individual case reports in EU and EEA countries. 2009 [cited 24 July 2009]. Available from: http:\\www.ecdc.europa.eu\en\files.pdf\Health_topics\090724_Influenza_A(....
    1. Health ProtectionAgency HPA weekly national influenza report (Week 30). 2009 [cited 24 July 2009]. Available from: http:\\www.hpa.org.uk\web\HPAwebFile\HPAweb_C\1247816573986.
    1. Scriven J, McEwen R, Mistry S, Green C, Osman H, Bailey M, et al. Swine flu: a Birmingham experience. Clin Med 2009;9:534–8 - PMC - PubMed
    1. Department ofHealth(UK) Swine flu adult hospital pathways — emergency department management. 2009 [updated 16 June 2009; cited 24 July 2009]. Available from: http:\\www.dh.gov.uk\en\Publicationsandstatisitics\Publications\Publicat....