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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 21, Issue 4, Pages e151-e157
Original Article

Identification and Epidemiology of Severe Respiratory Disease due to Novel Swine-Origin Influenza A (H1N1) Virus Infection in Alberta

George Zahariadis,1,2,3,4 Ari R Joffe,2,5 James Talbot,2,6 Albert deVilliers,2 Patricia Campbell,2,3 Kanti Pabbaraju,7 Sallene Wong,7 Nathalie Bastien,8 Yan Li,8,9 Robyn L Mitchell,10 Xiao-Li Pang,1,3 Stephanie Yanow,1,6 Linda Chui,1,3 Gerald Predy,2,6 David Willans,2,11 Bonita E Lee,1,2,5 Jutta K Preiksaitis,1,2,3,4 Bev Clement,2 Angela Jacobs,2 Joy Jaipaul,2 and Kevin Fonseca2,7,12

1Provincial Laboratory for Public Health, Edmonton, Canada
2Alberta Health Services, Canada
3Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
4Department of Medicine, University of Alberta, Edmonton, Canada
5Department of Pediatrics, University of Alberta, Edmonton, Canada
6School of Public Health, University of Alberta, Edmonton, Canada
7Provincial Laboratory for Public Health, Calgary, Alberta, Canada
8National Microbiology Laboratory, Public Health Agency of Canada, Canada
9Department of Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
10Public Health Agency of Canada, Ottawa, Ontario, Canada
11Queen Elizabeth II Hospital, Grand Prairie, Canada
12Department of Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: In March 2009, global surveillance started detecting cases of influenza-like illness in Mexico. By mid-April 2009, two pediatric patients were identified in the United States who were confirmed to be infected by a novel influenza A (H1N1) strain. The present article describes the first identified severe respiratory infection and the first death associated with pandemic H1N1 (pH1N1) in Canada.

METHODS: Enhanced public health and laboratory surveillance for pH1N1 was implemented throughout Alberta on April 24, 2009. Respiratory specimens from all patients with a respiratory illness and travel history or those presenting with a severe respiratory infection requiring hospitalization underwent screening for respiratory viruses using molecular methods. For the first severe case identified and the first death due to pH1N1, histocompatibility leukocyte antigens were compared by molecular methods.

RESULTS: The first death (a 39-year-old woman) occurred on April 28, 2009, and on May 1, 2009, a 10-year-old child presented with severe respiratory distress due to pH1N1. Both patients had no travel or contact with anyone who had travelled to Mexico; the cases were not linked. Histocompatibility antigen comparison of both patients did not identify any notable similarity. pH1N1 strains identified in Alberta did not differ from the Mexican strain.

CONCLUSION: Rapid transmission of pH1N1 continued to occur in Alberta following the first death and the first severe respiratory infection in Canada, which were identified without any apparent connection to Mexico or the United States. Contact tracing follow-up suggested that oseltamivir may have prevented ongoing transmission of pH1N1.