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Volume 18, Number 1—January 2012

Dispatch

Early Detection of Pandemic (H1N1) 2009, Bangladesh

Eduardo Azziz-BaumgartnerComments to Author , Mustafizur Rahman, Abdullah Al Mamun, Mohammad Sabbir Haider, Rashid Uz Zaman, Polash Chandra Karmakar, Sharifa Nasreen, Syeda Mah-E Muneer, Nusrat Homaira, Doli Rani Goswami, Be-Nazir Ahmed, Mohammad Mushtuq Husain, Khondokar Mahbuba Jamil, Selina Khatun, Mujaddeed Ahmed, Apurba Chakraborty, Alicia Fry, Marc-Alain Widdowson, Joseph Bresee, Tasnim Azim, A.S.M. Alamgir, Abdullah Brooks, Mohamed Jahangir Hossain, Alexander Klimov, Mahmudur Rahman, and Stephen P. Luby
Author affiliations: International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh (E. Azziz-Baumgartner, M. Rahman, A.A. Mamun, R.U. Zaman, P.C. Karmakar, S. Nasreen, S. Mah-E-Muneer, N. Homaira, D.R. Goswami, A. Chakraborty, T. Azim, A. Brooks, M.J. Hossain, S.P. Luby); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E. Azziz-Baumgartner, A. Fry, M.-A. Widdowson, J. Bresee, A. Klimov, S.P. Luby); Institute of Epidemiology, Disease Control and Research, Dhaka (M.S. Haider, B.-N. Ahmed, M.M. Husain, K.M. Jamil, A. Chakraborty, A.S.M. Alamgir, M. Rahman); World Health Organization, Dhaka (S. Khatun, M. Ahmed)

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Table 2

Clinical description of case-patients infected with pandemic (H1N1) 2009 virus seeking treatment, by surveillance platform, Bangladesh, June 2009–October 2010

Description of case-patient Event-based surveillance,
n = 182 (%) Sentinel-site surveillance,
n = 527 (%) Kamalapur community-based surveillance,
n = 621 (%) Mirpur community-based surveillance,
n = 41 (%)
At high risk for complications from influenza illness 79 (43) 331 (63) 285 (4) 41 (100)
Preexisting conditions* 54 (30)† 182 (35) 22 (3) 0
Danger signs (i.e., difficulty breathing or shortness of breath) 50 (27 )† 230 (44) 47 (8) 5 (12)
Treated with oseltamivir‡ when treatment indicated† 4/56 (84) 7/207 (3) 81/272 (30) 1/41 (2)
Median days from symptom onset to treatment with oseltamivir 2 (2–4) 5 (2–8) 4 (1–5) 5
Hospitalization 29 (16)† 259 (49) 0 0
Death 3 (2)† 25 (5) 0 0

*Preexisting conditions among event and sentinel site surveillance case-patients included asthma (71[10%]), chronic obstructive lung disease (31 [4%]), obesity (47 [7%]), immune suppression (20 [3%]), diabetes (12 [2%]), chronic heart disease (10 [1%]), neuromuscular disorders (10 [1%]), liver disease (10 [1%]), and hematologic disorders (8 [1%]), cancer (3 [0.4%]), and pregnancy (3 [0.4%]), while 2 community-based surveillance case-patients had immunosuppression (0.3%), 2 (0.3%) had asthma, and 1 (0.1%) had diabetes.
†Comparison between surveillance sites, Pearson χ2 p<0.0001.
‡Oseltamivir 5 mg 2×/d for 5 days.

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